“Missing out. The actual number getting repair is closer to 50 percent, and that's unacceptable, says David Adams, head of heart surgery at the Mount Sinai Medical Center in New York. "Too many miss out on optimal surgical treatment," he says. But this is fixable. Surgeons who offer patients only valve replacement because that's what they do well must think again. So must cardiologists reluctant to refer patients elsewhere for care. And insurance providers, who make doctors and patients jump through hoops for treatments outside of their networks, can't fight clear-cut practice guidelines.”