Three metro Atlanta hospitals — Piedmont Hospital, Emory University Hospital and Emory Crawford Long Hospital — filed written appeals this month opposing an open heart surgery center approved for Gwinnett Medical Center, according to the state Department of Community Health's Web site.

Gwinnett Medical Center President and CEO Phil Wolfe issued a written statement saying he is "deeply disappointed" by the opposition.

"None of these hospitals are in a position to effectively serve our community, nor are they prepared to do so in the future," Wolfe said. "However, we are confident that GMC will ultimately bring open heart surgery to Gwinnett."

Gwinnett Medical Center, the county's largest hospital, cleared a major hurdle June 5 by gaining approval from the state Department of Community Health to start the open heart surgery center.

The department grants approval, through what is called a certificate of need, only if a medical facility can show that a public need is not currently being met. Gwinnett is the largest county in the nation without an open heart surgery center, medical center officials have said.

However, the recent hospital opposition to the Lawrenceville hospital's $32.9 million project, initially scheduled to open in late 2010, places the project in limbo, said Mark Mullin, the medical center's director of planning.

All sides will prepare written arguments and make their cases in person to an independent panel of attorneys sometime this fall. Whoever loses could appeal to a Superior Court judge.

Lance Skelly, spokesman for the Emory hospitals, declined to comment, adding that Emory doesn't want public discourse on pending certificates of need.

State Sen. David Shafer (R-Duluth) said area heart patients are the ones who would suffer if the Lawrenceville hospital is blocked from opening the new surgery center.

"Gwinnett County is the largest county in America without a hospital authorized to perform open heart surgery," he said in a statement.

"It is ridiculous to suggest that someone suffering a heart attack in Suwanee or Dacula should be forced to drive to downtown Atlanta for treatment."

Piedmont disagrees.

"It has been well documented by numerous studies in other states that quality is higher and mortality rates are lower when hospitals perform high volumes of open heart cases," Piedmont spokeswoman Diana Lewis said. "The addition of Gwinnett Medical Center to the number of open heart services in Atlanta will dilute volumes.

"Open heart surgery is simply not a service that should be provided in every county."

But state community health officials sided with the Gwinnett hospital, writing in their 30-page analysis: "Patient outcomes could have been much better if they did not have to be transferred or redirected to existing open heart surgery providers.

"The proposed project will improve the quality, access and overall efficiency of adult open heart surgery services available within the local health care delivery system."