Unquestionably the most striking thing about Esther Barbieri is how young she looks. A youthful, radiant glow sweeps across her elegant face and belies her age.
She is the matriarch of a huge, close-knit family – nine children, 30 grandchildren, 46 great-grandchildren, three great-great-grandchildren – scattered across three different continents.
A native of Peru, Esther has been a picture of health for almost all of her 94 years. Active, independent, a lover of dance and travelling, Esther is also an avid walker – known to outrun just about anyone to catch the bus.
She was a seamstress in her homeland, raising her children on her own after becoming a widow in 1969. She immigrated to Canada at the age of 67 and, outside of regular visits to her home country, lives in the GTA with her youngest daughter.
Esther Barbieri is loved by many and even at 94 has much to live for.
Her journey to the Peter Munk Cardiac Centre came almost by accident.
In July 2014, she had a heart attack – the first health scare of her life. Visits to two other hospitals eventually led to her being fitted with a stent. Things improved but only for a short time. In the months following the procedure, she had several worrisome episodes, including fainting spells, and shortness of breath. Her family literally could not take their eyes off her for a second.
"The cardiologist at the other hospital told us she cannot be operated on," says Maria Barbieri, the eighth of Esther's nine children. "That her heart has been damaged.
"He was going to prepare a report to let doctors here (Peter Munk Cardiac Centre) know that there was not much to do, that in his opinion, if he was the one who had to operate, he wouldn't do it. He wouldn't touch her because of her age. It was devastating. It was like all the doors were closed."
Esther's valve was in urgent need of replacement. During one hospital visit, she went into cardiac arrest. But she came back.
In November 2014, she was referred to the Peter Munk Cardiac Centre, where doctors determined she would not be a candidate for a TAVI (transcatheter aortic valve implantation) procedure. The race to find another option ensued.
Enter, Dr. R.J. Cusimano, cardiac surgeon at PMCC. In tandem with a medical team, he decided surgery was the only option.
"We were expecting doctors here to agree with the cardiologist at the other hospital," Maria recounts. Instead, "he told us, if he was going to operate on a 94-year-old lady, it was going to be my mom," remembering Dr. Cusimano's words.
"The main risk was that I would have been wrong about her outcome," says Dr. Cusimano. "Most patients and families can accept death, especially in high-risk situations. The more difficult outcome is prolonged or permanent disability.
"In her case, any neurological impact such as stroke or memory loss would have been the absolute worst case. That is why we surgeons are so happy when our patients wake up normally after an operation, whether we show it or not."
And so, Esther became the oldest patient Dr. Cusimano ever operated on. Her overall good health, how strong she was physically and her heart health history – all positives – were key to Dr. Cusimano's decision.
During the three-and-a-half-hour procedure, the Barbieri family waited, wondered, wished and paced. "We were drinking coffee like crazy," daughter Maria remembers, tears welling.
"When he (Dr. Cusimano) came out, he came out like this
– with both his thumbs in the air, smiling. We knew right away everything was okay," says Maria.
"He told us, your mom is 94, but inside she is much younger."
Dr. Cusimano says: "Now that her heart is fixed, she faces a prolonged survival with a good quality of life. At that age, quality of life is our primary goal. She will likely not die from heart disease so she may live for many years."
"There is no word to describe how grateful we are," says Maria. "Total elation," adds Maria's husband, John Simpson.
During a recent clinic visit, Dr. Cusimano gave Esther the green light to go dancing – one of her passions. She is also now able to travel – less than three months after surgery. She plans to visit her sons in Italy and Peru.
Adds, Dr. Cusimano: "she is supposed to send me a postcard on her 100th birthday. That may very well happen."