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Fourteen years ago, underwater welder Adam Cianfagna went to a walk-in clinic with a chest infection. The doctor discovered a heart murmur – a diagnosis Adams's annual hyperbaric dive medical exam had missed.
He was referred to a cardiologist in his hometown of Thunder Bay, Ont. Further testing revealed Adam had a heart defect.
"I was born with a bicuspid valve instead of a tricuspid valve," explains Adam. "I could have lived my whole life and never known."
Doctors also found an aneurysm in Adam's ascending aorta. Aortic aneurysms are a bulge in the wall of the heart's main artery. Over time, they weaken the aortic wall, and may eventually burst or split the artery.
Doctors recommended monitoring Adam's aneurysm with regular ultrasounds.
"I was in my early 30s, newly married – I was a little naïve," he says. "It didn't really sink in that one day I would likely need major surgery."
Now in his early 40s, Adam is feeling better than ever a year after successful heart surgery at UHN's Peter Munk Cardiac Centre. To mark the anniversary of his surgery, he wrote a letter of thanks to renowned cardiovascular surgeon, Dr. Tirone David, his executive assistant, Victoria Vessio, and the entire team.
"My life has changed dramatically and it has been for the better," he wrote.
"Life is extremely fragile and I'm lucky to still be around for my kids and family. I am extremely grateful for the care and treatment I received from all the staff at the Peter Munk Cardiac Centre.
"I felt like a priority every step of the way. I am forever in your debt."
It's a happy ending to a story that took a dramatic turn.
After his diagnosis, the ultrasounds started at three-month intervals. When the care team in Thunder Bay observed no change, they were spaced out to six months, and then a year.
"Thankfully I had stopped underwater welding just before finding out about the aneurysm," says Adam. "It's a dangerous job, and you can't do it for long.
"I had already decided it was time to move on – this just gave me an extra push."
'If I'm not going to escape surgery, let's do it now while I'm in good health.'
Adam went on to own three successful businesses in Thunder Bay. He and his wife, Jen, had three children. Then, 10 years after his initial diagnosis, Adam's annual ultrasounds revealed a drastic change.
"There was a five millimetre change in the size of the aneurysm," remembers Adam. "The surgical threshold is 5.5 mm.
"My cardiologist told me it was time to start talking with surgeons at the Peter Munk Cardiac Centre in Toronto. That's when it began to feel real. I was going to have open-heart surgery at 41 years old."
Adam was referred to Dr. David, former Head of Cardiovascular Surgery at the Peter Munk Cardiac Centre. The pair met virtually. Dr. David explained surgery could wait six months if Adam needed time to prepare.
"Dr. David said, 'at this point, it's elective,' so I said 'let's wait,'" Adam recalls.
"I think I wanted to put it off. But I got uneasy almost immediately after the call.
"I called him back the next day and said 'book it. If I'm not going to escape surgery, let's do it now while I'm in good health.'"
Adam and Jen arranged child care, work coverage, and travel within a few short weeks. During the preparations, Adam spoke regularly with Victoria in Dr. David's office.
"I don't know anyone, personally or professionally, who communicates as well as Victoria does," Adam says. "I never had to wait for an answer. She responded so quickly to every question and concern, there was no time to spiral into 'what ifs.'"
"She set the tone for my surgery. It reduced a lot of stress, which was greatly appreciated by both myself and Jen."
'My life has changed dramatically and it has been for the better.'
When the time came, Adam and Jen said goodbye to their kids, then ages 10, nine and seven.
When they landed in Toronto, things moved quickly. Before he knew it, Adam was in the Cardiovascular Intensive Care Unit (CVICU) recovering.
"When I woke up, Dr. David was patting my leg and telling me my valve was fixed and strong," Adam says. "I remember a note of excitement in his voice that he was able to spare my valve.
"It was such a relief. It wasn't just the message, it was how it was delivered."
Recovery went quickly. Adam and Jen returned home five days earlier than expected, surprising their kids when they came home from school.
"Leaving the kids was by far the most difficult part of the whole thing," says Adam. "When we got home, it was really emotional."
Just over a year after surgery, Adam is better than ever before.
"Jen calls me Superman because I recovered so quickly – it was a surprise to both of us," he says.