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The last thing 70-year-old Dianna Graham remembers before open-heart surgery was Dr. Jennifer Chung, her surgeon, giving her a high-five and saying: "we got this."
It made her feel safe, calm and reassured – a far cry from how she felt a few weeks prior when she was told she was inoperable.
Dianna had an aortic aneurysm, an abnormal bulge located in the aorta, the main blood vessel carrying blood from the heart to the body. If left untreated, the bulge can dissect or rupture, potentially causing life-threatening bleeding or death.
But aortic aneurysms don't cause many symptoms. By the time Dianna had been diagnosed, the aneurysm had affected almost her entire aorta, extending through the chest and abdomen. Aneurysms can be repaired, but surgeons across Ontario turned her down due to the complex nature of her case.
When a former colleague approached Dr. Chung about Dianna, the cardiac surgeon at the Peter Munk Cardiac Centre (PMCC) knew her operation would be challenging – but not impossible. Dr. Chung and her surgical colleagues, Drs. Maral Ouzounian, Thomas Lindsay and KT Tan, had just opened the PMCC
Thoracic Aortic Surgery Clinic, and tough cases are their specialty.
"The goal of our clinic is to help patients like Dianna," says Dr. Chung. "Aortic patients are often looking for a medical home. They need somewhere dedicated and specialized, a place where they can receive comprehensive care and long-term follow-up. And I think this is that place."
The clinic is the first of its kind in the Greater Toronto Area and sees patients from all over Ontario. They often require multiple or complex surgeries, and the team can provide a tailored, multi-disciplinary approach. Because of the high volume of patients, a nurse practitioner also helps with a variety of different tasks, including tracking medications and following-up with patients after discharge.
Dr. Chung is excited about the chance to give aortic disease patients such as Dianna the high-quality and thorough care they need.
"Before aortic surgery became an established specialty, patients were followed however, whenever and by whoever," says Dr. Chung.
"I think it's time to change that."
Earlier this year, Dianna kept finding herself out of breath after a short walk with her dog, one of the few signs of an aneurysm. At first, she thought it was nothing to worry about – but after a trip to her doctor, she learned about the ticking time bomb in her chest.
A few weeks later, Dr. Chung's office called.
"At that point, I was floating around and trying different doctors, but it didn't seem I was going to find anyone willing to do the surgery," says Dianna. "To be honest, I was losing confidence that I was going to make it through this.
"But from the moment I met Dr. Chung, I knew she would be able to help. She just exuded confidence, and I felt like she was someone I could trust."
Dianna's surgical repair was split into two operations. During the first, Dr. Chung replaced the ascending arch of the aorta, located in the chest. During the second, she repaired the entire thoracic and abdominal aorta.
Dianna is at home and recovering well
"Now more than ever, medicine is a team sport," says Dr. Chung. "Having our clinic's multi-disciplinary team collaborate and plan a complex case like Dianna's is so important.
"I felt really confident heading into the OR."
Thankfully, both of Dianna's surgeries went well, and she's recovering well at home. It certainly hasn't been easy – Dianna had to spend a few months on dialysis, and unfortunately wasn't allowed any visitors while in hospital due to COVID-19.
But the team caring for her made all the difference.
"When I was in so much pain and agony, I'd look up and there would be one clinician after another, just there to see how I was doing," says Dianna.
"I could never thank any of the staff enough for what they did for me, from the bottom to the top."