Heart Surgeries with Team Approach Save Athlete

Lifelong athlete George Young needed multiple surgeries after suffering a severe heart complication. Thanks to the USC Comprehensive Aortic Center, he’s back on the golf course.

George Young has always stayed active. After turns in high school and college as a star basketball player, as well as a nationally recognized three-point shooting champion, he moved on to the world of business.

He kept himself sharp by continuing to work out and play sports recreationally.

But on Memorial Day weekend of 2018, George suffered an acute aortic dissection.

An aortic dissection is a tear in the inside of the aorta that allows the blood to flow out of its normal path and into the artery wall. The pressure can cause the artery wall to swell and puts it in danger of bursting.

Collaborative care for treating aortic dissection

Emergency open-heart surgery at a facility in Rancho Mirage saved George’s life. But something still wasn’t right.

Days after the surgery, George was nauseated. His blood pressure was spiking.

Finally, his doctors airlifted him to the USC Comprehensive Aortic Center at Keck Medicine of USC and into the care of cardiac surgeon Fernando Fleischman, MD, and vascular surgeon Sukgu Han, MD.

“I went from someone telling me I had a good chance of dying to Dr. Fleischman saying, ‘I got this.’”

George Young, patient, USC Comprehensive Aortic Center

USC Surgery founded the center to channel cases to experienced team members from multiple disciplines. “Normally, cardiac and vascular surgeons would hate each other,” jokes Dr. Han, who with Dr. Fleischman is co-director of the center.

At many institutions, vascular and cardiac surgeons compete. This means their patients may receive care that is geared toward just one area of expertise. But at the USC Comprehensive Aortic Center, the two specialties collaborate.

Both doctors speak at conferences around the country to help other teams develop close collaboration between disciplines. They also have taken a road show across Southern California to help emergency room teams spot the signs of aortic dissection and arrange for rapid transport to Keck Medicine’s center.

Multiple heart surgeries deliver successful results

George knew he was in good hands. “I went from someone telling me I had a good chance of dying to Dr. Fleischman saying, ‘I got this.’”

George hadn’t fully recovered from his open-heart procedure just 10 days before. This made another major surgery challenging.

But there was little choice. His previous operation had left him with a residual dissection that had ballooned. There was an extremely high risk of rupture.

Dr. Fleischman worked for more than eight hours to repair George’s aortic arch and the tears that extended to several major arteries.

He rebuilt George’s subclavian artery. It’s a major vessel that supplies the head, neck, shoulder and arm.

Dr. Fleischman had known his procedure might compromise an artery to George’s hindbrain, putting him at risk for a stroke, so he called in Dr. Han. The surgeons talked constantly as they prepared to transition between procedures.

“This case is a perfect example of how you get better results when you work together,” Dr. Fleischman says.

After a seamless hand-off, Dr. Han got to work.

In addition to a vertebral artery bypass, he performed a bypass of the left carotid to the subclavian artery. By the end of the two procedures, Drs. Fleischman and Han had rebuilt all the major parts of George’s circulatory system that led to his brain and arms.

They had to go in again when they found a dissection of his carotid artery. Dr. Han reconstructed George’s left common and internal carotid arteries. He used a mix of traditional open surgery and minimally invasive techniques.

This final operation was just seven days after George’s double procedure. It was seventeen days after his emergency open-heart procedure.

“He’s the poster child for cardiac and vascular collaboration,” Dr. Han says.

Resuming physical activity after heart surgery

Though they saved his life, the operations were a huge shock to George’s system.

“I could barely do anything for the first four weeks or so, including sleeping and eating,” he says. “I lost a lot of weight and strength.”

But as a lifelong athlete, George was sure the best way to get his strength back was to start working out again. His instincts were correct.

The Society for Critical Care Medicine and the Enhanced Recovery After Surgery Society both recommend movement to help speed recovery and reduce complications after an operation.

As soon as Drs. Han and Fleischman cleared him, George got to work. He started walking at the hospital and then inside his home with a walker. He gradually worked up to short distances without the walker. Then he kept going.

George’s wife Meryl kept a journal to help him track his amazing progress. “His doctors said he should work up to walking two miles a day over two months,” Meryl says. “He did that in 10 days.”

Within three months, he was walking 10 miles a day. George then moved on to the elliptical machine, which was another challenge.

George credits his success to Meryl’s devotion, to an outpouring of calls and e-mails from friends and family, the “wonderful care from Dr. Fleischman and Dr. Han and the fabulous staff at Keck Medicine,” and a willingness to make slow and steady progress.

“The first time I did the elliptical after surgery, I only lasted a minute and a half. But I increased it every day.” Those small gains built up.

Now George maintains a workout routine that would tax almost anyone: two 50-minute sessions on the elliptical every day, a half-hour stretching routine, resistance bands and golfing three times a week — usually walking instead of taking a cart, of course.

George’s main advice to someone who has had major surgery? “Don’t hide under the covers! As soon as you can get up and walk, start walking. When the doctor says you can walk miles, get out there. As soon as you can lift weights, do it.”

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