Father and son undergo aortic repairs a year apart
A father and son share a genetic heart condition called bicuspid aortic valve and had successful surgeries at Penn Medicine a year apart.
Family history repeats itself
When his son Tyler was born, Ed made sure he was tested for any cardiac issues. Tyler was found to have both BAV and tachycardia (a fast heart rate).
Now 27, Tyler recalled a life of regular monitoring by his local doctors and at the Children’s Hospital of Philadelphia.
“I used to have to wear this really big metal box at all times at school,” said Tyler. “When it beeped, I’d have to go the nurse’s office to get my blood pressure checked.”
It all became a familiar, if not always comfortable part of his childhood. Life went on at a pretty even keel for father and son until early 2021 when a routine test would change their lives.
The importance of routine testing
Ed, then 51 years of age, went in for the regular echocardiogram he had every two years to monitor his BAV. The results were startling. His cardiologist called him in and delivered the news—Ed had an ascending aortic aneurysm, the kind that can rupture or dissect. A later CT scan showed it was 5.4 centimeters—just over the threshold for surgery. The urgency was clear.
“Once I got the call, I knew I had to act fast,” said Ed. His cardiologist, recognizing the seriousness, immediately referred him to Nimesh Desai, MD, PhD, director of the Penn Aorta Center, reassuring him that Desai would take excellent care of him.
Although concerned, Ed and his wife remained calm and focused. They scheduled an appointment with Desai, who laid out a clear treatment plan. They learned Ed’s situation extended beyond the aneurysm. His aortic valve was also not functioning properly and needed to be replaced.
“All this happened pretty quickly,” Ed recalled. “I asked if I could postpone the surgery as summer was approaching and we’re avid boaters. However, Dr. Desai recommended not waiting.” That’s when Ed realized just how serious things were.
Ed’s surgery: Ross procedure
Desai discussed various surgical options. Ed chose the Ross Procedure, which Desai said would offer the best outcomes and least side effects.
The Ross procedure is like a heart valve swap, explained Desai. “A surgeon takes the patient’s own healthy pulmonary valve—which normally controls blood flow to the lungs—and moves it to replace the diseased aortic valve. A donor valve is then placed where the pulmonary valve used to be. This gives the patient a living, self-healing valve in the aortic position, which grows and functions naturally.”
Weeks before the surgery in May 2021, Ed underwent a battery of tests to ensure he was ready. An MRI confirmed the Ross Procedure was a viable option.
“I’d had a few minor surgeries in my life, but this was different,” said Ed, his voice filled with emotion. “This was a major surgery.”
The day of the operation, the hospital team kept his spirits high, and the eight-hour surgery went smoothly. By the fifth day, Ed was home and recovering—relieved, and deeply grateful for the care he had received.
A call to action for Tyler: the David V procedure
For Tyler, the call to action came when his father’s aneurysm was discovered. His mother had been urging him to see a cardiologist again for years, but he hadn’t taken it seriously. When his father’s condition became critical, Tyler knew it was time to listen.
“I thought they’d just tell me I was fine,” Tyler recalled. But when the echo technician expressed concern and asked if he was feeling okay, Tyler realized things might not be so simple. The tests revealed that he had severe aortic insufficiency and a 5.0 cm aneurysm. Just like his father, surgery was recommended.
Tyler’s decision to trust his father’s cardiologist led him to Desai, and after additional testing, it was clear Tyler would need surgery. In early 2022, a year after his father, he underwent a valve-sparing root replacement, known as the David V procedure. This surgery is designed for patients like Tyler whose aortic root is weak, but their valve can be preserved. The procedure reinforced the root of Tyler’s aorta, while keeping his valve intact—meaning he wouldn’t need lifelong blood thinners.
“Everything happened so fast,” Tyler said. “One moment, I was talking to the doctors, and the next, I was waking up from surgery.” Despite the gravity of the situation, Tyler’s recovery was smoother than expected, and he found comfort in the fact that his dad was there to guide him.
“Because we were living in the same house, my dad was with me through the entire process,” Tyler said. “He let me know what the tough parts would be, along with the easy ones.”
Looking to the future with gratitude
During his hospital stay, Tyler had the opportunity to speak with a geneticist at the Penn Aorta Center, who provided valuable insights into his inherited condition. Now engaged and looking to the future, Tyler is considering further testing to better understand how his condition might affect his own family someday.
“If you have surgery at Penn,” Tyler said, “know you are at one of the best hospitals in the country. The care doesn’t get better than what I received.”
Ed couldn’t agree more. “I think I had the best heart surgeon and care anyone could have, and for that I’m grateful,” he said.