Thoracic Aortic Aneurysm

Joel BrunsonA few months after moving to the Delaware shore, Joel Brunson arrived for a routine physical with his new primary care doctor armed with a list of nine concerns. None were major from his viewpoint, but he wanted to make sure they were addressed.

Before he ever got to his list, however, Joel’s doctor informed him he had “a pronounced heart murmur” and sent him for a nuclear stress test at the local hospital. This test is used to highlight areas of the heart with poor blood flow or damage. Before Joel even made it home after his test, a doctor from the hospital called. “My friend, you have a problem,” he said.

In the days that followed, Joel connected with a local cardiologist, underwent more tests, and finally learned what was causing the problem: a thoracic aortic aneurysm.

And there was a chance it would rupture.

A surgeon’s confidence

A thoracic aortic aneurysm is a weakened area in the aorta, the major blood vessel that feeds blood to the body. When blood pushes against the wall in the weakened segment, it can cause the area to bulge like a balloon. That’s what’s known as an aneurysm.

Small and slow-growing aneurysms may never rupture. But fast-growing and large aneurysms—like Joel’s—can tear the wall of the aorta and cause life-threatening bleeding or sudden death.

Joel read as much as he could about his condition and the surgery required to correct it. The more Joel learned, the more determined he became to seek out the best thoracic surgeon he could find.

“Most people think that because they were diagnosed at their community hospital, they need to have their surgery there too. But that’s just not the case,” Joel says. “You can go anywhere, and so I sought out the best.” Compelled by the experience of a neighbor, Joel inquired at Penn Presbyterian Medical Center, even though it was more than two hours from where he lives, and was quickly referred to Wilson Y. Szeto, MD, chief of cardiovascular surgery at the hospital.

Joel met with Dr. Szeto in December 2020. Immediately, he knew he was in the right place.

“Because Dr. Szeto had such an air of confidence, I felt incredibly calm,” says Joel, who didn’t want to know the details of the procedure. More important to him was that his surgeon was experienced and unwavering in his ability. “His approach aligned with my own: There’s a problem, so let’s fix it and not waste time feeling sorry for ourselves. He has a very positive attitude.

“And his team is excellent as well. Whenever I met with someone from his office, I never felt like it was a step down,” he says. “They coordinated everything with my cardiologist and primary care doctor. I like to say it was the best worst experience I could have in my life.”

After a few weeks of preparatory testing, Joel underwent surgery on February 5.

Life comes back into focus

In hindsight, Joel realizes that he ignored or explained away a number of potential warning signs. When he had trouble catching his breath after climbing a sand dune as he left the beach one day, he couldn’t deny something was wrong. (“Shortness of breath” was one of the nine concerns on his list.) But he never imagined it was something as serious as this.

Only now is Joel beginning to appreciate just how much he struggled before the surgery that saved his life. When Dr. Szeto checked on Joel after his surgery, Joel struggled to find a way to express the gratitude that overwhelmed him.

“How do you thank the person who just saved your life?” Joel asks. He shook Dr. Szeto’s hand and promised him that he would “lead a great life and pay this act forward.”

Joel was discharged a few days later. Dr. Szeto’s office arranged to have a home nurse visit daily for two weeks to check Joel’s vitals and make sure that he was getting up regularly and walking around.

Three months after surgery, Joel is feeling much better. He’s thinking faster and with greater clarity – a result, he believes, of his heart no longer having to work so hard to supply his brain with enough oxygen. “My brain has been on another level since the surgery,” Joel says.

While he was in the hospital, he was diagnosed with type 2 diabetes, so cutting out sugar has been a priority. He’s also more active because he has more energy. “I don’t get tired like I used to,” he says. “Now, my muscles wear out before I do.”

“I appreciate that life is sacred,” he adds. “After you go through something like this, you really count your blessings.”

headshot of Wilson Y. Szeto, MD

Wilson Y. Szeto, MD

Chief, Division of Cardiovascular Surgery; Julian Johnson Professor of Cardiothoracic Surgery II

Dr. Szeto serves as Chief of Cardiovascular Surgery at Penn Presbyterian Medical Center and provides aorta and heart valve care as part of the surgical team at the Penn Aorta Center. He has completed more than 5,000 heart procedures.

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