When 30-year-old Woodmere resident Jennifer Hearst was ready to think about planning for a family, she knew it was time to make an important medical decision. Hearst was born with a rare congenital aortic abnormality called middle aortic syndrome, which involves a severe narrowing of the thoracic and abdominal aorta, causing hypertension and walking problems from lack of blood flow to the abdomen and legs. Without surgery, many people with this condition do not survive past the age of 40.
“For a long time I put off surgery,” said Hearst. “When I was younger, the issue was that if I had this surgery, they would have to go back in and redo what they did after puberty. I was largely asymptomatic and did not have a lot of issues other than high blood pressure, which was controlled by medication. So we put it off for a while and just monitored the condition. But I knew I had to do something eventually; it was a matter of when.”
Though Hearst has been largely asymptomatic for much of her life, during the past couple of years she has experienced dizziness and numbness in her legs, in addition to high blood pressure. But it wasn’t until she became engaged and her thoughts turned to planning for a family that she found she was ready for more serious medical intervention.
Hearst’s obstetrician referred her to NYU Winthrop Hospital’s perinatal department for family planning, and experts there directed her to NYU Winthrop’s Khaled F. Salhab, MD, a cardiothoracic surgeon with aortic training. Upon evaluation, Dr. Salhab determined that surgery would be necessary to improve the blood flow in Hearst’s body, thus alleviating her symptoms and increasing her chances of a healthy pregnancy down the road.
“It was time,” said Dr. Salhab. “With her wedding planned for this summer, Ms. Hearst was thinking about starting a family. We’ve given her the best chance possible for this and will continue to monitor her.”
Early this year, Dr. Salhab and his vascular colleagues performed a complex aortic bypass on Hearst. In conducting a bypass, surgeons place artificial tubes, or grafts, near a section of the blood vessel that is blocked or narrowed, creating a path so that blood can move around the blockage.
“We bypass the entire narrowed part of the aorta—the main artery of the body which supplies oxygenated blood to the circulatory system—to provide blood flow beyond the narrowing, like a bridge,” explained Dr. Salhab. “In the right hands, when done correctly, prognosis is very good.”
This condition is very rare with less than 200 cases reported in the world, according to Dr. Salhab, who says that the surgery is very challenging and requires meticulous planning and technique. Usually, the surgery requires a large thoracoabdominal incision; however, Hearst’s surgery was done through two small incisions—one in the chest and one in the abdomen—that were minimally invasive to reduce scarring.
Today, Hearst is symptom free. She credits the team approach at NYU Winthrop with prompting her to undergo the lifesaving surgery she needed. Hearst also credits her parents, Ilene and Rod Hearst, for being her “biggest advocates, going to every doctor’s appointment and ensuring they were always there.”
“I didn’t come to NYU Winthrop looking for a cardiologist,” said Hearst. “I never experienced this at other institutions—providers getting together to make a plan and consult instead of just having one doctor make a decision. They all came together and made a plan with my health and wellbeing in mind, and that’s what made me the most comfortable. It wasn’t just one person sitting in a room. It was multiple people making a decision for the long term, not just the here and now.”
Hearst is now looking forward to her July 2 destination wedding in the Dominican Republic, and a future made even brighter with the help of NYU Winthrop’s dedicated team of specialists.
