On March 19, 2024, Hong Qin went to his basement to remove water from the dehumidifier. As he finished that routine task, he felt his heart race — something that had never happened before.
“I told my wife, Li Zhou, about the unusual heart palpitations and she immediately said ‘You need to have that checked,’” recalls Hong. “I didn’t think it was so serious to warrant a hospital visit.”
But, at the urging of his wife, Hong, a 54-year-old who lives in Shanghai, China, visited a local hospital on April 17, 2024. Various tests showed that what he thought was nothing was actually something. Hong had severe aortic regurgitation and dilated aortic root.
“Little did I know that I had a ticking time bomb in my body,” says Hong.
Aortic regurgitation is when your aortic valve doesn’t close tightly, so blood leaks backward with each heartbeat. A dilated aortic root is when the first section of the aorta, where the aortic valve resides, becomes enlarged.
Hong needed heart surgery to fix the two-fold problem. Since the surgery was very technical, the family wanted the best care possible; they were willing to go anywhere in the world for the care that Hong needed. His 25-year-old twin daughters, Kelly and Amy, dove in to do some internet research and found Cleveland Clinic as the leading hospital in the world for heart care.
“My daughters said that Cleveland Clinic was the best hospital for my husband to receive care. We wanted to lower any type of risk associated with heart surgery and we felt the best in the world would do just that,” says Li Zhou.
Their daughters found Cleveland Clinic’s Global Patient Services (GPS) on the website and gave their parents an email address for international patients to receive more information. They were contacted by a caregiver from GPS who spoke Chinese.
International patients who are at Cleveland Clinic for an extended amount of time are connected with GPS — dedicated to serving not only the medical but also the cultural and language needs of international patients in order to make their stay in Cleveland as comfortable as possible.
“Having a translator available is an amazing service for patients and families. The GPS members made all things easier and were very caring to my family,” recalls Kelly.
Hong’s case was reviewed by Lars Svensson, MD, PhD, a thoracic and cardiovascular surgeon who serves as Chief of the Sydell and Arnold Miller Family Heart, Vascular & Thoracic Institute at Cleveland Clinic. He determined that Hong needed a valve-sparing aortic root replacement, including modified David reimplantation surgery — a surgery that he specializes in and is internationally recognized for improving the original procedure.
Essentially, Hong needed the part of the aorta replaced that’s directly attached to the heart (aortic root) while keeping his natural aortic valve.
“Hong had a serious heart condition but, since this is a surgery that I do regularly, I was confident that I could correct his issues,” says Dr. Svensson.
About a month after their first contact with Cleveland Clinic, Hong, Li Zhou and Kelly flew to Cleveland.
“We knew this was a very difficult surgery and wanted the best doctor and best hospital,” says Li Zhou. “Life is just one time and more important than money.”
To prepare him for surgery, Hong had additional tests and met with Dr. Svensson. “Dr. Svensson and his team were always smiling, and their words gave us great encouragement and made us feel confident about the surgery,” says Hong.
On July 24, 2024, Hong had a six-hour surgery to correct his heart issues.
During the surgery, an incision was made in Hong’s chest and he was connected to a heart-lung bypass machine which would do the work of the heart and lungs during the surgery.
Dr. Svensson then separated his aortic valve from the tissues surrounding it and repaired damage to the valve flaps. Based on Hong’s body surface area, he reduced the diameter of the aortic annulus (the fibrous, crown-shaped base that supports the aortic valve). Using a tool called a Hegar’s dilator, he made the base of the graft the appropriate size to eliminate valve leakage. Next, he used pledgets (non-absorbable mesh) to anchor the new graft to heart muscle below the aortic valve.
He then removed the damaged portions of Hong’s aorta, cutting away the abnormally widened portions of his aortic root and again using the dilator to reduce the size.
A collagen-coated polyester tube graft that replaces the damaged portion of the aorta was inserted and the valve was implanted into the graft. A solution was sent through the graft to make sure the valves worked properly and the valves were checked to ensure the valve flaps were the correct shape and that they opened and closed as they should. Once the procedure was finalized, Hong was taken off the bypass machine and the incision was closed.
“The Hegar’s dilator brings things down to a normal size. This modification is key to having great long-term results with the reimplantation operation,” says Dr. Svensson. “Hong did fantastic with his recovery and his family was there to help him every step of the way. The Qin family has a love of history, cultures and traveling. They can now continue to see the world without limitations.”
After surgery, Hong spent about a week in the hospital (the first few days in the Intensive Care Unit). Afterwards, he stayed in Cleveland another month for follow-up appointments. He’ll continue to have checkups in Shanghai as needed.
“We saw a quote on the wall at Cleveland Clinic that said patients should be treated like family members. Those were not just words. Dr. Svensson and all of Cleveland Clinic’s caregivers really did,” remembers Kelly. “The surgery skill was of the utmost importance, but everything else they gave us was of great value. Because of the GPS service, we felt at home in Cleveland, like we were in Shanghai, not a foreign country.”
Related Institutes: Heart, Vascular & Thoracic Institute (Miller Family)