Passion for Care: Exploring the World of Aortic Surgery

Podcast Transcript

Announcer:

Welcome to Love Your Heart, brought to you by Cleveland Clinic's, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute. These podcasts will help you learn more about your heart, thoracic and vascular systems, ways to stay healthy and information about diseases and treatment options. Enjoy!

Eric Roselli, MD:

Good morning. I'm Eric Roselli. I'm the surgical director of the Aorta Center here at the Heart, Vascular and Thoracic Institute at the Cleveland Clinic. And I'm sitting with Dr. Xiao Xiao, Xiaoying Lou, and we thought it would be a nice opportunity for us to educate our patients and to talk a little bit about aorta, something that we both have a lot of passion about. Why don't you tell the audience who you are and a little bit about how you got here with us.

Xiaoying Lou, MD:

Sounds good. So it's a privilege to be here. Thank you for the opportunity and thank you, Dr. Roselli, for your time. So it all started, I think, with mentorship for how I got started in cardiac surgery. And I was my senior year of high school and I had a mentor. I got paired with a mentor through our high school program and she brought me into the operating room. I got to scrub in on a case, which I don't think high school students are allowed anymore, but back then it was allowed and I got to see the heart while it was still beating. And I think that's all it takes for someone. That's all it took for me. And I was mesmerized by just how intricate the procedure was, the whole team dynamic working together to help the patient. And she's just been an incredible mentor for me through the years, as well.

Eric Roselli, MD:

Did you know it was going to take you another 12 or 15 years or something to get to where...

Xiaoying Lou, MD:

No, and I don't think when you first have that image of who you want to become and you have that instant idea of this is what I want to do with my life. You don't know the training and the process it takes, but I think if you have that passion and that kind of vision of what you want to do with your life, you get guided by the ups and downs throughout the training and you persevere through all of that. But yeah, it's been a long road and it's good to finally be here and to be able to really do something for patients now.

But yeah, that was where cardiac surgery started. And then the same with my interest in aortic surgery started. In residency, I did the I-6, the six-year cardiothoracic surgery training program at Emory University, and my mentors who are both aortic surgeons and they brought me into the OR. I got to see aortic surgery, I got to do aortic surgery research projects and really fell in love with the aorta. The aorta and aortic surgery has everything about it. There's the genetics component of it. There's the pathophysiology of aortas and aortic dissections and aneurysms. The surgeries, I think, are the most fascinating surgeries that you can do. They're very complicated. They're very personalized and individualized to the patient's pathology. And then afterwards, there's so many interesting research questions to be answered

And it's a lifelong patient. So I think you really develop a relationship with those patients. So everything about it. I am preaching to the choir with Dr. Roselli.

Eric Roselli, MD:

Well, yeah.

Xiaoying Lou, MD:

That's why we love it.

Eric Roselli, MD:

I have a similar story about how... well, I didn't get to see a heart when I was a high school kid. I got to hang out with a doctor and talk to patients, and I thought that was pretty great. And then I kind of found myself down a similar pathway, and the aorta was a little different for me. I'm much older than you, but at the time, close to 20 years ago, it was sort of a burgeoning area of growth.

And, of course, I know the mentors you mentioned and they did a good job of getting you trained there. And then of course we were lucky enough to encourage you to come hang out with us and maybe kind of get a little bit next level.

Xiaoying Lou, MD:

Absolutely.

Eric Roselli, MD:

We are the largest aorta center in North America, and certainly at the cutting edge of so many things that I had the good fortune of being in the right place at the right time when a lot of things were just starting. And I think we continue to see a lot of new technology and developments in the treatment of aortic disease. I will, I guess confess to you now was a bit of an audition that you had when you were a fellow. We knew you were going to be great.

Xiaoying Lou, MD:

Thank you.

Eric Roselli, MD:

And you proved it. And now here you are doing great things. You talked about one of the really exciting things about treating aortic disease and the real draw about treating aortic disease is this ability to be creative and tailor the therapy to each individual patient because it isn't a very discreet lesion like you see in a single valve or something. There's multiple areas where disease are involved and that requires us to sometimes use different modalities. Can you talk about that a little bit?

Xiaoying Lou, MD:

Yeah, that's a super exciting area of aortic surgery, that there are so many more hybrid techniques out there. And the aorta extends from the aortic valve and it goes all the way to your head vessels, to your abdomen, and then to your lower extremities. So it's a huge segment of aorta that needs to be treated. And now there are more and more approaches through a hybrid, which is an open surgery, and then also an endovascular surgery approaches to treat the aorta. And really exciting developments and endovascular techniques to be able to treat problems for aortas that were previously more deadly and for patients who may not have been candidates for open surgery. And endovascular therapies really transformed the new innovations for aortic diseases.

Eric Roselli, MD:

And we've had the advantage of being trained as full open cardiac surgeons and endovascular specialists to learn how to combine those technologies, haven't we? When you're meeting a patient and you're discussing with them the problem they bring to you at the time, what do you think is one of the most important messages for the patients?

Xiaoying Lou, MD:

Well, I think that for the patient, the reason why I wanted to do this was to help people. Obviously every doctor says that, but I truly care about patients. I am definitely someone who thinks of patients. This is how I would want my family member to be treated, and I think I want them [to know] that we're going to be dedicated to your care for the lifelong term and want their family members to know that we're going to do the very best and find the best optimal management for your loved one. And that entails a multidisciplinary approach at the clinic.

I think the benefits of the Cleveland Clinic is the experience from you and from the whole team and developing new innovative strategies, the latest research and the latest strategies to treat you or your family member. And then we have that wealth of experience and the wealth of the teams that are here to be able to do that very expeditiously. I want them to know that you're going to be a patient for life. We'll take care of you, and we're going to do our best to do it in the most optimal expeditious manner using a multidisciplinary approach with the latest developments in care.

Eric Roselli, MD:

I think that's really well said. I certainly enjoy collaborating with you and we have that, I think, built into the DNA in this institution. It's a collaborative place. And feel that as soon as you've become part of our team, and not only you and I working together and the other members of the aortic surgery team, but members of the aortic team in general. We have cardiologists, our vascular surgery colleagues and us are wonderfully collaborative, and I always want to brag about that, because I think that's some special relationship that we have that's wonderfully collaborative, where we focus around the patients and also the intensive care unit docs, both in the pre-surgery phase and afterward. And then the imaging specialists that are here that see the patients along with us afterward. Make sure we pay attention to every detail like limiting radiation exposure and things like that. It's really great. And as we grow in knowledge, and you touched upon also what we're doing to explore the disease in a scientific space, I just see it becoming more and more exciting. So thanks for taking some time.

Xiaoying Lou, MD:

Thank you, Dr. Roselli.

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