March 16, 2023

Multispecialty expertise key to heart patient’s recovery

Vanderbilt’s multispecialty expertise helped a seemingly healthy 54-year-old man who needed major heart procedures get back to the gym and live a healthy life.

Vanderbilt heart patient Tony Raia, with his wife, Jenn, and daughter, Gabriella, 6, at their home in Franklin, Tennessee.
Vanderbilt heart patient Tony Raia, with his wife, Jenn, and daughter, Gabriella, 6, at their home in Franklin, Tennessee. (photo by Susan Urmy)

by Matt Batcheldor

Tony Raia was stunned when he was denied life insurance. At 54 years old, the Franklin, Tennessee, man was the sort of person who ran half marathons and completed high intensity workouts at the gym, with no known health problems. But blood testing for insurance revealed cardiac markers that resulted in coverage being denied.

Shortly thereafter, Raia came to Vanderbilt for an unrelated naval hernia surgery, when Richard Pierce, MD, assistant professor of Surgery, and his team discovered a heart murmur. That led him to the Vanderbilt Heart and Vascular Institute and, several tests later, eventually for an aortic root replacement and mitral valve repair. This is the story of a seemingly healthy man who needed major heart procedures and benefited from a multispecialty team that now has him back at the gym and living a healthy life.

“He represents a great case of what we can offer uniquely at Vanderbilt,” said Ashish Shah, MD, professor and chair of Cardiac Surgery, “saving his heart valve and not requiring an artificial valve, providing minimal access surgery but also complex reoperations with early extubation.”

When Raia saw a cardiologist, he received an echocardiogram that showed his mitral valve was leaking severely. He was surprised when Shah said he needed surgery right away.

“He’s like, what are you doing next week?” Raia recalled.

Raia was scheduled for mitral valve surgery days later, in February 2021. But that wasn’t the extent of his problems. On the eve of the surgery, Shah called Raia and said, “We’ve got one other result that came back,” Raia recalled. “I had an aneurysm on my aorta that measured over 5 centimeters, which is the danger zone… it could burst at any time.”

Shah repaired Raia’s mitral valve, and Raia was quickly up and walking around. His recovery in cardiac rehab was swift, but the aneurysm was nagging at him. He could live with it for years, or it could cause trouble at any moment. He was worried about being around for his wife, Jennifer, and his daughter, Gabriella, 6.

So, six months after his first surgery, he was back for another surgery — the aortic root replacement. Shah was able to salvage his valve without needing an artificial insert.

This surgery was a bit longer and more difficult to recover from. He resumed cardiac rehab, and because he was so serious about his workouts, was eventually discharged to, essentially, do his own cardiac rehab from his home gym.

Raia is now recovered and doing well, back to his regular workouts. He follows Shah’s advice for exercise: “Just do whatever doesn’t hurt.”

Shah said Raia’s medical journey highlights the remarkable changes in cardiac surgery at Vanderbilt.

“From shared decision making on his initial procedure, to removing the breathing tube in the operating room, cardiac surgery at Vanderbilt looks very different than it did 10 years ago and even five years ago,” Shah said.

“Our entire team — cardiac anesthesia, perfusion, perioperative nursing, outpatient nurse navigators, inpatient nursing and the advanced practice corps  — elevated our performance.”

Raia, who refers to Shah as the “Rembrandt of hearts,” said the surgeon always told it to him straight.

“He’s just not only a master of his craft, but he’s just a cool dude,” he said. “His bedside manner is unbelievable.”

Through all of this, Raia discovered his genetic markers for heart disease that could help other family members monitor future cardiac issues.

“Many families never know that there’s a genetic issue with heart disease until someone passes away,” Raia said.

“We were blessed to have this discovered, and for me to have my family tested to see if they have the same issue.  All of this is thanks to Vanderbilt and the fact that the doctors initiate review instead of relying on the patient to do it on their own. I may have put things off if the Vanderbilt doctors had not set up appointment phone calls and initiated the processes. The Vanderbilt system is second to none.”