Hello everyone! My name is Scott Stowell, and I am a 28-year-old male with a connective tissue disorder, and I am from the Dallas, Texas area. I am extremely grateful to be writing this 5 weeks after my PEARS operation, and I truly believe PEARS was the best option for me, and I hope that by sharing my story I am able to help others like me!
Initial Diagnosis
First, I’d like to start by going back to when I first found out I would need heart surgery one day. It was the fall of 2020, and the world had just gone through a pandemic. Personally, I was doing great. I had just transferred to a 4-year university the semester prior and was excited to finally be on campus. We had just moved to Texas two years prior and were starting to get things established for my health. At the time, we were primarily worried about my lungs because I have had five previous collapsed lungs, but I had also been referred out to cardiology due to the underlying connective tissue disorder. So I drove the three hours up from college to my parents’ house (thank goodness for Zoom classes), and my mom and I went to my cardiology appointment. They did a CT and ECG and all the standard tests. That’s when we got the bad news: my ascending aorta was dilated at 4.3 centimeters, and if it expanded further I would likely need surgery one day. They immediately started me on a beta blocker, and thus began the routine of getting an annual CT scan to monitor my aorta. Typically, every year I would go in, meet with the cardiologist, hear that there was no change in my dilation, and be on my way for another year. It could have been 20 or 30 years of this before needing surgery if my aorta remained stable, no one was really sure.
Now, during this time I had graduated college and started a new job, which meant new health insurance and changing all of my doctors once again. I had a slew of other health issues I was battling as well and didn’t worry that much about my heart while I focused on healing from those. Unfortunately, eventually my luck would run out, and my dilation started progressing up to 4.6 centimeters from the 4.3 centimeters that was measured 5 years prior, just around the beginning of the surgical threshold for someone with a connective tissue disorder. Surgery was now urgent.
Conventional Surgical Options vs PEARS
I’ll never forget the first cardiothoracic surgeon we met with. He sat me down, pulled out a blank sheet of paper, and drew my aorta and said, “I’m going to cut this part out,” drawing an X through my ascending aorta, “replace it with a Dacron tube,” which he then drew, “and sew it back together over your valves.” In my head, I was thinking, “the hell you are,” and then he said, “I can do this as soon as Monday if you want.” I could not get out of there fast enough. The idea of valve-sparing root replacement sounded absolutely horrific to me. Having been through the five collapsed lungs, the last thing I wanted was to have part of my heart cut out. Not to mention the downsides of VSRR, which weren’t even mentioned to me by this particular cardiothoracic surgeon.
Luckily, I had recently moved out of my parents’ house and into my own apartment, and my new primary care doctor asked if I would like to be referred to a cardiothoracic surgeon who was closer to where I was currently living. I immediately said yes, never wanting to return to the cut-happy surgeon I had originally met with again. In the meantime, I started to do research on alternatives to VSRR. The first one I found was the Bentall procedure, or total root replacement, which sounded even worse than VSRR to me.
Then, on a social media thread discussing dilated aortic roots and connective tissue disorders, I saw someone mention the acronym PEARS. I had no idea what it was and immediately started Googling it, mostly getting fruit results, until I changed my search to include the word “procedure” after it, and I found Tal Golesworthy’s TED Talk titled How I Repaired My Own Heart. After watching Tal’s TED Talk, I was amazed that the solution for me could be as simple as wrapping a custom bespoke mesh sleeve around the aorta. No need to cut out a part of my heart and replace it with Dacron. No need to go on a bypass machine. A simpler, less involved procedure with a much faster recovery time. Twenty-plus years of data showing no significant aortic dilation among PEARS patients. This operation sounded like a no-brainer to me!
“What about PEARS?”
The next cardiothoracic surgeon I was referred to was amazing. He was much gentler, didn’t draw any pictures crossing out parts of my heart, and I could tell he truly cared about me as a patient and wanted the best possible outcome for me personally. He still walked me through a VSRR operation, as that is unfortunately the procedure they typically do in the States. This time, he also made me aware of the downsides of that procedure: needing to go on a heart-lung bypass machine, long recovery, and most importantly, a cumulative 10% failure rate per decade, meaning I would likely not only need one heart surgery but a second one later on in life.
After he finished, I just kind of looked at him and said, “Well, what about PEARS?” Immediately, his eyes lit up. He told me he had actually just been to a medical conference and had seen some of his colleagues present on PEARS. He said he would refer me to Mr. Conal Austin and the team at London Bridge Hospital and was interested in seeing the procedure himself if they determined I was a good candidate for surgery. I was very fortunate to have such a supportive surgeon here in the States.
My surgery was now very urgent, and my cardiothoracic surgeon stateside said if I couldn’t get to London by the end of the year to have PEARS done, then in the new year he’d want to do the VSRR operation on me. So either way, I was going to have to have heart surgery within the next 6–12 months.
Preparing for Surgery in London
Thus began what I refer to as “the craziest thing I have ever done,” and my fight to get the best care possible for me and for my heart long-term started. First, I met with the incredible team at London Bridge Hospital virtually early one morning on Zoom. My cardiothoracic surgeon in the States had sent over my medical history and the latest CT of my aorta, and Mr. Austin reviewed it and agreed that I would be an excellent candidate for PEARS. Then began the coordination of getting me to London for surgery. Originally, we had been aiming to have my procedure done in September, but after a few timing setbacks it was eventually scheduled for mid-December, just before Christmas.
The first thing I needed to do was have a CT scan done so they could make the ExoVasc graft for my aorta. In the States, this CT is often referred to as a “gated CT.” Make sure that you confirm this before you have your CT done and that they attach the ECG leads to you while doing your CT. Next came booking flights, finding a place to stay, coordinating with my doctor stateside and with the team in London. Finally, on December 10th, 2025, my mom and I boarded the plane to London, and we were off.
Pre-Operative Care in London
In London, you’ll arrive a few days early, and they’ll do some pre-op tests, take some blood, do an echocardiogram, and make sure that everything looks good. Unfortunately, I ended up getting sick with a high fever in London right before my surgery (avoid traveling via the Tube if you can!), delaying my procedure from Monday to Friday. That meant that my cardiothoracic surgeon from the States wasn’t able to observe my specific procedure, but luckily Mr. Austin had another patient scheduled on that Monday, and so my stateside surgeon was still able to observe a PEARS procedure, which gives me high confidence in my follow-up care back home.
Despite being sick in London right before surgery, by Friday I was feeling better and arrived at the hospital with my mom and my aunt, who had flown in a few days later. The anxiety I had waiting for my procedure after it had been rescheduled while sick was probably the worst part of the entire experience. I think waiting for the surgery is worse than the procedure itself!
The Surgery Experience
Finally, though, the day had arrived. My PEARS procedure was scheduled for 1:00 PM, and we arrived at the hospital at 9:00 AM. After waiting in the lobby for a few minutes, they brought us up to a room and had me get ready for surgery. In the meantime, Alan Rayner, the PEARS programme lead and perfusionist at London Bridge Hospital, came by to show me the ExoVasc graft that would soon be inside me, protecting my aorta, custom-made just for me. We also discussed the benefits of the PEARS surgery and why it was a much better option for anyone with a dilated aortic root than VSRR. Mr. Austin also came by shortly before surgery, and soon enough they were wheeling me down to the operating room.
Things start to get a little blurry here as everything happens so fast. The anesthesiologist will check in with you, you will have an IV placed, and before you know it you’ll be headed to sleep. The next thing I remember is waking up and my throat being sore (partly from the breathing tube and partly from being sick earlier that week). I asked for a popsicle (note to my American friends in the UK: they’re called ice lollies). After some confusion about what I meant, I do believe I finally got one, and it helped my throat immensely. I then believe I fell back asleep for a few hours. When I woke up the next time, I was in a different room and checked my phone (and some American football scores) for a little bit before falling asleep again.
Hospital Recovery
The next day is when things really start to pick up. Most of the remaining tubes and wires that were attached to me were removed. My blood pressure was pretty low, and I had an episode of tachycardia, so they were concerned about that, but things eventually started to even out, and they started trying to get me to stand and walk. One thing to note is to make sure you ask that they bring your pain medicine consistently on a schedule and not wait for you to ask for it. Day three was more walking and the physio trying to get you to do a whole bunch of exercises that will tire you out but are also important to be completed. At this point, I started to notice how difficult breathing was. Make sure you ask for or bring a spirometer and start using it consistently. After having so many previous collapsed lungs, the last thing I wanted was another one.
Discharge and Early Recovery
On day four, I was allowed to take a shower, and it was the most amazing shower I have ever taken. If you can make it to that shower, you are doing great! My last day was on Christmas Eve, and there was no greater feeling than being released from the hospital after heart surgery on Christmas Eve. It was such an amazing accomplishment to celebrate. Your recovery afterward will be a struggle, but I was able to walk a mile just eight days after my surgery, something which I don’t think would have been possible had I opted to have VSRR in the States. Just take things slow and go as fast as your body allows, and make sure to leave plenty of time for rest as well. This was difficult for me, as I am always determined to be able to do just as much as my peers despite my connective tissue disorder, but it takes time for your body to heal.
Final Thoughts and Gratitude
Finally, I want to thank Conal Austin, Alan Rayner, and all the doctors and nurses at London Bridge Hospital. My stay there was truly exceptional. I would do it all again in a heartbeat if I had to. I also want to thank Tal Golesworthy for being an incredible human being and not just inventing a procedure that saved his life, but one that has and will save countless other lives as well. I’m very appreciative that he not only designed and invented PEARS but also started Exstent and has pushed for this procedure all across the world, oftentimes clashing with the elitism and naysaying that exists within the medical community. I think it’s rather unfortunate that PEARS isn’t available in the US, and I hope that it will be one day soon.
I believe the benefits of the PEARS procedure are too high for the medical community here in the States to continue to ignore: no bypass machine, a shorter operation, no part of your heart is cut out or replaced, the surgery is significantly cheaper than VSRR or Bentall, the ExoVasc graft is custom-made to your exact dimensions, and unlike VSRR, which will likely require a second surgery down the road, the ExoVasc graft is designed to last a lifetime. I hope one day this operation is available here in the States so that Americans like me do not have to leave the country just to get the care they need to save their lives. In the meantime, however, if you are considering this procedure over one of the riskier alternatives in the States, I highly recommend you choose PEARS! Thank you again, Tal and Exstent!
