Q&A With Vascular Surgeon Elizabeth Chou, MD

LOS ANGELES (Oct. 18, 2022) — After 11 years spent in medical school, residency and fellowships, Elizabeth Chou, MD, a vascular surgeon who recently joined the Smidt Heart Institute at Cedars-Sinai, has earned her dream career. And she has no plans of stopping there. She’s on a path toward ensuring women in vascular surgery are represented—as incoming physicians and as patients.

“Dr. Chou is wise beyond her years, having achieved more as a resident, fellow and now full-time faculty than many accomplish in their professional lifetime,” said Ali Azizzadeh, MD, director of the Division of Vascular Surgery in the Smidt Heart Institute at Cedars-Sinai and associate dean of Faculty Affairs. “She is pushing boundaries and changing the field of vascular surgery, one patient and research study at a time.”

Chou sat down with the Cedars-Sinai Newsroom to discuss her path toward vascular surgery, her passion for women’s representation in the field, and the latest research that’s reshaping how patients are treated—medically and surgically—for vascular-related diseases.

How did you decide on a career in vascular surgery?

My parents immigrated from China when I was a young child, and my grandmother and I joined them in the U.S. when I was just 4 years old. My grandmother had a huge role in my upbringing as a child. Through the hard work of my parents and my grandmother, I was able to pursue something that I was passionate about, not out of necessity of survival, as my parents and grandmother had to do. Those experiences subconsciously shaped many of the decisions I’ve made throughout my life, including my desire to attend medical school. But even by the time I entered medical school, I had no idea what vascular surgery was.

I was fortunate enough to learn alongside some incredible mentors in vascular surgery and appreciated that our patients are often older and come from marginalized areas of our society, whether financially, racially or socially. It’s a unique honor to get to know our patients and their families through medical or surgical interventions and through time, as we often support them for the rest of their lives. It’s pretty special. 

Vascular surgery tends to be a field dominated by men. How have you navigated this?

It’s true, there aren’t many women in vascular surgery. But there are more of us coming. At Cedars-Sinai, our current and incoming fellows are women, and we have a culture in which collegiality, teamwork and excellence—regardless of gender—are front and center. It’s part of what appealed most to me about working at the Smidt Heart Institute.

There is a lingering disparity, however, for women with vascular diseases. Vascular diseases tend to be less common in women, but they tend to have worse outcomes, longer hospital stays and increased mortality. Plus, many of the devices we use were not anatomically designed for women, and mostly studied in men. We have room for improvement in our research endeavors and in our clinical and surgical care for women with vascular diseases.

Tell us more about your research interests and priorities?

I have an interest in aortic diseases, with a specific focus on utilizing the tissues we collect during surgery to make translational advances. In vascular surgery, we aim to prevent catastrophic events like aortic aneurysm rupture, which have no symptoms prior to the event. By studying our patients and their vascular tissues, which are typically disposed of post-surgery, we hope to understand who else may be at high risk for aortic disease and establish better guidelines to screen and identify people at risk.    

What are the big takeaways from your two most recent research studies?

I had the opportunity to serve as first author of an exploratory study published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, in which we investigated healthy aortic tissue from patients and compared it to patients who had a sporadic aortic aneurysm, which means they had no family history or risk factors for the disease. Using a unique process and technology to isolate individual single cells from the tissue, we discovered that smooth muscle cells and fibroblasts in combination with specific genes played a key role in the development of an aortic aneurysm—something yet to be discovered until now. 

I also recently served as first author of a review published in Nature Reviews Cardiology that summarized the boom of recent aortic genetic research. The review article describes the history of aortic genetic technological advancement and explains how newer technologies, such as deep learning, in conjunction with genetic sequencing have greatly expanded and identified new targets that are specific to aortic traits and disease. We highlight how these new findings can be leveraged for future applications to detect and treat aortic disease.

Vascular surgery research is evolving at a rapid rate, and I’m grateful to be a part of these advances. I’m equally grateful to the selfless patients who participate in research studies—they are truly changing the field of aortic diseases. 

Read more from the Cedars-Sinai Blog: Minimally Invasive Surgery for Aortic Valve Repair