|
“I just really appreciate all these doctors have done to keep me going. Without them and the help of the good Lord, I wouldn’t be here.” —Duane Hagensick
Duane Hagensick has good reason to appreciate each and every day.
Indeed, the 71-year-old retiree credits two physicians at University of Iowa Hospitals and Clinics—UI Heart and Vascular Center cardiologist Theresa Brennan, M.D., and vascular surgeon Jamal Hoballah, M.D.—with keeping him alive despite medical odds against him.
“Let’s just say I have a lot of faith in those two,” says Hagensick, who lives with his wife, Phyllis, in Washington, Iowa. It was there he taught physical education classes and endured the stress of being a coach and high school basketball and softball official, all the while battling weight problems.
The first signs of trouble occurred in 1979 when he had to undergo triple coronary artery bypass surgery. By 1990, all three bypass grafts had closed. Chest pain sent him to Mercy Hospital in Iowa City, where he decided against repeat bypass surgery because some extra vessels had “sprouted” that kept the blood flowing.
Regardless, Hagensick was forced into retirement at age 58. As the years passed, he experienced occasional stomach pain until a particularly severe episode struck in 2000. Preliminary tests were performed by Hagensick’s family physician, Rey Lin, M.D., who then referred him to William Silverman, M.D., an internal medicine specialist at UI Hospitals and Clinics. Additional tests confirmed that Hagensick had an abdominal aortic aneurysm—a dangerous widening of one of the arteries. Essentially, the aorta had a 5.5- centimeter bulge, similar to a weak spot on an old car tire. A ruptured aorta causes profuse bleeding and usually—barring surgery or installation of a stent graft—death.
“One of the surgeons gave me a 10 percent chance of making it off the table,” Hagensick says. “I didn’t want to take the risk.”
As the months passed, however, the doctors at UI Hospitals and Clinics carefully monitored his heart and skillfully managed his medications to increase his odds of surviving surgery if it became unavoidable. That time arrived in late December 2003 when the aneurysm grew to 7.5 centimeters starting at the level of the kidneys. This eliminated the option of the less invasive stent graft endovascular treatment. Furthermore, a second, smaller aneurysm was developing in his right iliac artery.
As part of a pre-surgical evaluation, Brennan determined that there was no option for opening up a heart artery to improve blood flow to his heart. Plans were made for the operation despite the increased risk of heart problems it created.
“The risk of the aneurysm rupturing was greater than the risk of significant heart trouble during the operation,” Brennan explains. The procedure was exceptionally challenging because of his size and the need to control the aorta above the level of the kidneys. During a six-hour procedure, Hoballah replaced the aorta with a prosthetic graft starting from the kidney level to just above the groin.
“He was lucky to be alive,” Hoballah says.
Hagensick now lives a renewed life of moderate activity. He rides a stationary bike and walks 1.4 miles every day.
“Given his dedication to caring for himself and with the help of his devoted wife, Mr. Hagensick has done well for several years,” Brennan says. “He has religiously exercised and followed his physician’s recommendations. This is a big part of why he did so well during his highrisk operation and why his heart disease has remained stable.”
For questions about aortic aneurysms, patients and families should call UI Health Access and ask for the Vascular Surgery Clinic. For questions about heart disease, patients and families should call UI Health Access and ask for UI Heart and Vascular Center. Physicians should call UI Consult.
ABOUT ABDOMINAL AORTIC ANEURYSMS • More common in men (5%) than women (less than 1%) over age 60 • Rupture causes excruciating abdominal pain, profuse bleeding • Death may follow soon after rupture • Excellent results for surgical replacement or insertion of stent graft • Treatment of rupture is challenging with high risk of mortality |
