When Aortic Aneurysm Symptoms Mean Surgery, Teamwork Matters

How cross-system collaboration yielded a positive outcome for one bicuspid aortic valve patient — and what others can learn from his experience.

Mike VanderPol was an unlikely heart patient. In fact, when the 44-year-old went in for his annual physical a year ago, the last thing on his mind was any type of health issue, let alone heart disease.

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A regular runner with an active lifestyle, VanderPol, of Midland, Michigan, hadn't given much thought to his shortness of breath and minor heart palpitations.

But MidMichigan Health internist Phillip Kadaj, M.D., detected a heart murmur and referred him to cardiologist Susan Sallach, M.D. A follow-up echocardiogram revealed aortic insufficiency and an enlarged aortic root, the base of the main artery leading from the heart.

VanderPol's condition was the result of a bicuspid aortic valve, a defect in the heart's aortic valve that is present at birth. Diagnosed with the condition years earlier, VanderPol had no alarming symptoms related to it, which isn't unusual.

Beyond the shortness of breath VanderPol experienced, bicuspid valve symptoms can include fatigue, nighttime cough, rapid or fluttering heart palpitations, dizziness, chest pain and fainting. Some people with the condition don't have symptoms.

In VanderPol's case, Sallach says, "tests revealed his bicuspid aortic valve had become dysfunctional over time. He had a leaky valve as well as an enlarged heart and enlarged aorta."

Untreated, this could have led to aortic stenosis (blocked valve), aortic insufficiency (leaky valve), aortic aneurysm and aortic dissection, conditions that can be life-threatening.

A successful surgery

Sallach referred VanderPol to renowned cardiovascular surgeon G. Michael Deeb, M.D., of the University of Michigan Frankel Cardiovascular Center, part of Michigan Medicine, which partners with MidMichigan Health. Deeb confirmed VanderPol's diagnosis as an ascending aortic aneurysm related to his bicuspid aortic valve.

SEE ALSO: Observe or Operate? When an Enlarged Aorta Requires Action

In March 2016, VanderPol underwent open-heart surgery at U-M, where Deeb replaced his aortic valve, aortic root and ascending aorta with a tissue, or bioprosthetic, valve.

VanderPol was hospitalized for five days in Ann Arbor before returning home, where he was eager to get back to work and to pursuing his bachelor's degree.

VanderPol says the collaboration between the two health systems not only gave him direct access to an internationally known specialist in the treatment of aortic root and ascending aortic aneurysms, but also allowed him to undergo tests and cardiac rehabilitation closer to home.

"Having certain tests at MidMichigan Medical Center and doing my cardiac rehab there meant I could continue with school, despite the surgery and recuperation. That really helped," he says.

VanderPol recently graduated with a degree in business and health care administration, proud of the fact that he missed only one class during his heart issue. "It was a long year," he says, "but a rewarding one. I feel great."

Now, he's back to running three or four times a week, with a goal of tackling a half-marathon this summer.

"I knew I was in good hands when Dr. Sallach referred me to Dr. Deeb," says VanderPol, adding, "The synergy between MidMichigan Health and Michigan Medicine was fantastic."