Experience of Henry Ford Aortic Specialists Saved Iwan’s Life

Iwan Mich described taking off his coat in a restaurant and feeling what he thought was a muscle pull across his chest, but he dismissed the pain and enjoyed his meal. After all, for five years he had pain that radiated from his right shoulder and his PCP said he was okay. "I now know that was a symptom of coronary artery disease," Iwan shared.

"I felt fine the next morning, then 10 minutes later I didn't. I asked my wife, Joanne, to take me to Emergency," recalled Iwan. Joanne notes, "I asked him if he wanted to shower before we went to Emergency and he said, no. He always takes a shower before leaving the house, so I knew it was serious."

As they arrived at their local hospital on March 1, 2022, Iwan was experiencing an aortic dissection. The doctors at the community hospital did not have the capability to treat the aortic dissection, so Iwan was flown out. "I don't remember any of that," said Iwan. "I woke up at Henry Ford Hospital in Detroit where I meet Dr. Kabbani and learned what happened."

Loay Kabbani, M.D., a co-director of the Henry Ford Aortic Center, said, "We used a team approach to treat Iwan, the Henry Ford Aortic Center includes a team of experienced vascular surgeons, cardiologists, cardiac surgeons, vascular medicine specialists, radiologists, pathologists, and rheumatologists." These health care providers have a special interest in the diseases of the aorta and work together to integrate medical, surgical, radiologic and research expertise to benefit the people who seek them out for effective and innovative care.

Treating Iwan

Dr. Kabbani recalled that Iwan's case, like many others, required the care and expertise of several physicians. He said, "When Iwan arrived at Henry Ford Hospital we realized not only was he suffering from an acute aortic dissection, but he was also having a heart attack. Our multi-disciplinary team allowed for Iwan to quickly be treated by the experts in both aortic and cardiac diseases."

Dr. Kabbani explained, "Iwan was pretty critical by the time he got to Henry Ford. First, he had an aortic dissection, an entity where the artery tears and splits the artery wall layers. Cardiothoracic Surgeon Daizo Tanaka, M.D., said, 'I believe the severe pain from dissection induced stress and demand ischemia of the heart exposed his underlying severe coronary artery disease.'"

Iwan was found to have elevated troponin which prompted a cardiac catheterization revealing severe coronary artery disease. Iwan needed open heart surgery to treat his heart and a stent graft to treat his aortic dissection. During Iwan's initial episode, "we also found out that Iwan had a complex asymptomatic abdominal aortic aneurysm (also referred to as an AAA) that was at risk of rupturing," said Dr. Kabbani.

"We started by treating Iwan's aortic dissection by placing a stent graft to stabilize the thoracic aorta," Dr. Kabbani explained. "We usually proceed with bypass surgery relatively urgently when the patient has critical disease such as Iwan had," Dr. Tanaka explained. "However, a serious condition immediately after an acute dissection can increase the risk in a major open-heart surgery. Inserting the stent graft was very beneficial in stabilizing the aorta and minimizing the risk of surgery. Two weeks later, we performed a 6-vessel coronary artery bypass surgery."

Iwan's recovery was uneventful and by mid-July he was strong enough for Dr. Kabbani to perform the AAA repair. "This aneurysm was complex and required the insertion of a specialized fenestrated graft that would cover his abdominal aorta to a level above his kidney arteries but still be able to perfuse the kidney arteries through small fenestrations in the graft," explained Dr. Kabbani.

"Iwan's been through a lot, but his prognosis is excellent, and he will continue to be followed by my colleagues Vascular Medicine Specialist Dr. Syed Ahsan and cardiologist Dr. Michael Hudson. Both of whom will continue to monitor Iwan's progress," said Dr. Kabbani. "I trust them with my life," Iwan shared.

"It's been a lifestyle change for sure, I eat differently and exercise more. I've even reduced my workload and am more conscience of what's important in life, like my grandkids," Iwan concluded.