The Problem: Aortic Dissection
With a family history of aortic dissection, Jacob Fiske knew he was at risk of developing the often-fatal condition. But at age 36, it was the last thing the athletic father of two expected.
Jacob was working at his mother-in-law’s house in June 2020 when he picked up an 80-pound bag of concrete and felt two pops in his groin area. Within minutes, he was paralyzed from the waist down.
“I was scared. I felt like my legs were being ripped off my body,” says Jacob, an Edinboro, Pa., resident. “I knew the symptoms. I knew something major was happening,”
The Path to the UPMC Heart and Vascular Institute
An ambulance took Jacob to UPMC Hamot in Erie, where a CT scan confirmed he had experienced an aortic dissection and rupture — a major tear in the main artery supplying blood from his heart to his body.
Plans were made to fly Jacob by helicopter to UPMC Shadyside for advanced, high-level care. But due to poor weather conditions, he was transported to Pittsburgh by ambulance with his wife, Jenny, at his side. On his arrival, Jacob was rushed into the operating room under the care of Ibrahim Sultan, MD, director of the UPMC Center for Thoracic Aortic Disease and a cardiothoracic surgeon with the UPMC Heart and Vascular Institute.
While Jacob was being prepped for surgery, Dr. Sultan told Jacob he had a low chance of survival because of the degree of damage to his organs and his spinal cord from the aortic dissection — and if he did survive, there was a chance he would likely be permanently paralyzed due to the disruption in the supply of blood to his organs and legs.
An aortic dissection is rare, but not uncommon. In fact, Jacob’s mother experienced multiple aortic dissections during her lifetime. Testing later showed that multiple members of the family, including Jacob, carry the gene for aortic dissection and related disorders, including aortic aneurysm.
An aortic dissection is a serious condition in which the inner layer of the aorta tears. Jacob had a Type B dissection — a tear in the descending portion of the aorta, extending from his chest into his abdomen— which was cutting off blood flow to his organs, legs, and spinal cord.
During surgery, Dr. Sultan repaired the aorta with multiple stents. Within three days, Jacob was wiggling his toes; three days later he was taking his first steps.
The Results: A Thankful Family Man
Two weeks after surgery, Jacob was on his way home to Edinboro. While he has some lingering nerve damage affecting one leg, he is completely mobile.
“If you didn’t know what I went through, you’d never know there was anything wrong,” says Jacob. “Every day I wake up thankful to be able to hold my kids.”
He does have restrictions, including a 50-pound weight limit on lifting. He also switched to a light duty/supervisory role at his family-run building restoration and construction company. But Jacob is grateful to be able to enjoy outdoor activities with his children — James, age 3, and Elizabeth, 7 — and tend to the animals on his 6-acre “mini-farm.”
His children, who have a 50/50 chance of inheriting the same genetic mutation, are now taking part in a joint study led by UPMC and UPMC Children’s Hospital of Pittsburgh researchers who are examining the genetic causes of the disease.
Jacob, who describes his care at UPMC Shadyside as “excellent,” says, “I could not have asked for a better experience.
“I’m a man of faith and I put my trust in God. But I believe God sent me to UPMC Shadyside and Dr. Sultan saved my life.”
Dr. Sultan is now monitoring the rest of Jacob’s aorta that will eventually need surgery. “It’s comforting to know Dr. Sultan will be the one performing my next surgery,” says Jacob.
Jacob’s' treatment and results may not be representative of similar cases.