Troubles of the Heart: Aortic Dissection, Aortic Aneurysm and Arterial Occlusion

A Survivor's Rare Story

When Austin, Texas-based manufacturing team manager Ta-Gheng Wang, 65, experienced chest pain at work, he assumed it was nothing to worry about and that it would pass. No one expected his pain to set off a series of events that took him to two different countries and multiple cities before being fortunate enough to end up at Memorial Hermann Health System in Houston for three complex and lifesaving cardiac surgical procedures.

Over a period of about 18 months, Wang underwent endovascular aortic dissection repair, aortic aneurysm repair and double coronary bypass. This “cocktail” of surgical procedures required a specialized team that began treating Wang at Memorial Hermann Greater Heights Hospital before he was transferred for a higher level of care at Memorial Hermann-Texas Medical Center (TMC). Here, a team of renowned heart and vascular specialists collaborated, each delivering their unique piece of the health care puzzle, to correctly identify his condition and perform the procedures he needed to not only survive but to return to a full, active life.

Chest Pain on the Job

Wang was assigned to lead a team of manufacturing employees on a project in Juarez, Mexico, as a manager for a large electronics company located in Austin, Texas. While onsite in Mexico, he began feeling discomfort in his chest, followed by crushing pain in the chest, abdomen and between the shoulder blades and numbness in his legs. He was worried and made a call to his sister back in the United States looking for reassurance. What he got instead was some big-sister nagging, and Wang finally agreed to visit the local Juarez hospital where he was told all would be well if he just went home and got some rest. That misdiagnosis nearly cost him his life.

Not long after, Wang was taken across the border to a hospital in El Paso, Texas. The emergency medicine physician evaluated him and quickly determined the hospital staff lacked the training and experience to provide the critical care he needed. “The doctor told me my brother could die anytime,” said Florence Wang, his sister and English-language interpreter. “She said his heart was too big with many aneurysms and it had a large tear in the main aorta.”  Wang was transported via airplane to Memorial Hermann Greater Heights Hospital, where the team he needed was waiting.

A Trio of Heart Surgeries

Upon arriving in Houston, Wang was evaluated by Kourosh Keyhani, DO, a UTHealth Houston Heart & Vascular surgeon affiliated with Memorial Hermann, who confirmed the diagnosis of aortic dissection and multiple aortic aneurysms. The aorta is the largest artery in the body; it delivers blood to the organs and tissue and runs from the lower section of the heart downward through the chest and into the abdomen. With an aortic aneurysm, a balloon-like bulge forms on the aorta that is at risk of rupture. Aortic dissection is a life-threatening condition that occurs when the inner lining of the aorta tears apart.

Initially, Wang’s heart was too weak for immediate surgical intervention. “The aortic dissection had decreased the blood flow to the other organs, so we needed conditions to improve before we could proceed,” said Dr. Keyhani. “We don’t work on an artery in that condition unless absolutely necessary because of the risk of additional tearing and possible migration toward the heart which patients generally cannot survive.”

Wang spent a week in the intensive care unit (ICU), where his care was managed by Philip Haas, DO, a UTHealth Houston Heart & Vascular interventional cardiologist affiliated with Memorial Hermann, who treated Wang’s hypertension to ensure the heart would be healthy enough for the essential surgery. At the end of the week, his condition was stabilized, and he was ready for the first procedure. Dr. Keyhani performed thoracic endovascular aortic repair (TEVAR), a minimally invasive procedure that positioned a stent graft in the aorta to repair the tear. After Wang recovered, he returned to Houston for a second procedure to repair the aortic aneurysms.

Even after two heart procedures, Wang’s troubles were not over. During a follow-up exam, Dr. Haas performed a transesophageal echocardiogram, stress test and cardiac CT exam that revealed significant blockage in the coronary arteries. “Once we identified multivessel coronary disease, we got Mr. Wang into the hands of Dr. Anthony Estrera,” said Dr. Haas. “The entire aorta down the abdomen was enlarged and very few cardiothoracic surgeons are skilled enough to handle this type of complicated case. We knew Dr. Estrera was the one to do it.”

Anthony Estrera, MD, a UTHealth Houston Heart & Vascular cardiothoracic and vascular surgeon affiliated with Memorial Hermann, and co-chair of UTHealth Houston Heart & Vascular, “basically rebuilt my brother’s heart and aorta,” according to Mr. Wang’s sister, Florence. During the multihour, open-heart surgery on Memorial Day 2024, Dr. Estrera performed a double bypass to remove the blockages, repaired the ascending aorta and aortic root, and rebuilt a heart valve. Finally, Wang was on the road to recovery.

Lifesaving Teamwork: Comprehensive Heart and Vascular Care

“Any complicated cardiovascular condition needs care from a comprehensive team,” said Dr. Estrera. “These situations are very complex, involving multiple organ systems because the aorta is the main conduit supplying blood to the body, so it requires many different medical specialties. We all work together to care for these patients.”

Memorial Hermann Heart and Vascular’s program exemplifies the team approach to positive patient outcomes.  Memorial Hermann’s international reputation for exceptional care brought Wang into the system from West Texas, and after identifying his unique needs, affiliated physicians managed his care between Memorial Hermann Greater Heights and Memorial Hermann-TMC to put him in the hands of the interdisciplinary team that restored his health.

Looking Ahead with Heartfelt Gratitude

Today, Wang is back in Austin and back at work. He is focused on long-term recovery and enjoys taking walks through the neighborhood with his wife and spending time with their adult children. He feels better than he has in years and expressed deep appreciation for the medical care he received. His sister, Florence, translated his words to Dr. Estrera during a follow-up appointment, “I appreciate you so much from the bottom of my heart, the new heart you built for me.”