ST. LOUIS - At 85, Karl Abe was active and working nearly full time. A union machinist, his precision work was relied upon by companies big and small.
Despite having two heart attacks earlier in life and a history of congestive heart failure, he had it under control for 20 years with the help of medication, diet changes and his primary care physician.
Late last year, things began to change. Abe began feeling short of breath. His new doctor, Mercy cardiologist Dr. Anthony Sonn, ran some tests and discovered Abe had a severely leaking mitral valve and other heart conditions. Given his age and overall status, he was a very high-risk surgery candidate. Dr. Sonn offered Abe a relatively new procedure, Mitra-Clip, where clips are placed on the heart valve leaflets to improve the leakage problem without the need for open heart surgery.
The third week of March, Abe had the mitral valve clip procedure. Unfortunately, Dr. Sonn recognized that the clip was unlikely to significantly improve Abe’s symptoms.
“Abe had a previously unknown heart deformity – the left side of his heart was so large a clip wouldn’t work,” Dr. Sonn said. “Coming out of the procedure, I was honest with Karl and his daughter Kristi to let them know there were two options left – open heart surgery or go home on hospice.”
The risks were considerable.
“Needless to say, my father doesn’t see age,” Kristi said. “Hospice wasn’t an option for him. He’s a tough guy, a veteran, a member of the Model T Club of St. Louis and so active. He continued working 35 to 37 hours a week until December 2022.”
Enter Mercy cardiothoracic surgeon Dr. Farzin Fotouhi, who evaluated Abe for possible surgery.
“Dr. Fotouhi talked us through what the surgery would entail so we could work with my dad and siblings to weigh the risks involved,” Kristi said. “Ultimately, all of us kids wanted it done, but my dad left the decision up to Dr. Fotouhi.”
Abe fully trusted Dr. Fotouhi, much like Abe’s own customers trust him for his intricate machine work. He told Dr. Fotouhi, “All my children want it done, but you’re the specialist; you have all the facts. I want you to make the decision.”
Dr. Fotouhi told Abe that if he could commit to the recovery, which wouldn’t be easy, he would do the surgery.
On April 27, Abe had the highest level of open-heart surgery, repairing five conditions in one. His mitral valve was replaced, tricuspid repaired, mitral valve clip closed, a slit present since birth that had caused his atrial fibrillation sewn up and the area closed to prevent blood clots.
“His leaky valve condition is not rare, but an operation at his age and in his severe debilitated state and deconditioning carried a very high risk and a nearly 50% chance of not making it through the surgical course,” Dr. Fotouhi said. “Fortunately, with the patient’s determination, the decision was made to proceed with the high-risk surgery.”
Recovery was tough, as expected, but Kristi was amazed as she watched the team work together during her dad’s stay in the hospital – from nurses to doctors, physician assistants, anesthesiologists and urologists.
“I can’t say enough about his care team. There was such genuine concern, and every question I had was answered immediately,” Kristi said. “There was such a warm feeling. People would stop by to check on him. Everyone wanted to see him recover.”
Abe spent a couple weeks at Mercy Rehabilitation Hospital before going home. He then attended cardiac rehab at Mercy St. Louis until he “graduated” from the program. He’s now home, driving and doing everything on his own.
“He has done it all, and his results have been better than anticipated,” Kristi said. “Before the surgery, he could barely walk two car lengths due to his breathing. Now, he’s back to his old self.”
At a recent follow-up visit, Dr. Sonn was impressed, calling Abe a miracle of modern medicine.
“A lot of people counted Mr. Abe out,” Dr. Sonn said. “He is the perfect example of a patient’s determination. You have to take the individual into account. He was very motivated, and Dr. Fotouhi was the perfect surgeon for him.”
Abe knows life has changed. He may not return to full strength, routinely carrying 200-pound pieces of equipment, but he is thankful to have more time and be feeling better.
“We have to realize, mentally, that life does change,” Abe said. “I might not be able to lift hundreds of pounds, but I look forward to getting back to work and working on my Model Ts.”