Craig Nickelbein: Bypass Graft Aneurysm

At the Minneapolis Heart Institute Foundation’s Center for Coronary Artery Disease (MHIF CCAD), our team of world-class research physicians strive every day to “make the impossible possible” and provide lifesaving options for patients who otherwise might not have them. For Craig Nickelbein of southeastern Wisconsin, he finally found the expertise and hope for his condition that had continually proved elusive when he met Dr. Emmanouil (Manos) Brilakis, a Minneapolis Heart Institute® cardiologist who serves as chairman of MHIF CCAD.

Craig, 78, had previously undergone coronary artery bypass graft surgery and thought his heart was doing well. However, in late 2019, he was surprised to learn that he had developed a rare aneurysm (an abnormal bulge) on one of his bypass grafts. In 2018 the aneurysm hadn’t even appeared on a CT scan, but by June 2020, his heart was functioning at only 40 percent. By July it decreased to 15 to 20 percent. Four different cardiologists told him it was too risky to operate on his heart and that his chances at surviving a surgical procedure were unlikely.

“I can’t tell you just what a weight on my shoulders that aneurysm was … how fast it was growing,” said Craig. “And all four cardiology groups said, “You’re high risk. There’s just absolutely no two ways about it. Short-term is okay, but long-term is not so much.” I said, ‘What is short-term? Define short term.’ One doctor said, ‘Well, it could rupture tomorrow.’ I didn’t like to hear that.”

Craig continued his quest to find a doctor like Dr. Brilakis, a nationally known expert who leads a large clinical research group continually studying advanced treatment options for complex coronary artery cases, including cases of a bypass graft aneurysm like Craig’s. Unfortunately, he experienced another heart attack in October, but as luck would have it, Craig ended up seeing a cardiologist in the hospital who had previously studied under Dr. Brilakis.

“The doctor said, ‘The only way you’re going to fix this is with a procedure where they open up the native artery, reattach it and the bypass graft goes away,’” said Craig. “He said, ‘I can do that. I’ve been doing it for about seven to 10 years, but if you want the best of the best, you’ll see this man in Minneapolis by the name of Brilakis.”

Craig talked to Dr. Brilakis over the phone and was encouraged, but decided to get the opinion of one more cardiologist closer to home. The doctor’s answer was the same. “He said, ‘Craig, this thing is too large and it’s too fast growing and there’s not much we can do. Dr. Brilakis in Minneapolis … he’s the only guy in the country that can help you. He’s fantastic. He is so good and is known internationally.’ And I thought, “Well, now I’ve got two guys that are saying that this Brilakis is a great guy.’”

After talking with Dr. Brilakis on the phone Craig learned that it would indeed be a complex, difficult and long procedure, but Craig felt hopeful and got scheduled for the surgery in late February 2021.

“As we were starting our trip up to Minneapolis, I was thinking to myself, ‘I’m excited about going there,’” said Craig. “I was not afraid of dying on the table; I was just fearful that he wasn’t going to be able to fix this thing, because it was going to be too big.”

Dr. Brilakis successfully performed a technically advanced procedure. The native coronary artery was opened, followed by occlusion of the aneurysmal vein graft with coils. Just a couple weeks after surgery, Craig was feeling grateful and better by the day.

“All the staff spoke of Dr. Brilakis,” said Craig. “There was not one person who didn’t say he was great and the best thing about him is he’s so patient and humble. So, I was excited. I wanted to get this thing over with and by God he did it.”

He continued, “My wife Carla said that she knew the procedure was a success when she first saw Dr. Brilakis come into the room because he had such a big smile on his face,” said Craig. “He told her, ‘I got ‘er done. I got it done right. I’m so relieved. I’m so happy.’ I didn’t hear that until a little later, of course, but I thought, ‘Now there’s another humble pie story.’”

Looking to the future, Craig said, “It’s nice to know that basically I have a new lease on life for a little while … who knows how long you’re going to be on this earth … but I don’t have that large aneurysm over my head anymore. Having peace of mind, is the thing I’m looking forward to.”