45 years later, heart surgeon extends life of OB who delivered him

(MCT)

SACRAMENTO — On July 7, 1969, a young obstetrician named Dr. Jim Affleck delivered a baby boy named Robert Kincade in the maternity wing of Sutter Memorial Hospital.

More than 45 years later, that baby boy — now Dr. Kincade, a Sutter heart surgeon — performed surgery on the man who brought him into the world.

Their connection could have gone unnoticed.

Affleck, who retired in 1995 after 33 years at Sutter, was introduced to Kincade, one of his two heart surgeons, prior to his September procedure. Kincade, learning of Affleck's lengthy obstetrics career at Sutter, mentioned that he was born in the same hospital. Curious about the coincidence, Kincade went home and dug out his birth certificate. There in the bottom right corner was Dr. Affleck's signature.

"I, of course, didn't remember it," said Affleck, 83, who figures he delivered between 3,000 and 4,000 infants during his three decades at Sutter. "But I think that it's come full circle."

In September, Dr. Kincade was one of two Sutter cardiovascular surgeons who inserted a new aortic valve in Affleck's chest using a minimally invasive procedure. The valve, which acquired U.S. Food and Drug Administration approval just this June, is small enough to be inserted through an artery in the groin and situated in the aorta. It avoids having to open up the chest cavity, a particularly risky procedure for older patients.

"It's amazing to be able to offer this to people," Kincade said. "And it's great to help (Affleck) out, because he really helped me out 45 years ago."

Nearly 350,000 babies have been born at Sutter Memorial, often called "Sacramento's baby hospital," since it opened in 1937. Affleck delivered about 1 percent of those babies. Since retiring as a Sutter obstetrician, Affleck said he sometimes misses his career, but not "getting up in the middle of the night" to rush to the hospital.

Affleck has had a history of heart ailments and underwent heart bypass surgery when he was in his 50s. About a year ago, he began experiencing shortness of breath. He said it became urgent while on an Alaskan cruise in August 2013 with Donna, his wife of 62 years. Affleck's heart was so constrained that he almost fainted while trying to climb three flights of stairs for the ship's fire drill.

Shortly after, he set up an appointment with Dr. David Roberts, medical director of the Sutter Heart & Vascular Institute, who recommended that a new heart valve be inserted percutaneously, through a blood vessel. The valve available at the time was too large for Affleck's arteries, Roberts said, so they decided to wait until the FDA approved the smaller size.

Roberts, who performed the valve insertion with Dr. Kincade, estimates that Affleck would have had at most two more years of life if not for the procedure, and that those years would have become increasingly difficult due to his compromised blood flow.

The new heart valve, officially called the Edwards Sapien XT Transcatheter Heart Valve, is about the size of a pencil eraser when it's inserted through the femoral artery, said Roberts. Surgeons use a balloon catheter to push the valve up through the blood vessels and into the aorta, where it expands to its full one-inch width.

During the expansion, surgeons use a defibrillator to speed the heart up to about 180 beats per minute for about 20 seconds. They then remove the catheter and slow the heart down again. Once in place, the device functions as a heart valve normally would, opening and closing to help blood flow in the right direction.

The procedure is much safer and less painful for older patients and has a shorter recovery time, Roberts said.

Affleck's procedure was the 100th transcatheter aortic valve replacement performed at Sutter Memorial Hospital since surgeons there began offering the technique in 2012.

At a recent checkup, Roberts and Kincade reported that Affleck is recovering well. Both surgeons said their patient is breathing better, walking better and the color has returned to his face. Kincade said the new valve, made of bovine tissue, will keep Affleck "good for another 20,000 miles."

In January, the Afflecks, who have three children, five grandchildren and two great-grandchildren, say they'll be vacationing in Hawaii.

Affleck, who turned 84 on Halloween, said, "I feel like a new person."

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