When John Sauter’s doctor told him that his heart could burst on a long-distance bike ride, he knew it was time to get help.

An active cyclist for most of his life, Sauter had started getting lightheaded and feeling dizzy on some of his rides. When he mentioned it during a routine physical, his primary care physician recommended that he be evaluated for aortic stenosis, a narrowing of the valve in the large blood vessel branching off of the heart.

“He nailed it,” says Sauter.

As it turned out, Sauter’s aortic stenosis was a symptom of a larger problem. He was born with a bicuspid, or two-valve, aorta. Normally, an aortic valve has three small flaps that regulate blood flow from the heart to the aorta. Those with a bicuspid aorta have only two flaps. The valve doesn’t function perfectly, but someone could go years without symptoms. “Bicuspid aortas are almost destined to fail eventually,” he says. “And mine did fail.”

The most pressing need Sauter faced was that his ascending aorta was dilating—meaning it was going to burst. If he wanted to keep up his active lifestyle, he’d need surgery.

An old college classmate of Sauter’s was also born with a bicuspid aorta, and he underwent a complicated surgery. “My friend said, ‘John, you have to get the best care you can, especially with that dilated ascending aorta,’” Sauter recalls.

Sauter checked out some of the hospitals near his home in Reston, Virginia, and thought they looked good. But when he came to Johns Hopkins in summer 2012 for a consultation, a young cardiologist told Sauter, “Dr. Cameron can do these complicated surgeries in his sleep.” That sealed the deal for him.

It took two years and four surgeries to get Sauter fully back on his feet. His daughter, Dawn Regan, was by his side the entire time. “She was my No. 1 angel throughout the whole thing,” he says.

To thank his care team, which included Duke Cameron, chief of cardiac surgery, cardiac surgeon Christopher Sciortino and several nurses, Sauter returned to Baltimore with Dawn over a prearranged celebratory lunch. “I owe my life to them,” he says. “I don’t have confidence I could have survived hardly any place else. That’s why I feel obligated to support them.”

Sauter started out making a small donation. Now, he sends in contributions several times a year and named the Heart and Vascular Institute as a beneficiary in his will. Dawn made a donation as well.

With his fully healed heart, Sauter recently took his granddaughter on a 62-mile bike ride on an old tandem bike, and he completed another 62-mile ride by himself. And not once since the surgeries, he notes, has he experienced shortness of breath or heart symptoms.

Sauter also spends his time volunteering for his alma mater and former employer, Knox College, in Illinois, through alumni events in the Washington metro area. “Knox College has my heart, but Hopkins saved it,” he says.