FARGO — Fargo-Moorhead RedHawks pitcher Gage Hinsz has about an eight-inch scar on his sternum from a surgery the 25-year-old had three years ago.

Less than a month after his 22nd birthday, he had heart surgery to repair a leaky aortic valve on May 8, 2018.

“It wasn’t really a matter of playing at that point,” said Hinsz, from Billings, Montana. “It was a life decision type of thing.”

About a year after heart surgery, Hinsz had another health setback as he was resuming his pro baseball career. The right-handed starter had Tommy John surgery on July 3, 2019, to repair his throwing elbow.

“It’s obviously been tough because the past few years there hasn’t been a full focus on baseball, it’s been getting healthy,” said Hinsz, who the Pittsburgh Pirates selected in the 11th round of the 2014 Major League Baseball amateur draft.

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Hinsz has a 1-2 record with a 7.71 ERA in his four starts with the RedHawks this season. F-M is in first place in the American Association North Division entering Tuesday night’s game against the Milwaukee Milkmen at Newman Outdoor Field.

“We know he has the tools to succeed,” RedHawks manager Chris Coste said. “It’s just a matter of continuing to build up the endurance for him.”

Three years removed from open heart surgery and nearly two years removed from Tommy John surgery, Hinsz said he’s working his way back to full strength after pitching only 25 innings over 2018, 2019 and 2020.

“It’s definitely been nice to play again. I couldn’t be more thankful for the RedHawks giving me the opportunity to come back and play,” he said. “Other than working through some of the bugs with having a new elbow, my arm feels as good as it ever has. … I feel like there is just as much in the tank as in the past. It’s just a matter of building back up and getting to that point.”

The 6-foot-2, 222-pound Hinsz said coming back from the Tommy John surgery has been more challenging than bouncing back from the heart procedure. He still gets yearly checkups for his heart.

“I would say the arm,” Hinsz said on what took longer to recover. “The heart surgery, that was going to take time, that’s something that had to happen.”

Prior to the 2015 season, a routine physical with the Pirates is when Hinsz learned he had a heart murmur. After that, he had annual checkups to monitor his heart. A 2018 checkup revealed the valve leak had worsened.

“Luckily, I was getting physicals every year so we knew something was wrong,” Hinsz said. “We knew that I had a leaky valve. It just got to the point where it was time for surgery.”

After a successful surgery, Hinsz said he spent one night in the intensive care unit and a few nights in the hospital before he returned to Billings. Dr. Lars Svennson performed the surgery at the Cleveland Clinic.

“Recovery wasn’t bad,” said Hinsz, who wasn’t allowed to carry anything heavier than a carton of milk for four to six weeks after the surgery. “It was a slow gradual buildup.”

Hinsz said he started throwing again about 6 to 9 weeks after the surgery and played winter ball in Puerto Rico that following fall, pitching 25 innings. He returned home before Christmas in 2018.

“I just wanted to go home and be with the family, especially that year,” he said.

Hinsz said he is grateful for the support he’s received from family, friends and teammates over the past few years. Some of his friends set up a GoFundMe to help pay for his medical expenses.

“I couldn’t be more thankful for all of them helping out,” he said.

Hinsz said he was having a good 2019 spring training when something in his elbow didn’t feel right as he broke camp with the Pirates Class Double-A affiliate. He tried to rehab the injury for several months before having Tommy John surgery that July.

“We’re headed in a good direction right now,” Hinsz said of this season with the RedHawks. “The first several outings it was making sure I was taking care of my arm. … I feel like I finally got that nailed down.”

Hinsz, who went to Billings West High School, played American Legion baseball for the Billings Scarlets prior to being drafted since Montana doesn’t have prep baseball. Away from the baseball diamond, he likes to work on older vehicles and hunt. One of his favorite vehicles is a 1971 Plymouth Barracuda.

“It’s green at the moment with a little bit of rust,” Hinsz said with a laugh. “It’s not quite running yet, it’s pretty close. I like getting them mechanically as sound as possible.”