MOON, Pa. Pennsylvania Lt. Gov. John Fetterman won the Democratic primary for Pennsylvanias open U.S. Senate seat on Tuesday, kicking off a general-election battle that could determine control of the U.S. Senate.

Fetterman, a former mayor known for his towering height, bald head and casual attire, defeated Rep. Conor Lamb and state Rep. Malcolm Kenyatta for his partys nomination.

His victory is a triumph of personal branding, populist messaging and ideological flexibility over the power of the states Democratic elected officials and party leaders, who largely favored Lamb.

Fetterman also overcame a last-minute medical event. He suffered a stroke on Friday, sidelining him in the hospital for the final days of the campaign.

Fetterman seems to be able to communicate to both sides of the political aisle, said Joseph DiSarro, a political science professor at Washington and Jefferson College. This is a setback for the regular Democratic establishment.

Fetterman, who underwent surgery on Tuesday to have a pacemaker with a defibrillator inserted, was not present at an election-night results party at a hotel at the Pittsburgh airport. The campaign set up a row of poster-size get well cards on easels alongside one wall for Fetterman supporters to sign.

Fettermans wife, Gisele Barreto Fetterman, accepted the nomination on his behalf and was a hit with the crowd of over 100 people.

You may have noticed, I am not John Fetterman, she said, prompting laughs from the crowd.

Barreto Fetterman went on to describe how she wrote to Fetterman to express interest in working with him after reading about his work as mayor of Braddock, a small and struggling satellite of Pittsburgh. They fell in love and had three children together in Braddock.

Its not just that John looks nothing like a politician and is deliriously handsome, Barreto Fetterman joked. Its because John doesnt act like one.

At heart, hes still that hardworking, scrappy, small-town mayor, she continued. He wants to know the people hes serving. He feels a responsibility to each and every one of them. And he fights for people like hed fight for a neighbor and hed fight for his family.

When Barreto Fetterman was done speaking, a brief clip of Fetterman thanking the crowd from his hospital room appeared on screen.

Thank you so much for everything! he said.