Featuring: Ankit Bharat, MD, Jonathan D. Rich, MD
On November 3, 2021, Northwestern Medicine surgeons successfully performed the health system’s first combined heart and double-lung transplant.
The transplant recipient, Brittani Bury, 31, was born with total anomalous pulmonary venous return (TAPVR), an extremely rare condition that left her with five congenital heart defects and two congenital lung defects. Bury had numerous open-heart surgeries throughout her life, ultimately knowing she would one day require both a heart transplant and a double-lung transplant.
Over time, the blood vessels that connected Bury’s heart and lungs narrowed, and pressure inside her lungs was building up, causing ongoing damage and shortness of breath. In September 2020, Bury was placed on the organ transplant waiting list. Six months later, her conditioned worsened futher. Her organs were failing, and she was admitted to Northwestern Memorial Hospital in March 2021.
"All the veins draining blood and carrying oxygen from Brittani's lungs back to her heart were blocked, so the pressure inside her lungs got very high, which caused her heart to fail. Also, because the oxygen carrying blood couldn't get back to the heart, her body was severely lacking oxygen and slowly failing," says Ankit Bharat, MD, chief of Thoracic Surgery at Northwestern Medicine.
The rarity of this type of surgery posed a challenge. Less than 1% of all transplants performed in the U.S. are for a heart and both lungs. But as Bury’s health declined, the heart and lung transplant teams at NM pulled together.
“Her quality of life was deteriorating rapidly,” says Jonathan Rich, MD, heart transplant cardiologist, who is Bury’s cardiologist and a leading advocate for her transplant. “We knew she needed a transplant.”
When the right heart and lungs became available in November, the surgical transplant team was ready.
“It’s remarkable that we can perform a double-lung/heart transplant because it’s the entire replacement of the ‘engine of the body,’” says Ankit Bharat, MD, chief of Thoracic Surgery at Northwestern Medicine.
Dr. Bharat and team spent 12 hours in the operating room performing Bury’s transplant.
“After we started her (new) heart and the lungs, her whole body started to change color. It was much pinker; even her face seemed happier,” says Dr. Bharat.
Immediately following surgery, Bury went into the ICU. Soon after, she was able to come off the ventilator and begin her recovery.
Dr. Rich says Bury was approaching death awaiting the transplant, but she is now fully functioning and reunited with her family. “It's not only a privilege to take care of these patients, the reward for helping make people better is helping make people better,” he says. “There’s no better feeling in the world. I’m so glad to be a small part of this incredible team who made it happen for Brittani, and we can’t wait to make this happen for more patients going forward.”
Bury, who spent more than 200 days at Northwestern Memorial Hospital, was discharged on December 23, 2021, just in time for the holidays. Her story and lifelong journey to this milestone has received national media attention.
“This pandemic broke our morale because we saw a lot of people die in front of our eyes, despite our skills and best effort,” says Dr. Bharat. “To be able to help someone as sick as Brittani who was on the brink of death and at the height of the pandemic, find the right donor, perform a most challenging operation, and get her back to her family before Christmas… That inspires us to continue to fight for our patients and not give up hope.”
This article was originally published in the Northwestern Medicine's Medical Staff Minute in February, 2022.
Ankit Bharat, MD, is the chief of Thoracic Surgery in the Department of Surgery, Harold L. and Margaret N. Method Research Professor of Surgery and associate professor of Surgery (Thoracic Surgery) and Medicine (Pulmonary and Critical Care). Dr. Bharat specializes in malignant and benign chest and esophageal diseases. His research focuses on lung preservation, transplant immunology and airway biology, achieved through collaboration with the Kovler Comprehensive Transplant Center and the Division of Pulmonary and Critical Care Medicine.
Jonathan D. Rich, MD, is an associate professor of Medicine at the Northwestern University Feinberg School of Medicine. He serves as the Medical Director of the Mechanical Circulatory Support Program, as well as the Program Director of the Advanced Heart Failure and Transplant Fellowship Program at Northwestern Memorial Hospital in Chicago.
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