COLUMBUS, OH

2/25/05

A team of doctors successfully performed the first heart-lung transplant at the Ohio State's Ross Heart Hospital on February 9. Doctors say the patient, Michelle Vulhop, 33, is doing well and her condition continues to improve.

"We consider this a feather in our cap," said Dr. Patrick Ross, surgical director of lung transplantation in the division of cardiothoracic surgery. "We now offer the full range of thoracic transplant options."

Dr. Benjamin Sun, the new chief of cardiothoracic surgery, had performed six heart-lung transplants before and led the successful operation on Vulhop, who waited six years for the transplant.

"It's a privilege to be able to participate in such a life-giving operation," Sun said.

Dr. David Feldman, director of heart failure and cardiac transplantation, and Dr. Amy Loren Pope-Harmon, a pulmonary expert, were also primary figures in the surgery.

"We couldn't have asked for a better team to do this," Ross said.

Sun said Vulhop is recovering and continuously improving.

"She's still on a ventilator, but her heart looks wonderful," he said. "It's beating beautifully."

Vulhop suffered from a congenital heart defect known as double outlet right ventricle.

There are two parts to the heart - the part that usually pumps to the lungs and the chamber that pumps to the rest of the body, Ross said. He added that both of Vulhop's outlet valves came out of one chamber.

"She had a corrective surgery as a child but the unfortunate natural history of that disease is heart failure," he said. "Her heart was failing, and as a consequence, her lungs became frail."

Heart-lung combination operations are less common, but Vulhop's disease mandated the replacement of both types of organs, Ross said. However, the team was well-prepared because they perform similar operations regularly, he said.

Sun said heart-lung transplants are straightforward operations, but require a great deal of technical planning. Since the operation was the first attempt at a heart-lung transplant at the Ross Heart Hospital, multiple discussions were held between the heart transplant and lung transplant groups to determine if it was appropriate.

Many different conditions had to be met prior to the operation, such as determining if the organs were from a correct donor and verifying that Vulhop qualified as a good transplant candidate, Sun said.

Other challenges included establishing and organizing the collaborative team, he said.

The transplant groups also discussed the procedure with Vulhop and told her this would be the first time a heart-lung transplant would be performed at the university, allowing her to decide on the surgery independently, Sun said.

Vulhop decided to undergo the procedure at OSU rather than travel to Cleveland or elsewhere for the service.

She was very comfortable with the way her surgery was managed and she expressed her trust in the groups, Sun said.

"We had the strength of her to support us," he said.

Ross said the operation went without complications and was carried out smoothly.

Life expectancy values are highly variable and Vulhop's overall experience is too specific to predict, Sun said. He added that he is cautiously optimistic, but Vulhop's situation is better than average because of her age.

Sun said the Ross Heart Hospital is a very special place to be, and whereas doctors at other institutions would draw a line between different disciplines there is a sense of collaboration at the heart hospital that is unique.

"We have an extraordinarily collaborative group among cardiology, pulmonary, cardiovascular and surgery," he said.