Surgeons use breast implants during double-lung transplant

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Key takeaways:

• A 34-year-old man needed a double-lung transplant after a month-long infection.
• Doctors placed DD breast implants in the man’s chest cavity to support his heart while his body cleared the infection.

Surgeons used breast implants to hold a man’s heart in place during a double-lung transplant after he was diagnosed with a potentially fatal infection after years of smoking and vaping.

The surgical team at Northwestern Medicine removed 34-year-old David Bauer’s lungs after influenza and a secondary infection severely damaged them, which required the surgical team to create an artificial lung to keep him alive and place DD breast implants in his chest cavity to hold his heart in place.

Using a combination of new technology and quick thinking, the doctors said Wednesday that the success of Bauer’s procedure may help other patients with acute lung infection in need of a lung transplant.

“This innovative procedure now can allow us to help patients who need lung transplants but are too sick to immediately undergo that procedure,” Ankit Bharat, MD, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute, said during a press conference. “Taking the lungs out [and] supporting the body while the body recovers from the bad infection could help create a path for many patients who are otherwise quite sick.”

Bauer, who works in landscaping and hardscaping, smoked a pack of cigarettes a day from age 21 years until switching to vaping in 2014. He started to experience shortness of breath in April, and went to an urgent care center, where he was diagnosed with influenza and “a little bit of pneumonia” — which turned out to be a drug-resistant infection.

In May, when his condition had worsened and he was having trouble walking, Bauer’s girlfriend, Susan Gore, took him to an ED in St. Louis. He was admitted to the hospital and placed on extracorporeal membrane oxygenation, but his condition continued to worsen. Rade Tomic, MD, a pulmonologist and medical director of the Northwestern Medicine Canning Thoracic Institute lung transplant program, said that when doctors from St. Louis called, Bauer’s lungs had “started to liquify. If you looked at his X-ray, there was nothing left — the lungs were completely filled with pus.”

Doctors at Northwestern were confident they could help Bauer, but were unsure he could survive the transplant without the growing infection being cleared. In addition to the infection, Bauer’s heart also stopped at least once, and he had to be revived.

“It was clear to us that something had to be done,” Bharat said of the strategy to clear the infections in his lungs and chest cavity. The surgical team created an artificial lung to keep his heart pumping and keep him alive.

“Once we took the lungs out, we realized that now we’ve got to support the heart,” Bharat said. “That’s where some of the innovative thinking came about. We were looking for the biggest thing that will fit in there in his chest cavity, and he has big chest cavities, and hence the double-D implants.”

Within 24 hours of listing him for a transplant, surgeons received an offer and were able to implant the lungs in Bauer, who has fully recovered from the procedure.

“Despite his heart stopping, we were able to get him back … and then soon after we listed him, we found a perfect match,” Bharat said. “So, you know, a lot of stars aligned, and clearly he was very lucky.”

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