Cardiac Explantation and Autotransplantation

Wagner, Schelley; Hutchisson, Bettyann; Baird, M. Ginny

doi:10.1016/s0001-2092(06)61861-9

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…The extent of the approach depends on the tumor growth and the necessary exposure. Apart from requiring more surgical skills the risk is quite acceptable [14,15].…”

Section: Discussionmentioning

confidence: 99%

Radical Resection of Cardiac Sarcoma

Hoffmeier

Deiters²,

Schmidt³

et al. 2004

Thorac cardiovasc Surg

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We report on our experience with six patients with malignant sarcoma of the heart and show that long-term survival is possible after radical resection. At presentation, the 6 patients (3 male, 3 female) were 45.8 +/- 20 years old. Three patients are alive without evidence of metastases since 29.6 +/- 36.8 months, three patients died after 38 +/- 50.2 months due to distant metastases. Precise preoperative localization of the tumor by means of imaging techniques is very important. In some cases, radical surgery requires an ex situ procedure (autotransplantation). If necessary, the right heart can be resected almost completely, and reconstructed in the form of a Fontan-type circulation. A heart transplantation, as suggested by others, is not justified from our point of view, since prognosis is not better and donor organs are too rare. The results of radical resection are promising, but new concepts for treatment--in particular chemotherapy concepts--for these mostly middle-aged or young patients are required.

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“…The extent of the approach depends on the tumor growth and the necessary exposure. Apart from requiring more surgical skills the risk is quite acceptable [14,15].…”

Section: Discussionmentioning

confidence: 99%

Radical Resection of Cardiac Sarcoma

Hoffmeier

Deiters²,

Schmidt³

et al. 2004

Thorac cardiovasc Surg

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Untitled

et al. 2002

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This report describes the case of a 16-year-old boy who underwent surgical treatment of a cardiac malignant fibrous histiocytoma (MFH). He was admitted to our hospital for exertional dyspnea. An ultracardiogram (UCG) revealed a tumor about 10cm in diameter, in the left atrium. Extirpation of the left atrial tumor, including the part extending into the pulmonary veins, was performed under cardiopulmonary bypass. Histological examination confirmed a diagnosis of MFH. No adjuvant chemotherapy or radiotherapy was given. While there has been no evidence of local recurrence or metastasis in the 9 months since his operation, strict follow-up is being done by UCG and computed tomography. A few reviews of this entity have been reported; however, they have confused autopsy cases with surgical cases. Therefore, we reviewed only the surgical cases of this type of cardiac tumor documented in the literature. According to our review of the literature, this patient is the youngest among the 42 cases of surgically treated cardiac MFH reported to date.

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Cardiac Autotransplantation for Removal of Left Atrial Hemangioma and a Review of the Literature

Novitzky¹,

Guglin²,

Sheffield³

2009

The Heart Surgery Forum

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We describe the management of a patient who presented with symptoms of severe congestive heart failure. A 48-year-old man was initially seen in the emergency room, admitted to the hospital, and worked up with a transthoracic echocardiogram, a transesophageal echocardiogram, and a computer tomography scan of the chest. All cardiac valves were normal, as was the left ventricular ejection fraction. A mobile left atrial tumor measuring 6 x 4 x 5 cm was found attached to the left atrial dome, left atrial cuff, and left pulmonary veins. With each systolic atrial contraction, the mass prolapsed into the left ventricle across the mitral valve annulus, inducing a gradient of 19 mm Hg. The workup of the patient was negative for malignancy. The only feasible therapy for this patient was to excise the mass on cardiopulmonary bypass and cardioplegic arrest. At the time of surgery, the findings confirmed that the mass was attached broadly to the left atrial dome wall-epicardium, and the attachments were similar to those of the transesophageal echocardiographic findings. Atrial attachments extended from the base of the heart, along the atrioventricular groove, the left dome of the left atrium, the left atrial cuff, and the anterior aspect of both left pulmonary veins. The tumor could not be adequately excised, and reconstruction of the defect was not feasible with the heart in situ. We therefore decided to explant the heart and excise the tumor with a 0.5-cm margin of healthy tissue. The broad left atrial defect was reconstructed with bovine pericardium. The reconstruction encompassed the dome of the left atrium, the left atrial cuff, and the pulmonary veins. The heart was reimplanted back into the pericardial cavity. The superior vena cava with the retained sinus node was also anastomosed. The pathology diagnosis was a benign cavernous hemangioma. The sinus rhythm recovered following removal of the aortic cross-clamp and reperfusion of the heart. The patient had a rapid recovery and was discharged home on the 12th postoperative day. Placement of a pacemaker was not required because the patient retained the sinus rhythm. A review of the literature on cardiac autotransplantation revealed that this type of surgery has been performed frequently in centers that have a cardiac transplantation program or a surgeon who has cardiac transplantation experience. To our knowledge, this report is the first of cardiac autotransplantation for benign hemangioma.

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Cardiac Explantation and Autotransplantation

Cited by 3 publications

References 7 publications

Radical Resection of Cardiac Sarcoma

Radical Resection of Cardiac Sarcoma

Untitled

Cardiac Autotransplantation for Removal of Left Atrial Hemangioma and a Review of the Literature

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