Cardiac autotransplantation for malignant or complex primary left-heart tumors
| Autor: | Shanda H, Blackmon, Ashish R, Patel, Brian A, Bruckner, Erik A, Beyer, David C, Rice, Ara A, Vaporciyan, Zbigniew, Wojciechowski, Arlene M, Correa, Michael J, Reardon |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Heart Valve Prosthesis Implantation Male Reoperation Heart Ventricles Cooley Society 15th International Symposium Kaplan-Meier Estimate Middle Aged Combined Modality Therapy Transplantation Autologous Heart Neoplasms Chemotherapy Adjuvant Replantation Antineoplastic Combined Chemotherapy Protocols Heart Transplantation Humans Female Heart Atria Hospital Mortality Follow-Up Studies |
| Zdroj: | Texas Heart Institute journal. 35(3) |
| ISSN: | 0730-2347 |
| Popis: | Malignant or complex benign tumors of the left heart can present a formidable challenge for complete resection, due to anatomic inaccessibility. Cardiac autotransplantation (cardiac explantation, ex-vivo tumor resection, reconstruction, and reimplantation) was introduced for complex benign primary left-heart cardiac tumors by Cooley and for malignant left-heart tumors by Reardon. Herein, we update our previously reported experience.From April 1998 through July 2008, 20 patients underwent 21 cardiac autotransplantations for complex left-sided cardiac tumors that were nonresectable by traditional means. Demographics, tumor histology, operative data, and mortality rates were analyzed. Follow-up was complete in all patients.Of the 20 patients, 17 had malignant lesions, and 3 had benign disease. Two patients had left ventricular lesions and the rest had left atrial lesions. Histology showed 7 malignant fibrous histiocytomas, 5 undifferentiated sarcomas, 3 leiomyosarcomas, 1 malignant osteosarcoma, 1 myxoid sarcoma, 2 paragangliomas, and 1 myxoma. Fourteen patients had previous resection of their cardiac tumors, and 1 patient had repeat autotransplantation for recurrent disease. There were no operative deaths in patients undergoing autotransplantation alone (0/15), and 3 operative deaths in patients undergoing combined cardiac autotransplantation and pneumonectomy (3/6, 50%). All 3 patients with benign disease survived surgery and are alive without recurrent disease. Local recurrence occurred in 3/18 patients with malignant disease: 1 underwent successful repeat autotransplantation and 2 are receiving chemotherapy. The mean survival for all patients with sarcoma is 22 months.Cardiac autotransplantation enables complete resection and accurate reconstruction in many primary malignant and complex benign left-heart tumors. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|