Doctors Put Heart in a Bowl, Remove Tumors
A 57-year-old woman underwent a surgical gamble Tuesday in which doctors temporarily removed her heart, cut out three rapidly growing tumors and returned the repaired organ.
Doctors were cautiously optimistic afterward. Only one other patient has survived the surgery.
Joanne Minnich’s heart rested in a bowl while the team of cardiac surgeons at Methodist DeBakey Heart Center worked on it.
Doctors said the malignant growths, one as large as a lemon, were on the wall of her heart’s left atrium, restricting blood flow, and could have killed Minnich in as little as two weeks if left unchecked.
A heart-lung machine took over the function of Minnich’s diseased heart for the approximately 45 minutes it was out of her body. The team would have had a maximum of six hours, the length of time a heart can survive out of the body.
Surgeon Michael Reardon said a smaller tumor was behind Minnich’s aorta but did not involve the vital artery, which he called “good news” as he spoke to reporters observing the operation.
Reardon performed the procedure, called an autotransplant, successfully in 1999. Two other patients died, in 1983 and 1998.
Doctors had repaired the damaged organ with tissue from a cow’s heart and returned it to Minnich’s body when Reardon discovered a third, even smaller tumor. Surgeons had been aware of only two tumors.
The team again pulled out the heart, removed the last tumor, and reinstalled the organ. “It looks very clean now,” Reardon said.
Reardon sounded a note of caution Monday. “Can I remove the tumor and rebuild the heart? I don’t know,” he said. “I don’t know how much of the heart the tumor has invaded. The possibility exists that when I cut the tumors out, the heart will be so badly damaged I will not be able to reconstruct it.
“The patient knows that.”
Minnich, of Mahopac, N.Y., said the surgery was the only way she had a chance at life. A business manager who has three grown children, she said she learned about Reardon and his procedure on the Internet as she searched desperately for a way to defeat her illness.
“Of course it’s scary, but I have no other choice,” she said. “I don’t have time to wait for a heart transplant.”
Finding a donor heart would likely take five or six months, Reardon said. In addition, Minnich would have to take drugs to suppress her immune system so her body would not reject a new heart, and that would allow the tumors to grow.
She had an operation to remove a tumor in April, but the malignancy recurred.
“She was short of breath a few weeks ago, and by last week she had trouble climbing a stairway,” Reardon said.
Heart malignancy is extremely rare, Reardon said, because most cancers happen in cells that replace themselves regularly, unlike cardiac cells. He said he developed the procedure with famed cardiac surgeon Denton Cooley in 1983.
