In Rare Autotransplant Operation, Doctors Remove Tumor From Patient's Heart

Surgeons at the Methodist Heart Center have successfully removed a patient's heart, cut a tumor from it, replaced it, and restarted the organ.

The surgery took place Monday, Oct. 18, at The Methodist Hospital. Dr. Michael Reardon led a team of surgeons in the five and one-half hour procedure, which involved stopping the patient's heart with chemicals and removing a malignant tumor the size of a lemon. The patient, Walter Ward III, 36, of Atlanta, was in intensive care following the surgery. Dr. Reardon said the patient will probably remain in the hospital for at least 10 days.

Mr. Ward is director of public relations for Turner Network Television in Atlanta. Doctors there removed malignant tissue in 1996 when it was discovered, and followed with a course of chemotherapy. Last month, a checkup revealed the tumor had returned.

The procedure is believed to be only the second time the unusual heart transplant has been successfully performed. Dr. Reardon performed a similar operation in April 1998, on Guy Altmann, a 20-year-old college student from Louisiana. Although the surgery was successful, Altmann died three months later of complications from his cancer.

This extremely rare operation was necessary because a tumor was discovered to be attached to a wall of the left atrium inside Ward's heart. If allowed to grow any larger, the tumor could have blocked the flow of blood to the rest of Ward's body.

"The only way to treat a tumor of this kind is to remove it," said Dr. Reardon. Because of its location, the only way for doctors to get at the tumor was to completely remove the heart. With a machine pumping blood through Ward's body, surgeons placed the heart in a bucket of iced saline solution and removed the tumor. They then repaired the hole with bovine pericardium, which is tissue from the sac that surrounds a cow's heart.

In Ward's case, a heart transplant was not an option because the immunosuppression drugs used following a transplant would have interfered with treatment of his cancer. Dr. Reardon said repairing the patient's original heart eliminates the risk of organ rejection and increases his chance for survival.

Dr. Reardon led the surgical team that included: Dr. W. Roy Smythe of The University of Texas M. D. Anderson Cancer Center; Dr. Clement DeFelice, a cardiologist; and Dr. Tony Estraera, a surgical resident.

Speaking a week after the surgery, Dr. Smythe discussed the future course of treatment for Mr. Ward.

"It's not unusual in cardiac sarcoma cases to have some microscopic disease left along the margins where the large tumor was removed," said Dr. Smythe. "That's the case here. Our first order of business will be to treat this with a higher dose of chemotherapy than Mr. Ward was receiving before the surgery. The large tumor was an acute threat to his life, but that threat has been removed and this cancer is relatively slow growing. We're very optimistic."

- STEFANIE ASIN (Additional reporting by Roger Widmeyer)

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