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| Vol. 22, No. 22 |
| December 1, 2000 |
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Rare Heart Surgery Saves Life of New York Woman By DENNY ANGELLE The Methodist Health Care System
When doctors in her home state of New York offered Joanne Minnich, 57, a heart transplant, her family believed it would not be the cure for her rare condition. Minnich had a cancerous tumor the size of a lemon growing on the wall of the left atrium inside her heart. Every time her heart beat, the tumor threatened to obstruct blood flow to the rest of her body. Because the tumor was growing so rapidly, Mrs. Minnich's family felt she would not have survived the long wait for a transplant heart. Unsatisfied with the prognosis of local physicians, the Minnich family searched the internet for an alternative treatment. That's where they found Dr. Michael Reardon, a surgeon at the Methodist DeBakey Heart Center and a professor of surgery at Baylor College of Medicine. On Nov. 14, Dr. Reardon performed a unique surgical procedure called an autotransplant on Joanne Minnich. He removed her heart, cut out three malignant tumors and repaired the heart with parts from a cow, then successfully reimplanted the organ. It is thought to be only the third time such a procedure has been successfully performed. Dr. Reardon performed similar surgeries in 1998 and 1999 at The Methodist Hospital. In the days after her surgery, Mrs. Minnich continued to recover and was released from The Methodist Hospital approximately two weeks after her surgery. She will spend an additional two weeks in Houston for follow-up care, and should return home to New York in time for Christmas. Mrs. Minnich felt well enough to meet local and national news media at a press conference Nov. 21. "I feel a whole lot better than when I came in here," she said. "I can breathe a lot more easily." During the news conference, she continually held her husband's hand. They said they are looking forward to picking raspberries and making jam in the spring. "Our Thanksgiving has already occurred," William Minnich said, squeezing his wife's hand. During the seven-hour operation, Dr. Reardon and a team of five physicians stopped the patient's heart with chemicals, then removed her heart. With a machine pumping blood through Mrs. Minnich's body, Dr. Reardon placed the heart in a bucket of iced saline solution and removed the tumor. He then repaired the heart walls with bovine pericardium, which is tissue from the sac that surrounds a cow's heart. The physicians also located and removed a second tumor from the patient's aorta. Before the surgical team placed the heart back inside the patient's body, they discovered a third tumor on the back wall of the organ, which they removed. They then patched the heart with bovine material. "The third tumor was a surprise, but it was very easy to remove," said Dr. Reardon after the procedure. "If we hadn't found that one, I don't believe she would have been much better off." Mr. Minnich, along with the Minnichs' three grown children, praised Dr. Reardon after the surgery. During news media interviews that occurred shortly after the surgery, Minnich choked back tears as he thanked the team of doctors for saving his wife. "She wouldn't have lasted more than two weeks longer," he said. "After what the doctors told us in New York ... a heart transplant didn't make sense. But this procedure did make sense." For Mrs. Minnich, a heart transplant was not an option because the immunosuppression drugs used following a transplant would have interfered with treatment of her cancer. Dr. Reardon said repairing the patient's original heart eliminates the risk of organ rejection and increases her chance for survival. She may receive chemotherapy after she recovers from this surgery, to make sure that all the cancer has been eliminated. Dr. Reardon was a resident and part of the surgical team when the autotransplant procedure was first attempted in 1983 by Dr. Denton Cooley. Although that patient did not survive, Dr. Reardon successfully performed the autotransplant in 1998 on Guy Altmann, a 20-year-old college student from Louisiana. Altmann recovered from the surgery and made plans to finish his schooling, but he died two months later of complications from the cancer which spread to other parts of his body. Walter Ward III of Atlanta was 36 when he received an autotransplant at Methodist in 1999. He is doing well today and shows no signs of disease. Mr. Minnich said he and his wife spoke with Ward and were encouraged to try the rare procedure. But they were apparently convinced before that conversation, after communicating with Dr. Reardon. "When we found out about the surgery on the internet, we sent Dr. Reardon a letter, and he wrote back immediately," Mr. Minnich explained. "We felt his own heart in the letter." The Methodist DeBakey Heart Center is apparently the only place in the United States that offers the autotransplant. "The reason for that is simple - we have the support of Methodist and Baylor and a history of innovation in the treatment of heart disease. This is where heart transplants were pioneered, and we have in place the trained staff and facilities to allow us to do this type of procedure," Dr. Reardon said. "I learned how to do this procedure here, and I don't think I could have learned it anywhere else."
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