Friday, July 13, 2012

Vital Signs "We Can Take His Heart Out, Remove the Tumor, and Put It Back In"


My own heart sank. Primary tumors, which originate in tissues rather than spreading there from some other place in the body, are uncommon in the heart. They occur in less than 0.05 percent of autopsies. Seventy-five percent of them are benign, but this one did not look harmless. Benign tumors typically grow out from the surface of the cardiac wall like a mushroom on a stalk; malignant tumors look more like a bulge of varying thickness in the wall. Most cardiac surgeons will encounter only a few benign primary tumors in a career, and many will never deal with a malignant one.
“If we were to think about removing it,” I asked, “how would we approach it?”
“How old is the patient?”
“Thirty-seven,” I answered.
“Any history of coronary disease?”
“The transfer notes don’t mention anything.”
“Good,” said Mike. “There might be one way to remove this, but it is drastic. We can take his heart out of his body, remove the tumor, reconstruct the heart, and put it back in.”
“Okay…wow,” was all I could say.

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