1. Archive

Texas college student survives "autotransplant' of his heart

A 20-year-old college student is the first known person to survive a rare operation in which surgeons completely removed his heart, cut out a malignant tumor, then reimplanted the repaired organ in his body.

Guy Altmann had a tumor removed from his left shoulder in August, but doctors told him three months later they hadn't gotten it all.

After he suffered a stroke in March, he was told he had a lemon-sized tumor popping in and out of his left mitral valve as he breathed.

Left unchecked, the tumor eventually would have blocked the valve completely.

Altmann had no choice but to undergo the six-hour heart-removing surgery, performed Monday by a team of Houston doctors.

The technique has been done only a handful of times on patients with malignant tumors, and none have been known to survive, said Dr. Michael J. Reardon, chief of heart and chest surgery for Methodist Hospital and Baylor College of Medicine, who helped perform the "autotransplant" procedure.

The technique has had limited success on an unknown number of patients with benign cardiac tumors.

But Altmann had little choice but to consent.

Time was running out, ruling out a heart transplant, and he had little chance of surviving without the operation.

"I think he would have died within the next two to three weeks," Reardon said.

Altmann's heart was stopped with chemicals, removed and put into a bucket of ice and water, where the tumor _ called a fibrous histiocytoma _ was cut away.

The damaged valve was then replaced by one made of swine tissue, and the damaged wall of the chamber, where the tumor had been attached, was rebuilt using tissue from a cow's pericardium _ the sac that contains the heart.

Reardon last did this operation in 1984 with famed surgeon Denton Cooley of the Texas Heart Institute. The 42-year-old patient bled to death.

Reardon said about 40 cases of cardiac tumors occur for every 100,000 surgical heart patients.

"It's is a very rare tumor," said Dr. Patrick McCarthy, director of heart transplantation at Cleveland Clinic in Ohio. "It's extremely rare to have to remove the entire heart to remove the tumor, but it's certainly something people have thought about if you're in dire straits. You do what you need to."

Although he was running a fever on Friday, Altmann, an electrical engineering major at Texas A&M, was in good condition.

"He was only in intensive care for 24 hours when they thought he would be there for four days," said Angela McPike, Methodist hospital spokeswoman. "He is doing very well."

Reardon warned, though, that Altmann still had a difficult recovery ahead of him.

"We're not home free, but by far, we've given Guy his only good chance and at this point a pretty good chance."