HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Niloo Edwards Mark E. Galantowicz Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Talbot, S. M. Articles by Schulman, L. L. Search for Related Content PubMed PubMed Citation Articles by Talbot, S. M. Articles by Schulman, L. L. Related Collections Lung - transplantation Transplantation - heart

J Thorac Cardiovasc Surg 2002;124:1145-1148
© 2002 The American Association for Thoracic Surgery

Cardiothoracic Transplantation (TX)

Combined heart and lung transplantation for unresectable primary cardiac sarcoma

From the Departments of Medicine^a and Surgery,^b Columbia University, College of Physicians and Surgeons, New York, NY.

Received for publication Feb 14, 2002. Revisions requested March 29, 2002; revisions received April 19, 2002. Accepted for publication May 1, 2002. Address for reprints: Larry L. Schulman, MD, Columbia University, College of Physicians and Surgeons, Cardiopulmonary Transplant, PH 14 West, 622 W 168th St, New York, NY 10032 (E-mail: LLS2{at}columbia.edu).

Objective: The prognosis for patients with primary cardiac sarcoma is poor. Median survival is less than 10 months, especially when complete surgical excision is not feasible. Removal of all cardiopulmonary structures involved by tumor followed by orthotopic allotransplantation has been proposed to improve long-term survival.
Methods: From 1996 through 1999, we performed combined heart and lung resection followed by en bloc heart and bilateral lung transplantation in 4 patients (2 men and 2 women): 2 with inoperable pulmonary arterial sarcoma and 2 with left atrial sarcoma extending into the pulmonary vein.
Results: Median age at diagnosis was 39 years (range 37-45 years). All 4 patients were given chemotherapy before transplantation: doxorubicin and ifosfamide in 2 cases, and doxorubicin, ifosfamide, mesna, and dacarbazine in 2 cases. There were no operative deaths. Median survival after transplantation was 31 months (range 5-49 months). All patients had tumor recurrence: local recurrence in the chest (n = 1) and distant metastases in the brain (n = 2) and abdomen (n = 1). One patient remains alive 49 months after disease progression with cerebral metastasis as the only site of recurrence treated with whole-brain irradiation, resection, and stereotactic radiosurgery.
Conclusions: Combined heart and lung transplantation is a technically feasible treatment for highly selected patients with localized advanced primary cardiac sarcomas. The high incidence of metastatic disease, however, limits its utility.

This article has been cited by other articles:

				A. Nakahira, H. Ogino, H. Sasaki, and N. Katakami Long-term survival of a pulmonary artery sarcoma produced by aggressive surgical resection and adjuvant chemoradiotherapy Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 388 - 390. [Abstract] [Full Text] [PDF]

				A. Maruo, Y. Okita, K. Okada, T. Yamashita, S. Tobe, and N. Tanimura Surgical Experience for the Pulmonary Artery Sarcoma Ann. Thorac. Surg., December 1, 2006; 82(6): 2014 - 2016. [Abstract] [Full Text] [PDF]

				M. J. Reardon, S. C. Malaisrie, J.-C. Walkes, A. A. Vaporciyan, D. C. Rice, W. R. Smythe, C. A. DeFelice, and Z. J. Wojciechowski Cardiac Autotransplantation for Primary Cardiac Tumors Ann. Thorac. Surg., August 1, 2006; 82(2): 645 - 650. [Abstract] [Full Text] [PDF]

				B. Alsoufi, M. Slater, P. P Smith, T. Karamlou, A. Mansoor, and P. Ravichandran Pulmonary artery sarcoma mimicking massive pulmonary embolus: a case report. Asian Cardiovasc Thorac Ann, August 1, 2006; 14(4): e71 - e73. [Abstract] [Full Text] [PDF]

				G. Shanmugam Primary cardiac sarcoma. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 925 - 932. [Abstract] [Full Text] [PDF]

				H. Ashrafian, T. Athanasiou, J. Yap, and A. C DeSouza Two-Chamber Intracardiac Mesothelioma Asian Cardiovasc Thorac Ann, June 1, 2005; 13(2): 184 - 186. [Abstract] [Full Text] [PDF]

				S. S. Iskander, S. F. Nagueh, M. L. Ostrowski, and M. J. Reardon Growth of a Left Atrial Sarcoma Followed by Resection and Autotransplantation Ann. Thorac. Surg., May 1, 2005; 79(5): 1771 - 1774. [Abstract] [Full Text] [PDF]

				C. K. Choong, J. S. Lawton, M. R. Moon, and R. J. Damiano Jr Failure of medical therapy for pulmonary "thromboembolic" disease: Beware the unsuspected primary sarcoma of the pulmonary artery J. Thorac. Cardiovasc. Surg., November 1, 2004; 128(5): 763 - 765. [Full Text] [PDF]