Recently, United2Cure, a non-profit started by physicians at MD Anderson Cancer Center, funded and coordinated all logistics for the first partial heart auto-transplantation in Latin America to remove a rare tumor around the heart. Laura Caicedo is a 22 year-old Colombian girl who presented to a prominent cardiovascular institute in Colombia, Fundacion Cardioinfantil, with elevated blood pressure; and was found to have a hormone secreting paraganglioma located against her heart. After several multidisciplinary meetings and discussions at the institution in Colombia, experts concluded that her tumor was inoperable due its anatomic location and high risk of inter-operative death. The plan at that time was to continue medical management. Unfortunately, without surgery, she would ultimately die from obstruction of coronary blood flow causing heart failure.
After being contacted by Laura’s family, United2Cure Children evaluated her case and began to research a solution. After review from expert thoracic surgeons at MD Anderson Cancer Center, it was concluded that she would likely need a heart auto-transplantation, a procedure that involves removing the heart to make the tumor more accessible, removing the tumor, and then putting the heart back into the patient.
United2Cure Children Foundation wanted to support Laura’s treatment, because her family could not afford the care, but the problem was that there are only a few surgeons in the world who can perform this complex surgical procedure. Among them is Michael Reardon, MD, a world-renowned heart surgeon from Houston Methodist Hospital; who has shared his expertise and collaborated with our thoracic surgeon performing a few heart auto-transplantations at MD Anderson Cancer Center. United2Cure brought Laura to Houston with her parents on August 15th, 2017 to meet Dr. Reardon and the team. He thoroughly explained the surgical description of a cardiac autotranplantation as well as the risks involved with this very complex procedure. Laura was also introduced to the first paraganglioma survivor after cardiac autotransplantation operated by Dr. Reardon decades ago. The experience was very rewarding and reassuring for Laura and it was agreed that a team from Houston Methodist and MD Anderson Cancer Center would travel to Colombia to perform this complex procedure Laura’s cardiac auto-transplantation was scheduled for November 3, 2017.
Over the ensuing months, Laura had to be optimized medically. United2Cure organized the communication between the Fundacion Cardioinfantil and experts in Houston for her care planning.
Drs. Mena, Reardon and Jessica Brown, a cardiothoracic anesthesiologist from Methodist, arrived to the Fundacion Cardioinfantil on Friday, Novemeber 3rd for an initial de-briefing and Grand Rounds for the presentation of the case by a multidisciplinary team including surgeons, anesthesiologists, critical care intensivists, cardiologists and radiologists.
After the presentation, Dr. Reardon reassured Laura and her family that everyone was ready to provide her with world-class surgical and medical care. Laura was taken to the operating room at 8:00am.
Over the next 10 hours, an incredibly complex operation was performed in which the patient was placed on bypass, and the heart was partially removed from the chest to extract the tumor. Because of involvement of the coronary arteries that nourish the heart, multiple vein grafts to bypass these arteries were performed at the same time as the tumor removal. “This is only the third paraganglioma case requiring bypass from saphenous veins to the circumflex and obtuse marginal for vital cardiac perfusion after surgery,” says Dr. Reardon of Houston Methodist. Four hours after surgery Laura was responding well to verbal commands and letting us know she was feeling well. At 10 pm Laura was successfully extubated in the ICU. The next day she was already drinking liquids and able to have a conversation with the team. One week after this complex surgical procedure, Laura was discharged home.
This life-saving, first of its kind procedure in Latin America, was made possible by the hard work and dedication of United2Cure Children, the world class expertise of the Texas Medical Center physicians participating, and the generous donations of those who support the foundation.
“The mission of UNITED2CURE Children Foundation is to provide access and availability to life saving oncologic treatment to underprivileged children around the world. Its was a great privilege and honor to economically support and coordinate the logistics for this collaborative, multidisciplinary and multi-institutional team of experts from Colombia and The Texas Medical Center to successfully perform the first cardiac hormone secreting paraganglioma resection in Latin America.” Gabriel Mena, M.D., Founder and President of the UNITED2CURE Children Foundation.
