Not only is a heart transplanted due to systolic failure, but also in this type of unusual scenario.
Dr. Gisela Puig Carrión, specialist in heart failure and heart transplantation at the Cardiovascular Center of Puerto Rico and the Caribbean. Photo: Journal of Medicine and Public Health. Fabiola Plaza.
He was a completely healthy young man, athletic and full of life, until a supraventricular cardiac arrhythmia was the body’s alert that his heart was compromised.
The pediatric patient played basketball and had no significant clinical history. However, he began to present symptoms of palpitations, shortness of breath, which he went to the emergency room and there was detected a supraventricular tachycardia, irregularly fast heartbeats that occur when defective electrical connections of the organ trigger a series of early beats in the upper cavities or atria, exclusively reported Dr. Gisela Puig Carrión, a specialist in heart failure and heart transplantation at the Cardiovascular Center of Puerto Rico and the Caribbean.
The patient was referred to Pediatric Hospital of the Medical Center of Puerto Rico.
“The patient was given medication, amiodarone (antiarrhythmic drug). The tachycardia resolves, however, it was necessary to investigate where this tachycardia came from, which first rose (instance),” the specialist explained to the Journal of Medicine and Public Health.
“In the studies we see that the young man had a mass in the left atrium of the heart and it was decided to transfer the young man to the Cardiovascular Center (of Puerto Rico and the Caribbean) for the resection of that mass,” he added.
He reported that once the patient entered the operating room, the surgeon noticed that the mass was highly vascular and that it presented considerable bleeding while trying to perform the resection of the mass. The medical team decided to perform a biopsy on the pathology.
“The result of the mass was that it was a malignant paraganglioma. Heart tumors are extremely rare, not all of them are benign or malignant, they are endocrine tumors that secrete different substances in the body, causing different symptoms. In the case of our This cardiac tumor was found in the patient, but it was not secreting norepinephrine (…),” he added.
He added that more in-depth studies were carried out on the patient and incidentally, the oncology team determined that it was an aggressive tumor that could require treatment with palliative chemotherapy.
“The pediatric team was extremely diligent in consulting the transplant team because the cure in these cases is complete resection of the mass. The curious thing about this case is that there is no evidence in the literature that they had been transplanted for a cardiac paraganglioma, since malignancy is a contraindication for transplanting,” he said.
“In his case, he had a malignancy only in the left atrium and the cure would be complete resection. When I contacted the organ donation institution, there were no reported or similar cases. His team met to make the decision and The patient was listed in status one (of six) and we managed to find a donor and he was transplanted successfully,” he celebrated.
He maintained that “for us it is gratifying to have helped in a case like this, where the only cure for this patient was to be able to transplant him. We are pioneers in this case, there are no similar cases and we already have experience of this situation.”
He concluded by explaining that not only is a heart transplanted due to systolic failure, but also in this type of unusual scenario of cardiac masses where it serves as the only chance of life for the patient.
To date, 176 heart transplants have been performed in Puerto Rico.
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