tumour removal surgery
A mul​ti-disciplinary surgical team led by Dr. Robert James (RJ) Cusimano, cardiac surgeon, Peter Munk Cardiac Centre, work to remove a cardiac myxoma, the most common type of heart tumour, from a 77-year-old great-grandmother. Cardiac myxomas are the focus of the third Toronto Cardiac Tumour Conference in January 2018. (Photo: UHN/PMCC)

If you build it, they will come.

And for the architect of the Toronto Cardiac Tumour Conference, set to host a third international meeting on January 25, 2018 - they are.

"I've been impressed with the number of people who have heard of the conference from a medical point of view, and have also been impressed with the number of emails and requests to review cases, by me, from around the world," says Dr. Robert James (RJ) Cusimano, cardiac surgeon, Peter Munk Cardiac Centre. "I've had referrals from India, China, England, South America."

Take one example of a referral from Brazil.

In early February of 2017, just days after concluding the second conference, Dr. Cusimano and fellow heart surgeon, Dr. Juglans Alvarez, travelled to South America's largest country. Their mission was to address the case of a 20-year-old boy with a heart tumour.

"Initially, they thought the young man had a myxoma (benign cardiac tumor)," says Dr. Alvarez. "Doctors were surprised by the finding of a recurrent aggressive sarcoma.

"They declined to re-operate on him. As I worked with RJ and knew that we could offer a surgical option, we went ahead with all sorts of arrangements (technical and logistical) to get it safely done in Brazil."


​The case required the expansive skill set of a multidisciplinary medical team from the Peter Munk Cardiac Centre and Toronto General Hospital, which included the building of a 3D printed model of the young patient's heart – a task undertaken by Dr. Azad Mashari and his team from the Lynn and Arnold Irwin Advanced Perioperative Imaging Lab (APIL) at Toronto General.

The delicate operation would also require autotransplantation, whereby the patient's own heart is removed and transplanted back into the body after removal of the tumour.

The surgery garnered national news headlines in Brazil.

"The patient is doing well almost a year later, living a normal Brazilian 21-year-old life, which includes playing soccer and dancing samba," says Dr. Alvarez.

Dr. Cusimano discusses the 3rd Toronto Cardiac Tumour conference to be held in January 25, 2018, and hosted by the Peter Munk Cardiac Centre, University Health Network. (Video: UHN/PMCC)

"The request for treatment of cardiac tumours can be difficult, especially when people can't necessarily afford to come here, or may not have the expertise in their own country. It's still frustrating," says Dr. Cusimano.

"It would be great to have centres of excellence, so when we get emails from other parts of the world, we can direct it to a centre closer to them."

In the meantime, Dr. Cusimano fields requests, gives lectures around the globe and refers both medical professionals and patients to the website, which contains lectures from past conferences and patient stories.

"The hope of the cardiac tumour conferences in general is to improve knowledge, not necessarily by patients, although that is very important, but also by the practicing medical professionals who are going to be treating them in the future."

And, he has this further advice:

"For patients, make sure that you don't' stop until your physician goes forward and finds an expert in this area, even if it's just to the website, so that they know that someone in the world is interested in and can possibly treat or know where to send a person with this sort of problem."​

cardiac tumour
It took over two hours for the operating room team to locate the cardiac tumour or mass near the patient’s heart. If it had not been removed the growth could have led to a stroke, blindness, a heart attack, or worse. (Photo: UHN/PMCC)
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