Autotransplantation of the heart for primary cardiac malignancy: development and surgical technique.

Primary cardiac malignancy presents an unusual and difficult surgical challenge. Malignant tumors of the left atrium have proved problematic due to their posterior location and difficulty of surgical exposure. The technique of cardiac explantation, ex vivo resection and cardiac reconstruction, and reimplantation--the cardiac autotransplantation procedure--was developed to solve this anatomic problem. Herein, we discuss the development of this approach and describe the surgical technique.