Technical details for complex cardiac tumor resection are sparse. We
describe the operative technique of modified autotransplantation for
resection of a complex pericardial synovial sarcoma in a 63-year-old,
Caucasian female. Surgical exposure demonstrated tumor origin at the
superior cavoatrial junction and invasion of the aorta, main pulmonary
artery, superior pulmonary veins, and left atrial roof. Full macroscopic
surgical resection was achieved. The patient received adjuvant radiation
for microscopic positive margins and remains alive and with no tumor
progression at one year postoperatively. We conclude that modified
autotransplantation is a challenging but effective surgical technique
when performed with careful patient selection and availability of
skilled, cardiothoracic surgeons at a cardiac center of excellence.