A heart transplant surgery, very simply put, is the replacement of the patient’s damaged or malfunctioning heart with a healthy donor heart from a brain-dead or recently deceased individual.
Why are you being considered for a heart transplant surgery ?
A major and high-risk surgery like heart transplant surgery is suggested by heart surgeons in those patients who are suffering from end-stage heart failure and when it is found that none of the other available treatment options would help to improve the functioning of their heart. If you are being considered for this procedure, you are most likely already suffering from severe heart disease/ heart failure. A heart transplant surgery may give you prospect to have a normal heart with normal blood circulation.
What is heart failure ?
The heart is the core driving pump of the body, circulating blood and oxygen throughout the body. When we say heart failure, we mean the heart is not capable enough to pump blood for the body’s requirements. It means a damaged heart- either the muscle of the heart, or its valves, or the blood vessels supplying it can be affected and do not function as expected.
What can cause damage to your heart ?
Any of the following causes can damage your heart.
- The most prevalent ground for heart failure is CORONARY ARTERY DISEASE, which is the most common cause of heart attacks. Coronary artery disease is a blockage in one/ many of the arteries, supplying oxygenated blood to the heart. When the artery is blocked, blood flow to the heart is reduced, and the muscles of the heart, which continuously pump and work, thus start to undergo ischemic damage (due to inadequate oxygen), bringing about a heart attack or cardiac arrest.
- Increased blood pressure (Hypertension).
- Diseases of the heart valves (either since birth or from infections)
- Infections affecting the heart (either with viruses/ bacteria)
- Alcohol and illicit drug use & abuse (especially cocaine)
- Inherited (familial disease) or from birth (Congenital heart disease)
- In some cases, causes of heart failure are unknown (idiopathic).
How is a heart transplant surgery different from other heart procedures ?
- Heart transplant surgery Vs. Coronary Angioplasty : Many patients undergo coronary angioplasty to recover the impaired blood supply to the cardiac muscle. A balloon (initially deflated) is used to increase the width of the artery in the blocked area by inflation, and a stent is used to make it stay wide. This is done in relatively fewer, initial and early blockages- say just one or two arteries.
- Heart transplant surgery Vs. Bypass graft surgery/ Open Heart Surgery : However, if you have blockages in three or more coronary arteries, your cardiologist is likely to recommend heart bypass surgery. A coronary artery bypass graft surgery (CABG) works on the principle of GRAFTS- arteries or veins from other parts of your body and using these grafts as alternative pathways to redirect the blood around the blocked artery. Either a single or numerous grafts could be needed, depending on how many coronary arteries are choked-up.
A heart transplant surgery, on the other hand is done only in end- stage heart failure patients and is complete replacement of the heart by another heart.
What are the investigations/ diagnostic work up you would undergo before a heart transplant surgery ?
- A check up of your blood- Routine lab tests, HIV and hepatitis tests.
- Analyzing your chest cavity, heart and lungs- Routine chest X-rays and Pulmonary Function Tests.
- Checking heart function- Electrocardiography (ECG) and Echocardiography.
- Checking flow of blood vessels to heart- By performing a dye test, the Coronary angiogram.
- Assessing exercise tolerance and predicting results in patients with heart failure and other cardiac conditions- Cardiopulmonary tests. It lets us know the consolidated exercise responses involving the lungs, heart, blood vessels & skeletal muscles, which cannot be truly observed through studying each organ system function, alone.
- Making sure the lungs are working fine- Breathing tests/pulmonary function tests.
- A check-up of all the abdominal organs- the stomach, kidneys, liver & intestines– By ultrasonography, urine and stool samples.
- Measurements of pressures in heart chambers (to make sure the pressure isn’t excessive).
Who can donate a heart ?
Donor hearts are taken from persons who have been confirmed brain dead (in severe trauma, road accidents or gunfire wounds). The donor and the recipient are matched for blood group type, and appropriately, must be of a similar weight and height. The ethnicity and gender of the donor will not have a bearing on your heart transplant.
What is the procedure for getting a heart transplant surgery ?
Once your doctor and medical team decide that you need a transplant, you become a transplant candidate, and you are then enlisted in a waiting list. Psychological and social evaluation and counselling will be started, to help you through this process. You and your family have to be prepared mentally, physically as well as financially for a heart transplant surgery. The waiting time for the donor heart is variable depending on the donors available and also on how unwell you are. The hearts, as mentioned earlier, have to be matched for blood group and body size. If there are other serious medical problems, co-existing with the heart condition, you may be removed from the list as the chances of successful transplantation reduce.
What does heart transplant surgery involve ?
No food is to be taken after midnight of the day preceding the surgery. On the morning of the surgery, you will be given a mild sedative to reduce the anxiety of the surgery. You will be taken to the operating room, and monitoring electrodes will be attached and intravenous lines will be placed. Catheters (thin tubes) that perform such duties as collecting urine and monitoring blood pressure will be inserted. The surgery will take approximately 3-4 hours and is a procedure done under general anaesthesia. For the duration of the surgery, a cardiopulmonary bypass machine (popularly known as the “heart-lung machine”) will be linked to provide oxygen to the blood, and supply this blood to your aorta for the rest of your body while the surgeon operates on your heart. After an incision placed to your chest, the damaged heart has to be completely removed and the new donor heart is placed. It is then tied to the incoming and outgoing blood vessels and blood flow through the heart is established.
What happens after the heart transplant surgery ?
After the surgery, you will be taken to the cardiovascular intensive care unit (CICU) for monitoring and recuperation. The duration of the recovery and stay in hospital differs in each patient, but as a general rule, four to six days is recommended.
What is the post-operative care after getting a heart transplant surgery ?
If the transplant is successful, heart functioning and blood flow will definitely improve from what it was earlier, before the heart transplant. A patient who has had a heart transplant has to be mentally prepared for taking medication and monitoring, all through the lifetime of the patient for possible refusal and rejection of donated heart. If you are worrying about how soon you can get on with your normal activities, you can slowly start over the period of 6 to 8 weeks, post surgery. Your cardiologist will formulate a program for you to regain your strength and stamina for activities, slowly but surely. Follow your doctor’s instructions to the dot, to keep yourself healthy, regarding medicines and physical activity.
What medicines do you have to take after the heart transplant surgery ?
As a heart transplant recipient, you will have to be on immunosuppressive medications to prevent your immunity from rejecting the new heart. The amount of immunosuppressive medication will be tailored to each individual as these medicines do have their side effects such as concomitant occurrence of infections and cancers, if they are used indiscriminately.
What are the possible complications of heart transplant surgery ?
On going home, you should be on the look-out for likely warning signs of infection, like fever, sore throat, cough, sputum; ulcers, redness, swelling at the site of the incision. There are many precautions to be taken post surgery. Do not expose yourself to dust and extreme cold climes. Be careful while handling animals and pets. The signs of rejection consist of difficulty in breathing, weight gain or loss, fever and tiredness. If any of these build up in your body, you should contact your cardiologist and transplant team as soon as possible. As mentioned earlier, you have to be prepared for regular cardiologic follow-up with your physician life-long.
How to find and reach heart transplant surgeons for heart transplant surgery ?
Now you can find and reach heart transplant surgeons from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions and information from multiple heart transplant surgeons , get approximate cost of heart transplant surgery from heart transplant hospitals, compare things and then choose a heart transplant surgeon or a hospital for heart transplant surgery .
Find, reach and choose a heart surgeon for heart transplant surgery on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
