The heart transplantation surgery involves replacing a failing or diseased heart with a healthy donor heart. The heart transplant is usually performed on people, when their condition does not improve with medicines and other surgeries. This involves a major operation and chances of survival are good with proper care.
The procedure involved in Heart Transplant operation
It is often difficult to find a donor heart and it must be donated by a person who is brain dead and other organs are working fine on life support system. The donor heart must match as closely as possible to the patient’s tissue type to avoid the chances of rejection. The process of heart transplantation begins with general anesthesia. Post that a cut is made through the breastbone to access the heart.
A heart lung machine is connected through which the blood flows while the surgical procedure is performed on heart. This machine performs the functions of heart and lungs during surgery and supplies blood and oxygen to the body.
The patient’s aorta is removed by transecting the aorta, main pulmonary artery, superior and inferior Vena cavae. The left atrium is divided leaving its back wall and pulmonary vein openings in place. The donor heart is connected by sewing together the donor and recipient vena cavae, pulmonary artery, aorta and left atrium.
The heart lung machine is removed after this and the blood flows through the transplanted heart. The tubes are also inserted to drain, fluids, air and blood out of chest for many days so that the lungs can re-expand completely.
Complete cardiac transplant
The reasons to perform heart Transplant
The heart transplant operation has to be performed in following cases:
• When a heart attack causes severe damage to the heart.
• In case of severe heart failures when other treatments, medicines and surgeries cannot help.
• Congenital/ severe heart defects that are present at birth cannot be fixed with surgery.
• Abnormal rhythms of heart that are life threatening and do not respond to other treatments.
The heart transplant cannot be performed in following people who are malnourished, have dementia, HIV, Hepatitis, have kidney, nerve, lung or liver disease, and are older than 65 to 70 years. The people with diabetes or kidney malfunction, pulmonary hypertension must also avoid heart transplant.
The Risks associated with heart transplantation
The various risks associated with anesthesia are breathing problems and reactions to medicine. The surgery may cause bleeding or infection. The risks that are associated with
The transplant are:
• Blood clots and heart attack/stroke.
• Damage to vital organs such as liver, lungs & kidney, high cholesterol, bone thinning, diabetes and cancer risk from the anti- rejection medicines.
• Problem with heart rhythms
• Rejection of heart by the body.
• Severe disease of coronary artery and wound infections.
Procedure before and after Transplant
Before performing transplant the transplant team performs a couple of blood and skin tests to ensure you are a good candidate for transplant. They also test your kidneys and liver. Perform EKF, ECG and cardiac catheterization to evaluate heart condition. Ultrasound of neck and legs and Tissue and blood typing to ensure the body does not reject the donated heart are also performed.
Post the procedure you may need to stay in hospital for around 7 to 21 days and for the first 2 days you are likely to be in ICU. Close follow ups are needed initially to ensure no infections develop. The recovery period is around 3 months and regular check-up is needed.