Facts on Heart Transplant Surgery & Procedure

A heart transplant involves replacing a diseased heart with a donor’s healthy heart. With a team led by some of the best heart transplant surgeons in India, Apollo Hospitals has been a pioneer in the field of cardiac care and is considered to be one of the best heart transplant hospital in India. Mentioned below are some frequently asked questions and facts about heart transplants.

Who needs a Heart Transplant?

A heart transplant is considered when heart failure is so severe that it does not respond to any other therapy.

What is Heart Failure?

Heart Failure is a condition when the pumping action of the heart is unable to supply the needs of the body. It can be sudden in onset (acute heart failure) or develop more slowly without the person knowing that anything is wrong (chronic heart failure). Causes for heart failure could include viral infections of the heart [myocarditis], post heart attack, narrowed valves or cardiomyopathies.

How is heart failure diagnosed?

There are 2 very simple tests done – an echocardiogram and a blood test called NT-pro BNP (a hormone that rises in the blood as a response to a failing heart). The echocardiogram will measure the Ejection Fraction or EF which is a measure of how well the heart is contracting.

Can one do anything to prevent heart failure?

The answer is an emphatic YES. NO smoking, avoidance of heavy drinking, control of sugars and BP, exercise and a healthy diet, not only prevents heart failure but can help you lead a normal life even after it has been diagnosed.

Why is heart failure a serious diagnosis?

Once the heart starts malfunctioning, in time other organs deprived of a good circulation will start getting damaged as well. The lungs, kidneys, brain and liver are particularly vulnerable. Advanced heart failure has a 70-80% chance of death if untreated. This is worse than most cancers.

Is heart failure invariably fatal?

Most patients will require nothing more than medications, life style changes and close monitoring to ensure they are stable. There are many new innovations in the treatment of heart failure, from new drugs to pacemakers and new surgical therapies. When determining your treatment options, it is important to be evaluated by a doctor who specializes in heart failure.

In patients with severe heart failure that is unresponsive to therapy, treatment options fall into 2 categories – support with an artificial heart or replace with another heart (heart transplant).

What is the procedure for a heart transplant?

There is a waiting list maintained for recipients awaiting Solid Organ Transplantation and when there is a suitable patient, he is added on to the waiting list and offered the organ strictly on waitlist priority basis.

How is a heart transplant performed?

Once a donor heart becomes available, a surgeon surgically removes the heart from the donor’s body. The heart is cooled and stored in a special solution. The transplant surgery is performed at the earliest, after the donor heart becomes available. During the surgery, the patient is placed on a heart-lung machine. This machine allows the body to receive vital oxygen and nutrients from the blood even though the heart is being operated on.

Surgeons then remove the patient’s heart except for the back walls of the atria, the heart’s upper chambers. The back of the new heart is opened at the left upper chamber, which is connected to the corresponding remnant of the recipient. The 2 large veins of the right side – the venae cavae are connected independently.

Surgeons then connect the blood vessels, allowing blood to flow through the heart and lungs. As the heart warms up, it begins beating. Surgeons check all the connected blood vessels and heart chambers for leaks before removing the patient from the heart-lung machine. It is a complex procedure that lasts from 4 to 10 hours.

What are the risks associated with Heart Transplants?

The most common causes of death following a transplant are infection and rejection. With the exception of having to take lifelong medication to keep the body from rejecting the new heart, many heart transplant recipients lead a long and productive life.