Many individuals are suffering from heart diseases or heart failure. Hence they are suggested heart transplant surgery. This condition is common and serious for them. It develops when blood does not function properly in the heart. This problem leads to several symptoms like sweating, heartburn etc.
Heart transplant is a surgical procedure in which a damaged heart is replaced with a healthy one. This treatment is recommended for individuals when their condition is not managed from medication drugs and other surgeries. It is not applicable for people above 65 years of age.
Types of Heart Transplant
This surgery is of two kinds. These include the following:
- Orthotopic Transplant: It is a most common heart transplant which involves the replacement of the recipient heart with a donor one. This method is recommended for end-stage heart failure in patients.
- Heterotopic Transplant: In this surgery, a donor heart is attached with a patient’s native heart in parallel. It is applicable for pulmonary artery pressures or severe rejection of a donor heart .
Benefits
The advantages of this surgical method are as follows:
- It provides long-term survival in patients.
- This surgery makes the work and travel easier.
- It improves the symptoms of heart failure and quality of life in individuals.
- The energy level gets higher in people from this surgical procedure
Risks and Complications
This surgery is considered the safest procedure but can cause several risks and complications. These include the following:
- Blood clots
- Cardiac allograft vasculopathy
- Diabetes
- Kidney disease or failure
- Primary graft failure
- Delirium
- Osteoporosis
- Organ rejection
- Nerve damage
- Breathing Problems
- Poor circulation of blood
- Bleeding and Infection
Procedure
Before Procedure
The following steps that can be possible before the heart transplantation surgery:
Transplant program and Evaluation
A transplant program will be recommended for patients before the surgical procedure. During this process, the medical history and health assessment will be discussed with a relevant doctor. After that, a transplant will be evaluated in the following steps:
- Psychological and social evaluation: It is a preoperative evaluation process which assesses a patient’s mental health, social support etc. This formal assessment helps to determine whether a patient is mentally prepared for the surgery or not.
- Blood tests: They are most important for heart transplant surgery, which identifies the tissue and blood type as well as blood sugar level in patients.
- Diagnostic tests: The lungs as well as the patient’s overall health can be assessed from these tests. They include CT scans, dental exams etc. The pap test, mammogram and gynecological evaluation are some other tests which are applicable for females.
- Other preparations: The several vaccines might be required in patients, which decrease their chances of infection during heart transplantation surgery.
Bridge Treatment
- Medications: The heart function can be affected in several ways. A heartbeat can become faster or it may pump harder in individuals.
- Left ventricular assist device: A heart might become weaker in individuals in which an inadequate amount of blood gets pumped to the body. In this condition, a left ventricular assist device is recommended from a healthcare provider for the treatment.
- Mechanical support: A pump is inserted with a major blood vessel and then it threads up to the heart. The small balloon gets inflated or deflated which makes the heart pump easily.
During Procedure
The following steps that can be performed during the surgical procedure are:
- An intravenous injection can be applied in the arms or legs to provide IV fluids to a patient.
- Some additional catheters will be attached with a neck and wrist for monitoring the status of the heart and blood pressure as well as taking blood samples for patients. These devices might be applied on other sites such as collarbone, groin etc.
- The bladder is connected with a soft and flexible tube known as Foley catheter. It is essential for the purpose of the urine drainage system.
- A tube is placed into the stomach which helps to drain stomach fluids and provides relief from nausea and vomiting in patients.
- A lot of hair might be shaved or clipped from the chest.
- The general anesthesia will be provided to the patient and a breathing tube is inserted through the mouth and into the lungs. This device is connected with a ventilator, which helps a patient to breathe during the surgery.
- The heart rate, oxygen levels and blood pressure will be examined during the surgical procedure.
- An antiseptic solution will be used to clean the skin over the chest.
- A surgeon makes an incision between Adam’s apple and the navel to access the heart.
- After making an incision, the heart is connected with a cardiopulmonary bypass machine to pump the blood through the body.
- A surgeon removes the damaged heart completely and then it is replaced with a donor heart.
- After a donor heart is attached, the blood vessels are connected carefully without any proper leakage.
- The circulation of blood will be allowed back into the heart through bypass surgery.
- The tubes are removed from the machine and a surgeon uses small paddles to restart the heartbeat.
- When the heartbeat gets started, the healthcare team checks the proper function of the new heart.
- After that, the temporary pacing wires are connected with a new donor heart to control the heartbeat.
- The sternum will be rejoined and attached with the small wires.
- Some stitches or surgical staples are used over the sternum to close the incision.
- A surgeon may also apply sterile bandage over the incision.
After Procedure
The things that a patient can expected after a heart transplantation are as follows:
- A patient will stay in the hospital and spend some time in the intensive care unit. The vital signs or other signs which involve the rejection of a new heart are going to be monitored in the healthcare department.
- The plan of care will be provided to a patient before he or she leaves the hospital.
- An individual can join a prescribed and monitored program known as cardiac rehabilitation. This helps to improve their strength, endurance as well as heart function.
A patient must follow a plan of care before he or she reaches the home. It consists of the following instructions:
- He or she must take medications as prescribed from a relevant doctor.
- Strenuous activities and heavy lifting objects must be prohibited for a certain period.
- Drink plenty of water and follow a proper diet for overall health. Some foods such as undercooked meats, raw eggs etc., must be prohibited.
Why is this Surgery Needed for Patients?
A healthcare provider recommended this surgery for the management of several health conditions. These include the following:
- Coronary artery disease
- Ventricular Arrhythmias
- Cardiomyopathy
- Congestive heart failure
- Valvular heart disease
- Congenital heart defects
Patients suffering from dementia, hepatitis, HIV infection etc., are not suggested for this procedure. They must consult with a relevant doctor for the management of these health conditions.
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