Heart transplant – Heart transplant

Description of heart transplant

Heart transplant – surgery to remove the abnormal and wrong working of the heart. It is replaced by a healthy heart from a deceased donor.

Causes of heart transplant

Transplant the heart is performed in the presence of the following pathologies:

• The last stage of heart disease, which is life threatening and can not be cured (but all the other health indicators are OK) – occurs most often because of kardiomiopatii (disease of the heart muscle) with severe congestive heart failure;
• Weight coronary artery disease, which cannot be cured by medication or other operations;
• Congenital heart defects;
• Valvular heart, that complicates the blood pumping;
• Uncontrolled and dangerous for the lives of irregular heart rhythm.

Possible complications of heart transplantation

If you plan to heart transplantation, you need to know about possible complications, which may include:

• Infection;
• Exclusion of new heart;
• Coronary artery disease (50% all heart transplant recipient sick coronary artery disease);
• Pneumonia;
• Blood clots;
• Bleeding;
• Reduced brain function;
• Damage to other organs of the body, such as kidney;
• Irregular heart rate;
• Problems, associated with anesthesia;
• Infection or cancer, associated with taking immunosuppressive drugs;
• Death.

More than 80% patients with transplanted hearts live for at least one year after surgery. A big part of getting back to normal life, including work.

Some factors, that may increase the risk of complications:

• Age: 60 or older;
• Lung disease;
• Poor circulation;
• Kidney disease or liver disease;
• Smoking;
• A serious active infection, such as pneumonia or tuberculosis;
• Treatment for cancer in the past five years;
• Exhaustion and malnutrition;
• Uncontrolled diabetes;
• Previous stroke or other damage to the blood vessels of the brain;
• Prolonged substance abuse or alcohol abuse;
• Autoimmune disease.

We need to discuss these risks with your doctor before surgery.

How is a heart transplant?

Preparation for the procedure

There is a shortage of donors,so you can expect a transplant for a long period of time. Maybe, you will always have to carry a mobile phone, which will allow the clinic to contact you, If a donor heart becomes available.

Maybe, you have to go to hospital for monitoring and constantly take medications, including intravenous, to help stabilize the patient's heart function. Some patients may be installed mechanical pump, called artificial ventricle (SGF). The device will help stabilize heart function, While you are waiting for transplant.

• The doctor will monitor the State of health, To make sure, that you are ready for a heart transplant;
• Talk to your doctor about taking any medications. You may be asked to stop taking aspirin or other anti-inflammatory drugs for a week before surgery. You might also want to stop taking blood-thinning drugs, such as clopidogrel (Plaviks) or warfarin;
• Do not take the drug without consulting your doctor;
• We need to organize a trip for the operation and back home from the hospital;
• Organize home care after surgery;
• The night before the operation can eat a light meal. Do not eat or drink anything after midnight.

Before the surgery, the doctor, probably, appoint the following tests:

• Medical checkup;
• Heart catheterization;
• Echocardiogram – test, which uses high-frequency sound waves (ultrasound), to examine the size, shape and motion of the heart;
• Analysis of blood and tissue type;
• Tests, to exclude diseases in other organs and systems, that may hinder transplants.

Anesthesia

Used general anesthesia, which blocks any pain and support the patient during surgery in sleep.

Heart transplant procedure description

After, as you fall asleep, the doctor cuts the skin and breastbone. Chest cavity is opened, vessels connected to the machine extracorporeal circulation (AIK). This device performs the function of the heart and lungs during surgery. The doctor then removes the heart. Prepared by the donor heart is set in place of the old heart patient. Finally, blood vessels are connected with a new heart. After that, the blood starts to flow and warms the heart.

The new heart may begin beating itself, or doctor may use electroshock, to start the heart. For security purposes, set a temporary pacemaker, to maintain a regular heartbeat. When the doctor is confident, that the heart is beating normally, AIC will be disabled. In the chest cavity can be placed temporary drainage tubes to drain fluid and blood. The chest will be closed brackets, and the skin is sewn seams.

Immediately after heart transplant

The state of health will be supported and closely monitored in the intensive care (OBE) with the following devices:

• Kardiomonitor;
• Heart pacemaker – to help the heart beat normally;
• Drainage tube in the chest, for discharging accumulated fluid and blood from the chest;
• Snorkel, until the patient is able to breathe on their own.

How long does it take to get a heart transplant?

About 8 hours.

Heart transplant – Will it hurt?

The pain will be felt during recovery. The doctor will give pain medicine.

The average hospital stay

This procedure is performed in a hospital. Usually stay is two weeks. The doctor can extend the period of stay, If there are signs of rejection of the donor heart or if you experienced some other problem.

Care after heart transplant

Care in a hospital

During recovery, the hospital you need:

• Deep breathing and coughing 10-20 times each hour, to help the lungs and clear them;
• Take immunosuppressive drugs. Probably, they need to take the rest of his life. These drugs reduce the likelihood, that the body will reject the new heart.

Doctor, perhaps, hold Biopsie hearts, If the following problems:

• Continued fever;
• Problems with the functioning of the heart;
• Bad feeling;

Home Care

When you return home, follow these steps:, to ensure the normal recovery:

• Take your medicines as intended;
• Visit the cardiologist to check heart function, and, perhaps, for the selection of tissue for biopsy;
• Work with a physical therapist. Keep in mind, the new heart will respond poorly to increase physical activity;
• Ask the doctor, when it is safe to shower, bathe, or to expose the surgical site to water;
• Be sure to follow your doctor's instructions.

The incision in the chest will live through 4-6 weeks.

Communication with a physician after heart transplant

After discharge from the hospital need to see a doctor, If the following symptoms:

• Signs of infection, including fever and chills;
• Redness, edema, increased pain, bleeding or discharge from the incision;
• Changes in sensations, coordination, or blood circulation in hands and feet;
• Chest pain, pressure, or pain in the heart;
• Fast or irregular heart rate;
• Constant pain;
• Cough or shortness of breath;
• Coughing up blood;
• Severe nausea and vomiting;
• Sudden headache or feeling of weakness;
• Waking up at night due to shortness of breath;
• Excessive tiredness, swelling of the feet;
• Pain, burning, frequent urination or persistent bleeding in the urine.