 |
|
 |
|
|
|
| SURGERIES OF THE HEART |
Heart Transplant
|
Heart Transplant is a surgical procedure to remove a severely diseased and failing heart and replace it with a healthy heart from a deceased donor.
REASONS FOR THE PROCEDURE
A heart transplant is done to treat irreversible, life-threatening heart diseases that cannot be managed using any other type of medical or surgical method. Transplant recipients are severely disabled by their heart condition but are otherwise in good health. The procedure is most often performed for the following reasons:
* Cardiomyopathy (disease of the heart muscle)
* Severe coronary artery disease unresponsive to other treatments
* Congenital heart defects
* Valvular defects leading to severe, unremitting congestive heart failure
RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE
* Pre-existing heart condition
* Age: 60 or older
* Lung disease, including chronic obstructive pulmonary disease ( emphysema ) and pulmonary hypertension
* Poor circulation or other vascular disease
* Kidney or liver disease
* Smoking
* Presence of serious active infection, such as pneumonia and tuberculosis
* Treatment for cancer within the previous five years
* Debilitation and malnourished
* Uncontrolled diabetes
* Previous stroke or other damage to the blood vessels of the brain
* Mental illness or continued substance or alcohol abuse
* Autoimmune disease
* Potentially recurrent heart disease
BEFORE THE PROCEDURE
The patient may be asked by the doctor to likely undergo the following:
* Physical exam
* Echocardiogram – a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
* Tissue typing
* Identify the blood group
And in the days before the surgery -
* One should arrange for a ride to and from the hospital.
* One should arrange for help at home after returning from the hospital.
* Take medications as directed and do not take over-the-counter medications without consulting the doctor.
* The night before, one should have a light meal and do not eat or drink anything after midnight unless told otherwise by the doctor.
DURING THE PROCEDURE
The patient is given the following during the surgery -
* IV fluids
* Oxygen
* General Anesthesia
* Diversion of circulation through a heart-lung machine
PROCEDURE
The surgeon cuts through the skin and breastbone, opens the chest, and connects you to a heart-lung machine. This machine takes over the functions of the heart and lungs during the operation. Doctors remove all but the back wall of the upper chamber of the heart. The upper chambers of the donor heart are opened, and the donor heart is sewn in place. Next, the blood vessels are connected, and the blood starts to flow and warms the heart.
The new heart may begin beating on its own or doctors may administer an electrical shock to get it started. For safety, the patient will also have a temporary pacing wire attached to the heart. Once doctors are sure that the heart is beating fine and no further problems are anticipated, the blood is rewarmed, the heart-lung machine disconnected, and catheters are placed in the chest cavity to drain any residual blood that may collect. The surgeon closes the chest with stainless steel wires and the skin is closed with absorbable sutures.
AFTER THE PROCEDURE
The patient will be closely monitored in the Intensive care unit(ICU), with the help of the following devices:
* Heart monitor
* Pacing wires used to help control heart rate
* Tubes connected to a machine that helps drain excess blood and air
* Breathing tube until you can breathe independently
TIME FOR THE PROCEDURE
4-6 hours
POSSIBLE COMPLICATIONS
* Infection
* Rejection of the new heart
* Coronary artery disease (half of all heart-transplant recipients develop coronary artery disease)
* Pneumonia
* Phlebitis (blood clots of a vein)
* Excessive bleeding
* Neurological deficits, stupor, coma, decreased intellectual function
* Kidney dysfunction
* Irregular heart rate
* Anesthesia-related problems
* Infection or cancer related to taking immunosuppressive medications
* Death
POSTOPERATIVE CARE
* Breathe deeply and cough 10-20 times every hour.
* One should take immunosuppressive drugs and other medications as directed by the doctor; only take drugs approved by the doctor.
|
|
|
| Last Modified :
Monday, May 11, 2009 |
Compiled and edited by the Editorial team and
approved by Expert panel of h4heart.com
|
|
|
|
|
|