HEART TRANSPLANTATION

General Information

DEFINITION--Replacement of a diseased heart with a healthy heart.

BODY PARTS INVOLVED--Diseased or abnormal heart; healthy heart from donor.

REASONS FOR SURGERY

• Coronary-artery disease.
• Cardiomyopathy.
• Valvular-heart disease with congestive heart failure.
• Severe congenital heart disease.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity.
• Smoking.
• Poor nutrition.
• Recent illness.
• Alcoholism or other chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Cardiovascular surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; studies of the immune system; ECG; cardiac catheterization; sonograms (See Glossary for all).
• During surgery: Cardiac monitoring (See Glossary).
• After surgery: Blood studies; ECG.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• A healthy heart is obtained from a donor who has died from disease (other than heart disease) or accident.
• An incision is made in the recipient's chest to expose the heart.
• A heart-lung machine sustains life while the diseased heart is cut free and removed.
• The donor heart is sewn into place. The aorta, pulmonary artery, superior vena cava and inferior vena cava are connected to the new heart.
• The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Life-threatening general infections.
• Rejection of transplanted heart.

AVERAGE HOSPITAL STAY--3 to 4 weeks.

PROBABLE OUTCOME--A successful transplant prolongs life and improves the quality of life for patients who might otherwise have died. Allow about 6 weeks for recovery from surgery. Rejection of the transplant remains a risk indefinitely. If rejection can be controlled, the patient has a life expectancy of up to 10 years or more.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the chance of deep--vein blood clots.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume exercise after consulting your doctor. > Resume sexual relations when your doctor determines that healing is complete.

DIET---Your doctor will prescribe a diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms, such as: nausea; vomiting; constipation; abdominal swelling; heartbeat irregularities; or extreme fatigue.