Heart transplant surgeryis perhaps one of the most complicated surgical procedures done on the human body.
It is considered as an option for patients with End stage cardiac failure when other treatments are not effective anymore. For conditionslike Myocardial Infarction, High blood pressure, Valve diseases and irregular heartbeat rate etc., this procedure can extend the life span of the patient significantly.
It is recommended to consult a specialist to see if one is a suitable candidate for this procedure and to understand the risks and the success rate of the procedure to set realistic expectations.
- Review health history
- Run physical exams and diagnostic tests like CT scan, ultrasound and PFT etc.
- Brief about the procedure and risks based on the tests
A team of cardiac surgeons take the lead on this surgery, which could take up to several hours. After the patient is given general anesthesia, the surgeons connect him to a heart-lung bypass machine to perform the procedure.
A majorly invasive procedure, during this surgery, the chest is cut open and the rib cage opened to access the deep-seated heart.
The surgeons then remove the failing heart and replace it was a donor’s heart that often starts to beat the moment the major vessels are stitched to the heart.
Complications in surgery can change the expected outcome from a surgery; patients are explained about the unexpected risks like
- Infection due to suppressed immunity
- Blood loss and bleeding before or after surgery
- Blood clots that cause the risk of heart attack, brain stroke, or lung problems
- Troubled Breathing
- Kidney failure due to rejection
- Coronary allograft vasculopathy (CAV)
- Failure of the donor heart & Death
After the surgery is over, the patient is given medication to manage pain. The ventilator is still connected and tubes are inserted to drain fluids that accumulate around the heart.
The patients, depending on their condition, take different recovery time and are kept in the Intensive Care Unit for around two weeks. Afterwards the patient is moved to general ward is the recovery is strong and steady.
After two to three weeks, the patient is discharged from the hospital but required to make frequent visits for monitoring recovery for at least three months. The most crucial period after the surgery as the chances of rejection of the new heart is highest.
Many tests are run on the patients to check for symptoms of rejection, such as fever, fatigue, less urine pass etc. A heart biopsy may also be performed after regular intervals to check for rejection along with echocardiogram and electrocardiogram.
Such a major event in the life of the patient may require lifelong changes in lifestyle to live a quality life.
The first and the most prominent change will be taking medication for preventing rejection. Immunosuppressants prevent the body from seeing the heart as a foreign component by decreasing the activity of immune system. This also makes the patient more susceptible to infections and other diseases.
The side effects of immunotherapy can be prominent like swelling of the face, weight gain, acne and facial here and stomach related ailments. But the patient has to develop a coping strategy to minimize the effect of these changes on his life.
At times, the immune suuppressants may lead to other major diseases like high blood pressure, cancer, dissolving of bones(osteoporosis) and diabetes.
Many hospitals for heart failure surgical treatment in Chennai have special training and coping programs for such patients to help them better manage this lifelong regimen.