Type of Surgery
Information
Last updated: 11/24/2009
Immediately following surgery, patients are monitored closely in the intensive care unit (ICU) of the hospital for 24–72 hours. Most patients need to receive oxygen for four to 24 hours following surgery. Continuous cardiac monitoring is used...
to diagnose and treat donor heart function. Renal, liver, brain, and pulmonary functions are carefully monitored during this time.
Heart transplant patients start taking immunosuppressive drugs before or during surgery to prevent immune rejection of the heart. High doses of immunosuppressive drugs are given at this time, because rejection is most likely to happen within the first few months after the surgery. A few months after surgery, lower doses of immunosuppressive drugs usually are given, and then must be taken for the rest of the patient's life.
For six to eight weeks after the transplant surgery, patients usually come back to the transplant center twice a week for physical examinations and medical tests, which check for any signs of infection, rejection of the new heart, or other complications.
In addition to physical examination, the following tests may be done during these visits:
- laboratory tests to check for infection
- chest x ray to check for early signs of lung infection
- electrocardiogram (ECG) to check heart function
- echocardiogram to check the function of the ventricles in the heart
- blood tests to check liver and kidney function
- complete blood counts (CBC) to check the numbers of blood cells
- taking of a small tissue sample from the donor heart (endomyocardial biopsy) to check for signs of rejection
During the physical examination, the blood pressure is checked and the heart sounds are listened to with a stethoscope to determine if the heart is beating properly and pumping enough blood. Kidney and liver functions are checked because these organs may lose function if the heart is being rejected.
An endomyocardial biopsy is the removal of a small sample of the heart muscle. This is done by cardiac catheterization. The heart muscle tissue is examined under a microscope for signs that the heart is being rejected. Endomyocardial biopsy is usually done weekly for the first four to eight weeks after transplant surgery, and then at longer intervals after that.
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This 3D animation explains how the heart muscle contracts to pump blood throughout the body. The action of cells at the microscopic level affects the function of the entire cardiovascular system, as the video explains.
For a heart transplantation, the area around the heart is exposed through a chest incision (A). The blood vessels leading to the heart are clamped, and the heart function is replaced by a heart-lung machine. The diseased heart is removed (B). The donor heart is placed in the chest, and the left atrium is attached (C). The right atrium is connected (D), and the aorta and pulmonary artery are finally attached (E). (Illustration by GGS Inc.)
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Other Information
Heart transplantation or cardiac transplantation, is a surgical transplant procedure performed on patients with end-stage heart failure or severe coronary artery disease. The most common procedure is to take a working heart from a recently deceased organ donor (allograft) and implant it into the patient. The patient's own heart may either be removed (orthotopic procedure) or, less commonly, left in to support the donor heart (heterotopic procedure). It is also possible to take a heart from another species (xenograft), or implant a man-made artificial one, although the outcome of these two procedures has been less successful in comparison to the far more commonly performed Bold textallografts.
Other Information
From 1979–2005, the total number of inpatient cardiovascular operations and procedures increased 484 percent to 6,989,000 annually. (AHA computation.)
From: AHA computation
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