This is surgery to remove a severely diseased and failing heart. It is replaced with a healthy heart from a deceased donor.
Reasons for Procedure
A heart transplant is done if you have:
If you are planning to have a heart transplant, your doctor will review a list of possible complications, which may include:
More than 80% of heart transplant patients live for at least one year after surgery. Most return to normal activities, including work and exercise.
Some factors that may increase the risk of complications include:
Be sure to discuss these risks with your doctor before the procedure.
What to Expect
Prior to Procedure
There is a shortage of donors, so you may be on a transplant list for some time. You may need to carry a cell phone with you at all times. This is to allow the transplant team to reach you if a donor heart becomes available. You may need to stay in the hospital for monitoring. You may need to be on continuous IV medicines to help stabilize the function of your diseased heart. Some may need to have a mechanical pump called a ventricular assist device (VAD). The device will help to stabilize your heart while you are waiting for a transplant.
Before the surgery, your doctor will likely do the following:
General anesthesia will be used. It will block pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.
Description of the Procedure
After you are asleep, the doctor will cut through the skin and breastbone. She will open the chest and connect you to a heart-lung machine. This machine takes over the functions of the heart and lungs during surgery. The doctor will then remove your heart. The donor heart will be prepared and sewn into place in your chest. Next, the blood vessels will be connected. After this, the blood will start to flow and warm the heart.
The new heart may begin beating on its own, or the doctor may give you an electrical shock to get your heart started. For safety, you will also have a temporary pacemaker attached to the heart to help the heart beat stay regular. Once the doctor is sure that the heart is beating fine, the blood will be rewarmed. The heart-lung machine will be disconnected. Next, temporary tubes may be placed in the chest cavity to drain any blood that has collected. The doctor will close the chest with stainless steel wires. Lastly, the skin will be closed with absorbable sutures.
Immediately After Procedure
You will be closely monitored in the intensive care unit (ICU) with the help of some/all of the following devices:
How Long Will It Take?
Will It Hurt?
You will have pain during the recovery process. Your doctor will give you pain medicine.
Average Hospital Stay
This procedure is done in a hospital setting. The usual length of stay is at least two weeks. Your doctor may choose to keep you longer if you shows signs of rejecting the new heart or have other problems.
At the Hospital
While you are recovering at the hospital, you will need to:
Your doctor may need to take a biopsy of your heart routinely and additionally as needed if you:
When you return home, do the following to help ensure a smooth recovery:
The surgical site in your breastbone will heal in 4-6 weeks.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occur:
In case of an emergency, get medical care right away.
Scientific Registry of Transplant Recipients
Heart and Stroke Foundation of Canada
Heart transplant. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=3066619. Updated May 2009. Accessed July 21, 2009.
What is a heart transplant? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/ht/ht_whatis.html. Updated September 2008. Accessed July 21, 2009.
Last reviewed September 2012 by Marcin Chwistek, MD