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Heart Transplant

WHAT YOU NEED TO KNOW:

A heart transplant is surgery to replace a damaged heart with a new heart from another person.

HOW TO PREPARE:

Weeks and days before your surgery:

While you wait for your donor heart:

  • Your surgeon may suggest that you have counseling about your surgery and condition. He or she may talk to you or your family about your expectations, benefits, and possible outcomes of the surgery.
  • Continue taking the heart medicines your healthcare provider has ordered for you.
  • You may need to decrease the amount of liquid you drink before your surgery. Your healthcare provider may also have you weigh yourself daily.
  • You may need a heart catheter procedure before your heart transplant. A heart catheter allows your healthcare providers to monitor your heart condition.
  • You may need devices such as a heart defibrillator or a pacemaker before your surgery. These devices may help your heart beat normally so it can pump blood to other parts of your body. Ask your healthcare provider for more information about these devices and why you might need them.
  • You may need an EKG, echocardiogram (echo), or blood tests. These tests help healthcare providers be sure you are healthy enough for surgery. Ask your healthcare provider for more information about these and other tests you may need. Write down the date, time, and location of each test.
Prepare for surgery:
  • Arrange to have someone drive you home after surgery.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • You may need a blood transfusion if you lose a large amount of blood during surgery. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than 3 days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

The night before your surgery:

  • You may be told not to eat or drink anything after midnight.
  • An arterial line is a tube that is placed into an artery (blood vessel), usually in the wrist or groin. An arterial line may be used for measuring your blood pressure or for taking blood.
  • A Swan-Ganz catheter is a thin tube put in a vein near your collarbone, or in your neck or groin. The tube goes into your heart and through to a blood vessel in your lungs. A Swan-Ganz can monitor the fluid in your blood vessels. The pressure in your heart and lungs may also be monitored. The catheter may also be used to give medicines or IV fluids.

WHAT WILL HAPPEN:

What will happen:

  • You will receive anesthesia to keep you asleep and free from pain during your surgery. A large incision will be made down the middle of your chest. Your sternum (breastbone) will be cut so your surgeon can see your heart. Large blood vessels from your heart will be connected to a bypass machine. A bypass machine keeps oxygenated blood pumping through your body during your surgery. Your surgeon may make a cut through your right and left atria to remove your heart. He or she may leave a small part of both your atria to connect to the donor heart. Your aorta and an area of your vena cava may also be cut and connected to the donor heart. Your surgeon will then use stitches to attach the atria and blood vessels of the donor heart to your remaining heart tissue.
  • Your surgeon may also choose to do a bicaval heart transplant. He or she will remove your heart by cutting through your vena cava above and below your heart. He or she will also cut through your aorta. A piece of your right atrium will be left for attaching the donor heart. The large vessels of the donor heart will be attached to your aorta and upper and lower vena cava with stitches. The donor heart will also be connected to your remaining right atrium.
  • Steroid medicine may be given as a shot to prevent swelling during and after surgery. Temporary pacing wires may be attached to the chambers of your new heart with stitches. Pacing wires connect to a pacemaker to keep your heartbeats normal. Once the donor heart is secured, you will be removed from the bypass machine. Your new heart may start beating when blood flows through it. Drains may be placed in your chest to remove extra blood and fluid after your surgery. When your surgeon sees that your new heart is functioning without problems, your sternum will be closed with wires. Your chest incision will be closed with stitches or staples and covered with a bandage. The bandage will keep your wound clean and dry to help prevent infection.

After your surgery:

You will be taken to the recovery room or an intensive care unit (ICU). Healthcare providers will monitor you closely. When you are fully awake you may still have many tubes in place. The tubes may make it hard for you to move, but are needed to monitor your condition. Do not get out of bed until a healthcare provider says it is okay and is there to help you. Healthcare providers will check your wound often. Healthcare providers will also give you pain medicine.

CONTACT YOUR HEALTHCARE PROVIDER IF:

  • You get sick with a cold or the flu.
  • You have a fever.

Seek Care Immediately if

  • You feel very tired and confused.
  • You feel cold and sweaty, and your hands and feet look blue or gray.

Risks

  • You may bleed more than expected or get an infection. Nerves, blood vessels, muscles, and other organs may get damaged. You may develop a life-threatening blood clot in your arm or leg. Your condition may get worse during surgery, and may become life-threatening. Your body may reject the new heart.
  • After your transplant, you are at an increased risk for diabetes, kidney problems, and high cholesterol. You may have abnormal heartbeats, high blood pressure, and heart valve problems. You may also be at risk for coronary artery disease (CAD) after surgery. CAD may cause the blood vessels to your heart to narrow and may lead to a heart attack or heart failure.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

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