End stage heart disease that is life threatening and cannot be fixed with medication or other surgeries, but you are in otherwise good health—This is most often due to
cardiomyopathy, which is a disease of the heart muscle, along with severe
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 medications 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 procedure:
Your doctor will monitor your health to make sure that you are ready for the heart transplant.
Talk to your doctor about all medications you are taking. You may be asked to stop taking some medications before surgery.
Do not take over-the-counter medication without checking with your doctor.
Arrange for a ride to and from the hospital.
Arrange for help at home after the surgery.
Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
Before the surgery, your doctor will likely do the following:
The doctor will cut through the skin and breastbone. The chest will be opened and you will be connected to a heart-lung machine. This machine takes over the functions of the heart and lungs during surgery. Most of your heart will be removed. The back wall of the left atrium with the pulmonary vein openings will be left in place. 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 you may be given 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. After the doctor is sure that the heart is beating fine, the blood will be rewarmed. The heart-lung machine will be slowly turned down and disconnected. Next, temporary tubes may be placed in the chest cavity to drain any blood that has collected. The chest will be closed with stainless steel wires. Lastly, the skin will be closed with absorbable sutures.