Heart Transplant Surgery- What One Need To Know

 A deteriorating heart is substituted by a healthier donated heart during a heart transplant procedure to save the life of the diseased patient. People who need a heart transplant are typically those whose heart conditions haven't progressed enough with medication or other procedures. Even though a heart transplantation is a big procedure, the chances of survival are strong with the right aftercare and proper surgical management.

Everyone is a little apprehensive about surgery whenever it is mentioned, especially when it involves the heart. Renowned heart surgeon, Dr. Sujay Shad, has extensive knowledge about heart transplant and open heart surgery in Delhi and procedures concerned with heart failure, and in this blog he has shared more information related to heart failure and transplant treatment.

 

Why is heart transplant surgery performed?

 

When other methods of treating cardiac issues have failed and heart failure has occurred, heart transplants are done to save the patient's life. 

People may Suffer From Heart Failure Due to:

• A deterioration of the heart's muscle (cardiomyopathy)

• Cardiovascular disease

• Heart valve dysfunction

• An inherited heart condition (congenital heart defect)

• Ventricular arrhythmias that are dangerously recurrent and are not under control with conventional therapies

• A prior heart transplant that failed.

Congenital heart defects or cardiomyopathy are the two main causes of heart failure in children. In certain cases, patients with specific diseases may undergo a heart transplant along with another organ transplant (multiorgan transplant). 

• Kidney and heart: Some patients with both kidney and heart failure may be candidates for this surgery.

• Liver and heart: For those with specific liver and cardiovascular issues, this treatment might be an option. 

• Lung and heart: Rarely, if a heart transplantation or lung transplant alone cannot cure a patient's serious lung and heart issues, a specialist may recommend this operation.

How is the Surgery done?

Wait for the donor heart:

One will be added to a waiting list by the transplant center, it is determined that one is an excellent contender for a heart transplant. As there are more patients in need of hearts than there are donors, the wait may be lengthy. The doctors may advise having a Ventricular Assist Device (VAD) inserted to maintain the heart whilst patients wait for a donor organ if medical therapy is unable to support the vital organs.

Just before the procedure:

The donor organ must be used for a heart transplant within 4 hours of the organ's removal. As a result, hospitals within a specified interval of the donation hospital are provided hearts first, followed by a center nearby. The medical team will perform a final evaluation once one gets to the hospital to determine whether the donor heart is a good match for the patient.

During the procedure:

Open-heart surgery for heart transplants lasts for several hours. If one has had previous cardiac operations, the procedure will be more difficult and take longer. To maintain oxygen-rich blood moving throughout the body, patients are attached to a heart bypass machine. The chest will be cut open. The surgeon splits the chest bone and cracks apart the rib cage. The damaged heart is subsequently removed, who then stitches the donated heart into position. The main blood vessels are then joined unto the donor heart.

After the procedure:

One's health will be checked for any indications of resistance, such as weight gain, feeling short of breath, fever, exhaustion, and decreased urination. One will undergo repeated cardiac biopsies in the initial few months following transplantation, while rejection is most likely to take place, to ascertain whether the body is resisting the new heart. Over time, fewer biopsies are required on a regular basis.

If one is feeling any discomfort that can lead to heart problems or heart failure, one can book an appointment at Sir Ganga Ram Hospital, best heart hospital in India to get examined and treated by the best bypass surgeon in Delhi, Dr. Sujay Shad. 

 

Risks-

Every surgery is associated with some kind of risk. Hence It is important to underwent the surgery from an expert for best outcomes and obtain lower risks after surgery:

• Rejection of the transplanted heart: The body discarding the donor heart is one of the most concerning dangers following a heart transplant. The immune system can attempt to reject the donor heart if it perceives it as a foreign entity, which could harm the organ. Immunosuppressants are given to every heart transplant patient. 

• Primary graft failure: The donor heart is not functional in this condition, which is the most common reason for death in the initial months following transplant. 

• Issues with one’s arteries: It's possible that following the transplant, the artery walls in the heart may thicken and stiffen. As a result, the heart may have trouble pumping blood through it, which may result in a cardiac arrest, heart failure, myocardial infarctions, or sudden death.

• Side effect of medicines: One will  need to take immunosuppressants for the rest of their life, and they can severely damage the kidneys, among other things.

• Infection: Immunosuppressive medications make it harder for one to fight infections. In the first year after the surgery.

• Cancer: Its risk can also be increased by immunosuppressants. These drugs can increase the risk of developing several cancers, including Hodgkin's and skin cancer.

To know more about heart issues and life saving heart transplant surgery, book a visit now with Dr. Sujay Shad, best heart doctor in India at Sir Ganga Ram Hospital.

Heart Transplant Surgery: Cause, Procedure and Risks

A Heart Transplant Surgery is performed when a malfunctioning heart is replaced with a healthier donor heart. People who need a heart transplant are typically those whose condition hasn't progressed adequately with medication or other procedures. Although a heart transplant is a major surgery, patient survival is excellent if ongoing medication and follow-up can be assured.  

Everyone is a little apprehensive about surgery whenever it is mentioned, especially when it involves the heart. The top heart surgeon in Delhi, Dr. Sujay Shad, has extensive knowledge about heart surgery, equipment, and procedures concerned with heart transplant. 

Why is it done?

When other methods of treating cardiac issues have failed and heart failure has a high risk, heart transplants are done. Congenital heart defects or cardiomyopathy are the two main causes of heart failure in children. In adults it is done because:

• Cardiomorphy or deterioration of the heart's muscle

• Cardiovascular disease

• Congenital heart defect or heart valve dysfunction, an inherited heart condition

• Ventricular arrhythmias that are dangerously recurrent and are not under control with conventional therapies

• Heart transplant surgery that was done earlier but has failed now.

Ideal Candidate for Heart Transplant:

 

• Is too old to heal from transplant surgery because of their senior age.

• Have a major kidney, liver, or lung illness or other medical issue that could reduce the life even if you receive a donor heart.

• Have an existing infection

• Have recently been diagnosed with cancer personally

• Is unable or unwilling to make the lifestyle modifications required to maintain the health of the donor heart, such as quitting smoking, abstaining from drugs of abuse, and consuming less alcohol.

Risks Involved:

• Donor Heart Rejection: The body refusing the donor heart is one of the most concerning dangers following a heart transplant. The immune system can attempt to refuse the donor heart if it perceives it as a foreign object, which could harm the organ. Immunosuppressants are administered to every heart transplant patient to minimize organ rejection. Rejection frequently happens without warning. 

• Primary graft failure: The donor heart is not functional in this condition, which is the most common reason for death in the initial months following transplant.

• Atrial problems: It's possible that following the transplant, the artery walls in one's heart could thicken and stiffen, developing cardiac allograft vasculopathy. As a result, the heart may have trouble pumping blood through it, which may result in a heart attack, arrhythmias,  heart failure or sudden death.

• Side effects of medicines: One needs to take immunosuppressants for the rest of their life, and they can significantly damage kidneys, among other things.

• Cancer: Risk can also be increased by immunosuppressants. These drugs can increase the risk of developing several cancers, including non-lymphoma.

• Infection: In the initial year following a heart transplant, a lot of recipients experience infections that necessitate hospital admission.

Availability of Donor Heart:

One will be added to a waiting list by the transplant facility if the medical staff determines that one is an ideal candidate for a heart transplant. The chances of locating a donor depends on one's size, blood type, and degree of illness. The doctors may advise having a ventricular assist device (VAD) placed to maintain one's heart while they wait for a donor organ if medical treatment is unable to support the sensitive organs. 

Procedure:

• Open-heart surgery for heart transplants lasts for several hours. If one had past cardiac operations, the procedure will be more difficult and take longer. General anesthetic is given before the surgery. To maintain oxygen-rich blood moving throughout the body, the surgeons will attach patients to a heart-lung bypass machine.

• The chest will be cut open by the surgeon. To perform a cardiac operation, the surgeon will split your chest bone and crack apart your rib cage.

• The damaged heart is subsequently removed by your surgeon, who then stitches the donor heart into position. The important blood vessels are then reconnected to the donated heart by the surgeon. 

After the Surgery:

• After the procedure, patients will be given medicine to assist in managing the pain. Additionally, one will have tubes in the chest to drain fluid from the area around the heart and lungs as well as a ventilator to assist with breathing. 

• During the first three months, a lot of people remain near the transplant center because of the frequency and severity of the monitoring. Once treatment is complete, follow-up appointments become less regular, and travel is simpler. Throughout the first year following the transplant, patients will undergo many cardiac biopsies to assess whether the body is refusing the new heart. 

• Additionally, one's health will be checked for any indications of refusal, such as shortness of breath, weight gain, exhaustion, fever and decreased urination.

Result:

The majority of heart transplant recipients have a decent quality of life. One  might be able to resume a lot of their regular activities, including employment, interests and sports, and exercise, depending on overall health. 

If one is feeling any discomfort that can lead to heart problems or heart failure, one must book an appointment at Sir Ganga Ram Hospital to know more about heart transplant surgery in Delhi, and to get examined and treated by Dr. Sujay Shad. Over the years, countless local patients have placed great trust in the doctor. Consult now for more information!

 

Coronary Bypass Heart Surgery - Dr. Sujay Shad

Coronary artery disease is a condition wherein the coronary arteries that supply oxygen-rich blood to the heart muscles get blocked or become narrow. It is caused by the build-up of plaque made up of either fatty material or calcium at the inside lining of the wall of the coronary artery. Coronary bypass surgery is one of the best treatment options for correcting coronary artery disease. Dr. Sujay Shad, Heart Specialist in Delhi, explains that undergoing coronary bypass surgery can ease the patient with symptoms like chest discomfort, palpitations, abnormal heart rhythm, and shortness of breath. It can also increase the chances of survival of the patient with better life quality. The surgery helps improve the blood supply to the heart muscles by redirecting the flow of blood around the section of the partially blocked or completely blocked coronary artery.

How to prepare for coronary bypass surgery?

Dr. Sujay Shad, heart doctor in Delhi, India gives a detailed explanation of the procedure to the patients, conducts a physical exam to check for their overall health, and review their medical history, before performing the surgery. He also gives certain instructions to the patients about any modifications in their diet and medications or restrictions in the physical activities before the surgery.

The patients must also inform the doctor about any allergies, current intake of medications, and any history of bleeding disorders during the consultation period or before undergoing surgery. For a healthy recovery of the patient, smoking, and drug or alcohol consumption must be avoided as soon as possible before the procedure commences.

Dr. Sujay Shad, specializes in performing lifesaving heart surgeries like Heart Transplants, Coronary Bypasses, HOCM, Aortic Surgery, and Mitral Valve at the Best Hospital for Heart Surgery, Sir Ganga Ram Hospital, located at Rajinder Nagar, New Delhi.

What to expect during coronary bypass surgery?

The coronary bypass surgery in Delhi involves the following steps:

• The anesthesiologist provides general anesthesia or intravenous sedation and continuously monitors the patient for vital signs like breathing rate, heart rate, blood pressure, and blood oxygen levels throughout the surgery. As the patient goes to sleep, a ventilator is connected to help him/her breathe during surgery. 

• A catheter is placed into the urinary bladder to drain all urine. 

• Next, the operation site is cleaned with an antiseptic solution to keep it sterile.

• The heart surgeon makes an incision in one or both legs or one of the wrists to take out the blood vessels to be used as a graft. After removal, the incisions are closed with sutures.

• Another vertical cut is made by the doctor in the mid-section of the chest extending to above the navel. The breast-bone (sternum) is also cut lengthwise into two halves to expose the heart. 

• Now the surgery may be performed using a heart-lung bypass machine or without it. In the off-pump procedure, the area around the diseased coronary artery is stabilized with a special instrument and the rest of the heart continues to function normally. For the on-pump procedure, the heart is stopped permanently and the blood is pumped using a heart-lung bypass machine. 

• In the bypass graft procedure, one end of the harvested blood vessel is sewed over a tiny opening made in the aorta and another end is attached to the coronary artery just below the blockage or narrowing of the artery. In some cases, an internal mammary artery may be used as a graft which requires only one end to be sewed to the opening of the coronary artery just below the blockage. 

• The patient may need multiple grafts based on how many blockages are there and what is their location. 

• The doctor closely examines the working of the bypass graft bypassing some blood through it.

• When all grafts are properly positioned and are in working condition, all the incisions made in the chest are closed using sutures. In the case of an on-pump procedure, the heart may either restart on its own after removing the heart-lung bypass machine or would require a mild electric shock for restoring the beating of the heart. Sometimes, the pacing of the heart may be done using a pacemaker device.

• After procedure completion, the surgeon inserts drainage tubes in the chest to take out extra fluids and blood from around the heart. 

• Lastly, a sterile dressing or a bandage is applied over the surgical site. 

Coronary arteries supply the heart with energy, nutrients, and oxygen. A blockage in these arteries can lead to cause a heart attack or other problems. Hence it is essential to keep the heart well supplied with blood. To know more about Coronary Artery Disease and Heart Surgery Cost in Delhi, schedule an appointment with the best heart specialist in India, Dr. Sujay Shad.