Heart transplant surgery is usually considered a last resort in efforts to treat end-stage heart failure. In most cases, individuals will go through various therapies, medication protocols, and treatments to manage heart failure, but if such efforts fail, a heart transplant may be an option. Since the first heart transplant in the 1960s, techniques and technology have improved, offering heart transplant patients increased chances of survival than ever before.
Individuals suffering from a multitude of heart conditions may benefit from a heart transplant. A major factor is the heart's ability to pump blood through the body. Individuals diagnosed with heart failure or congestive heart failure is a prime candidate. Heart failure describes a heart muscle that is weakened and does not pump blood as efficiently as it should.
Congestive heart failure is caused by a multitude of issues, including high blood pressure, enlargement of the heart muscle, known as cardiomyopathy, heart attacks, also known as MIs, or myocardial infarction, as well as congenital heart conditions.
Determining whether or not an individual is a candidate for heart transplant surgery incorporates a multitude of procedures and evaluations that include blood tests, diagnostic tests, social as well as psychological evaluations, age of the candidate, as well as general overall health.
In the United States, there are nearly 4,000 people waiting for heart transplants on a daily basis, though only a portion of donor hearts becomes available to provide such transplants. Donors must be matched by blood type, medical urgency, size of the donor heart, and the time spent on the waiting list. Heart transplant candidates will be placed on a waiting list, and may wait for months or even years for a suitable heart donor.
The actual surgical procedure takes an average of four hours. During the surgery, an incision is made over the breastbone, or sternum. The chest cavity is opened, and the individual is placed on a heart-lung bypass machine that enable the body to continue to receive blood flow and oxygen while the damaged heart is being removed. Major vessels leading to and from the damaged heart are clamped off and detached. Then, the donor heart will take its place, and blood vessels reconnected. The heart-lung bypass machine will be disconnected, and the heart will be shocked with small paddles to initiate the first heartbeat of the transplanted heart. Surgeons will assess the function of the heart and make sure there are no leaks before closing the incision.
While this explanation seems simple, the surgery is a complex procedure that requires a great amount of skill and experience to complete. The actual heart transplant is only the first part of a long process.
When any new organ is placed in the body, it may undergo a period or process called rejection. The body is capable of identifying foreign tissues and will fight against them. Because of this, any individual who undergoes a heart transplant will need to be on anti-rejection medications for the rest of his or her life to make sure the body does not reject the new heart. Common medications to prevent rejection may include but are not limited to:
New anti-rejection medications are being developed in order to increase efficiency and to help balance against increased risks for infections because of decreased immune functions.
In the United States, heart transplant surgery can cost upwards of $1,000,000. While this seems daunting, medical travelers to foreign destinations enjoy massive savings. In Jordan, whose first heart transplant occurred in the late 1960s, medical travelers can save up to 25% on costs found in the U.S. Those traveling to India or Singapore may save up to 50% to 75%on costs. Such costs are not a reflection on the training, experience or expertise of foreign cardiac surgeons, but are benefits of the reduced costs of liability and malpractice insurance that are enjoyed outside of the U.S.
Cardiac surgeons must meet basic requirements and training for certification in various cardiac fields and techniques, as well as specialties. A cardiac surgery resident may stand anywhere from five to ten years training to become a fully qualified surgeon in cardiac surgery and procedures. Cardio thoracic surgeons typically complete a five-year general surgery residency, followed by two to three years of specialization in cardiothoracic surgeries. Various licensing boards that certify surgeons in cardiac surgery as well as subspecialties differ per country of origin. When looking for qualified cardiac surgeons in any country, look to national and statewide boards, associations, and memberships in specific cardiovascular specialties.
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