Cardiovascular Surgery: the Ins and Outs of a Heart Transplant
By: Lisa Kim
Heart disease is the leading cause of death worldwide, and in the United States alone roughly 640,000 people die a year due to heart-related diseases (Nichols). However, as medical technology and knowledge advances, physicians and researchers have discovered innovative approaches to help patients who face these diseases. Heart transplants are one of the many surgical procedures carried out by cardiovascular surgeons that have been used to help patients suffering from heart failure (a condition diagnosed when a heart is unable to pump blood throughout the body properly). Thus, this surgery allows patients with damaged hearts to receive a new, functional heart from a brain-dead organ donor. Although survival rates and conditions of patients can vary after a heart transplant, the surgeries have overall proven to increase a patient’s lifespan and quality of life.
Before a heart transplant can take place, however, physicians are required to ensure their patient is eligible for a transplant. But it is important to note that since there is a shortage of organ donors, even if patients are eligible for a transplant, this does not mean they are promised a new heart. Oftentimes, they will be placed on a transplant waitlist amongst other patients until a heart is available. This criteria and waitlist help people with the highest priority and with the best chances of recovering to receive a new heart. Requirements for a heart transplant include multiple factors but are not limited to the list below:
- Patients’ diagnosis needs to be at/near the end stage of a heart disease
- Patients must be mentally/psychologically healthy
- Patients cannot have an infection or cancer
- Patients cannot be underweight or obese
- Patients must have a support system post-transplant surgery
- Patients must be the same blood type and similar age and weight as the organ donor
The transplant itself is a complex procedure that usually lasts 4 hours and requires patients to be under general anesthesia. Due to the fact that hearts can only survive for 4-6 hours outside of a body, physicians must move at an adequate pace to perform the surgery (Health Resources & Services Administration). Before removing the damaged heart, surgeons will place patients on a cardiopulmonary bypass machine which helps pump blood throughout their body as their old heart is being removed and replaced. Then, the donor’s heart will be sewn in place and blood vessels will be reconnected to the new heart (Johns Hopkins Medicine). Finally, as proper blood flow is replenished, the new heart will begin beating. If this fails to occur on its own, the heart must be shocked by a defibrillator to help it start beating. Lastly, surgeons will sew together the patients’ breast bone and the initial incision made.
After the surgery is complete, patients must stay at the hospital for 1-2 weeks to receive postoperative care. This includes medication to prevent infections and to confirm that patients accept their new heart. Just like any other surgical procedure, heart transplants have risks of their own including infections, blood clots, breathing problems, and in the most severe cases, death (Johns Hopkins Medicine). Thus, this postoperative care is crucial as it helps to prevent patients from developing these risks. Once patients are discharged, they will still have multiple follow-up checkups with their physician to ensure their heart is functioning properly.
In summary, heart transplants involve more than just the replacement of a damaged heart. There are many factors about a patient that must be considered before a heart transplant can occur, and even the post-operative care that patients receive is an important aspect that benefits their recovery process and survival rates.
Risk Factors and Prevention for Heart Diseases
By: Truc Le
Coronary artery disease, also known as heart disease, is a leading cause of death in the US with one person dies every 36 seconds (CDC). Therefore, it is important to know the factors that put you at risk and know how to lower those risks.
According to the CDC, about 47% of all American have at least 1 of 3 main risk factors for heart disease: high blood pressure, high cholesterol, and smoking.
- High blood pressure: is a major risk factor for heart disease. About 19% of the US population have this condition. Having high blood pressure for too long can cause serious damage to heart vessels. The condition is also called “silent killer” since it usually has no symptoms while it can still lead to a heart attack.
- High cholesterol: there are two types of cholesterol: low-density lipoprotein (LDL), also known as bad cholesterol, and high-density lipoprotein (HDL), also known as good cholesterol. The extra LDL cholesterol can build up the wall of arteries, including those of the heart, which narrows the arteries and decreases blood flow. On the other hand, high HDL cholesterol level can have good effects because of its protection from heart diseases.
- Smoking: increases the risk for heart conditions such as atherosclerosis and heart attack. Cigarette smoking can damage blood vessels. Nicotine raises blood pressure while carbon monoxide from cigarette smoke reduces blood’s oxygen-carry ability.
Besides these three common risk factors, there are also other factors such as age, family history, medical conditions, and lifestyle. There is no restriction for age but the risk goes up as your age, especially 55 years or older people. Family history is also another factor. Genetic factors likely play some role. However, it is also likely that people in the same family history with heart disease share living lifestyle, conditions, and environment. People with medical conditions such as diabetes, obesity, endometriosis, PCOS, or a history of preeclampsia during pregnancy, and autoimmune disorders are more likely to have heart diseases.
Having a healthy lifestyle and habits can help reduce risk factors and maintain good heart health.
- Go to regular health check-ups: keep track of your health in order to maintain a good level of blood pressure, cholesterol, and blood sugar.
- Quit smoking: According to Felman, a person quitting smoking for 12 months can reduce 50% chance of heart disease risk.
- Regular physical exercise: control weight and lower stress
- Eat healthy: replace trans-fat, which are industry-produced fats often used in packaged baked goods, snack foods, margarines and fried fast foods to add flavor and texture, by polyunsaturated and unsaturated fats.
In conclusion, heart disease is serious and potentially fatal. There are many risk factors; some of which we can prevent if we are aware of. Moreover, maintaining a healthy lifestyle and habits in your daily activities can significantly reduce risks and protect our hearts.
Work Cited:
Cardiovascular Surgery: the Ins and Outs of a Heart Transplant
American Heart Association. “Heart Transplant.” American Heart Association, https://www.heart.org/en/health-topics/congenital-heart-defects/care-and-treatment-for-congenital-heart-defects/heart-transplant. Accessed 7 June 2021.
Eisen, Howard J. “Patient education: Heart transplantation (Beyond the Basics).” UpToDate, 13 May 2019, https://www.uptodate.com/contents/heart-transplantation-beyond-the-basics. Accessed 7 June 2021.
Health Resources & Services Administration. “Matching Donors and Recipients.” organdonor.gov, https://www.organdonor.gov/about/process/matching.html. Accessed 10 June 2021.
Johns Hopkins Medicine. “Heart Transplant.” Johns Hopkins Medicine, The Johns Hopkins University, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/heart-transplant. Accessed 7 June 2021.
National Kidney Foundation. “The Kidney Transplant Waitlist- What You Need to Know.” National Kidney Foundation, National Kidney Foundation, 10 2 2017, https://www.kidney.org/atoz/content/transplant-waitlist. Accessed 9 June 2021.
Nichols, Hannah. “What are the leading causes of death in the US?” Medical News Today, 4 July 2019, https://www.medicalnewstoday.com/articles/282929. Accessed 7 June 2021.
Tampa General Hospital. “Heart Transplant Criteria for Selection & Referral.” Tampa General Hospital, Tampa General Hospital, https://www.tgh.org/heart-transplant-criteria. Accessed 7 June 2021.
Risk Factors and Prevention for Heart Diseases
Felman, Adam. “What to Know about High Blood Pressure.” MedicalNewsToday, 13 Nov. 2019, www.medicalnewstoday.com/articles/159283.
Fulton, Alex. “Type 2 Diabetes and Heart Disease Risk.” HealthyWomen, 17 May 2021, www.healthywomen.org/created-with-support/connection-diabetes-cardiovascular-disease-womens-health/type-2-diabetes-and-heart-disease-risk.
“Heart Disease Facts | Cdc.Gov.” Centers for Disease Control and Prevention, 8 Sept. 2020, www.cdc.gov/heartdisease/facts.htm.
Milanowski, Ann. “5 Things to Do Every Day to Keep Your Heart Healthy.” Health Essentials from Cleveland Clinic, 23 Sept. 2020, health.clevelandclinic.org/5-things-to-do-every-day-to-keep-your-heart-healthy.
“Risk Factors for Heart Disease.” WebMD, 1 Jan. 2007, www.webmd.com/heart-disease/risk-factors-for-heart-disease.
The Healthline Editorial Team. “28 Healthy Heart Tips.” Healthline, 12 Aug. 2020, http://www.healthline.com/health/healthy-heart-tips.
Medical Wonders 