Diseases, Conditions & Treatments
Doctors affiliated with the Center
for Advanced Heart Failure at Memorial Hermann Heart & Vascular
Institute-Texas Medical Center performed the facility’s first heart transplant
in October, 2012. Since then, it has
become one of the fastest-growing transplant programs in the United States –
completing more heart transplants than any other hospital in Houston. Certified by both the United Network for
Organ Sharing (UNOS) and the Centers for Medicare and Medicaid Services
(CMS), the Institute strictly adheres to the ethical standards established by
these two organizations.
Detailed current data about the program is
available from the Scientific Registry of Transplant Recipients.
Heart & Vascular Institute at the Texas Medical Center is known for
innovation leading to outstanding outcomes. From isolating the genetic origins of
life-threatening thoracic aortic aneurysms to advanced imaging technology that
allows cardiologists to detect heart disease early enough to reverse it, The
Institute’s groundbreaking accomplishments put it among the leading heart
programs in the world.
Backed by a commitment to
excellence in care and research, the Institute’s role as the primary teaching
facility for the cardiology, and cardiothoracic and vascular surgery programs
at The University of Texas Health Science Center at Houston (UTHealth) Medical
School ensures patients access to cutting-edge programs and technology.
The Heart Vascular Institute-Texas Medical Center has earned
the Mission: Lifeline® Silver Achievement award from the American Heart Association
and is an accredited Chest Pain Center, recognized by the Society of
Cardiovascular Patient Care (SCPC) for the quality of care provided to patients.
transplant is a surgical procedure that replaces a diseased or defective heart
with a healthy heart from a donor. It is performed when other treatments for
coronary problems have not been effective. A transplant gives a patient with
congenital heart disease an opportunity to have a normal heart with normal
failure is staged on a four-point scale, the last of which is end-stage heart
failure. At this point, medications and other treatments become ineffective and
heart transplantation may become the only option.
Heart failure in
adults can be caused by:
have severe functional impairment with no medical or surgical therapeutic
options and are referred for transplantation undergo a rigorous medical,
psychological and social evaluation. On the basis of this evaluation, previous
medical records and psychosocial information, a decision is made by the Medical
Review Board at the Center for Advanced Heart Failure regarding the
advisability of cardiac transplantation.
Patients who are considered for transplantation:
patients with advanced heart failure are eligible for a heart transplant.
Generally, those who meet one or more of these criteria are not recommended:
Approved transplant candidates
are placed on the United Network for Organ Sharing (UNOS) list while awaiting
transplant. During this time, the transplant team monitors the patient to
ensure his or her condition remains stable. Should the patient’s condition
begin to decline, other innovative procedures such as intravenous medications
and left ventricular assist device (LVAD) implantation may be recommended until
a compatible donor heart is located.
donor heart becomes available, the donor-recipient matching system considers
several factors in finalizing a match:
Once a donor
heart has been identified, the patient is called to the hospital immediately,
where a thorough evaluation is conducted on the donor organ and the patient.
receiving a donor heart can save a person’s life, transplantation is an
open-heart surgical procedure accompanied by serious risks, the most
significant of which is rejection. All heart
transplant recipients receive immunosuppressants (medications that reduce the
activity of the immune system), but about one in four have some signs of
rejection during the first year after surgery. Usually the rejection has no
symptoms and requires only an adjustment of medications.
specific risks and potential benefits of a heart transplant vary for each
patient, Memorial Hermann-affiliated physicians will discuss all possibilities
in detail and take strict precautions to decrease these risks.
transplant is performed under general anesthesia with the patent on a bypass
machine, which keeps oxygen-rich blood flowing throughout the procedure. It
generally lasts four to six hours, longer if the patient has had previous
coronary surgery or if there are complications. The surgeon exposes the
chest cavity and opens the pericardium. The diseased heart is removed, leaving
the back part of the left atrium in place. The donor heart is implanted and the
chest is closed. In some patients both heart and lungs may be
transplanted during the same procedure.
after surgery, patients receive pain control medication. A ventilator is used
to help a post-operative patient breathe and tubes are inserted in the chest to
drain fluids from around the lungs and heart.
The post-surgery hospital stay will last
one to two weeks. For about three months afterward, transplant recipients are
closely monitored on an outpatient basis, including blood work,
echocardiograms, electrocardiograms and heart biopsies.
After a heart transplant, patients must
make some permanent long-term adjustments, including:
Our transplant patients are treated
by a dynamic, multidisciplinary team of highly skilled, board-certified
physicians whose specialties include cardiothoracic surgery, advanced heart
failure, transplantation, mechanical assist devices, robotic and video-assisted
surgery, and high-risk coronary intervention.
These affiliated physicians serve as principal investigators in national and
international research trials, giving patients access to new medical therapies,
innovative devices and technologies very quickly after their introduction.
highly skilled nurse clinicians guide each candidate for heart transplant
through the process from pre-surgery preparations to post-surgery follow up.
Throughout the evaluation and treatment process, referring physicians are kept
informed about patient progress. After a patient’s transplant, referring
physicians receive information on follow-up care, including immunosuppressants
and other medications, cardiac rehabilitation and any other patient