About 10 percent of the more than 6 million Americans living with heart failure have advanced heart failure – stage D, according to the American Heart Association and American College of Cardiology’s A-to-D staging system. Advanced heart failure treatment is complex, involving the implantation of devices or, when all other treatments are no longer effective, heart transplantation, a surgical procedure that replaces a diseased or defective heart with a healthy heart from a donor.
Since performing the first heart transplant at the Heart & Vascular Institute at Memorial Hermann-Texas Medical Center in 2012, physicians affiliated with the Institute’s Center for Advanced Heart Failure (CAHF) have created one of the fastest-growing transplant programs in the U.S.
Detailed data about the program is available from the Scientific Registry of Transplant Recipients.
World-renowned Heart Transplant Team
At CAHF, a joint collaboration between the Memorial Hermann Heart & Vascular Institute1 and the McGovern Medical School at UTHealth, patients with advanced heart failure are treated by a dynamic, multidisciplinary advanced heart failure team of highly skilled, board-certified physicians whose are specialists in cardiothoracic surgery, advanced heart failure, mechanical assist devices, video-assisted surgery, high-risk coronary intervention and heart transplantation.
The team is led by cardiothoracic and vascular surgeon Igor Gregoric, M.D., professor at McGovern Medical School and chief and program director of the Surgical division of the CAHF, and cardiovascular disease specialist Biswajit Kar, M.D., professor of Medicine at McGovern Medical School and chief of the Medical division of the CAHF. Collectively, they have over 50 years of experience in heart transplantation and ventricular assisted devices (VADs), have published well over 400 research/publications and have given hundreds of International presentations on the topics of advanced heart failure and transplantation.
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. Patients who qualify have the opportunity to participate in clinical trials of treatments not otherwise available.
Heart Conditions That May Require Transplant
The following are common diseases or conditions which, may necessitate a heart transplant.
- Coronary artery disease, also known as coronary heart disease, is the most common form of heart disease in the U.S. and the No. 1 killer of men and women in this country. It occurs when fatty deposits, or plaque, build up in the coronary arteries, which supply oxygen-rich blood to the heart. This accumulation of plaque thickens and narrows the arteries, decreasing or blocking the flow of blood to the heart. Coronary artery disease develops over time, so people usually do not experience symptoms until after age 50. Reduced blood flow to the heart can cause chest pain or shortness of breath. A heart attack occurs when blood supply is completely blocked. Risk factors include family history, high blood pressure, high cholesterol, diabetes, sedentary lifestyle, obesity, smoking and stress.
- Cardiomyopathy occurs when the heart muscle becomes enlarged, thickened or rigid (and thus weakened), potentially causing dangerous arrhythmias (irregular heartbeats) or heart failure. Symptoms of heart failure may include shortness of breath; fatigue; dizziness; light-headedness; swelling of the ankles, legs, feet, abdomen or veins in the neck; fainting during physical activity; chest pain, especially after physical exertion or heavy meals; or heart murmurs, extra or unusual sounds heard during a heartbeat.
- Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy and typically occurs in middle-aged and older adults. It is a progressive, usually irreversible, disease that occurs when the heart’s main pumping chamber, the left ventricle, becomes enlarged, inhibiting the heart’s ability to pump blood, weakening the heart and ultimately causing heart failure. DCM can also lead to heart valve problems, arrhythmias and blood clots in the heart. According to the American Heart Association, up to one third of people with DCM inherited it from their parents, but it can also be caused by coronary heart disease or heart attack, metabolic disorders (such as diabetes or thyroid disease), HIV and other viruses, chronic alcoholism, exposure to certain toxins, drug use or abuse, certain cancer medications or complications in pregnancy.
- Restrictive cardiomyopathy typically affects older adults and occurs when the heart muscle becomes rigid and less elastic. Over time, blood flow in the heart is reduced, leading to problems such as arrhythmias or heart failure. Restrictive cardiomyopathy can be idiopathic (of unknown cause) or can result from hemochromatosis, a condition in which iron builds up in the heart; sarcoidosis, a condition that causes inflammation and can cause lumps of cells to grow in the heart and other organs; amyloidosis, a disease in which abnormal proteins build up on the body’s organs, including the heart; connective tissue disorders and some cancer treatments, such as radiation and chemotherapy.
- Hypertrophic cardiomyopathy (HCM) is characterized by a thickening of the heart muscle, particularly the left ventricle, which makes the inside of the left ventricle smaller, restricting the amount of blood it holds. HCM can raise the blood pressure in the ventricles and in the blood vessels in the lungs and may disrupt the heart’s electrical signals causing arrhythmia. People of any age may be affected by HCM, especially people with a family history of the disease. Symptoms can range from nonexistent to severe.
- Heart valve disease, also called valvular heart disease, occurs when one (or more) of the heart’s four valves ceases to open correctly, so that blood can empty from the chamber, and/or to close properly, so that blood cannot flow the wrong way. Many people with valve disease are unaware of their symptoms, as symptoms may develop slowly, or because they attribute their symptoms to simply being out of shape or other reasons. Symptoms may include chest pain or palpitations; shortness of breath; fatigue, weakness or inability to maintain regular activity level; lightheadedness or loss of consciousness; or swollen ankles, feet or abdomen. Heart valve disease may be caused by a narrowing (stenosis), collapsing (prolapse) or leaking (regurgitation) of the valve. Although many valve problems are age related, people with illnesses, such as rheumatic fever and infective endocarditis (infection in the lining of the heart), may be at higher risk.
- Congenital heart disease, also called congenital heart defect, refers to an abnormality in the structure of the heart that occurs while the fetus is developing in the uterus. The word “congenital” means the defect exists at birth. The most common type of birth defect, congenital heart defect may affect approximately one in 100 children and may be caused by generic or chromosomal abnormalities; the mother’s use of drugs, alcohol or tobacco during pregnancy; a maternal viral infection or a family history of congenital heart disease. Symptoms may appear at birth, during childhood or not until adulthood. Physicians affiliated with the Children’s Heart Institute at Children’s Memorial Hermann Hospital provide care for infants and children with congenital heart disease.
In addition, a heart transplant might be required due to failure of a previous heart transplant.
The Organ Donation Process
Life-saving heart transplantation is made possible through the generous “gifts of life” by donors who, while living, registered to become donors (upon their death), either when signing up for or renewing their driver’s licenses or through the DonateLifeTexas.org registry. If the deceased has not registered but is a candidate for donation, his or her next-of-kin can provide consent for donation on his or her behalf. Currently, 47 percent of Texans are registered donors, and there are over 100,000 individuals awaiting organ transplants in the U.S.
Upon a donor’s death, the donor’s organs and/or tissues are recovered by an organ procurement organization (OPO). The OPO serving the Greater Houston area is LifeGift.
To learn more about the organ donation process, click here.
Heart Transplantation Process
From the time a patient enters the Memorial Hermann Heart Transplant program, he or she will receive individualized care from the same multidisciplinary team of physicians, nurse clinicians, social workers, coordinators and others, to ensure continuity and quality of care. Throughout the process, referring physicians are kept informed about the patient’s progress.
Read about the heart transplantation process, from start to finish.
Heart Transplant Support Groups
Transplantation can sometimes seem overwhelming for patients. We sponsor support and education groups for heart and lung transplant patients, their families and caregivers, at the Texas Medical Center location. The groups are as follows:
- Patient and Family/Support persons: Every Tuesday from 11 a.m. to noon in the 5th Floor Waiting Area of the Heart & Vascular Institute at Memorial Hermann-Texas Medical Center, 6411 Fannin Street, Houston, TX 77030.
- Caregivers Only: Every Thursday from 11 a.m. to noon in the 5th floor Waiting Area of the Heart & Vascular Institute at Memorial Hermann-Texas Medical Center, 6411 Fannin Street, Houston, TX 77030.
- LVAD/Mechanical Circulatory Support Patient Only: The second Thursday of each month from 11:30am-12:30 at the Center for Advanced Heart Failure Clinic, 6400 Fannin, Suite 2500, Houston, TX 77030
- Heart/Lung Transplant Classes for patients and their family/support persons: Every Wednesday morning from 7:30 am to 9:30 am on 23rd Floor of Medical Plaza, 6400 Fannin, Suite 2350, Houston, TX 77030
For more information, please contact Beth Mosele, LCSW, CCTSW-MCS, at (713) 704-4300.
Memorial Hermann sponsors Mended Hearts, a support group for anyone with heart disease. The Mended Hearts Support Groups are held at various Memorial Hermann hospitals throughout the Houston area.
Heart Transplant Patient Stories
Jennifer's Story - Heart Failure at 32
After a heart attack left 32-year-old Jennifer Cheak, a mother of two young boys, with a faint heartbeat and little hope, she was transferred via Life Flight to the Heart & Vascular Institute at Memorial Hermann-Texas Medical Center
Watch the Video »
Steve's Story - Heart Transplant
After several heart attacks and multiple unsuccessful attempts to manage his congestive heart failure, Steve sought a heart transplant team to begin a new journey.
Watch the Video »
Erika's Story - Congestive Heart Failure at 29
Erika was just 29 years-old when she was diagnosed with congestive heart failure. Nearly a year after the birth of her first child, she began to experience shortness of breath along with other concerning symptoms.
Watch the Video »
Venola's Story - Hard-Won, Heart-Felt Victory
Venola was so overcome with joy at winning that the sweet victory did not sink in immediately. After all, it was only about 17 months after her lifesaving heart transplant.
Read the full story »
Clarence's Story - Double Heart Transplant
When Clarence Fontenot was in junior high, he wanted badly to play football. But when his mother took him for his required physical, he immediately failed to get clearance to join the team.
Read the full story »
To refer a patient or for additional information
regarding the heart transplant program at Memorial Hermann Heart & Vascular Institute, please use our Contact
Us page here.