Heart failure treatment and transplantation

father of organ transplants in Russia and was a pioneer of artificial organ surgery. Known

for first successful human-to-human
heart transplant in Russia

Association indicates that:
116.4 million, or 46% of adults are estimated

to have hypertension. ...
On average, someone dies of CVD every 38 seconds. ...
On average, someone dies of a stroke every 3.70 minutes.

of these tests:
Blood tests blood sample to look for signs

of diseases that can affect the heart. He or she may also check for a chemical called N-terminal pro-B-type natriuretic peptide (NT-proBNP) if your diagnosis isn't certain after other tests. B-type natriuretic peptide (BNP) blood test. BNP is a substance secreted from the heart in response to changes in blood pressure that occur when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen, and decrease when the heart failure condition is stable. The BNP level in a person with heart failure -- even someone whose condition is stable -- may be higher than in a person with normal heart function. BNP levels do not necessarily correlate with the severity of heart failure.

cardiac MRI, you lie on a table inside a long

tubelike machine that produces a magnetic field, which aligns atomic particles in some of your cells. Radio waves are broadcast toward these aligned particles, producing signals that create images of your heart.

sound waves to produce a video image of your heart.

This test can help doctors see the size and shape of your heart along with any abnormalities. An echocardiogram measures your ejection fraction, an important measurement of how well your heart is pumping, and which is used to help classify heart failure and guide treatment.

failure live longer and feel better. ACE inhibitors are a

type of vasodilator, a drug that widens blood vessels to lower blood pressure, improve blood flow and decrease the workload on the heart. Examples include enalapril (Vasotec), lisinopril (Zestril) and captopril (Capoten).
Angiotensin II receptor blockers.  These drugs, which include losartan (Cozaar) and valsartan (Diovan), have many of the same benefits as ACE inhibitors. They may be an alternative for people who can't tolerate ACE inhibitors.

and keep fluid from collecting in your body. Diuretics, such

as furosemide (Lasix), also decrease fluid in your lungs so you can breathe more easily.
Because diuretics make your body lose potassium and magnesium, your doctor may also prescribe supplements of these minerals. If you're taking a diuretic, your doctor will likely monitor levels of potassium and magnesium in your blood through regular blood tests.

failure in the hospital to improve heart pumping function and

maintain blood pressure.
Digoxin (Lanoxin). This drug, also referred to as digitalis, increases the strength of your heart muscle contractions. It also tends to slow the heartbeat. Digoxin reduces heart failure symptoms in systolic heart failure. It may be more likely to be given to someone with a heart rhythm problem, such as atrial fibrillation.

are potassium-sparing diuretics, which also have additional properties that may

help people with severe systolic heart failure live longer.
Unlike some other diuretics, spironolactone and eplerenone can raise the level of potassium in your blood to dangerous levels, so talk to your doctor if increased potassium is a concern, and learn if you need to modify your intake of food that's high in potassium.

rate and reduces blood pressure but also limits or reverses

some of the damage to your heart if you have systolic heart failure. Examples include carvedilol (Coreg), metoprolol (Lopressor) and bisoprolol (Zebeta).
These medicines reduce the risk of some abnormal heart rhythms and lessen your chance of dying unexpectedly. Beta blockers may reduce signs and symptoms of heart failure, improve heart function, and help you live longer.

contributing to your heart failure, your doctor may recommend coronary

artery bypass surgery. In this procedure, blood vessels from your leg, arm or chest bypass a blocked artery in your heart to allow blood to flow through your heart more freely.

your heart failure, your doctor may recommend repairing or replacing

the valve. The surgeon can modify the original valve to eliminate backward blood flow. Surgeons can also repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring around the valve (annuloplasty).
Valve replacement is done when valve repair isn't possible. In valve replacement surgery, the damaged valve is replaced by an artificial (prosthetic) valve.
Certain types of heart valve repair or replacement can now be done without open heart surgery, using either minimally invasive surgery or cardiac catheterization techniques.

pacemaker. It's implanted under the skin in your chest with

wires leading through your veins and into your heart.
The ICD monitors the heart rhythm. If the heart starts beating at a dangerous rhythm, or if your heart stops, the ICD tries to pace your heart or shock it back into normal rhythm. An ICD can also function as a pacemaker and speed your heart up if it is going too slow.

impulses to both of the heart's lower chambers (the left

and right ventricles) so that they pump in a more efficient, coordinated manner.
Many people with heart failure have problems with their heart's electrical system that cause their already-weak heart muscle to beat in an uncoordinated fashion. This inefficient muscle contraction may cause heart failure to worsen. Often a biventricular pacemaker is combined with an ICD for people with heart failure.

circulatory support device, is an implantable mechanical pump that helps

pump blood from the lower chambers of your heart (the ventricles) to the rest of your body. A VAD is implanted into the abdomen or chest and attached to a weakened heart to help it pump blood to the rest of your body.
Doctors first used heart pumps to help keep heart transplant candidates alive while they waited for a donor heart. VADs may also be used as an alternative to transplantation. Implanted heart pumps can enhance the quality of life of some people with severe heart failure who aren't eligible for or able to undergo heart transplantation or are waiting for a new heart.

place. He or she then attaches the major blood vessels

to the donor heart. The new heart often starts beating when blood flow is restored. Sometimes an electric shock is needed to make the donor heart beat properly.

an advanced age that would interfere with the ability to

recover from transplant surgery
Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
Have an active infection
Have a recent personal medical history of cancer
Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

surgery, complications may occur. Potential risks of a heart transplant

may include:
Infection
Bleeding during or after the surgery
Blood clots that can cause heart attack, stroke, or lung problems
Breathing problems
Kidney failure
Coronary allograft vasculopathy (CAV). This is a problem with the blood vessels that carry blood to the heart muscle itself. They become thick and hard. This can cause serious heart muscle damage.
Failure of the donor heart
Death

greatly enhance the quality and length of life for people

with severe heart diseases, such as:
Advanced heart failure.
Arrhythmia.
Cardiomyopathy.
Congenital heart disease.
Coronary artery disease.
Heart valve diseases.

the general approach is similar to that used for coronary revascularization or

valve replacement. Frequently, patients will have undergone a prior median sternotomy; repeat sternotomy is cautiously performed using an oscillating saw. The groin should be prepped and draped to provide a rapid route for cannulation for cardiopulmonary bypass (CPB) if necessary. After the pericardium is opened, the aorta is cannulated as distally as possible and the IVC and SVC are individually cannulated via the high right atrium. Manipulation of the heart before institution of CPB is limited if thrombus is detected in the heart with transesophageal echocardiography (TEE

the heart is arrested and excised The aorta and PA

are separated and divided just above the level of their respective valves, and the atria are transected at their grooves. A variant of this classic approach totally excises both atria, mandating bicaval anastomoses. This technique may reduce the incidence of atrial arrhythmias, better preserve atrial function by avoiding tricuspid regurgitation, and enhance cardiac output (CO) after transplantation.

to be connected to the native heart in a parallel fashion. The

main advantage of HHT is to assist the patient's native heart and to maintain circulation in the cases of severe acute rejection It is once-in-a-lifetime procedure a doctor performs. The surgery – known as a heterotopic or piggyback heart transplant – is rare and worldwide only about 150 such procedures have ever been reported