Heart transplantation is the surgical procedure aimed at implanting a healthy heart from a recently deceased donor in an individual with severe heart failure .
Heart failure means that serious pathological condition in which a person's heart is irretrievably damaged and no longer "works" as it should; in other words, it is difficult to pump blood into the circulation and to supply the various organs and tissues of the body with oxygen.
The most frequent causes of heart failure are: coronary heart disease, cardiomyopathies, heart valve defects ( valvulopathies ) and congenital heart defects .
The traditional intervention procedure - designed in 1958 by two American cardiac surgeons named Norman Shumway and Richard Lower - is called orthotopic and includes the following operational steps:
- Sternotomy . It is the surgical opening of the sternum, which allows the surgeon to access the chest cavity in which the heart resides.
- Opening of the pericardial sac and deviation of the patient's blood vessels towards the so-called heart-lung machine . The latter provides extracorporeal circulation and takes the place of the heart or lungs.
- Removal of the diseased heart, with the exception of part of the left atrium, and insertion of the "new" heart . It is important to remind readers that the heart of a donor declared in brain death is still vital and beating. Therefore, at the time of its collection, it must be temporarily stopped by an injection of potassium chloride.
- Connection, by means of sutures, between the "new" heart and the recipient's afferent and efferent cardiac vessels . After this phase, the operating surgeon must make sure that the heart has started to beat again.
- Disconnecting the patient from the heart-lung machine and closing the chest .
The donor's heart is kept in ice: here, the organ can survive without blood supply for about 4-6 hours. Then it becomes unusable.
