Transplant Team Committed to Ensuring a High Rate of Surgical Success

The Heart Transplant Program at University Hospitals Transplant Institute is on the leading-edge of organ transplant in every way. Along with the latest surgical techniques, our academic medical center research continually advances the safety and success of transplant procedures.

Successful heart transplant surgery has resulted in high patient satisfaction as well as approval and trust from referring physicians who are pleased with our well-designed transplant program and procedures.

All transplant surgeries at UH Transplant Institute take place at UH Cleveland Medical Center in Cleveland.

What Happens During Heart Transplant Surgery

A heart transplant requires open heart surgery and a stay in a hospital. The procedure may vary depending on your condition but generally follows this process:

• You will be asked to remove any jewelry or other objects that may interfere with the procedure and change into a hospital gown.
• A healthcare professional will start an intravenous (IV) line to inject medicine and to give fluids. Additional catheters will be put into the blood vessels in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples.
• A soft, flexible tube (Foley catheter) will be put into your bladder to drain urine.
• A tube will be put through your mouth or nose into your stomach to drain stomach fluids.
• If there is a lot of hair on your chest, it may be clipped or shaved.
• You will be given general anesthesia to put you in a deep sleep during surgery. Once you are asleep, a breathing tube will be put through your mouth into your lungs. The tube will be attached to a machine (ventilator) that will breathe for you during the surgery.
• The anesthesiologist will watch your heart rate, blood pressure and blood oxygen level during the surgery.
• The skin over your chest will be cleaned with an antiseptic solution.
• The surgeon will make an incision down the center of your chest from just below the Adam's apple to just above the navel.
• The surgeon will cut the breastbone (sternum) in half. Once cut, the surgeon will separate the two halves of the breastbone and spread them apart to reach your heart.
• The surgeon will put tubes into your chest so that your blood can be pumped through your body by a heart-lung (cardiopulmonary bypass) machine while your heart is stopped and replaced.
• Once the blood has been completely diverted into the bypass machine and is being pumped by the machine, your surgeon will remove the diseased heart.
• The surgeon will sew the donor heart into place. Once your new heart is in place, they will connect the blood vessels carefully so there are no leaks.
• When your new heart is fully connected, the blood circulating through the bypass machine is allowed back into the heart and the tubes to the machine are removed. Your surgeon will shock the heart with small paddles to restart the heartbeat.
• Once your new heart starts to beat, the team will watch the heart to see how it’s working and make sure there are no leaks.
• Wires for pacing may be put into the heart. Your surgeon can attach these wires to a pacemaker outside your body for a short time to pace your new heart, if needed, during the initial recovery period.
• The surgeon will rejoin the sternum and hold it together with small wires.
• The surgeon will close the skin over the sternum back together using stitches or surgical staples to close the incision.
• Tubes will be put into your chest to drain blood and other fluids from around the heart. These tubes will be connected to a suction device to drain fluids away from the heart as it heals.
• A sterile bandage or dressing will be applied.