Heart Transplantation is a major heart surgery. It is considered for a patient with heart disease only when there is no other option to make him/her to live longer with quality life and without it person is unlikely to live longer than a few months.
Classical indications for Heart Transplantation are:
1.NYHA class III or IV* Heart Failure refractory to medical and surgical therapy. Objective data would include a reduced left ventricular ejection fraction
2.Inoperable CAD with intractable angina/equivalent symptoms
3.Malignant ventricular arrythmias unresponsive to medical or surgical therapy.
Patients accepted as transplant candidates should have recent right heart catheterization test., Left ventricular ejection fraction and oxygen consumption measurements within 6 months.
All these patients need to undergo rigorous pre-operative assessment to correct any correctable causes for heart damage and for evidence of major infection or tumors in the body. Once they are deemed fit for this surgery, they are put in the waiting list by the center which performs these transplants.
- NYHA Class Symptoms I : No symptoms and no limitation in ordinary physical activity, e.g. shortness of breath when walking, climbing stairs etc.
- NYHA Class Symptoms I I: Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity.
- NYHA Class Symptoms I I I: Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20–100 m). Comfortable only at rest.
- NYHA Class Symptoms I V: Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients.