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Overview

Heart Transplant: Procedure, Recovery, Cost, Risk & Complication

What is Heart Transplant?

A heart transplant is a surgical procedure where a failing or diseased heart is replaced with a healthier heart. This treatment is usually recommended to patients whose conditions have failed to show any improvement even after medications and other surgeries. In most cases, a brain-dead patient is considered as a donor for a heart transplant.

Before a heart transplant, an assessment will be done for checking whether you are suitable for a heart transplant. You would be then put in the waiting list, where you have to wait till the time you get a suitable donor. It may take a few days to get a donor, but in some cases it may even take months or years.

Indication

A patient may need a heart transplant in the following conditions:

  • Coronary artery disease
  • Cardiomyopathy, a condition where your heart muscles get weakened
  • Heart valve disease
  • Congenital heart defect (problem in the structure of the heart from birth)
  • Abnormal rhythms of the heart that keep recurring and cannot be controlled by medications
  • Amyloidosis (deposit of abnormal proteins in organs and body tissues)
  • A previous heart transplant that has failed

What Procedure is followed :

Pre Procedure

The pre-procedure guidelines before undergoing a heart transplant are:

  • First and foremost, you will be evaluated to check for certain conditions like if you are healthy enough for undergoing the surgery and the lifelong medications that you need to take post-surgery.
  • While you will be put on the waiting list for a suitable heart donor, make sure that you are nearby as you can get a call any moment. You will be informed once the donor heart is available and you need to come to the hospital immediately.
  • Timing is an important factor here as the donor heart can survive only for 4-6 hours after taken out from the body.
  • Once you arrive at the hospital, you will be administered the pre-operative medicines and prepared for the surgery. The chest area will be shaved, and rubbed with an antiseptic lotion. The IV line will be started, for administering the anaesthesia.

During Procedure

Heart transplant surgery is basically an open heart surgery that may take several hours. General anaesthesia will be administered in this procedure. You will be connected with a heart-lung bypass machine to ensure there is proper blood flow during the whole operation. The surgeon first makes an incision in the chest, and opens the rib cage to get access to your heart. The diseased heart is then removed and the donor heart will be placed in its place. The surgeon will then attach the major blood vessels to the donor heart. Once the blood flow gets restored, the heart starts beating again. In some cases, an electric shock needs to be given for the heart to start beating properly.

Post Procedure

Post surgery, you will be shifted to the ICU where you have to stay for a few days. During this time, you will be closely monitored by the doctors to see how the donor heart is functioning, or watch out for any symptoms of rejection like fever, fatigue, shortness of breath, etc. You will be given medications for your pain. There would also be drainage tubes fitted so that the excess fluid can be removed from the chest cavity. Generally, you will have to spend 1-2 weeks at the hospital, although it depends on your rate of recovery.

There will be several follow-up tests and appointments with the doctor in the initial months. In the first few months after a heart transplant, you will also have to undergo biopsy test at regular intervals so that the doctor can analyse if your body is rejecting the donor heart or not.

Risk & Complication

The possible risks or complications of a heart transplant may include:

  • Bleeding or infection from the incision site
  • Formation of blood clots
  • A sudden stroke
  • Rejection of the donor heart by your body
  • Problems in the coronary arteries, where the walls of the arteries may thicken or harden, leading to heart failure or irregular heart rhythms
  • The medications that you have to take for the rest of your life can lead to health issues like high cholesterol, diabetes, high blood pressure, kidney damage or osteoporosis. The medicines can also increase your risk of cancer and infection, as it decreases the ability of your body to treat infections.

More Info

There will be several adjustments that you will need to make in your lifestyle after a heart transplant. There will be some medicines that you have to take for the rest of your life, which may make you more vulnerable to infection and develop health conditions like high cholesterol, high blood pressure or diabetes. Gradually, the dosage might decrease depending on your condition. Ensure that all the medications are taken regularly. Eating a healthy diet, exercising regularly and avoiding tobacco products are the basic changes that needs to be made in your daily life. Your doctor may also suggest a cardiac rehabilitation programme for you, involving exercising and diet guidelines to recover better after a transplant.

The cost of a heart transplant would be approximately Rs. 15 lakhs – Rs. 20 lakhs.

Popular Health Tips

Heart Transplant - How To Manage Your Life Post Surgery?

MCH DNB (CTVS), Advanced fellowship, MS
Cardiologist, Delhi
Heart Transplant - How To Manage Your Life Post Surgery?

Heart transplant surgery is one of the most critical cardiac surgeries that exists. Since the procedure requires an open-heart surgery, it often takes a long time to complete the operation. General anaesthesia is applied to the patient so that he doesn't feel a thing. The surgeon then connects the patient to the heart-lung bypass machine so that oxygen-rich blood keeps flowing inside the body. The surgeon then separates the chest bone, opens the rib cage, takes out the old heart to replace it with the new one. As soon as the blood flow is restored, the new heart starts functioning (pumps blood). Sometimes an electric shock is required to make the new heart work.

What to expect after the procedure?
The patient is given pain medications and connected to a ventilator. It helps the patient to breath and ejects body fluid. The medications and the fluid in transferred to the body through IV tubes. The patient is kept in an intensive care unit till his condition stabilizes. He might have to spend a couple of weeks to one month in the hospital before he is permitted to go home.

What to expect after the patient is released from the hospital?
The patient is now closely monitored by the transplant team at the outpatient transplant center. Since the intensity and the frequency of the monitoring are frequent, many patients chose to stay close to the hospital. Frequent tests such as regular blood work, echocardiogram, heart biopsies etc. are conducted at regular interval to monitor any signs of the body rejecting the new heart.

What are the long-term adjustments needed?
consumption of immunosuppressants medications would be sacrosanct for the rest of the life. Since the immune system would never fully accept the new organ, immunosuppressant would ensure that the body's antibodies do not attack the new organ. Over time though, as the risk of rejection comes down, the dosage of the immunosuppressant is reduced by the doctor. Since immunosuppressant has some side-effects, a doctor also prescribes certain antifungal, antiviral and antibacterial medications as well.

  • Managing therapies, medications and lifelong health plan: Heart transplant essentially means following a set of lifelong instructions as prescribed by the doctor. Taking medications on time, eating healthy, regular exercise, skipping junk foods, refraining from tobacco and alcohol are some of the instruction a patient might have to abide by for the rest of his life. Meeting the doctor once in a quarter is also important to ensure that any upcoming complications could be addressed proactively.
  • Emotional Support: Often patients feel overwhelmed by the experience of a heart transplant. The stress of the procedure gets to some patients resulting in less sleep, low appetite, lethargy etc. It makes sense to talk to the doctor and seek help for the same.
4635 people found this helpful

Heart Transplant - When Is It That You Have To Go For It?

MCH DNB (CTVS), Advanced fellowship, MS
Cardiologist, Delhi
Heart Transplant - When Is It That You Have To Go For It?

There are many people worldwide who suffer from heart problems (irrespective of their age and sex). While in most cases, the condition improves with proper treatment and medications, in few, the condition is beyond treatment. A heart transplant comes as a savior for such people. It gives them a new lease of life. The transplant involves replacing a heart that has stopped functioning normally (damaged or may be diseased) with a healthy heart (from the donor).

Over the years, heart transplant has undergone a sea of change. With the advancement of science and technology, the success rate in a heart transplant has seen an exponential rise.

People who need a heart transplant:
A heart transplant may be essential in the following cases.

  • A congenital heart disorder (a person born with a heart problem).
  • Defective or diseased heart valves.
  • Amyloidosis (a condition where amyloid fibrils get deposed in the tissues and organs of the body intracellularly or extracellularly).
  • Problems in the coronary artery.
  • Cardiomyopathy (A condition where the muscles of the heart become weak, thereby affecting the normal functioning of the heart).
  • A heart transplant that failed previously.
  • Ventricular Arrhythmias (a condition that originates in the ventricles, in ventricular arrhythmias, the heart rhythms are abnormally rapid).


However, under the following circumstances, a heart transplant may not be a wise idea

  • People with infections or chronic lung or kidney disorders.
  • A case of cancer in the past.
  • Age may be a deciding factor.The recovery from a heart transplant may not be 100% in an aged person.

The heart transplant procedure:
The first step in heart transplant is the availability of a suitable donor. In this case, a donor is a person whose brain is dead but the other organs, including the heart, is healthy and functioning properly. A surgeon performs three operations in a heart transplant.

  • The first operation is essentially the removal of the healthy heart from the donor body. The heart is kept in a cool place, preferably ice (to keep the heart alive and in good condition until the heart transplant takes place).
  • In the second operation, the recipient's damaged or diseased heart is operated out.The situation may, however, be complicated if the patient had a heart surgery in the past.
  • The third and the final surgery involves implanting the donor heart into the recipient body (the recipient's upper heart chambers and the atrial back wall are however not removed).
  • Once the implantation takes place (without any complications), the surgeons sew the heart into place.
  • The blood vessels are then connected back to the heart and the lungs. The heart starts beating again once it is warmed up.
  • To enable the patient to receive the nutrients and oxygen (during the heart transplant), the patient is put on a heart-lung machine.
  • If no complications develop after the transplant, the patient is discharged within a fortnight.

In some unfortunate cases, there may be organ rejection. The condition arises when the recipient's immune cells see the transplanted heart as non-self (foreign agents). If left unattended, it may damage the heart. Immunosuppressant drugs can help avert the rejection. However, it is important to monitor the patient closely for any infections that may arise to the administration of the immunosuppressants. If you wish to discuss about any specific problem, you can consult a Cardiologist.

2589 people found this helpful

Heart Transplant - When to Go For it?

M.Ch. CVTS
Cardiologist, Ahmedabad
Heart Transplant - When to Go For it?

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

Why it's done

Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by several conditions, including:

  1. A weakening of the heart muscle (cardiomyopathy)
  2. Coronary artery disease
  3. Heart valve disease
  4. A heart problem you're born with (congenital heart defect)
  5. Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
  6. Amyloidosis
  7. Failure of a previous heart transplant
  8. In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.

Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers. Multiorgan transplants include:

  1. Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
  2. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
  3. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.

Factors that may affect your eligibility for a heart transplant

A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:

  1. Are an advanced age that would interfere with the ability to recover from transplant surgery
  2. Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
  3. Have an active infection
  4. Have a recent personal medical history of cancer
  5. Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

What happens after the transplant?

Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.

In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.

Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.

Once you feel fit and able, you can start doing things like light vacuuming or light gardening. If you wish to discuss about any specific problem, you can consult a cardiologist.

2797 people found this helpful

Cardiomyopathy - Types, Causes and Treatment

DM Cardiology
Cardiologist, Delhi
Cardiomyopathy - Types, Causes and Treatment

Our heart is basically a muscle. So when this muscle weakens the heart is unable to do its function i.e., to pump blood throughout our body and keep us alive.

The heart muscle gets progressively weak due to a disease called cardiomyopathy.

There are different types of cardiomyopathy caused by different causes. Untreated cardiomyopathy can lead to heart failure or early death. Treatment can’t cure the condition but can give you extra healthy years of life and prevent serious complications.

Cardiomyopathy has 4 main types, they are:

  1. Dilated Cardiomyopathy: This is the most common form and its principal cause is that your heart muscle becomes too weak to pump blood. The heart muscles stretch and become thinner in this case leading to the four chambers of the heart to expand causing a pathology called an enlarged heart.

  2. Hypertrophic Cardiomyopathy: This happens due to genetics. It occurs when the walls of your heart thicken and prevent the flow of blood through this natural pump.

  3. Arrhythmogenic Right Ventricular Dysplasia: This is a rare form of cardiomyopathy. It causes sudden deaths of athletes and is caused when fat and fibrous tissues replace muscle in the right ventricle of the heart.

  4. Restrictive Cardiomyopathy: This is the least common form of the disease. The cause is the stiffening of the ventricles, the part of the blood which receives blood. When these stiffen, the heart doesn’t get enough blood to oxygenate. Scarring of the heart due to heart disease and a heart transplant operation can be a cause of this stiffening.

  5. Ischemic Cardiomyopathy: Ischemic cardiomyopathy is caused due to coronary artery disease which causes blood vessels supplying blood to the heart to become narrow. The heart doesn’t get enough oxygen and a person can die due to a heart attack.

  6. Other types of cardiomyopathy are grouped into this category and can include:

    • Left ventricular noncompaction happens when the left ventricle has trabeculations, projections of muscle inside the ventricle.

    • Peripartum cardiomyopathy, another form of the disease can occur during or after pregnancy. This is a form of dilated cardiomyopathy and can be fatal. There’s no documented cause.

    • Alcoholic cardiomyopathy is caused due to alcoholism causing an enlargement of the heart.

    • Takotsubo cardiomyopathy, or broken heart syndrome, happens when extreme stress leads to heart muscle failure. Though rare, this condition is more common in post-menopausal women.

Treatment

Doctors will decide the treatment after finding out the extent of damage due to cardiomyopathy.

Few people will not require treatment till symptoms like chest pain, dizziness, shortness of breath and edema appear.

Others whose life is affected due to symptoms are treated with lifestyle changes and medicines. The bad news is that cardiomyopathy can’t be cured but can only be managed and controlled by doing the following:

  1. Heart-healthy lifestyle changes are key. You will be advised to maintain a healthy weight, eat a modified diet, get enough sleep, manage stress, and quit smoking.

  2. Exercise is also crucial to keep the heart healthy and maintain a healthy weight through regular bouts of low-intensity exercise.

  3. Medications for high blood pressure will be prescribed to prevent water retention, keep the heart beating normally, prevent blood clots and reduce inflammation.

  4. Pacemakers and defibrillators can be implanted.

  5. Surgery like heart transplant can be done as a last resort. If you wish to discuss about any specific problem, you can consult a homeopath.

4002 people found this helpful

Heart Transplant - What To Know?

Fellowship In Electrophysiology, Fellowship In Interventional Cardiology, DM - Cardiology, MD - Medicine, MBBS
Cardiologist, Delhi
Heart Transplant - What To Know?

A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

Why it's done

Heart transplants are performed when other treatments for heart problems haven't worked, leading to heart failure. In adults, heart failure can be caused by several conditions, including:

  1. A weakening of the heart muscle (cardiomyopathy)
  2. Coronary artery disease
  3. Heart valve disease
  4. A heart problem you're born with (congenital heart defect)
  5. Dangerous recurring abnormal heart rhythms (ventricular arrhythmias) not controlled by other treatments
  6. Amyloidosis
  7. Failure of a previous heart transplant
  8. In children, heart failure is most often caused by either a congenital heart defect or a cardiomyopathy.

Another organ transplant may be performed at the same time as a heart transplant (multiorgan transplant) in people with certain conditions at select medical centers. Multiorgan transplants include:

  1. Heart-kidney transplant. This procedure may be an option for some people with kidney failure in addition to heart failure.
  2. Heart-liver transplant. This procedure may be an option for people with certain liver and heart conditions.
  3. Heart-lung transplant. Rarely, doctors may suggest this procedure for some people with severe lung and heart diseases, if the conditions aren't able to be treated by only a heart transplant or lung transplant.

Factors that may affect your eligibility for a heart transplant

A heart transplant isn't the right treatment for everyone. Certain factors may mean you're not a good candidate for a heart transplant. While each case is considered individually by a transplant center, a heart transplant may not be appropriate if you:

  1. Are an advanced age that would interfere with the ability to recover from transplant surgery
  2. Have another medical condition that could shorten your life, regardless of receiving a donor heart, such as a serious kidney, liver or lung disease
  3. Have an active infection
  4. Have a recent personal medical history of cancer
  5. Are unwilling or unable to make lifestyle changes necessary to keep your donor heart healthy, such as not drinking alcohol or not smoking

What happens after the transplant?

Most people leave hospital within about four weeks of the operation, but depending on your condition, you may need to stay in hospital for longer.

In the first few months after your surgery you will need to spend a lot of time visiting the hospital – you might even need to stay near the transplant centre. Your transplant team will talk to you about practical arrangements for after your surgery.

Although you will be weak after the operation, recovery can be very quick. It is important to build up your level of activity gradually. You should avoid activities involving lifting and pushing until your breastbone is fully healed, which can take up to three or four months.

Once you feel fit and able, you can start doing things like light vacuuming or light gardening.

2003 people found this helpful

Popular Questions & Answers

Hi, before a month she had an operation of heart transplant now she is unable to go to washroom I mean like constipation.

BHMS
Homeopath, Faridabad
Hello, you want a solution for constipation then take bio combination no. 04, 4 tablets at a time, three times a day, 15 min. after meals. Alpha LIV, 2 tsp daily after dinner. Avoid the following foods that can cause constipation include: Chocolate Dairy products Red meat Bananas and Caffeine Tips to Prevent Constipation Have more fibres in your diet. 25 to 30 grams of daily intake can prevent constipation. Fibres help retain water in the stools thus making them softer and easier to expel. Whole grain cereals and breads Dried fruits, such as prunes and raisins Popcorn, nuts, and seeds Beans and legumes Raw fruits and vegetables Drink plenty of fluids, preferably water. 8 glasses a day will help. Have more if you are physically active. Prune (manukka) juice, and other fruit drinks are known to normalize bowel motility.
1 person found this helpful

Is there any solution for heart muscles weakening, I'm afraid that is it leads to a heart transplantation?

MBBS, MD-General Medicine, DM - Cardiology
Cardiologist, Secunderabad
Hello lybrate-user. Heart transplantation is the lasr resort, only after all the options are exausted. There can be quite improvement with proper treatment which includes diet, exercise and medications. Apart from this there are options for devices which can improve the pumping. If the heart weakness is due to a reversible cause then it can also be taken care of. So be optimistic and enjoy life.
15 people found this helpful

I have diabetes and my heart pumping is 15%. What should I do? My doctor advice me for heart transplant.

Bachelor of Unani Medicine and Surgery (B.U.M.S)
Ayurveda, Kanpur
Yogendra ras 125 mg twice a day hridyavaran avleh 10 gm twivce a day jawahar mohara pisti 500 mg twice a day contact with reports.

What are the precautions required for an ADS patient? Is there possibility of heart transplantation?

Homeopath, Buldhana
AIDS patients need to protect themselves from sources of infection. Also ensure not infecting others through their body fluid or mucosal membrane. Heat transplantation is possible theoretically however risks are very high of post operative infections. So not advisable.
1 person found this helpful

My father is 72 years old. Is heart failure patient no blockage in heart. Eco is showing 35. Doctor said heart transplant. Suggest Ayurveda medicine and doses for a day please.

International Academy of Classical Homeopathy, BHMS
Homeopath, Pune
U may take below course if your interested in homoeopathy Cratagus mother tincture for WK Cactus 3c 3tims day for WK Digital 12c as above.

Table of Content

What is Heart Transplant?

Indication

What Procedure is followed :

Risk & Complication

More Info

Play video
ECMO - Extracorporeal Membrane Oxygenation
I am Dr. Kewal Krishan. I am a cardiac surgeon at max hospital, Saket. I am director of heart transplant ventricular assist device program. We have a separate vertical. Its only vertical in this country.

A spate department for heart transplant ventricle assist device and ECMO. When I was trained in US at MIO clinic and mount san in New York and then I came back to India and we started this ECMO program. ECMO is a Extracorporeal membrane oxygenation. When your patient is on ventilator in ICU and they are told that we don t have any other option. When your lungs are completely diseased because of swine flu or other pneumonia or some any reason. The ventilator despise 100% settings of ventilator a full ventrilatory support, they are not being oxygenated, the organs will dead and the patient will die. So what we do is we put these patients are referred to us to put the patient on ECMO. ECMO is basically takes out 5 litters of blood in a minute from the body and puts back the oxygenated blood. Weather your lungs are working or not for a few days we can be use this. This thing, this thing, this particular therapy can be used up to 28 days to 36 days and what we do is we put the patient on ECMO, the ventilator settings we keep to the down level so the hearts, the lungs they get, they take rest. And it can be used either for heart or for lungs or for both the organs and once the patients get better we wean the ECMO and we put the patient, we remove the ECMO and patient goes home safely. We have done so far 52 ECMOs . so probably this is the maximum number in the country. We have referral number center for ECMO in this north India and, and our results are close to, to the international results, 60 to 70% results. I am talking of those patients those who otherwise would have died had they not put on ECMO. So believe me it s a very important tools to save many lives. If your patient is on ventilator and Dr. says now there is no chance for survival you should first, I think you should concern, consult for weather their patient can be put on ECMO and save their life. And that s the way we save many lives because of far acute conditions.

Thank you very much and if you can, you can go more on detail on this you go on my website, kewalkrishan.com or you can go to Lybrate website.
Play video
Heart Transplant and Ventricular Cyst Device
I am Dr. Kewal Krishan. I am a cardiac surgeon at max hospital, Saket. I am director of the program of heart transplant. And we have separate vertical of a heart transplant advert and echmo. I was trained in US in MIO clinic as well as mount stannic New York for five years and then came back to this country to start heart transplant, ventriculus device and echmo program.

So we have started this heart transplant program for those patients who are in end stage heart failure those who have already burned out, ejection fraction is less than 25% and they have problems of breathlessness or the problem of walking. When these patients go to other physicians they are they told them, give medications and there is no treatment left after this. So these patients we offer them heart transplant. Heart transplant is basically you take out the diseased heart and put a new heart which require a diseased brain death donor which is allocated by NOTO, National organ Tissue and transplant organization. So another thing is ventricular assist device which is an artificial pump which we, which we put in the heart and that takes blood from the heart and puts that blood into the aorta so it works as a left ventricle or right ventricle and or by ventricular so the patient life s becomes normal, because before that the blood pumping was 2 litters and once we put the device or we put a new heart the pumping become 5 litters which is a normal and patient start to get blood to all organs and they become normal and their life becomes normal with that. So those patients who are with end stage heart failure, they are told by their physicians that there is no other treatment left for these, these patients. They can come to us and they can go to my website kewelkrishan.com and visit and what are the options left over for such kind of patients. So I am doing these surgeries for many years, almost 11 years I am doing this and results are really good. 90, more than 90% a 1 year survival, I am talking of those patients who otherwise die in 1 year so we, first the patient comes to us, we work up the patient, weather patient qualifies the heart transplant ventricle assist device or heart lung transplant and then we offer them accordingly and we put the patient, if the patient is ready to go to ventricular assist device which the cost is close to 19 lac and for the heart transplant the cost is close to 18 lac to 22 lac depending upon the age and other factors. So these patients they get benefit, they can speak to our previous patients also, how their life has transformed from a diseased patient to a normal person and they live a good quality of life and quality of life with either transplant or ventricular assist device it s close to 15 to 20 so it s not less. So it s like a normal life so, and they live a normal life. People even can t make they are going through this procedure.

So for future if you have any problem you can go to Lybrate to find my contact and contact me.

We will treat your patients and make them happy.
Having issues? Consult a doctor for medical advice