Heart Transplant Surgery

When you arrive at the hospital for surgery, you will be taken to taken to a prep area. You and your caregivers will meet with members of the transplant team, including your surgeon and anesthesiologist. You will also have a chest X-ray, EKG, and routine blood tests. The time between when you arrive at Duke University Hospital and when you go to the operating room (OR) for your transplant varies for each person; you may wait for several hours.

During transplant surgery, a heart-lung machine (also called cardiopulmonary bypass) will take over your heart’s function of circulating blood throughout your body. Your surgeon will make an incision down the length of your breastbone (sternum). Your diseased heart will be removed, and your new heart will be sewn into place. If you have a ventricular assist device (VAD), pacemaker, or defibrillator, it will also be removed.

Once the new heart begins beating, you’ll be taken off the heart-lung machine. The surgery usually lasts six to eight hours, but you may be in the operating room for much longer depending on the time required for the donor heart to be brought back to Duke. Your caregivers will be updated periodically about your condition during surgery and when it is complete.

After surgery, you will be transferred to the Cardiothoracic Intensive Care Unit (CICU) to recover. Most people are out of bed, walking, and working with a physical therapist within 24 hours after transplant surgery. When you are ready to leave the ICU (usually after two to four days), you will be transferred to a thoracic surgery step-down unit, where you will stay until discharge.

Before you leave the hospital, you will undergo testing to check for rejection and to ensure that your heart is functioning properly. Your transplant coordinator will provide training and resources to make sure you understand how to take care of your new heart. You and your family members and caregivers will learn more about required medications, follow-up appointments and tests, diet, protecting yourself from infection and rejection, and more. Most people who were in fairly good health before transplant are able to leave the hospital seven to ten days after surgery.

Step 4: After Transplant