Every patient who comes to the Hartford Hospital Transplant program with advanced heart failure wants a second chance at life.
Our mission for all of our patients is to make every transplant as good as the program’s first in 1984. That year, Andrzej “Andy” Buczek of Farmington, became the first successful heart transplant recipient in Connecticut history when doctors at Hartford Hospital, led by cardiothoracic surgeon Henry B.C. Low, performed the procedure with a team of surgeons, clinical cardiologists and immunologists.
Since 1984, our program has performed more than 500 heart transplants.
Today, the Heart Transplant team includes heart failure specialists, transplant surgeons, transplant coordinators, transplant nurses, social workers, a transplant psychologist, dentists, nutritionists, transplant pharmacy specialists and infectious disease experts.
We are dedicated to providing comprehensive care from the time the patient is referred to the program and indefinitely after transplantation. There is nothing more rewarding to our entire team than seeing our sickest patients do well following transplant.
Heart Failure Facts
- About 6.2 million adults in the United States have heart failure, according to the Centers for Disease Control and Prevention.
- In 2018, heart failure was mentioned on 379,800 death certificates
- Approximately 550,000 new cases are diagnosed in the U.S. each year.
- Congestive heart failure affects people of all ages, from children and young adults to the middle-aged and the elderly
- In 2020, 3,658 heart transplants were performed in the U.S.
What is Congestive Heart Failure?
A healthy heart pumps blood and oxygen to your organs so your body functions properly. With congestive heart failure, a weakened heart muscle can’t keep up with the body’s needs to pump out blood. When this happens, fluid builds up in the lungs or other parts of the body.
Signs of heart failure:
- Shortness of breath
- Feeling tired
- Swelling in the feet/ankles/legs
- Weight gain
- Loss of appetite/upset stomach
Potential heart transplant recipients are usually referred to Hartford Hospital when their cardiologist finds that their heart function has worsened despite changes in lifestyle, diet and medications. Your cardiologist might recommend an examination at Hartford Hospital to determine the best treatment for your condition, which might be a transplant.
Some causes of heart failure that result in heart transplantation:
Primary cardiomyopathy: A weakened heart muscle with no other signs of cardiac issues.
Coronary artery disease: Narrowing or blocking of the coronary arteries.
Dilated cardiomyopathy: An enlarged, dilated and weakened left ventricle, the heart’s primary pumping chamber, can’t pump blood as it should
Valvular heart disease: A damaged or defective heart valve (mitral, aortic, tricuspid or pulmonary).
Congenital heart disease: A structural heart problem that’s a birth defect.
Inoperable hypertrophic cardiomyopathy: Thickened heart muscle that makes it more difficult to pump blood.
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If You’re a Candidate for a Heart Transplant
Patients with advanced heart failure, or those with heart disease that has not responded to any medical treatment, should be considered for transplant evaluation.
Here’s a closer look at our team of specialists who will evaluate you:
Heart Failure Cardiologist: Determines the extent of your heart disease and if a transplant is a possible treatment option for you. The cardiologist also oversees your care after your heart transplant.
Transplant Coordinators: These nurses and/or advanced practice nurses collect and review information on your overall physical health and information from other specialists who evaluate you. They answer all your questions about a transplant and will help with your medical care after the surgery.
Transplant Social Workers and Psychologists (as needed): An assessment of your mental health and your well-being and support structure. You can also talk to these specialists about any concerns before the transplant.
Transplant Dietitian: Reviews your current nutrition, with recommendations on a post-transplant diet.
Transplant Pharmacist: Checks your current medications and possible drug interactions, helps you learn about your transplant medications.
Transplant Financial Coordinator: Reviews your current insurance coverage for heart transplant evaluation, surgery and medications. We can also help connect you with other resources, if needed, to help cover the cost of transplant.
Infectious Diseases Doctor: Reviews your lab results and vaccination records, checks to see if you need any vaccinations before the transplant and identifies possible infection risks that could become a problem.
Transplant Surgeon: Reviews information about the surgery and heart donor. This is the doctor who will perform the operation.
Once the evaluation is complete, the transplant team will recommend treatment options and discuss if a heart transplant is the best option. The risks and benefits will be discussed with each patient.
If you’re accepted for transplantation, your name is placed on the national transplant waiting list maintained by the United Network for Organ Sharing (UNOS). The time on the waitlist varies depending on the supply of donor hearts available, blood type and the urgency of everyone on the waiting list. While waiting, the patient is followed in the office periodically to assist with any medical issues that may arise.
As you wait, you’ll visit our doctors as needed for any medical issues.
While You’re Waiting: Ventricular Assist Devices
A heart pump, or ventricular assist device, can save the life of a patient with a failing heart who is awaiting a transplant. These pumps help move blood from the ventricles, the lower chambers of the heart, to the rest of your body. For those expecting a transplant, these are known as bridge devices – they sustain your heart as you await a replacement.
Emerging research suggests what was once thought impossible: Some patients find that a ventricular assist device, or VAD, find that their hearts actually improve with help from these mechanical pumps.
Left Ventricular Pumps
A ventricular assist device is most often used to assist blood flow in the left ventricle, which pumps oxygenated blood to the rest of the body. When used in the left ventricle, these devices are known as left ventricular assist devices, or LVADs.
Here are types of LVADs:
ECMO: Hartford Hospital is among the few hospitals in the region with an artificial heart-lung machine known as ECMO, or Extracorporeal Membrane Oxygenation, that oxygenates and pumps blood outside the body, assuming the duties of your heart and lungs.
Left-heart Impella: The left-heart version of the world’s smallest heart pump, the pump within a catheter.
HeartMate: Assists a weakened heart pump blood.
Vented electric HeartMate: An electric motor inside the pump is powered and controlled externally.
Right Ventricular Pump
The pump the transplant team recommends is the world’s smallest, the right-heart Impellato assist blood flow from the right ventricle to the lungs.
It’s actually a pump with a catheter, placed from the inferior vena cava through the right atrium and right ventricle, ultimately positioned in the pulmonary artery. This pump assumes the function of the right ventricle by withdrawing blood from the inferior vena cava and pumping it into the pulmonary artery.
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Heart Failure Infusion Program
Hartford Hospital’s Heart Failure Infusion Program is changing the way today’s patients live with heart disease. Our outpatient treatment facility is dedicated to caring for patients with advanced heart failure.
We offer:
- Ventricular assist devices, the mechanical pumps that facilitate normal blood flow in people with a weakened heart.
- Intravenous administration of medications that restores normal fluid status and improves symptoms rapidly.
- Nutritional counseling to help patients adhere to a complex medical regimen and a specialized low-sodium diet. Patients learn to recognize weight gain that signals fluid retention.
- Cardiac rehabilitation and individualized exercise plans that strengthen the heart muscle to improve circulation and support recovery.
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