Each heart transplantation patient benefits from a comprehensive set of quality assurance standards including functional status and patient satisfaction measurements, severity adjustments, clinical outcomes, and post discharge follow-up. Improving Selection With the remarkable success of heart transplantation in prolonging the lives of patients with end-stage heart disease, the list of potential recipients grows longer. As the need for healthy hearts becomes more acute, physicians at Penn Medical Center are working to improve the selection process so that patients who receive other treatments get the most benefit from the care they receive, preserving donor hearts for those who have no other choice. According to Timothy J. Gardner, MD, chief of cardiothoracic surgery, many patients who are referred to Penn Medical Center as candidates for heart transplantation can be treated with more conventional measures. Frequently, we can offer medical or surgical therapies short of transplantation that prove to be highly effective.
PET detects myocardial viability in patients with previous myocardial infarction or severe ischemia.
If live tissue still exists in the infarcted area, angioplasty or surgery can reperfuse that area, and the myocardial tissue can be salvaged and returned to contractile condition. New Drug Therapies New drug therapies are also available for heart failure patients, according to Evan Loh, MD, medical director of the heart failure and cardiac transplantation program. Persistent pulmonary hypertension, unresponsive to conventional vasodilators, is a major contraindication to heart transplantation. Endothelium-derived relaxant factor in the form of inhaled nitric oxide can help identify patients with reversible pulmonary hypertension who can undergo transplantation safely. Loh is also investigating the use of novel inotropic agents to support patients with advanced heart failure.