When other treatments for advanced heart failure haven’t worked, we offer a wide range of options, including artificial heart devices and heart transplant. Our specialists work with you to determine the best treatment plan to meet your needs.

We offer several heart transplant options:

If your heart can no longer effectively pump on its own, we surgically connect an artificial pump to your heart called an LVAD.

A machine takes over the work of your heart for one to two weeks while awaiting your heart transplant surgery or LVAD placement.

Your diseased heart is removed and replaced with a healthy heart from a deceased donor.

We may discuss several alternative heart surgeries with you, including heart valve repair or heart bypass surgery.

The expert pediatric cardiologists at St. Louis Children’s Hospital offer hope for families of children who need a heart transplant.

Thanks to our affiliation with Washington University School of Medicine, you get access to leading-edge heart failure research and clinical trials.

Available trials may study:

• Medications for acute and chronic heart failure

• The role of exercise in patients with heart failure

• Remote monitoring of patient health status

• Implantable devices, including defibrillators, biventricular pacemakers and artificial heart devices

• Left ventricular assist devices (LVADs)

You stay in the hospital for two to three weeks following your heart transplant surgery. Our heart transplant team follows you closely as you recover from surgery. You are seen frequently in our outpatient clinic in the first few weeks after transplant.

If you live outside the St. Louis area, you can arrange temporary lodging near the hospital for the first few weeks of observation.

Follow-up care after a transplant is individualized, but patients often experience the following: 

1. The first four weeks: You have clinic visits once a week for the first four weeks after you leave the hospital. 

2. Biopsies during the first month: We do biopsies every seven to 10 days for the first month to check for potential rejection. 

3. The next two months: We see you every two weeks for the next two months for a biopsy and clinic visit. 

4. The rest of the first year: We see you monthly for a clinic visit. You may have a biopsy or AlloMap testing to check for potential rejection. 

5. Once per year afterward: We see you once per year for follow-up after the first year. We do not do regular biopsies, so you can avoid this more invasive procedure. Instead, our annual evaluation will consist of tests, including an echocardiogram and cardiac catheterization, to check for the presence of coronary artery disease (blocked arteries).

After several years, if you have no evidence of heart disease, you may be offered the option of medication or an exercise stress test (treadmill test) instead of a cardiac catheterization. We prefer to offer less-invasive options to make sure your heart is working well.

Organ transplantation requires life-long immunosuppressive medication. We help you understand your prescriptions and monitor you for side effects.

It is important to remember:

• Anti-rejection medications suppress your immune system so your body doesn't reject the transplanted heart.

• Because the medication suppresses your immune system, you are more prone to infection, especially during the first three to six months after transplant.

Our team helps you avoid and manage rejection by:

• Discussing the signs and symptoms of rejection with you

• Testing and routine clinic appointments

• Treating rejection with additional medication to prevent complications

The risk of rejection decreases over time but can occur at any time. Follow your medication regimens and physician orders to prevent rejection. If you experience any unusual symptoms, call your transplant nurse coordinator immediately.

Symptoms of rejection may include:

• Drop in blood pressure

• Fast heartbeat or skipping some beats

• Fatigue/weakness

• Low-grade fever

• Nausea

• Not feeling "quite right" or flu-type aches and pains

• Shortness of breath

• Sudden weight gain

• Swelling of hands or feet