question: How do doctors restart a dead donated heart?
comment: > And if they can make a dead heart beat again then why is it so difficult to revive a flat-lined person? They mostly can't. Donated hearts are not transported like most other organs. Donor hearts come exclusively from brain-dead but still technically living patients who are transported in full to the operating room, where the heart can be immediately given to the recipient while it's still beating. [Technologies are being developed]( URL_0 ) to preserve a heart from a truly dead patient *provided* the heart is in good shape and removed quickly. Hearts can spontaneously restart, provided they continue to receive oxygen and the tissue stays alive. From there, doctors can certain drugs to stimulate the nerves to begin firing again, maybe.
passages: BULLET::::9. The heart is restarted by removing the aortic cross clamp; or in "off-pump" surgery, the stabilizing devices are removed. In cases where the aorta is partially occluded by a C-shaped clamp, the heart is restarted and suturing of the grafts to the aorta is done in this partially occluded section of the aorta while the heart is beating.
  
  BULLET::::10. Once the grafts are completed distally and proximally, the patient is rewarmed to a normal temperature and the heart and other pressures are normal to support coming off the bypass machine, weaning off the bypass machine begins.
   In January 2010 Thoratec acquired catheter-based heart pump technology from the Swedish medical-technology company Getinge. The technology is for use in a minimally invasive, acute cardiac axial-flow pump that can be delivered percutaneously in a cardiac catheterization lab or operating room.
   Once the procedure on the heart vessels (coronary artery bypass grafting) or inside the heart such as valve replacement or correction of congenital heart defect, etc. is over, the cross-clamp is removed and the isolation of the heart is terminated, so normal blood supply to the heart is restored and the heart starts beating again.
   BULLET::::- In July 2009 in England, surgeons removed a donor heart that had been implanted in a toddler next to her native heart, after her native heart had recovered. This technique suggests mechanical assist device, such as an LVAD, can take some or all the work away from the native heart and allow it time to heal.
  
  BULLET::::- In July 2009, 18-month follow-up results from the HeartMate II Clinical Trial concluded that continuous-flow LVAD provides effective hemodynamic support for at least 18 months in patients awaiting transplantation, with improved functional status and quality of life. (see below).
   BULLET::::- With LVEF ≤ 35% due to prior Myocardial Infarction (MI) who are at least 40 days post-MI and are in NYHA Functional Class II or III
  
  BULLET::::- With LV dysfunction due to prior MI who are at least 40 days post-MI, have an LVEF ≤ 30%, and are in NYHA Functional Class I
  
  BULLET::::- With nonischemic DCM who have an LVEF ≤ 35% and who are in NYHA Functional Class II or III
  
  BULLET::::- With nonsustained VT due to prior MI, LVEF  40%, and inducible VF or sustained VT at electrophysiological study
   In some cases, doctors recommend surgery to treat the underlying problem that led to heart failure. Different procedures are available depending on the level of necessity and include coronary artery bypass surgery, heart valve repair or replacement, or heart transplantation. During these procedures, devices such as heart pumps, pacemakers, or defibrillators might be implanted. The treatment of heart disease is rapidly changing and thus new therapies for acute heart failure treatment are being introduced to save more lives from these massive attacks.
   Revivent
  
  Revivent is a medical device used to treat heart failure due to damage to the heart muscle in the left ventricle in people who are too weak for open heart surgery. It addresses the ventricular remodeling that occurs in this condition.
   Patients who have some remaining heart function but who can no longer live normally may be candidates for ventricular assist devices (VAD), which do not replace the human heart but complement it by taking up much of the function.
  
  The first Left Ventricular Assist Device (LVAD) system was created by Domingo Liotta at Baylor College of Medicine in Houston in 1962.
   Defibrillation or cardioversion may be accomplished by an implantable cardioverter-defibrillator (ICD).
  
  Electrical treatment of arrhythmias also includes cardiac pacing. Temporary pacing may be necessary for reversible causes of very slow heartbeats, or bradycardia (for example, from drug overdose or myocardial infarction). A permanent pacemaker may be placed in situations where the bradycardia is not expected to recover.
  
  Section::::Management.:Electrical cautery.
   When the septal defects have been repaired and the atrial incision is closed, the previously removed cannula are replaced and the HLM is restarted. The left ventricle is then vented and the cross clamp removed from the aorta, enabling full-flow to be re-established and rewarming to begin; at this point the patient will receive an additional dose of Regitine to keep blood pressure under control. The previously harvested pericardium is then used to patch the coronary explantation sites, and to extend - and widen, if necessary - the neo-pulmonary root, which allows the pulmonary artery to be anastamosed without residual tension; the pulmonary artery is then transplanted to the neo-pulmonary root.
   The device is a set of three to five paired anchors that are used to pinch off, or "plicate", a part of the left ventricle where the heart muscle is damaged. One anchor in each pair is deployed using a catheter and pierces the wall between the ventricles from the inside of the right ventricle. The other is deployed using a long needle, and pierces the wall of the left ventricle from the outside. The two paired anchors are connected within the left ventricle, pulling the outside wall into contact with the inside wall. 
   Lectures are held by experts on the most challenging themes such as clinical outcomes of transplantation of controlled and uncontrolled
  
  DCD organs, progress made on machine perfusion of kidneys, livers, lungs and hearts and ethics and legal issues regarding donation after cardiac death.
  
  Section::::Procedure for uncontrolled donors.
  
  Following declaration of death, cardiopulmonary resuscitation (CPR) is continued until the transplant team arrive. A "stand-off" period is observed after cessation of CPR to confirm that death has occurred; this is usually from 5 to 10 minutes in length and varies according to local protocols.
   In March 2011, Craig Lewis was suffering from amyloidosis and not eligible for heart transplant due to the severity and extent of the disease, affecting also his kidney and liver. Unsuitable for a heart transplant, temporary mechanical TAH or LVAD, his small diseased heart was replaced with a continuous flow device, a pair of HeartMate II pumps, an apparatus of two pumps embraced together, following six years of research on more than fifty calves at the Texas Institute. He awoke from a coma and spent the last five weeks of his life interacting with his family. During the following year, Frazier and his colleague William Cohn engaged with the public and professionals on their experiences. Their TEDMED talk introduced them to Daniel Timms, who was driven to find a technological resolution and whose father had died of heart failure. Timms had an idea and sought out Frazier and Cohn in the States. The surgeons became interested, particularly with the idea that Timms's device had the potential to be a small size. Trialed in numerous calves between 2013 and 2016, some were able to run a treadmill after implantation.
   On 12 March 2011, an experimental artificial heart was implanted in 55-year-old Craig Lewis at The Texas Heart Institute in Houston by O. H. Frazier and William Cohn. The device is a combination of two modified HeartMate II pumps that is currently undergoing bovine trials.
  
  Frazier and Cohn are on the board of the BiVACOR company that develops an artificial heart. BiVACOR has been tested as a replacement for a heart in a sheep.
   Return of spontaneous circulation
  
  Return of spontaneous circulation (ROSC) is resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest. Signs of ROSC include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure. Cardiopulmonary resuscitation and defibrillation increase the chances of ROSC.
  
  The return of circulation, while a good thing and a favorable short-term indicator, is not on its own a predictor of a favorable medium- or long-term outcome. Patients have died not long after their circulation has returned.
   This is not possible in a donation from someone pronounced dead.
  
  Section::::History.
   The channels in the heart muscle seal over almost immediately with little blood loss while the new channels allow fresh blood to perfuse the heart wall immediately.The Heart Laser uses a computer to direct laser beams to the appropriate area of the heart in between heartbeats, when the ventricle is filled with blood and the heart is relatively still.
  
  Section::::TMR demand.
  
  TMR is a treatment option for patients who:
  
  BULLET::::- Have severe chest pain (angina), which limits the patient's daily activities or causes the patient to wake from pain at night, despite medications
  
  BULLET::::- Have pre-operative tests that show ischemia
   BULLET::::- Aortic valve replacement – Replacement of the aortic valve due to aortic regurgitation, aortic stenosis, or other reasons. A special kind of replacement called percutaneous aortic valve replacement is done through catheters are does not require open-heart surgery.
  
  BULLET::::- Aortic valve repair – Repair, instead of replacement, of the aortic valve.
  
  BULLET::::- Aortic valvuloplasty – Repair of the valve by using a balloon catheter to force it open.
  
  BULLET::::- Mitral valve – Disorders and treatments of the mitral valve that separates the left atrium and left ventricle.
   While medication and sympathectomy aim to prevent abnormal heart rhythms from occurring in the first place, an implantable defibrillator (ICD) may be used to treat arrhythmias that medication has failed to prevent and restore a normal heart rhythm. These devices, usually implanted under the skin at the front of the chest below the shoulder, can continuously monitor the heart for abnormal heart rhythms. If a life-threatening arrhythmia is detected, the device can deliver a small electric shock to terminate the abnormal rhythm and restart the heart.
   With the 2001 Thermo Cardiosystems merger, Thoratec acquired the HeartMate Left Ventricular Assist System, an implanted VAD for end-stage heart patients. A landmark three-year study of 129 patients at 22 major medical centers, called REMATCH (Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure) and published in November 2001, found that the HeartMate VE (vented electric) more than doubled the likelihood that terminally ill heart-failure patients would be alive at the end of one year, and it increased the likelihood of survival for two years to 22.9% vs. 8.1% for patients who were treated with only medication.
   The final option, if other measures have failed, is heart transplantation or (temporary or prolonged) implantation of an artificial heart. These remain the recommended surgical treatment options. However, the limited number of hearts available for transplantation in a growing group of candidates, has led to the development of alternative surgical approaches to heart failure. These commonly involve surgical left ventricular remodeling. The aim of the procedures is to reduce the ventricle diameter (targeting Laplace's law and the disease mechanism of heart failure), improve its shape and/or remove non-viable tissue. These procedures can be performed together with coronary artery bypass surgery or mitral valve repair.
   Section::::Power expenditure.:MVO2.
   BULLET::::- "Electrical cardioversion" involves the restoration of normal heart rhythm through the application of a DC electrical shock. Exact placement of the pads does not appear to be important.
  
  BULLET::::- "Chemical cardioversion" is performed with medications, such as amiodarone, dronedarone, procainamide (especially in pre-excited atrial fibrillation), dofetilide, ibutilide, propafenone, or flecainide.
  
  After successful cardioversion the heart may be in a stunned state, which means that there is a normal rhythm but restoration of normal atrial contraction has not yet occurred.
  
  Section::::Management.:Surgery.
  
  Section::::Management.:Surgery.:Ablation.
   BULLET::::- A global change in treatment of arrhythmia as a result of trials led by D. George Wyse.
  
  BULLET::::- APPROACH database and Heart Alert
  
  BULLET::::- Innovative STEMI protocol resulting in mean time to Percutaneous Coronary Intervention of a commendable 62 minutes
   Once full formal consent for organ donation has been obtained from relatives, and other necessary formalities such as identification of the deceased by the police and informing the Coroner (in the UK), the donor is taken to the operating room, and the kidneys and heart valves retrieved.
  
  Section::::Procedure for controlled donors.
  
presuppositions: Doctors can restart a dead donated heart.  Doctors can restart a dead donated heart.
corrections: Doctors can likely not donate a dead donated heart.  Doctors cannot restart a dead heart, hearts are transplanted while still beating.
raw_presuppositions: Doctors can restart a dead donated heart.  Doctors can restart a dead donated heart.
raw_corrections: Doctors can likely not donate a dead donated heart.  Doctors cannot restart a dead heart, hearts are transplanted while still beating.