When patients are refractory to treatment, both medical and surgical (such as valve replacement), and are in New York Heart Association class IV, then they are unlikely to survive for I year and should be considered for heart transplantation. The survival rate is about 69c)~ at 5 years, although most patients have one episode of rejection and 25% have multiple episodes.
They are also prone to accelerated coronary atherosclerosis. In 1967, Christiaan Barnard, a South African surgeon, was the first to perform cardiac transplantation in humans. Sir Magdi Yacoub, contemporary Professor of Cardiology at University of London and Royal Brompton Hospital and Harefield Hospital is an Egyptian-born surgeon who performed several pioneering cardiac operations.
R. Sanders Williams, MD, Professor of Medicine and contemporary Dean, Duke University Medical School and Vice Chancellor, Duke University, has worked successively at Duke, Harvard, Oxford, and UT Southwestern in Dallas. He has made major contributions to the understanding of molecular mechanisms of cardiac function.