Totally side effect free if we ignore the risk of stroke from cardiopulmonary bypass (at least 0.5%), infection of the chest cavity (0.5-3% incidence of mediastinitis after median sternotomy), anesthesia complications, post op pulmonary embolism, pneumonia, UTI, etc.

I think that's the joke.

Open heart surgery - let alone replacement - isn't likely to be side effect free in our lifetime. A detached sternum is also a side effect, after all, requiring a couple months to recover to basic function...

Perhaps a similar molecule can be found instead which does not have this problem. Or another compound can be added to prevent heart damage.

It's probably going to be interpreted as cynical b/c it's HN but I do honestly believe that solving heart function will be lot easier than solving cognitive decline, and a win on cognitive decline is huge news (hopefully not paired with not pig hearts, but it's a reasonable proof of concept).

I guess it depends on how long the bad effects on the heart last after taking ISRIB. If it keeps lingering, you may need new pig hearts over time. Or.. Just keep taking ISRIB and just schedule a yearly pig heart transplant.

There we have it, yet another way to get those prion diseases...

Sounds very cyber punk.