(People's Daily health client reporter Shi Mengzhu) The human body exchanges gas with the outside world through breathing, of which the pulmonary artery plays a key role. But if you are born without pulmonary arteries, how do you survive?
On March 24, looking at the twin brothers who were laughing and playing like other children, the parents of the children were full of emotions, in order to cure their pulmonary artery atresia, the family was worried, "Nearly six years, every day is suffering, every night before going to bed, I think I must stick to it, wait until the child has a radical surgery, thank the doctor for giving my two children the opportunity to live, giving me and the child's father hope for future life!" Mom said.
Both twin brothers suffer from pulmonary atresia
Just after the Spring Festival in 2022, a cardiac surgery operation was performed at Huaxin Hospital in Beijing (the First Affiliated Hospital of Tsinghua University) as scheduled. Xiao Kai (pseudonym), a 6-year-old boy who was diagnosed with pulmonary artery atresia (type IV), a ventricular septal defect, was undergoing open surgery for the second time.
Doctors are making a diagnosis for the twin brothers. Courtesy of the hospital
Xiao Kai also has a twin brother named Xiao Song (pseudonym). At the end of 2015, the twins arrived, and the whole family was immersed in a state of joy. But just a month after birth, because the child was found to be "purple" compared to the lips and limbs of other children, and the crying was particularly serious, after examination at the local hospital, the doctor told the twins that they all suffered from an extremely complex congenital heart disease: pulmonary artery atresia, ventricular septal defects... The local hospital cannot be treated, and it is recommended that parents take their children to the higher hospital for treatment as soon as possible, otherwise the children will not live long.
In 2016, the brothers came to a hospital in Beijing, and the older brother Xiaosong was diagnosed with pulmonary artery atresia (type I); younger brother Xiaokai was diagnosed with pulmonary artery atresia (type IV) and no pulmonary artery in the mediastinum. The older brother underwent a first-stage orthopedic operation (right ventricular outflow tract reconstruction), but the younger brother's condition was too complicated and the operation was extremely difficult, and the hospital recommended that the younger brother transfer to the Pediatric Department of the Heart Center of the First Affiliated Hospital of Tsinghua University to continue treatment.
Jin Yongqiang, deputy chief physician of the Heart Center of the First Affiliated Hospital of Tsinghua University, introduced that pulmonary artery atresia is an extremely serious type of congenital heart disease, accounting for 1%-1.5% of the incidence of congenital heart disease. The disease is often divided into four types according to the degree of pulmonary vascular development and the supply of lung blood( I/II/III/IV), and the lower the classification, the more serious it is.
How serious is Xiao Kai's illness? Simply put, he was born without a pulmonary artery, and his survival depends on some lateral branches of the body's lungs from the descending aorta to supply blood to the lungs, thereby maintaining oxygenation.
Type IV pulmonary artery atresia due to poor pulmonary vascular development, like the younger brother Xiao Kai, there is no left and right pulmonary artery structure, it is necessary to find out the lateral branches of the body one by one to find out a very fine connection and suture, do pulmonary artery fusion surgery, extremely difficult, each step is full of challenges. Jin Yongqiang said that medical staff need to take huge risks, and a little carelessness may cause heavy bleeding and endanger the lives of children. Therefore, in the face of these children, many medical institutions have to choose to give up, and there are only a few hospitals in China that can perform such surgery.
First surgery 6 years ago
A lot of tossing and turning, brought dawn to his younger brother Xiao Kai. After coming to Tsinghua First Affiliated Hospital, Professor Wu Qingyu, a well-known cardiovascular surgery expert in mainland China and chief consultant of the hospital, received the brothers and carefully studied the preoperative examinations of the children.
It is important to judge the surgical period of pulmonary artery atresia. Jin Yongqiang introduced that according to the child's condition and surgery, it is necessary to closely observe the growth and development, blood oxygen saturation, heart valves and function, and some children may need multiple surgeries to fully restore the normal heart structure. This kind of surgery has been done a lot in Tsinghua First Affiliated Hospital, but each child has its own particularities, and it is necessary to conduct a detailed preoperative assessment before surgery and formulate a thorough surgical plan to ensure that nothing goes wrong. After treatment, most children are eventually able to get a complete cure.
After careful preparation, Professor Wu Qingyu performed a phase of surgery for Xiao Kai: dissected and severed the pulmonary artery from the aorta, and connected it with a "T" shaped pipe to form the left and right pulmonary arteries. The surgery was very successful due to the need to wait for the pulmonary arteries to mature further, preserving the ventricular septal defect.
As the child's indicators returned to normal, his symptoms improved, and he was successfully discharged from the hospital after the operation. When he was discharged from the hospital, Chen Guoliang, deputy chief physician of the Pediatric Cardiac Surgery Department of the Heart Center, repeatedly advised parents to review regularly and decide the timing of the next radical surgery based on the results of future examinations.
After being discharged from the hospital, the Heart Center of Tsinghua First Affiliated Hospital followed up and observed the twin brothers for a long time, and the parents of the children also poured all their efforts into them, took good care of them, and always looked forward to the opportunity to give Xiao Jing and Xiao Kai radical surgery.
A special Spring Festival
In January 2022, on the eve of the Spring Festival in the Year of the Tiger, Dr. Chen Guoliang believed that the child had the opportunity to undergo radical surgery based on the results of the follow-up examination. After the mother brought the two brothers to tsinghua first affiliated hospital again, after perfecting the relevant examinations, Professor Wu Qingyu led the pediatric cardiac surgery team to discuss the brothers' condition in detail, and concluded that both children can undergo radical surgery! For the mother of the child, all the good news is less than the weight of this sentence.
Before the Spring Festival, the operation came as promised, the operation of the elder brother Xiaosong was mainly operated by Jin Yongqiang, and the pulmonary artery atresia radical surgery was performed, the operation was very smooth, and the brother spent a "special" Spring Festival in the extracardiac care unit after the operation.
In those days, his younger brother Xiaokai, who was waiting for surgery in the ward, always asked his mother: "Where has my brother gone?" How come I couldn't see him for days? Mom replied that my brother had gone to surgery and would come back in a few days when he was well. After careful treatment and care by the medical staff of the extracardiac intensive care unit, his brother Xiaosong recovered smoothly.
Medical staff are taking care of their younger brother Xiao Kai. Courtesy of the hospital
Just after the Spring Festival, the pediatric cardiac surgery team worked intensively to prepare for the operation of his younger brother Xiao Kai. Because the younger brother's condition is more complicated, the original fusion of the left and right pulmonary artery ducts have a long section of obvious narrowing, the operation is more difficult. Professor Wu Qingyu personally took charge of the knife.
Secondary open chest, establishment of cardiopulmonary circulation, thorough widening of the left and right pulmonary arteries, repair of ventricular septal defects, connection with the right ventricle to the pulmonary artery with a new valve tube... Minutes and seconds passed by the clock, and Professor Wu Qingyu on the operating table carefully operated every step. After nearly 14 hours, looking at the stable circulation index and 100% blood oxygen saturation on the intraoperative monitor, the younger brother Xiaokai's operation was successful!
After the operation, Jin Yongqiang told the child's mother waiting outside the operating room that the operation was very successful, at this time, the pressure and tears that the mother had accumulated for too long were finally released... After the operation, after the meticulous supervision and care of the medical staff all night long, the brothers were safely transferred from the intensive care unit back to the general ward. Mom said: "The heart that our family has been hanging on for so many years has finally settled down. ”