The world's smallest artificial heart was implanted at Huazhong University of Science and Technology: the 58-year-old patient had a good postoperative mental state

Let humanity have a "steel heart", this once science fiction has become a reality.

On April 5, Mr. Chu, 58, was undergoing rehabilitation training at the Cardiovascular Hospital of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.

"Good location and nice staff"

On March 14, concord's team installed a walnut-sized mechanical heart at the tip of his "heart," allowing the severely irreversible heart failure patient to restart his life.

△ Professor Dong Nianguo of Xiehe Cardiovascular Disease Hospital operated on the patient

Unable to wait for the donor, he implanted an artificial heart

In December last year, Mr. Chu, who worked on a farm in rural Zhijiang, suddenly developed severe chest tightness and dizziness while carrying heavy loads.

Various examinations showed that Mr. Chu's heart suffered from severe irreversible heart failure combined with a series of complex lesions and was in urgent need of heart transplantation.

In the same ward, there are more than 20 patients who are waiting indefinitely like him. Unable to wait for the transplant, the installation of artificial heart became the only way to buy more life time for heart failure patients like Mr. Chu.

The artificial heart is not a replicated replacement for the human heart, but a small "pump" that partially or completely replaces the ventricles through implantation surgery to maintain blood circulation and help the human heart work properly.

It is divided into two kinds, in vivo and in vitro, both suitable for the treatment of patients with end-stage heart failure, in vitro artificial heart is mainly used to buy time for patients who can undergo heart transplant surgery in the short term, and in vivo artificial heart is mainly used to replace heart function for a long time.

The artificial heart implanted by Mr. Chu belongs to the latter.

Professor Zhou Cheng, Deputy Director of Cardiac Surgery, has long assisted Professor Dong Nianguo in perioperative treatment of patients undergoing artificial heart surgery.

He said that in addition to the need to carry a power pack 24 hours a day and take anticoagulant drugs, Mr. Chu will soon return to normal life. At present, Mr. Chu has successfully entered the rehabilitation treatment stage and is about to be discharged from the hospital.

△ Patients who recovered well shook hands with Professor Dong's team to express their gratitude

Artificial heart is the survival hope of patients with heart failure

If we compare the human body to a machine, the heart is the engine of this machine, which is mainly responsible for pumping blood, that is, ensuring the blood supply to various organs in the body.

Once the cardiac arrest occurs, the "engine" stops working and life will come to an abrupt end.

At present, it is estimated that there are about 10 million people with heart failure in mainland China. About 7% to 10% of patients with heart failure are critically ill, and due to the serious shortage of donors, only more than 600 patients with end-stage heart failure can complete heart transplant surgery every year.

Dong Nianguo said that for patients with end-stage heart failure, drug treatment and conventional surgery are basically ineffective, and the only way is heart transplantation, but due to the shortage of heart donors, many patients often regret to die before waiting for a suitable heart supply, and artificial hearts give patients with end-stage heart failure hope to live.

The ultra-small magnetic levitation centrifugal artificial heart implanted this time, also known as CorHeart 6 left ventricular assist system, belongs to the third generation of ventricular assist device, has independent intellectual property rights, and is an authentic "Chinese heart".

The diameter of the pump body is 34 mm, the thickness is 26 mm, the weight is 90 grams, such as the size of a walnut, which is currently the world's smallest size and the lightest magnetic levitation centrifugal artificial heart.

At present, Academician Hu Shengshou of Fuwai Hospital is responsible for clinical trials.

△ Professor Xie Xingxing of the Ultrasound Department operative ultrasonic exploration

Dong Nianguo introduced: "In China, doing our own artificial heart research and development is a very meaningful thing, I believe that with the improvement of artificial heart materials, with the further deepening of its hemodynamic research, the application prospects of artificial heart must be very broad." ”

Magnetic levitation centrifugal pumps are less damaging to patients

"In fact, the accurate term we are talking about artificial heart should be implantable ventricular assist devices, not all-artificial hearts in the strict sense." Dong Nianguo introduced.

According to the development of ventricular assist devices (VADs), they can be divided into three generations.

The first generation vad mainly refers to the pulsating (pneumatic) pump, and the second generation VAD is the axial rolling pump.

Compared with the first generation, the second generation is significantly smaller in size, has good durability, and significantly improves the quality of life of patients.

The third generation of VAD is a centrifugal pump that uses magnetic suspension and liquid suspension techniques, and complications are further reduced after transplantation. The third-generation VAD has been built-in, while the miniaturization of high-energy batteries has improved energy portability and improved the quality of life of patients.

When left heart failure occurs, the most important left ventricle power is insufficient, at this time, the doctor can put the centrifugal pump into the left ventricle, let it pump blood, play a parallel circulation with the heart, to achieve the effect of one plus one is greater than two.

The centrifugal pump works by using centrifugal force (the washing machine's drying function also uses centrifugal force) to pump and perfuse the blood of the left ventricle into the aorta, thus partially replacing the left ventricle function.

In order to be able to use for a long time, the suspension technology commonly used by centrifugal pumps adopts the method of magnetic suspension, hydraulic suspension or the combination of magnetic suspension and hydraulic suspension.

Among them, the presence of high shear stress in the blood film of the liquid suspension can lead to blood damage.

Dong Nianguo believes that magnetic levitation seems to be a trend of development. Magnetic levitation refers to the fact that under the action of magnetic force, the impeller is in a suspended state when the artificial heart is running, and there is no mechanical bearing, so there is no friction, less heat production, less loss, and high durability.

△ Walnut-like ultra-small magnetic levitation centrifugal artificial heart

"The advantages of magnetic levitation centrifugal pumps are good blood compatibility, low destruction of blood cells, small size, relatively small damage for patients, and a wide range of people." Li Ping, deputy chief physician and deputy chief physician of the Department of Cardiac And Macrovascular Surgery of Union Hospital, said.

The continent has entered a new era of artificial heart

"There is still a big gap between the number of artificial heart applications in the mainland and foreign countries, but it is already on the right track and has a bright future." Dong Nianguo said that it can be said that under the leadership of Academician Hu Shengshou, China has entered a new era of artificial heart.

Compared with similar artificial hearts in the world, the pace of domestic artificial heart technology innovation is accelerating, such as concentric CH-VAD is the smallest full magnetic levitation left ventricular assist device that has been listed, and CorHeart 6 can be used for lower weight patients and even children.

Xia Jiahong, vice president of Union Hospital, introduced that in order to face the forefront of the world, face the major needs of the country and the people, and strive to overcome the cardiovascular acute and critical diseases that seriously endanger the health of the people, at the beginning of this year, the hospital combined strong disciplines such as cardiac surgery, cardiology, ultrasound medicine, and anesthesia to establish the Union Cardiovascular Disease Hospital to explore the "heart" program for patients with end-stage heart disease.

△ The expert team of Concord Cardiovascular Disease Hospital introduced the artificial heart

In order to usher in the new era of artificial heart, Dong Nianguo hopes that experts in the field of artificial heart research in China can play a "combination fist" together.

He said that the magnetic levitation artificial heart needs to be further developed and improved, including the realization of a fully built-in drive system.

At present, the magnetic levitation artificial heart still needs to be further improved, the magnetic levitation artificial heart pump blood is mainly adjective, hoping to produce a pulsatile blood flow that is consistent with its own heart beat and more physiological; it is necessary to further reduce the volume and develop products for children and even babies; it is necessary to further optimize the implantation method to make the operation simpler and minimally invasive.