The world's smallest artificial heart was implanted in Henan
Author: Wang Hang
This is the world's smallest and lightest "artificial heart".
It is only the size of a ping-pong ball, metal, and weighs 90 grams. During the procedure, it is delicately fixed in the left ventricle close to the tip of the heart. A cable connecting the "artificial heart" penetrates from the percutaneous subcutaneous cavity of the chest cavity from the skin above the navel, connecting to two extracorporeal batteries and a controller.
It can partially replace heart function, help maintain blood circulation throughout the body, and ensure the needs of human life and metabolism.
Professor Cheng Zhaoyun, one of the surgeons and vice president of Fuwai Huazhong Cardiovascular Disease Hospital, told the "medical community" that this marks a new historical height in China's ability to treat acute and critical heart diseases, and some technologies have reached the international leading level.
Implantation of an "artificial heart"
Mr. Ma is the owner of this "artificial heart".
He is 43 years old, from Dengzhou City, Henan Province, and has been engaged in the construction industry for many years after transferring from the army, working overtime for a long time, staying up late, drinking often, and has been smoking for more than 30 years since he was eight years old. Four years ago, he began to experience intermittent chest tightness, shortness of breath and palpitations.
After a hospital examination, he was diagnosed with heart disease, severe mitral insufficiency and moderate tricuspid valve insufficiency. It is reported that the human heart has a total of 4 valves, and Mr. Ma's 2 valves are problematic.
Professor Cheng Zhaoyun said in an interview with the "medical community" that not long ago, Mr. Ma's above symptoms worsened, and after admission to the hospital, it was found that he had developed into "dilated cardiomyopathy", and there was arrhythmia, heart failure, insufficient strength, even to sit on the bed to eat, the condition was very serious, and there would be sudden death at any time.
Cheng Zhaoyun, vice president of Fuwai Huazhong Cardiovascular Hospital
The pictures in this article are provided by the interviewees
"First, the patient's daily activities have been severely limited, usually bedridden; second, blood pressure needs to be maintained by drugs all the time; third, according to medical standards, if diuretics are not used, patients urinate very little, these are all signs and indications of heart failure."
After a series of auxiliary examinations such as ultrasound, X-ray, CT, magnetic resonance, etc., the hospital confirmed That Mr. Ma had heart failure and determined that the drug treatment had no obvious effect on the patient's condition, and artificial heart implant surgery was the best solution.
President Cheng Zhaoyun introduced that in order to ensure that the world's first surgery is foolproof, the hospital has made full preparations for all aspects.
"The patient's admission time is September 3, and the operation is October 8, and more than a month of preoperative examination and preparation are carried out in the middle, assessing heart function and lung function, adjusting the speed and various indicators of the 'artificial heart' to match the patient; it is also necessary to adjust the patient's medication, improve the diet structure and adjust the psychological state."
The day before the operation, Fuwai Hospital of the Chinese Academy of Medical Sciences and Fuwai Huazhong Cardiovascular Disease Hospital also jointly held a coordination meeting of multidisciplinary experts in cardiac surgery, cardiology, operating room, anesthesia, intensive care, cardiopulmonary circulation, blood transfusion, laboratory, and pharmacy to discuss preoperative cases.
Multidisciplinary Expert Coordination Meeting
The operation was carried out by Professor Hu Shengshou, academician of the Chinese Academy of Engineering, general president of Fuwai Huazhong Cardiovascular Hospital, president of Fuwai Hospital of Chinese Academy of Medical Sciences, Professor Wang Xianqiang of Fuwai Hospital of Chinese Academy of Medical Sciences, Professor Cheng Zhaoyun, vice president of Fuwai Huazhong Cardiovascular Disease Hospital, and other experts as assistants.
After about 3 hours, the operation was successfully performed. Under the precise adjustment of professionals, the magnetic levitation artificial heart began to "beat", the patient successfully escaped the cardiopulmonary bypass machine assist, and with the assistance of the parallel work of the "artificial heart", the patient's heart rate, blood pressure and other vital signs were normal and stable.
After putting on the "artificial heart",
Patients live like normal people
Heart failure is the terminal stage of the development of various types of heart disease, which means that the heart can no longer beat and can no longer supply blood to the whole body, which is one of the main causes of death for heart disease patients.
There are many heart failure patients in China. According to the latest results of the epidemiological survey of heart failure published by academician Gao Runlin and Professor Wang Zengwu of Fuwai Hospital in the European Journal of Heart Failure, among 35-year-old residents in China, the weighted prevalence of heart failure is 1.3%, that is, about 13.7 million heart failure patients.
After heart failure, other organs of the body such as liver, kidney, lungs, stomach and other organs will be reduced, and patients with end-stage heart failure rely solely on oral medication, and the 5-year survival rate is only 50%.
The "artificial heart" offers the hope of life for such patients. President Cheng Zhaoyun introduced to the "medical community" that the full name of this operation is "ultra-small magnetic levitation centrifugal artificial heart implantation", which is the first case in the world and has Independent Intellectual Property Rights in China.
After it is implanted in the patient's body, it is connected to the heart in parallel, one end is connected to the left ventricle of the heart, and the other is connected to the person's aorta. In the case of insufficient blood supply capacity in the left ventricle, part of the blood enters the "artificial heart" from the left ventricle through the "inflow tube", and the "artificial heart" then pushes the blood out and transports it to the aorta through the "outflow tube".
"Ultra-small magnetic levitation centrifugal artificial heart implantation" surgical site
For normal people, the heart beats 60-100 times per minute, pumping out about 5 liters of blood. The "artificial heart" implanted in the body can pump 1-10 liters of blood per minute, assisting the human heart function in pumping blood, and also ensuring the blood perfusion of important organs such as the brain, kidneys, and liver.
For some time after that, in addition to physical rehabilitation, Mr. Ma also had to adapt to the changes in his life brought about by the "artificial heart", such as how to coexist with the extra batteries on the body and how to take a bath.
Dean Cheng Zhaoyun said that after the patient is discharged from the hospital, it will not have a particularly large impact on daily life, and running, bathing, cycling and even strenuous exercise can be carried out like normal people.
The only thing to note is that the "artificial heart" cannot be powered off. He introduced that the endurance implanted in this "heart" is up to 33 hours, including two batteries, one large and one small. When going out, it is powered by a small battery, and will automatically switch to a large battery when the power is low.
The patient puts two batteries connected to the body and a controller that shows the speed, flow, and power of the "artificial heart" in the body into a special cross-body bag, and even when he goes out, he can't see anything unusual.
Regarding the specific operation and use of "artificial heart", President Cheng Zhaoyun said: "Before the operation, there will be 1-2 nurses to conduct professional training for patients, such as the problem of changing drugs, because the blood concentration will become thin after taking medicines, so he needs to learn to measure the indicators of his body and feedback to the hospital in time." ”
In addition, patients and their families also receive theoretical training and practical guidance from "artificial heart" to prevent accidents in the power line of "heart"; bathing requires the use of waterproof bags to avoid water ingress at the wire of the wound... These precautions are written in a booklet and sent to patients and need to be learned repeatedly.
After implantation of the "artificial heart", the human body will have new challenges that have not been encountered in traditional cardiac surgery, such as changes in blood clotting and blood pressure indicators. Dean Cheng Zhaoyun said that patients need to pay attention to diet and other aspects, control the value within a reasonable range, and the specific indicators are determined by doctors according to the physical conditions of different patients.
Can "artificial heart" replace heart transplantation?
The artificial heart is the most complex and sophisticated medical device, known as the "jewel in the crown of medical devices".
It is mainly divided into two categories: one is to dig out the real heart and replace it with a mechanical heart; the other is the auxiliary artificial heart, that is, to keep the original heart, place a second "heart" next to it, and work in concert with the original heart.
In the past, for patients with severe heart failure, it could not be reversed by drugs, and heart transplantation was the only effective treatment. However, the annual number of heart transplant surgeries in China is only about 500 cases, often facing the shortage of donors, and many patients lose their life treatment opportunities while waiting for donors.
Based on this rigid demand, "artificial heart" has become one of the directions of medical technology, which can be used for transitional treatment before heart transplantation, transitional treatment before heart failure recovery, and can also be used as a permanent replacement treatment.
Can "artificial heart" really replace heart transplantation? Dean Cheng Zhaoyun believes that in the case of a serious shortage of suitable heart donors, "artificial heart" is the general direction of the domestic medical community in the treatment of patients with advanced heart failure in the future.
"After a heart transplant, there are many uncontrollable factors, some patients will have tumors, and it will have immune rejection. However, after implanting the "artificial heart", there is no need to take immune rejection drugs, avoiding the possibility of tumorigenesis, and the artificial heart is actually more beneficial to patients, and it is simple to manage. ”
In addition, China's latest third-generation "artificial heart" is magnetic levitation technology, that is, the rotating impeller is suspended in the blood field without any mechanical contact, which can reduce the damage to blood function and achieve better healing effects.
There are also different opinions. Dr. Dong Nianguo of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology previously said in an interview with the Beijing News that at this stage, if the situation allows, the best way is still a heart transplant. Foreign studies have shown that after the third year after surgery, patients with heart transplantation have a higher survival rate than patients implanted with mechanical hearts.
In the field of international medicine, the "artificial heart" has been widely recognized by the medical community. Thousands of patients abroad receive artificial heart implants every year, the number of artificial heart implants in the world has exceeded 14,000 cases, and the clinical application conditions of "artificial hearts" that replace natural organs with artificial organs are gradually maturing.
President Cheng Zhaoyun said that China's "artificial heart" technology has been in line with international standards, and has performed well in the prevention and control of infection risks, device reliability, blood compatibility and other performance, and has reached the international leading level in all aspects.
However, at present, a certain number of clinical trials to save patients with advanced heart failure need to be completed, considering research and development, clinical and cost issues, China is still some distance away from popularizing "artificial heart" assistive devices.
Source: Medical community
Disclaimer: Handan Health reprints this article for the purpose of conveying more information and does not represent the views and positions of this number. If there is any copyright issue, please contact to delete it.