The world's smallest artificial heart was implanted at Huazhong University of Science and Technology: the 58-year-old patient was in good spirits after the operation
This article is reprinted from the public account of Huazhong University of Science and Technology
Quantum Bit | Public Account QbitAI
Let humans have a "heart of steel", this once science fiction has become a reality.
On April 5, 58-year-old Mr. Chu was receiving rehabilitation training at the Cardiovascular Hospital of Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.
“Very good mental state”
On March 14, the Union Medical College team installed a walnut-sized mechanical heart at the "apex of his heart", enabling this patient with severe irreversible heart failure to restart his life.
△
Professor Dong Nianguo of Union Hospital of Cardiovascular Diseases performs surgery on a patient
Unable to wait for a donor, he implanted an artificial heart
Last December, Mr. Chu, who worked at a breeding farm in Zhijiang rural area, suddenly experienced severe chest tightness, dizziness and difficulty breathing while carrying heavy objects.
Various examinations showed that Mr. Chu suffered from severe irreversible heart failure combined with a series of complex diseases and urgently needed a heart transplant.
In the same ward, there are more than 20 patients who are waiting indefinitely like him. Without the chance of a transplant, installing an artificial heart has become the only way to buy more life for heart failure patients like Mr. Chu.
An artificial heart is not a replica of the human heart, but a small " pump " that is implanted to partially or completely replace the work of the ventricles, maintain blood circulation, and help the human heart work normally.
It is divided into two types: in vivo and in vitro, both of which are suitable for the treatment of patients with end-stage heart failure. The extracorporeal artificial heart is mainly used to buy time for patients who can undergo heart transplantation in the short term, while the intracorporeal artificial heart is mainly used to replace heart function in the long term.
The artificial heart implanted by Mr. Chu belongs to the latter .
Professor Zhou Cheng, deputy director of the Department of Cardiac Surgery, has long assisted
Professor Dong
Nianguo
in the perioperative management of patients undergoing artificial heart surgery.
He said that apart from carrying a power pack with him 24 hours a day and taking anticoagulants, Mr. Chu will soon return to normal life. Currently, Mr. Chu has successfully entered the rehabilitation stage and will be discharged soon.
△
The patient who recovered well shook hands with Professor Dong's team to express his gratitude
Artificial heart is the hope for survival for heart failure patients
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 all organs in the body.
Once the heart stops working, the "engine" stops working and life comes to an abrupt end.
It is estimated that there are about 10 million heart failure patients in China . About 7%-10% of heart failure patients are in critical condition. Due to the severe shortage of donors, only about 600 patients with end-stage heart failure can complete heart transplant surgery each year.
Dong Nianguo said that for patients with end-stage heart failure, drug therapy and conventional surgery are basically ineffective, and the only way is heart transplantation. However, due to the shortage of heart donors, many patients often die before they can wait for a suitable donor heart. Artificial hearts give patients with end-stage heart failure hope of survival.
The implanted ultra-small magnetically suspended centrifugal artificial heart , also known as the CorHeart 6 left ventricular assist system, is a third-generation ventricular assist device with independent intellectual property rights. It is a genuine "Chinese heart".
The pump body has a diameter of 34 mm, a thickness of 26 mm, and weighs 90 grams, about the size of a walnut . It is currently the smallest and lightest magnetically suspended centrifugal artificial heart in the world.
Currently, the clinical trial is led by Academician Hu Shengshou of Fuwai Hospital .
△ Professor Xie Mingxing of the Ultrasound Department performed ultrasound detection during surgery
Dong Nianguo said: "In China, it is very meaningful to develop our own artificial heart. I believe that with the improvement of artificial heart materials and the further in-depth study of its hemodynamics, the application prospects of artificial hearts will be very broad. "
Magnetic levitation centrifugal pumps cause less damage to patients
"In fact, the accurate term for the artificial heart we are talking about should be an implantable ventricular assist device, rather than a strictly artificial heart," said Dong Nianguo.
According to the development history of ventricular assist devices (VAD), they can be divided into three generations .
The first generation of VAD mainly refers to pulsating (pneumatic) pumps, and the second generation of VAD is an axial flow scroll pump.
Compared with the first generation, the second generation is significantly smaller in size, has better durability, and significantly improves the quality of life of patients.
The third-generation VAD is a centrifugal pump that uses magnetic levitation and hydraulic levitation technology to further reduce complications after transplantation. The third-generation VAD is built-in, and the miniaturization of high-energy batteries improves the portability of energy and improves the quality of life of patients.
When left heart failure occurs, the most important thing is insufficient power of the left ventricle. At this time, the doctor can put a centrifugal pump into the left ventricle to pump blood, playing the role of parallel circulation with the heart, achieving the effect of one plus one being greater than two.
The working principle of a centrifugal pump is to use centrifugal force (the spin-drying function of a washing machine also uses centrifugal force) to draw blood from the left ventricle and perfuse it into the aorta, thereby partially replacing the function of the left ventricle.
In order to ensure long-term use, the commonly used suspension technology for centrifugal pumps adopts magnetic suspension, hydraulic suspension or a combination of magnetic suspension and hydraulic suspension.
Among them, the high shear stress in the fluid-suspended blood film can cause blood damage.
Dong Nianguo believes that magnetic levitation seems to be the development trend. Magnetic levitation means that under the action of magnetic force, the impeller of the artificial heart is in a suspended state when it is running, without mechanical bearings, so there is no friction , less heat generation, 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 damage to blood cells, small size, relatively small damage to patients, and a wide range of users," said Li Ping, deputy chief physician and head of extracorporeal circulation and extracorporeal life support in the Department of Cardiovascular Surgery at Union Hospital.
my country enters a new era of artificial heart
"There is still a big gap between the number of artificial hearts used in China and that in foreign countries, but it has been put 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 hearts .
Compared with similar artificial hearts internationally, the pace of innovation in domestic artificial heart technology is accelerating. For example, the Concentric CH-VAD is the smallest fully magnetically levitated left ventricular assist device on the market, and the CorHeart 6 can be used for lower body weight patients and even children.
Xia Jiahong, deputy director of the Union Hospital, introduced that in order to face the world's forefront, meet the major needs of the country and the people, and strive to overcome the critical cardiovascular emergencies that seriously endanger people's health, the hospital combined strong disciplines such as cardiac surgery, cardiology, ultrasound medicine, and anesthesia at the beginning of this year to establish the Union Cardiovascular Hospital to explore "heart" solutions for patients with terminal heart disease.
△
The expert team of Union Hospital of Cardiovascular Diseases introduces the artificial heart
To welcome the new era of artificial hearts, Dong Nianguo hopes that domestic experts in the field of artificial heart research can work together to launch a "combination punch."
He said that the magnetic levitation artificial heart still needs further development and improvement, including the realization of a fully integrated drive system.
At present, the magnetic levitation artificial heart needs further improvement . The magnetic levitation artificial heart mainly pumps blood in horizontal flow, hoping to produce pulsating blood flow that is consistent with the heart's own beating and more in line with physiological conditions. The volume needs to be further reduced to develop products for children and even infants. The implantation method needs to be further optimized to make the operation simpler and less invasive.
-over-
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