Dare to take risks and rebirth a 19-year-old boy with a rare heart deformity

  The 19-year-old Tibetan boy Jinmi Duoji is the oldest of the 32 patients with congenital heart disease in the "Lizang Family and Fulfilling the Dream of Health" in Xigaze, Tibet. His heart deformity is relatively rare. , Is also accompanied by renal insufficiency. If surgery is not performed in time, life may come to an abrupt end at any time.

Although the operation is very tricky, the brave and careful Zhang Fengquan team of the Department of Cardiac Surgery of Jinan Central Hospital, with their strong strength, after ten hours of hard work, successfully lifted the long-hidden "bomb" in Jinmy Dorjee's body and brought him back to life.

  Qilu Evening News, Qilu One Point Reporter Wang Xiaomeng

  Correspondent Guan Tianxing and intern Chen Wenjing

  Rare heart malformation

  Serious complications

  A year ago because of "hemoptysis", Jinmi Dorje was diagnosed as "gastric ulcer combined with Tetralogy of Fallot" in a local hospital. Such heart surgery is extremely difficult and cannot be performed locally. To realize the dream of health", in Xigaze, Tibet, a wholehearted rescue project for children with congenital heart disease, Duoji came to Jinan Central Hospital for treatment.

  After examination, it was found that in addition to the tetralogy of Fallot, Jinmi Dorje also had an abnormal origin of the coronary artery, a coronary artery malformation that could easily lead to "sudden death".

  "Tetralogy of Fallot, the origin of the coronary arteries is abnormal. These are two major diseases of cardiac surgery. If they exist in two patients separately, they are considered to be a big operation, let alone concentrated on a 19-year-old child. There are still so many complications." Zhang Fengquan, director of the Department of Cardiac Surgery at Jinan Central Hospital, has accumulated rich experience in tens of thousands of heart operations in the past 20 years, and this is the first time he has encountered such a difficult situation.

  "I have done many difficult heart surgeries, especially for children under 1 year old. Simple tetralogy of Fallot surgery, or simple correction of coronary artery origin, surgery is routine surgery for me. But this The two congenital malformations are concentrated together, and the difficulty of the operation is not at all as people imagined 1+1=2." Zhang Fengquan said that such an operation is undoubtedly a huge challenge for him.

  According to reports, the radical surgery for children with typical tetralogy of Fallot is mostly performed after 6 months of age. It is not recommended to postpone it until after 3 years of age. The heart structure and function cannot be corrected, which will bring serious complications.

For example, hypoxemia, endocarditis, liver and kidney insufficiency, cerebral embolism, hemorrhage, etc., can be life-threatening in severe cases.

  He grew up in Bailang County, Xigaze City, Tibet Autonomous Region, at an altitude of more than 3,000 meters, with thin air, high cold and hypoxia. The 19-year-old Jinmi Dorje has suffered serious complications. Anemia and hypoproteinemia have seriously affected his study And life.

Jinmi Dorje's already overwhelmed heart cannot afford to wait for a long time.

  10 consecutive hours of surgery

  The guy was finally saved

  Because Jinmi Dorje was in a very special condition, he was arranged for surgery in the last of the 32 children with congenital heart disease who came to receive treatment.

Zhang Fengquan said that four risk factors need to be fully considered before surgery: First, low cardiac output syndrome caused by right ventricular insufficiency, combined with preoperative renal insufficiency, the possibility of hemodialysis treatment after surgery is greatly increased. Heart failure, there is no surgery; second, arrhythmia, conduction block, severe atrioventricular block, need to install pacemaker adjuvant therapy; third, renal insufficiency is further aggravated, it will require long-term hemodialysis Treatment; Fourth, respiratory system complications such as acute lung injury and acute respiratory distress syndrome, which lead to prolonged ventilator-assisted breathing time. In severe cases, severe complications such as ventilator dependence and tracheal softening require auxiliary treatment such as tracheotomy.

  In corrective surgery for Tetralogy of Fallot, the dredging of the right ventricular outflow tract and the repair of the ventricular septal defect are two key points.

The longitudinal incision of the right ventricular outflow tract and the removal of the hypertrophic muscle bundles of the right ventricular outflow tract, especially the wall bundles, must absolutely avoid coronary septal branch damage.

In addition, when repairing ventricular septal defect, it is necessary to avoid conduction beam damage.

And these difficulties, Zhang Fengquan's team has repeatedly deduced before the operation, imagining all kinds of unexpected response plans.

  On November 18, 2020, Director Zhang Fengquan led the team to perform the "Intracardiac Correction of Tetralogy of Fallot + Coronary Artery Malformation Correction, Temporary Pacemaker Implantation" for Jinmi Dorje.

The operation lasted from 8 a.m. to 6 p.m., after nearly 10 hours of continuous struggle with high tension, Jinmi Dorje's operation was successfully completed.

  On December 14, 2020, Jinmi Dorje was discharged from the hospital, and his family was very happy.

So far, the Shandong Provincial Red Cross, the Shandong Provincial Health Commission, and the Management Group of the Ninth Batch of Aid-Tibet Cadres Center of Shandong Province, hosted by the Jinan Central Hospital, "Lizang Family Realizes a Healthy Dream" All children with congenital heart disease in Xigaze City The heart relief project was successfully concluded by the 19-year-old Jinmi Dorje.

  "Jimi Duoji has been in Jinan for two months. He has become accustomed to the oxygen content of the air at low altitudes. After returning to his hometown in Bailang County for half a month, he has not adapted to it. At the beginning, he has typical symptoms of altitude sickness. Rest at home. However, my physical condition is much better than before the operation.” After New Year’s Day in 2021, Zhang Bei, the head nurse of the Department of Cardiac Surgery of Jinan Central Hospital, had a phone call with Jinmi Duoji. The other party said that after a period of rest, he could return to school. went.

  ◆Zhang Fengquan:

  Director of Cardiac Surgery, Jinan Central Hospital, member of the Communist Party of China, chief physician.

The current vice chairman of the second committee of the Cardiovascular Surgery Branch of the Shandong Medical Association, a member of the Cardiovascular Surgery Branch of the Shandong Medical Association, a member of the Cardiac Surgery Expert Group of the Shandong Endoscopic Surgery Quality Control Center, and the Shandong Research Hospital Association Cardiac Surgery Member of the branch, member of the Fifth Committee of the Organ Transplantation Branch of Shandong Medical Association.

Won the "Top Ten Physicians in Shandong Province", "Ten Best Physicians in Jinan", "Good Doctor Bethune", and "Most Beautiful Doctor in the City" of the Fifth Health Guardian.

  He is good at the clinical diagnosis and treatment of coronary heart disease, valvular heart disease, common and complex congenital heart disease, cardio-macrovascular disease, heart tumor, cardiomyopathy, heart transplantation, combined heart-lung transplantation, atrial fibrillation and other diseases.

He has rich clinical experience in the diagnosis and treatment of critically ill patients.

Won the second prize of Military Medical Achievement Award and the second prize of Shandong Province Science and Technology Progress Award each, participated in the National Natural Science Foundation of China, and published more than 10 SCI papers and Chinese papers.