■ On July 6, after completing the routine review after the operation, the patient Luo could be discharged from the hospital "with" a strong new heart.
■ On June 18, Luo, who had severe heart failure, received a heart transplant at the West China Hospital of Sichuan University.
At this time, it had been half a year since Luo installed the "artificial heart" in December last year. With the help of the "artificial heart", Luo finally waited for this precious transplanted heart.
■ It is understood that this is also the first patient in Southwest China who has transitioned from an artificial heart to a heart transplant.
Currently, the patient is in good condition.
Artificial heart "extended life" for patients with severe heart failure weighing nearly 200 catties
A year ago, Luo had a sudden cough and difficulty breathing. He sought medical treatment everywhere. After several turns, he came to the West China Hospital of Sichuan University for treatment, and was diagnosed with dilated cardiomyopathy and refractory heart failure.
It is understood that the cardiac ultrasound examination found that Luo's cardiac systolic function (cardiac ejection fraction) was only 9%, while the normal human systolic function should be greater than 50%. 9% means that the left ventricle hardly contracts and hardly pumps blood to the whole body. patients are at high risk of sudden death.
Coupled with the insufficiency of liver and kidney caused by heart failure, under the condition of maximum medical treatment, heart function is still difficult to improve, and repeated heart failure attacks.
The transplanted heart becomes a possibility for the patient to live.
Luo received a pre-transplant evaluation and was waiting for a heart transplant in the hospital.
But a new problem has emerged. There is a serious shortage of potential donors. In addition, Luo’s weight is close to 100kg. The heart transplant operation requires the donor’s weight to be close to the recipient’s weight, which is almost impossible to achieve in a short period of time.
On the other hand, Luo's physical condition is getting worse, and there is a risk of death at any time, so he can't wait any longer.
Fortunately, the third-generation implantable magnetic fluid suspension ventricular assist device (HeartCon) developed by a company was approved by the State Drug Administration and entered clinical trials.
After comprehensive evaluation and multidisciplinary consultation, Director An Qi and Dr. Wang Yabo's team from the Department of Cardiac and Great Vascular Surgery of West China Hospital of Sichuan University decided to perform left ventricular assist device implantation for the patient and place an "artificial heart" to improve the patient's organ function. Reduce your risks while waiting for a heart transplant and prolong your life.
On December 2, 2021, Luo successfully placed an "artificial heart", which was also the fifth "artificial heart" operation completed by West China Hospital.
The operation preserves the patient's heart that cannot contract, and at the same time installs an auxiliary device in this weak heart to deliver blood to the whole body through the newly added ventricular assist device.
The "artificial heart" device is only 180g, can be placed directly into the pericardium, and the wire is also very small.
Both the controller and the battery are small, consisting of two straps, which are carried on the patient like a vest, very light and small, and have little impact on the patient's daily life.
Postoperatively, the patient felt well and her dyspnea symptoms improved significantly.
After learning how to use the equipment, how to change dressings, and how to take a bath, and after passing the examination, the patient was discharged from the hospital wearing the "artificial heart".
After discharge, the Department of Cardiac and Great Vascular Surgery arranged a follow-up visit and started continuous care, urging patients to take medicine regularly, measure their weight, and report their daily health status. Real-time monitoring of working parameters, and comprehensive care of patients after surgery outside the hospital.
Lose 20kg in half a year for transplanted heart
Finally a new life
However, Luo, who finally adapted to the "artificial heart", deteriorated again.
In mid-April this year, Luo felt dizzy, nauseated and uncomfortable after having lunch, and the average pressure was at a high value.
The medical and nursing team who monitored the data in real time immediately performed remote antihypertensive treatment on the patient, and at the same time monitored the electrocardiogram. It was found that the patient was accompanied by severe ventricular arrhythmia, and the green channel was immediately arranged for hospitalization.
After relevant examinations, it was suggested that the patient had a potential risk of sudden malignant arrhythmia, and heart transplantation became his only option. The waiting state for heart transplantation was also elevated to a state of medical emergency.
In order to wait for a suitable heart donor and perform a heart transplant, under the guidance of a doctor, Luo's weight decreased from nearly 100kg to 80kg within half a year.
On June 18, Luo finally waited for a suitable heart offering.
The Cardiac and Great Vascular Surgery team cooperated with the team of Professor Zhang Qing and Professor Chen Yucheng of the Cardiology Department, as well as the Department of Anesthesia, Cardiopulmonary Circulation, and Critical Care Medicine, etc., and successfully performed a heart transplant for Luo.
The operation lasted more than 6 hours. After overcoming various difficulties such as severe adhesions in the thoracic cavity, difficulty in anatomy of tissue structure, and difficulty in postoperative hemostasis, the surgical team withdrew the ventilator assist device and removed the previous tired heart. The patient's body regained a strong pulsation.
Within 24 hours after surgery, the patient was extubated and successfully awakened.
On the 3rd day after the operation, he was transferred to the specialized general ward after transplantation, and entered the postoperative rehabilitation stage smoothly.
At the same time as the new student, Luo was also the first patient in Southwest China to transition from an artificial heart to a heart transplant.
Currently, the patient is in good condition.
Implantation of left ventricular assist device has won precious time waiting for transplant for patients with refractory heart failure, especially overweight, acute organ insufficiency, secondary pulmonary hypertension and other patients who cannot complete heart transplantation in time.
Chengdu Commercial Daily-Red Star News reporter Yu Zunsu