The smallest artificial heart staged "levitation surgery" "Chinese Heart" has entered the third-generation technology camp
Recently, Union Hospital Affiliated to Huazhong University of Science and Technology (hereinafter referred to as Union Hospital) announced to the public that a multidisciplinary team of experts headed by Professor Dong Nianguo from the Cardiac and Great Vascular Surgery Department of the hospital has successfully implanted an ultra-small magnetic levitation in the body of 58-year-old Mr. Chu (pseudonym). Centrifugal artificial heart.
It is reported that this is the 12th artificial heart implantation completed by the hospital.
What are the advantages of magnetic levitation centrifugal artificial heart?
Have we ushered in a new beginning for artificial hearts?
With these questions, a reporter from Science and Technology Daily interviewed experts from Union Hospital.
Artificial heart is hope 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 various organs in the body.
In the event of cardiac arrest, the "engine" stops working, and the person dies quickly.
At present, it is estimated that there are about 10 million heart failure patients in my country.
About 7%-10% of heart failure patients are critically ill. Due to the severe shortage of donors, only more than 600 patients with end-stage heart failure can complete heart transplantation 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.
Artificial hearts give hope to patients with end-stage heart failure.
The ultra-small magnetic levitation centrifugal artificial heart implanted this time is also called CorHeart 6 left ventricular assist system. It belongs to the third-generation ventricular assist device with independent intellectual property rights and is an authentic "Chinese heart".
The pump body has a diameter of 34 mm, a thickness of 26 mm and a weight of 90 grams, such as the size of an egg. It is currently the world's smallest and lightest magnetic levitation centrifugal artificial heart.
Currently, the clinical trial is led by Academician Hu Shengshou of Fuwai Hospital.
Dong Nianguo introduced: "In China, it is very meaningful to do our own artificial heart research and development. 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 greatly improved. It must be very expansive."
Magnetic levitation centrifugal pump causes less damage to patients
"Actually, the accurate term for what we call an artificial heart should be an implantable ventricular assist device, rather than a strictly total artificial heart," Dong Nianguo said.
According to the development of ventricular assist device (VAD), it can be divided into three generations.
The first generation VAD mainly refers to pulsating (pneumatic) pumps, and the second generation VAD is an axial flow rolling pump.
Compared with the first generation, the second generation has significantly smaller volume, better durability, and significantly improved patients' quality of life.
The third-generation VAD is a centrifugal pump, which uses magnetic suspension and hydrodynamic suspension 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 left ventricular power is insufficient. At this time, the doctor can put a centrifugal pump into the left ventricle, let it pump blood, and play the role of parallel circulation with the heart, so that one plus one is greater than two. Effect.
The working principle of the centrifugal pump is to use centrifugal force (the spin-drying function of the washing machine also uses centrifugal force) to pump the blood from the left ventricle and perfuse it into the aorta, thereby partially replacing the function of the left ventricle.
In order to be used for a long time, the suspension technology commonly used in centrifugal pumps adopts the method of magnetic suspension, hydraulic suspension or combined application of magnetic suspension and hydraulic suspension.
Among them, the high shear stress of the fluidly suspended blood film can lead to blood damage.
Dong Nianguo believes that maglev seems to be the trend of development.
Magnetic levitation means 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 generation, less loss and high durability.
"The advantages of the magnetic levitation centrifugal pump are good blood compatibility, low damage to blood cells, small size, relatively small damage to patients, and a wide range of users." The Department of Cardiovascular Surgery, Union Medical College Hospital is responsible for extracorporeal circulation and extracorporeal life support. Li Ping, deputy chief physician, said.
my country enters a new era of artificial heart
"There is still a big gap in the number of artificial heart applications in my country compared with foreign countries, but it is on the right track and has a bright future." Dong Nianguo said, 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 in the world, the pace of domestic artificial heart technology innovation is accelerating. For example, the concentric CH-VAD is the smallest fully magnetic levitation left ventricular assist device on the market, and the CoreHeart 6 can be used for low-weight patients and even children.
Xia Jiahong, Vice President of Xiehe Hospital, introduced that in order to face the frontiers of the world, meet the major needs of the country and the people, and strive to overcome critical cardiovascular diseases that seriously endanger people's health, at the beginning of this year, the hospital will include Cardiac Surgery, Cardiology, Ultrasound Medicine, and Anesthesiology. Combined with other strong disciplines, the Union Medical College Cardiovascular Hospital was established to explore the "heart" program for patients with end-stage heart disease.
In order to usher in a new era of artificial hearts, Dong Nianguo hopes that domestic experts in the field of artificial heart research can play a "combination punch" together.
He said that the magnetic levitation artificial heart still needs to be further developed and perfected, including the realization of the full built-in drive system to avoid the cable going out of the skin and secondary infection; further optimizing the product to improve its durability and reduce bleeding and thrombosis complications.
At present, the magnetic levitation artificial heart still needs to be further improved. The magnetic levitation artificial heart pumps blood mainly by advection. It is hoped that it can generate pulsatile blood flow that is consistent with the beating of its own heart and more in line with the physiology. It needs to be further reduced in size and developed for children and even infants. It is necessary to further optimize the implantation method to make the operation simpler and less invasive.
Our reporter Liu Zhiwei correspondent Nie Wenwen Chen Youwei