Recently, Professor Zhou Xinmin, Li Jianming, and Zhao Yuan, the Department of Cardiovascular Surgery of Central South University Xiangya Second Hospital, combined with the Extra Vitro Life Support Center, Color Ultrasound Room, Critical Care Medicine and other multidisciplinary experts, used the first domestically produced short- and medium-term in vitro full magnetic levitation ventricular assist device Extra-VAD, which was developed independently in China, successfully treated a critical patient with ventricular septum perforation after after acute myocardial infarction. It is reported that this is the first in vitro artificial heart implantation in Hunan Province. The patient has successfully overcome the difficulties and will recover and be discharged from the hospital in the near future.
patient Mr. Chen is 49 years old this year. He went to the hospital for treatment due to sudden dizziness, shortness of breath, weakness in the limbs without cause, accompanied by low back and left shoulder pain. The other hospital clearly diagnosed him with acute myocardial infarction and huge ventricular septal defect. On November 1, Mr. Chen's condition worsened and he was transferred to our hospital for treatment. After comprehensive evaluation by the multidisciplinary cardiovascular team (MDT), it was diagnosed as coronary heart disease after acute myocardial infarction, acute left heart failure , and cardiac function level IV.
Due to the further aggravation of severe depression edema in both lower limbs, congestion in both lungs, sitting upright and respiratory , and heart failure , the effect was not good after being transferred to the cardiovascular surgical monitoring room for IABP assisted treatment. On November 7, a multidisciplinary cardiovascular team performed "ventricular septal rupture repair + ventricular wall tumor resection + coronary artery revascularization" for him under extracorporeal circulation . During the operation, Mr. Chen found a large amount of effusion in the pericardial cavity of Mr. Chen, a large area infarction foci of the anterior wall of the left ventricular ventricular apex, and a huge defect from the apical to the middle of the ventricular septal (2.5cm×2.0cm), and there was a necrotic septal tissue (2cm×1.5cm) above it, with a brittle texture and spot-like texture. In order to ensure that Mr. Chen successfully escapes from extracorporeal circulation, maintains good hemodynamics , and ensures effective perfusion of important organs, after the team evaluates and obtains informed consent of the family, it was decided to complete intracardiac repair and coronary artery revascularization, the femoral vein peripheral approach was used to pass the catheterization method, and the venous cannulation was sent through the atrial septum and into the left atrium for drainage; the perfusion end was placed in the perfusion tube through the femoral artery to link the extracorporeal magnetic levitation artificial heart (MoyoAssist® Extra-VAD), and the in vitro artificial heart circulation system was successfully established.
Mr. Chen successfully returned to the cardiovascular surgical monitoring room with the dual assistance of in vitro magnetic levitation artificial heart and IABP. The vital signs after the operation were stable, and they woke up as scheduled, and their heart function gradually improved. They were successfully withdrawn on the 4th day after the operation, and were transferred to the general ward on the 9th day after the operation.
In vitro Artificial cardiac assistive device is simple to install and has less surgical trauma (intervention method), which can facilitate medical staff to elastically establish pipeline circuits, and achieve rapid installation and portable emergency rescue. For patients with lung function, have good lung function, external artificial heart can provide effective circulatory support, giving medical staff sufficient time, and helping to decide the next treatment plan, providing a accessible heart failure solution for patients with heart failure, and bringing welfare to the majority of patients.
Manuscript source: Central South University Xiangya Second Hospital
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