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Yesterday, Nanjing Gulou Hospital Cardiothoracic Surgery, held a news conference to announce the successful implementation of the hospital in East China's first autologous cardiac transplantation. August 23, Gulou Hospital, Wang Dongjin,http://mr007ouzhou.com/forum.php?mod=viewthread&tid=443097, director of cardiothoracic surgery for a patient with severe rheumatic heart disease, heart as big as a football patient, the successful implementation of autologous cardiac transplantation, while completing mitral valve replacement, aortic valve replacement tricuspid annuloplasty and radiofrequency ablation of atrial fibrillation. In layman's terms, that is, the patient's "bad heart" removed from the body, after the "plastic" + "downsizing", and then transplanted back into the body. It is currently the second case reported in situ autologous heart transplantation.
Correspondent Liuhui Yan
Yangzi Evening News reporter Dandan
A "giant heart" full chest brace
Is three to four times the normal heart function remaining 30%
Wu, 58, from the sound of water, 20 years ago, he felt after the event palpitation, chest tightness, wheezing, mild limitation of physical activity, when the symptoms of colds and cold weather will increase. Family poverty on the one hand,http://nagrayt.com/thread-683362-1-1.html, on the other hand and he did not pay attention, it has not been treated. Until four years ago, when Wu cough due to a cold at a local hospital, diagnosed with rheumatic heart disease.
By the end of July this year,http://pcbbbs.net/read.php?tid=468/read.php?tid=468, further aggravating the patient's condition, appeared flustered at rest, chest tightness, shortness of breath, lower extremity edema, generalized weakness; especially at night, difficulty breathing, or even can not sleep lying down; due to insufficient blood supply to the organ, but also oliguria other symptoms. County Hospital, said nothing, recommended that he came to Nanjing Gulou Hospital director Wang Dongjin find cardiothoracic surgery.
Director Wang Dongjin after inspection found that Wu due to severe rheumatic heart disease leading to heart failure, mitral, tricuspid and aortic valve disease are serious, there is severe pulmonary hypertension and other cardiac function only 30%.
From the image point of view, Wu's heart significantly expanded volume is almost 3-4 times normal heart. Especially the left atrium,chaussures tn pas cher, left atrium diameter is generally normal in the 3.5 to 4 cm, while patients with left atrial diameter of 14 cm, the left ventricle has expanded nearly doubled. Judging from the chest, the patient's heart representing the proportion of up to 95% of pleural, stays almost over the entire chest,http://www.122job.com/home.php?mod=space&uid=33615, while the normal value is less than 50%. Enlarged heart severe oppression and lung tissue surrounding the esophagus, seriously affecting lung function, but also cause dysphagia.
B traditional surgery can not "burden"
Experts decided to take the heart out of "downsizing"
Depending upon the patients, conservative treatment is no longer possible, a simple valve replacement surgery results are not good. "Patients with heart, especially the left atrium is too large, simple valve replacement surgery can not solve the problem because of left atrial enlargement cause lung oppressed." Wang Dongjin Director explained that the final after a comprehensive assessment of the patient's condition, it was decided to implement valve replacement surgery At the same time, the patient is taken out of the left atrium, partial resection,moncler uomo, reach for the heart "burden" purposes.
In layman's terms, that is, the "bad heart" removed from the body, "cosmetic" and then transplanted back into the body. In medicine, this is called "in situ autologous heart transplant." Surgical operations and procedures in allogeneic heart transplantation is the same, but others allogeneic transplantation Heart transplantation is a good heart, and autologous transplant is his bad heart after doing some "plastic" and "downsizing" and then "loaded "go back.
It is understood that since the first heart transplant for certain heart resection of malignant tumors. In 1999, foreign experts will be applied first valve disease leads to excessive treatment of the left atrium. And in 2010, Beijing Union Medical College Hospital was the first of its kind in the country,http://www3.2009st.com/bbs/home.php?mod=space&uid=231160, carried out in situ since the first case of heart transplant.
C255-minute cardiac arrest
The stained-shop in the chest surgery
Through careful preparation, August 23, to director Wang Dongjin, and anesthesiologist Dr. Pan Jun Luo Xuan, cardiopulmonary bypass surgery team, led by teacher Chen Yang patients scheduled for surgery.
10 am, after a series of preparatory anesthesia,http://www.menqiu.com/home.php?mod=spacecp&ac=blog&blogid=, doctors Wu opened the chest, the heart of a huge pop, "like a football so much," Wang Dongjin director recalls.
11:15,scarpe hogan,http://www.xrfang.com/home.php?mod=space&uid=107084, after cardiopulmonary arrest, the cut, the inferior vena cava, aortic and pulmonary artery, the patient's heart is removed Wu. Gulou Hospital Cardiothoracic Surgery team removed most of the first annular wall of the left atrium, and the residue left atrium and right atrium radiofrequency ablation of atrial fibrillation, mitral valve replacement is completed, and tricuspid aortic valve replacement surgery, heart and then be sutured back into place pericardial cavity.
Wang Dongjin, director, told reporters after the patient's heart removed, not imagined, as the heart of the basin filled with ice on the inside of the surgery, "in order to protect other organs, we still choose to be placed in the chest heart surgery . "said Wang Dongjin,http://www.xinhelan.com/home.php?mod=spacecp&ac=blog&blogid=, in order to maintain a low temperature environment of the chest, also need to be placed in the ice chest,woolrich sito ufficiale, but for fear of frostbite ice organs, they saline frozen ice, ground ice shavings shop inside the patient's chest . Meanwhile, in order to allow a patient's heart during cardiac arrest without cell necrosis, into a patient's heart for myocardial preservation solution, so that the blood supply in the absence of the heart condition can be maintained for 4-5 hours.
15:30, after 255 minutes after successful resuscitation of cardiac patients. Until 19:00, which lasted more than nine hours of surgery was finally successful conclusion, the patient was transferred to the intensive care unit to accept guardianship and care.
Currently, patients with heart function recovered well, ultrasound showed the left atrium diameter from 14 cm preoperatively been reduced to 6.6 cm. Tomorrow, Wu will be officially discharged while director Wang Dongjin said that after a period of rehabilitation, his heart function will be restored to near the level of ordinary people.
■ Experts
Autologous transplantation is much higher than the risk of allograft
Compared with allogeneic heart transplantation, since the difficulty and risk higher heart transplant, Why? Wang Dongjin, director explained that this is mainly reflected in three aspects.
An allogeneic heart transplantation is the normal heart transplant patients, and autologous transplantation of heart transplantation is already sick of heart, but also on the "bad heart" to complete the double valve replacement surgery and postoperative cardiac function will be subjected to the test. Two, left atrial wall as long as the wall is propped ball, thin and brittle,hogan milano, cut and stitched to such organizations, if slightly larger needle, can cause bleeding. Third, take out the heart but also put it back, but the original shape of the heart has changed, how and vascular "pair" is also a problem.