Popularization and Application of the third Generation artificial Heart Auxiliary device in China

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The research and development of domestic full maglev artificial heart was successfully completed throughout the play, and the first domestic full maglev artificial heart implanted patient was discharged. The artificial heart implanted by the medical team of Beijing Anzhen Hospital was exquisite in structure. Which patients need to use artificial heart, the treatment of end-stage heart disease, including drug treatment, surgical treatment and so on. However, these methods are not applicable to all patients with end-stage heart disease. "these patients should consider heart transplantation, but some end-stage heart disease cannot wait for a chance for heart transplantation. due to the lack of heart donors and the high requirements of heart donors for heart transplant surgery, only about 600 patients in the country are lucky to get heart donors every year. There are also some patients with end-stage heart disease who are not suitable for heart transplantation. the most common contraindication for heart transplantation is pulmonary hypertension, when the pulmonary vascular resistance is greater than 6 Wood Unit units. "

Recently, the TV series "everything about Doctor Tang" ended with the successful completion of the research and development of a domestic fully maglev artificial heart throughout the series, and "Chinese Heart" was successfully implanted into the human body in the final episode of the film. Coincidentally, on the eve of the end of the show, the first domestic patient with full maglev artificial heart was discharged from the hospital. The artificial heart implanted by the medical team of Beijing Anzhen Hospital for the patient is exquisite in structure and weighs only 186 grams and is close to the size of a pocket watch.

Which patients need to use artificial heart? What are the characteristics of a fully maglev artificial heart? A reporter from the Science and Technology Daily interviewed Gong Ming, deputy director of the Heart and Lung Transplantation Center of Beijing Anzhen Hospital.

A survey in 2020 showed that there were nearly 8.9 million patients with heart failure in China, and 5% of them developed end-stage heart disease. "at present, the treatment of end-stage heart disease includes drug treatment, surgical treatment and so on, but these methods are not applicable to all patients with end-stage heart disease." Gong Ming said.

Some of the patients with end-stage heart disease have been assessed by specialist cardiac surgeons that their heart function cannot recover even after cardiac surgery or drug treatment, and such patients should consider a heart transplant.

But some end-stage heart disease does not wait for a heart transplant. Due to the lack of heart donors and the high requirements for heart donors in heart transplantation, many patients died unfortunately without waiting for a matching heart source. "at present, only about 600 patients across the country are lucky enough to receive heart donors each year. Many patients need to wait for a long time, and some patients may lose the opportunity for treatment while waiting. " Gong Ming said.

"there are also some patients with end-stage heart disease who are not suitable for heart transplants." Gong Ming explained that the most common contraindication for heart transplantation is pulmonary hypertension. In general, when a patient's pulmonary vascular resistance is greater than 6 Wood Unit (Wood units), even if replaced with a normal heart, the heart is not enough to work in his body, and the postoperative survival rate is low. Generally speaking, elderly patients (over 70 years old) are not suitable for heart transplant surgery.

For those patients with end-stage heart disease who can't wait for or can't use a heart donor, the artificial heart is the last straw.

What is an artificial heart? Gong Ming explained that, exactly, the artificial heart does not refer to the total artificial heart, but to the implantable ventricular assist device (VAD), which works similar to a mechanical pump, which assists the body's own heart and builds an auxiliary flow channel for the patient's heart blood.

Take the commonly used left ventricular VAD as an example, it can partially or completely replace the left ventricular function. After it is implanted into the patient's body, the patient's blood flows into the blood pump through the blood vessels, and the centrifugal force caused by the rotation of the impeller in the blood pump pushes the blood out and flows through the blood vessels to the ascending aorta. So as to assist the patient's blood circulation.

"compared with human heart donors, the power of VAD is adjustable and can be used widely. Compared with heart transplantation, VAD implantation is less invasive and more beneficial to patients. Therefore, VAD can not only partially solve the problem of insufficient heart donors, but also provide treatment for patients with end-stage heart disease who cannot undergo heart transplantation. " Gong Ming said.

There are many types of VAD in clinic. According to the time of use, VAD is usually divided into temporary assist devices and permanent heart assistance devices. Temporary assist devices, including IABP,ECMO,Impella,Century Mike, etc.; permanent heart assistance devices include left ventricular assistance, right ventricular assistance, biventricular assistance and so on. According to the development process, VAD can be divided into three generations. The first generation VAD mainly uses the pulsating (pneumatic) pump, the second generation VAD is the axial flow pump, and the third generation VAD is the centrifugal pump.

Gong Ming said that the third generation of VAD is now used clinically, and this kind of VAD uses magnetic levitation and hydraulic levitation technology. Compared with the previous two generations, it has further fewer complications after implantation, less damage to blood, is not easy to form thrombus, and is small in size, easy to install, and can be worn for a long time. In addition, the third generation VAD is built-in, while the miniaturization of high-energy batteries improves portability.

"the fully maglev artificial heart we mentioned belongs to the third-generation VAD, which has many advantages of the third-generation VAD and is usually used for left ventricular assistance, but it can also be used for right ventricular assistance." Introduced by Gong Ming.

Although compared with the previous two generations of VAD, the full magnetic levitation artificial heart has many advantages, but it also needs to be improved. "for example, with a wire outside the body, patients have to carry controllers, batteries, and so on, and need to be recharged from time to time. Sleeping, bathing, flying and other activities will be affected. " "it is hoped that with technological innovation and continuous improvement of products, the products will be more miniaturized, charging and wearing more convenient, and solve a series of functional problems such as thrombosis and anticoagulation," Gong said. "

In addition to the full magnetic levitation artificial heart, the third generation of VAD products have hydraulic levitation, liquid magnetic levitation and other different styles. Gong Ming stressed that different styles of driving methods are different, applicable to the population is also different, they have no absolute advantages and disadvantages, each has its own advantages and disadvantages. As for which kind of VAD the patient should choose, it is necessary for the clinician to make an individual judgment according to the patient's condition.

"up to now, a number of third-generation artificial heart assist devices have been put on the market in China, and some devices are in clinical trials, all of which have achieved good results. In a word, China's medical device industry has entered an era of vigorous development. " Gong Ming said.(reporter Dai Xiaopei)

Popularization and Application of the third Generation artificial Heart Auxiliary device in China

Source: science and Technology Daily