September 2023

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最近，华中科技大学同济医学中心附属协和医学院心脏外科的董念国教授使用了一种与苏州新青医疗科技有限公司合作开发的体外短期至中期心室辅助设备，通过微创颈静脉和腋窝介入额外安装磁悬浮人造心脏，成功完成了循环支持。 它可以显著减轻患者的创伤，帮助他们在手术后快速恢复，并且对下肢的移动方式没有影响，使他们能够毫无问题地移动到地上等待心脏移植。 该手术在中国首次成功实施，代表着短期至中期体外磁悬浮心室辅助装置的成功完成，这是一项重大突破。 病人是一名正在遭受痛苦的56岁男子。 9年前，没有明显的胸闷和气喘的原因。 诊断被认为是心力衰竭和扩张型心肌病。 两个月前，没有明显的胸闷和气喘加重的原因。 治疗后血压仍然很低，心室心率异常很常见。 我们医院接待了家属进行进一步的诊断和治疗。 由于病情危重，他在进入重症监护病房之前被转移到我们的医院。 急性恶化的慢性心力衰竭。 患者中均发现扩张型心肌病、耐药性心力衰竭、心源性休克、心室心律失常、多器官损伤和其他疾病。 目前尚无医疗救助，病人情况危急。 考虑使用机械循环支持。 经过董念国教授团队的评估和家人的批准，决定安装新青医疗的体外磁悬浮人造心脏作为循环支持。 右颈静脉右腋动脉导管术用于建立左心房静脉体外人工心轴循环辅助。在董念国教授的指导下，在心脏病学、超声波、麻醉学和物理医学小组的协助下，陈舒教授等人进行了手术。 术后使用右股静脉穿刺插入导丝，并检查右心导管。 在超声波和 Dsa 引导下进行房室穿刺后，将大腿延伸的静脉导丝插入右心房。 通过被陷阱捕获的右颈静脉，将导管插入左心房。 为了形成一条与颈静脉、上腔静脉、右腔室和左侧腔室分开的排水路径，然后将锯齿状的静脉导丝插入灌溉管中。 左心房、体外人工心脏和腋窝动脉循环辅助由右锁骨下切口建立，该切口与人造血管分裂并吻合。然后，这些血管连接到新京医疗的人工磁悬浮心脏并打开泵。 由于李平教授的调整，人造心脏功能正常，患者健康状况稳定，手术成功完成后，他们被转移到重症监护室（ICU）。 患者是一位24多岁的男性患者。 九年前，发烧后，没有明显的胸闷病因。 他平躺时感觉不舒服。 邻里医院的检查显示，他的心脏变大了。 四年前，经常出现气喘吁吁和胸闷的发作。 两年前，进行了心脏移植手术，但注册仍在等待中。 后来，他到我们医院接受了第二次心脏移植手术。 患者被诊断为扩张型心肌病、Nyha Iv级、终末期心力衰竭、肺动脉高压、III级左心室舒张功能减退、严重二尖瓣功能不全等。 患者在入院期间心力衰竭恶化，后来住进了重症监护室。 患者的治疗效果不佳，例如强心剂和利尿剂，以及心率低。 心率仍为每分钟82次，血压继续保持在60至70/40至50 mmhg。 虽然心脏供应仍有等待期，但随时可能发生多器官衰竭、恶性心律失常、心脏骤停甚至死亡等风险。 科技部微型介入式人工心脏 ，然后在超声波和 Dsa 的指导下进行心房隔穿刺。然后插入导丝，然后使用陷阱将延伸的大腿静脉导丝插入右心房。 导管与延伸的大腿静脉导丝一起，通过右颈静脉进入左心房，右颈静脉被陷阱捕获。 为了形成一条与颈静脉、上腔静脉、右腔室和左侧腔室分开的引流路径，然后将锯齿状的静脉导丝插入引流管中。 右侧锁骨下切口将腋动脉分开，末端与人造血管吻合。这建立了左心房、体外、人造心脏，然后将其连接到新京医疗的人造磁悬浮心脏，然后打开泵。 由于李平教授的调整，人造心脏功能正常，患者健康状况稳定，手术成功完成后，他们被转移到重症监护室（ICU）。

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