Chen Yuxi: Minimally invasive valve technology is comprehensive, old-lived, high-risk surgery, driving

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Chen Yuxi: Minimally invasive valve technology is comprehensive, old-lived, high-risk surgery, driving

2021-11-28 06:09:51 35 ℃

From the big knife, there is a need for in vitro recycling, to minimally invasive, open the small hole, and then do not open the knife ... With the constant iteration of cardiovascular surgery, the advancement of cardiac valve technology has made many surgical prohibitions have been repeatedly broken. From the medical treatment for more than 20 years, Director Chen Yan, Chongqing Hospital of the Chinese Academy of Sciences (Chongqing People's Hospital), has always been in the end of the "the best treatment", all the way to master, and master a new technology. Today, the team he led can not only provide a cardiac replacement of unknophoresis, but also provide minimally invasive thoracoscopic cardiac repair and replacement for young patients, and truly achieve film treatment technology cover.

From the chest to minimally invasive, no knife

Cardiac valve technology is constantly innovation

In July of this year, 79-year-old Yang Haibei is a cardiovascular surgery for the Chongqing People's Hospital because of labor and cold, and has discovered that the aortic valve is severely lesom. The best treatment is to replace the aortic valve. However, traditional surgery is an old and complicated Yang's Yang Po, up to 15% of death risks are difficult to bear. In order to help the elderly to restore health, the experts of Chen Hao's director team have repeatedly discussed, assessed, and considered to be treated with a catheter aortic valve replacement (TAVR).

By adequate preoperative preparation, the TAVR team was successfully completed with the joint participation of cardiovascular surgery, internal medicine, anesthesiology, radiology, ultrasonic video department and other multi-department rooms. Due to the almost no incision of surgery, Yang Haibei quickly recovered to the hospital after surgery.

In fact, this is not the first time, the first time in Chongqing People's Hospital. In 1982, the 40-year-old Yang Haibei lived in Chongqing Surgery Hospital because of his heart, his chest tightness has been in the Chongqing Surgery Hospital (now Chongqing People's Hospital Yin Zhongyuan District), and it was found that the rheumatic heart disease caused the stenosis of mitral valve and closed. Considering that Yang Hairo is still young, if the replacement of the valve needs to take anticoagulation drugs for a long time, the doctors have done the more advanced "mitral petal separation surgery". This surgery is safe, the incision is small, no flap, no need for vitro Circulation, she quickly recovered after surgery.

In 1994, the 52-year-old Yang Haoyu found that mitral valve was narrow again in the review. With the medical technology at the time, the flap is no longer a problem, but it takes an oral anti-coagulation. After careful assessment, doctors have used another micro-invasive way - mitral balloon expansion. This technology is also an advanced treatment method at the time, and only a few hospitals can carry. Minimally invasive surgery makes Yang Haibei once again returns to normal heartbeat.

In 2002, Yang Haibei once again seriously, in addition to exhaustion, the heart is also accompanied by lower extremity edema. After inspection, her mitral flap is again aggravated, the best way is to replace the artificial valve. So, under the lifetime of the doctor, the doctors reminded the mitral petus of Yang Hapo serious lesions and changed the artificial valve. This difficulty is significantly increased, but the exquisite techniques of doctors have made Yang Haima to successfully recover.

From the opening to minimally invasive, from the repair and replacement of mitral valve, the replacement of the aortic valve, Yang Haibei experienced four technological innovations in the history of cardiovascular surgery, and also witnessed the heart of Chongqing People's Hospital for more than 60 years. Vascular surgery development history.

Thoracic mirror heart valve replacement

Provide minimally invasive treatment for young patients

"I have been doing more than 20 years. I am very fortunate that I have been in the hospital, and I have participated in the technical innovation of cardiovascular surgery." Chen Yue said, the previous heart valve surgery needs to be opened, even stop the heart, use vitro recirculation support Can complete the surgery. As the treatment means continuous improvement, the heart valve surgery is increasingly invasive, and there is less and less in vitro circulation, and the incision is getting smaller and smaller.

Minimally invasive species are very different. For example, some hospitals have developed a minimally invasive, actually open a relatively large incision, doctors still look directly at the incision surgery. The Chongqing People's Hospital has carried out heart valve surgery under whole pleural in more than 10 years ago. The incision is only 4cm, and the incision is very concealed. Traditional chest surgery.

"At present, our thoracoscopic heart valve surgery has been carried out, one hundred cases in one year. Moreover, in addition to valve disease, other partial cardiac surgery, especially valvular disease combined with atrial fibrillation can also be solved in this way. The hospital that can carry out in the country is very small. "Chen Yu said that due to their thoracoscopic technology in the southwest, the effect is good, the effect is good, and the thoracoscope cardiac surgery training class is held, which is fully promoted.

Cardinal valve membrane replacement

Provide choice for sensed critically ill patients

Although thoracoscopic heart valve technology is mature, how do you do it in elderly, critically ill patients? At the end of 2017, Director Chen Hao led the team to carry out the "non-knife" heart valve replacement, so that surgery has a disruptive development.

Director Chen Yus said that this surgical is called the conduit aortic valve replacement, which is by interventional catheter technology, from the patient's leg vascular puncture, the special artificial heart valve is delivered to the aortic valve position, fixed in the original valve Inside, the valve replacement is completed. This technology was approved by my country Drug Food Authority for the first time in 2017. And he was in Germany in 2013 to 2014, and the US training studied the technology. After returning to the country in 2015, he established a conduit valve replacement group, tissue anesthesia, intervention, nursing, surgery team, in vitro support team, etc. Learning, ready to prepare, only to be officially approved, on the first time. Therefore, Chongqing People's Hospital has become the first hospital for the first batch of surgery in China. "Currently, this type of surgery has been very mature. It can be completed for 2 hours. It can make the problem that cannot be solved before and safe." Chen Wei said that this technology can be a senior patient over 70, and Physical difference reluctant patients with surgery, opening a life gate. Moreover, now due to the price reduction fee, the entire fee is also reduced, and only more than 100,000 can be completed. "In addition to the aortic valve energy replacement, mitral valve, three-pointed replacement, is also carried out in this direction. It is expected that all heart valve surgery can be solved by this non-open minimally invasive way. The patient's pain will be further reduced. "

Expert profile

Chen Yue, University of Chongqing Hospital, China (Chongqing People's Hospital) Director, Chief Physician, Postdoctive Workstation, Master's Instructor, Chongqing Academic Technology Head, Chongqing Middle Youth Medicine High-end Talent, National Minimally Invasive Cardiovascular Surgery Commission member, member of the Cardiosalance of Cardiology, China Research Institute, Cardiology, Department of Cardiovascular, Department of Cardiology, Cardiology, Cardio Surgery, Chongqing Municipal Medical Association, Department of Cardiology, Chongqing Medical Association Member of the Surgery Committee committee, member of the Chongqing Municipal Medical Association Surgery Committee, member of the International Ministry of Medicine.

He has went to Beijing Fuwai Hospital, the German Karlsruhe Heart Surgery Center, and the New York Wilcomanir Medical Center made a high-end visit scholar. From medical, the technology is comprehensive, especially in the field minimally invasive surgery, atrial fibrillation, valve forming (repair), hybrid surgery (including the catheter valve replacement) and other fields, innovation, innovation, various thoracoscopic cardiac surgery. And there is an experience in patients with aortic dissection, aneurysm, and hypertrophic myocardial diseases.

In 2011, the Chongqing Municipal Committee Propaganda Department was awarded the honorary title of "Excellent Communist Party", 2011-2014 won the honorary title of Tencent for four consecutive years. In 2016, the honorary title of "Chongqing Excellent Management Worker", 2016. In 2017, he won the "most beautiful medical worker" nomination award in Chongqing. In 2019, the honorary title of "the most beautiful health and health volunteer" in Chongqing, 2019 "Chongqing Good Doctor" and other honorary titles.

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