Doctors 'patch' broken hearts with futuristic technology

(Dan Tri) - Heart surgery is difficult, minimally invasive open heart surgery is even more difficult. Every operation must be very careful, precise, no unnecessary movements are allowed because sometimes small mistakes can cost the patient's life.

Those are the shares of Associate Professor, Dr. Nguyen Sinh Hien, Director of Hanoi Heart Hospital when talking about minimally invasive open heart surgery. At Hanoi Heart Hospital, the number of minimally invasive heart surgeries accounts for about 30%. Up to now, almost all types of diseases can be treated with minimally invasive surgery, from children to adults. "Minimally invasive heart surgery is an inevitable trend in the world . Therefore, for the benefit of patients, to update with modern surgical centers in the world as well as for the future of not being unemployed (without minimally invasive surgery, there will be no patients coming), over the past many years, the hospital has applied this technique for many diseases", Associate Professor Hien said with a smile.

"10 years ago, my hair turned completely gray. At first, I dyed it black, but then I ignored it. After being hospitalized, I realized that gray, ugly, beautiful, fame, career, and money are nothing," Ms. Xuan ( Hanoi , character name has been changed) confided. At the age of 54, she was assigned to have an urgent heart valve replacement due to severe heart failure. At the age of 30, she had mild heart valve stenosis and had a heart valve dilation surgery. After taking medicine for a while, her condition stabilized, so gradually, she forgot that she had a history of heart disease until the days before Tet when she felt very tired. After going to 2 major hospitals in Hanoi, she was surprised to be diagnosed with severe heart failure, had to have urgent heart valve replacement surgery, and had many blood clots in her heart.

At Hanoi Heart Hospital, she was admitted to the hospital and had the necessary tests done to prepare for surgery. However, her surgery was postponed twice because she had an infection, and surgery would be dangerous. Even after the surgery was scheduled, her surgery could not take place as planned because she took anticoagulants the day before the surgery. Because of that, she suddenly became famous throughout the hospital as a "gray-haired lady" who took anticoagulants before surgery. Although she was determined to have the surgery, she was still afraid that she might not wake up, so she wrote a will. In the end, the surgery went well, she was pushed into the operating room at 12:10 pm and woke up at 7:00 pm. After more than a week, she was discharged in time to celebrate Tet with her family. "On the 6th day of Tet, the agency organized a New Year's meeting, and my son also brought me to visit. When they saw me, everyone was very surprised, no one thought I would recover so quickly. When they learned that I had written a will, everyone in the agency was shocked," Ms. Xuan recalled with a laugh. Associate Professor, Dr. Nguyen Sinh Hien said that the patient was hospitalized in a state of heart failure, severe mitral valve stenosis and regurgitation, requiring urgent surgery. After consultation, the doctors decided to replace the mitral valve and repair the tricuspid valve. The patient underwent endoscopic surgery to replace one heart valve and repair the other, minimally invasive heart surgery.

"During the surgery, we discovered many old and new blood clots in the left atrium. The heart valve was heavily calcified, narrowed and severely leaky. This case is very susceptible to complications because the blood clot can break loose and follow the blood flow, causing blockage of the brain, coronary, visceral and limb vessels, which can be life-threatening," Associate Professor Hien analyzed. The doctors removed all the blood clots, cut the damaged heart valve and replaced it with an artificial heart valve, and repaired the leaky tricuspid valve. This entire process was conducted under a 3D endoscopy screen.

Minimally invasive cardiac surgery is defined as all open heart surgeries through small incisions that do not require sawing the entire sternum. Minimally invasive cardiac surgery is divided into many levels, including surgery without using endoscopy, assisted endoscopy or complete endoscopy. Extracorporeal circulation can be established centrally in the chest or peripherally or not used. According to Associate Professor Hien, the minimally invasive cardiac surgery method is a development trend of medicine in the world as well as in our country. Previously, in the open surgery method, the classic surgery, the doctor had to cut the sternum with a large incision, sometimes leaving serious consequences such as chest deformity, sternum inflammation leading to death. "Today, many heart diseases can be treated with minimally invasive surgery using endoscopy. We can perform heart valve replacement surgery, mitral valve, aortic valve, repair heart valves, and ablate atrial fibrillation. Many congenital heart diseases can also be treated with endoscopy, minimally invasive surgery, without having to split the patient's sternum but through the intercostal space," Associate Professor Hien said.

This technique has many advantages such as small incisions, ensuring aesthetics, reducing pain, reducing complications for patients, especially avoiding damage to the sternum, especially in the elderly. In the elderly, the sternum loses its calcium, is very soft, when damaged it will be difficult to heal, easily inflamed, infected, requiring long-term treatment, even increasing the mortality rate for patients. After surgery, patients recover quickly, after a week they can be discharged from the hospital. With the old surgical method, patients need to stay in the hospital for 2-3 weeks. "When performing minimally invasive heart surgery, the doctor must operate very carefully, must not make mistakes, must not make unnecessary movements because small mistakes but large ones can cost the patient's life. These techniques in Vietnam are at the same level as the world, we are not inferior to any country in the field of minimally invasive heart surgery", Associate Professor Hien emphasized. With minimally invasive surgery technology, in developed countries the cost for a treatment is very high. That technology requires special tools. However, in Vietnam, due to the financial constraints of patients, we have made improvements and used homemade tools. These tools are suitable for the size of Vietnamese people, have the right functionality and are not as expensive as imported equipment. In addition, Hanoi Heart Hospital has also researched a number of methods to repair heart valves for patients, without having to replace the heart valve, optimizing the preservation of the heart valve for patients. When the heart valve is repaired well, after surgery, the patient will not have to take anticoagulants, thereby increasing the quality of life and reducing the risk of complications during surgery.

Associate Professor Hien compares conventional surgery with minimally invasive surgery like riding a motorbike with a car. "At first, anyone who drives a car feels shy, afraid of going in the wrong lane, going at the wrong speed... but once they can drive a car, they just like driving a car. Minimally invasive heart surgery is the same, over time it becomes "addictive", the patient also feels much less pain, the surgical scar is beautiful, the risk of complications is low. For the benefit of patients, keeping up with modern surgical centers in the world, if we don't do minimally invasive surgery, patients won't come to us, so over the years we have gradually applied minimally invasive heart surgery," Associate Professor Hien shared.

According to him, in the world, minimally invasive heart surgery techniques originated from Europe and the US, but not all centers perform minimally invasive heart surgery. On the contrary, Hanoi Heart Hospital receives many foreign delegations, even from European countries such as France, Germany, etc. to exchange and learn. He always believes that patients are also his teachers because treating patients helps doctors gain experience and become better at their jobs. There are many things that are not in books or in theory, but we have to learn from patients.

Each person has only one heart, when the heart stops beating, the body will die. Therefore, heart surgery is very special, doctors must make the most of their time, otherwise the patient will quickly die. "While operating on other organs, doctors can stop to consult with colleagues for 5-10 minutes, but for cardiovascular surgery, when using drugs to stop the heart to operate, it is necessary to take advantage of every minute and second and the operation requires high precision because if done wrong, there is no chance to fix it", Associate Professor Hien said. Associate Professor Hien added that he feels happy when healing damaged hearts. Therefore, as long as he is healthy, he will continue to contribute to continue the journey of "patching" hearts with irregular rhythms. Content: Nam Phuong Design : Tuan Huy.

Content: Nam Phuong

02/25/2024 - 02:00

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