Transthoracic minimally invasive congenital heart disease blocking, —- Revolutionary changes in congenital heart disease treatment Yang Zaizhen, Department of Cardiac and Macrovascular Surgery, Zhengzhou People’s Hospital Introduction: On February 28, 2012, Zhengzhou People’s Hospital launched the On February 28, 2012, Zhengzhou People’s Hospital launched a large-scale public welfare activity of “free assistance for thousands of children with congenital heart disease”, and has successfully performed free surgery for nearly 600 children with congenital heart disease, and continuously innovated techniques and challenged difficult surgeries, setting a number of surgery records for ultra-low weight children and low age children in the province. On February 28, 2013, exactly one year later, the Department of Cardiac and Macrovascular Surgery was the first in the province to carry out “transthoracic minimally invasive congenital heart disease blocking surgery”, which brought revolutionary changes to the treatment of congenital heart disease. Minimally invasive heart surgery, so that parents are no longer in a dilemma from Shandong Heze Xiaobing 1 year 7 months, the little guy looks like a tiger head very pleasant, and children of the same age constantly running around, happy to play, do not see any difference to. But soon after his birth, Xiaobing was found to have congenital heart disease, which became a big “heart problem” for his parents. According to Xiaobing’s father, Mr. Gao, the doctor said that the child had a heart murmur during the physical examination after birth, which made their happy mood sink. After the local hospital ultrasound, the doctor said it was a ventricular septal defect. They then took Xiaobing to several hospitals, where doctors told them that Xiaobing’s condition was not very serious at the moment, but that it would affect the child’s growth and development in the long run, such as easily causing respiratory infections, heart failure, pulmonary hypertension and other cardiopulmonary impairments, and suggested that they perform surgery for Xiaobing’s precordial disease at least before school age. “Because the child is small, but also because this is a major surgery on the heart, so ran several hospitals to consult the surgery how to do, inquiring which expert technology is good.” Mr. Gao said, “Experts have also said that the surgery is not difficult, but to open the chest, thinking that the child is so small, do not want him to suffer so much. In addition, the child usually has no obvious symptoms other than easy to catch a cold, so we parents have been hesitant to give Xiaobing surgery, but also afraid not to do his development, really difficult ah.” When they heard that Zhengzhou People’s Hospital was carrying out rescue activities for precocious heart disease, and that several well-known experts in the province would consult and operate, they brought Xiaobing to seek medical advice. After listening to their concerns and after a detailed examination, Director Yang Zaizhen said he could use the advanced technology of “transthoracic minimally invasive precordial occlusion” to cure Xiaobing’s disease without moving his sternum or ribs to open his chest, and only a small incision as big as a band-aid, and the surgery was safer and recovery was faster. He was discharged from the hospital three days later, with only a small 2 cm long scar on his chest compared to the time he was admitted. Minimally invasive heart surgery for many patients When it comes to congenital heart disease, many people think of children. So when 35-year-old Ms. Cha heard the doctor say that she had an unclosed ductus arteriosus, a type of congenital heart disease, she couldn’t believe it for a moment. She said, “I haven’t felt anything wrong with my body since I was a child, but I just recently went to the hospital for a checkup because I felt tired and weak”. Director Yang Zaizhen said, Ms. Cha belongs to the congenital arterial duct closure insufficiency, because the resulting flow is not large, so the symptoms are not obvious, but the hidden danger of this disease has always existed, with the young increase, the symptoms will become more and more serious, so it is necessary to timely surgery. When she heard that she was going to have surgery, Ms. Cha first asked how big the incision was. She said, “Although I am married and have children, I don’t want to have a long scar on my body that will affect my beauty.” After hearing Director Yang’s introduction of “transthoracic minimally invasive precordial occlusion”, she did not hesitate to choose this procedure. On February 28, the same day as Xiaobing, Director Yang Zaizhen successfully completed the “closure of unclosed ductus arteriosus” for Ms. Cha through a 2 cm incision in her chest under the guidance of color ultrasound. Three days after the operation, Ms. Cha recovered and was discharged from the hospital with great satisfaction. Yang Zaizhen, director of cardiac surgery, introduced that the new technology of “transthoracic minimally invasive precordial occlusion” can be widely used in the treatment of atrial septal defect, ventricular septal defect, arteriovenous stenosis, pulmonary valve stenosis, mitral valve stenosis and other heart diseases, and it is suitable for people from children to adults, bringing gospel to the majority of heart disease patients. Compared with traditional surgery, there are five advantages According to Yang Zaizhen, director of the conventional congenital heart disease surgery, there are two main ways, one is open-chest or axillary incision surgery, the incision is large and affects the aesthetics, especially to rely on extracorporeal circulation during surgery, there is a risk of complications in the heart, brain, lungs, kidneys and other important organs. The other way is the transcatheter cardiac intervention, which is performed under the intermittent projection of a digital subtractive X-ray machine from the large blood vessels of the leg through a specific cardiac catheter operation technique to image and block the heart disease, which requires X-ray guidance and exposes the doctor and patient to radiation damage. In contrast, “transthoracic minimally invasive precordial occlusion” is performed by inserting an ultrasound probe into the esophagus to collect the ultrasound signal of the heart and then making a 2 cm incision at the left or right edge of the chest under the guidance of cardiac ultrasound to seal the defect or dilate the stenosis through the pulmonary artery or right atrium. During the whole procedure, the heart does not stop beating and no extracorporeal circulation has to be established, which can be done in ten minutes. Director Yang Zaizhen said that this surgical method has five distinct advantages: First, the incision is small. The original median and lateral incisions range from 6 cm to 20 cm in length, while the incision in this technique is only 2 cm (about the width of a person’s thumb). Second, fewer complications. It avoids the destruction of blood cells and serious complications of heart, brain, lung, kidney and other organs that may be caused by the original conventional surgery to establish extracorporeal circulation. Third, no side effects. Completely under color ultrasound, ultrasound has almost no damage to the human body, avoiding the damage of blood cell reduction and bone marrow suppression that may be caused by X-rays during vascular intervention, and also avoiding the occurrence of contrast nephropathy. Fourth, the operation time is short and recovery is fast. ICU monitoring and hospitalization time, etc. are greatly shortened;, generally three days after the operation can be discharged from the hospital, which greatly saves medical resources. Fifth, no age limit. The method can be used for children with precocious heart disease over three months old who meet the indications, while cardiac interventional surgery is generally performed only after 3-5 years old. Director Yang Zaizhen said that this new technology carried out by Zhengzhou People’s Hospital is at the leading level in the province, making cardiac surgery in our province enter the era of ultra-minimally invasive. In order to help more children with precocious heart to recover their health, Zhengzhou People’s Hospital not only continues to carry out the “Thousands of Children with Precocious Heart Free Relief” and “Welfare Fund for Precocious Heart Disease Project”, but also organizes the strongest team of experts and adopts the latest and most advanced technology to ensure that