The heart of a normal person is held by the diaphragm and pericardium and beats in the chest cavity. The 5 month old He Le has a “hole” in his diaphragm and pericardium, and his heart is leaking into his abdomen, which is not necessarily one in a million. 5 month old He Le (pseudonym) has an egg-sized protrusion on his abdomen, but surprisingly, this protrusion is beating. The examination found that the protrusion was actually the child’s heart! A “live egg” protruded from the abdomen. Now only 5 months old, He Le was born not long ago and showed himself to be “different”. He Le even just lying quietly, but also as if playing for a long time, sweating, shortness of breath; drinking milk, always drinking more and more powerless, often choking; development is also much slower than the average child. He Le weighed 3.5 kilograms when he was first born, but after 5 months, his weight only increased by 2 kilograms, while children of the same age, generally grew four or five kilograms; in addition, he was also relatively weak, moving fever and cold. The company’s main business is to provide a wide range of products and services to the market. What is this thing? The hospital’s cardiothoracic surgery Dr. Wang Ping Shan after observation that this protrusion is the child’s heart! “Because the beating speed of this mass is the same as the heartbeat frequency, and there is nothing in the human body that can beat on its own, only the heart.” Wang Ping Shan said, to He Le after the heart ultrasound and chest X-ray, also confirmed that the bulge is the heart, 4 cm long, 3 cm high, and He Le whole body also combined with seven congenital malformations, namely atrial septal defect, ventricular septal defect, pulmonary valve stenosis, pericardial defect, permanent left superior vena cava, diaphragm defect, abdominal white line hernia. Why does the heart grow in the belly? Wang Pingshan said, this is related to the child has a diaphragmatic defect, pericardial defect. “The normal human heart beats in the chest cavity, with the diaphragm and pericardium ‘holding’, will not fall out, but the lack of diaphragm and pericardium, the heart will leak out into the abdominal cavity.” Because of the prolonged friction, today Hele’s heart is dangerously tightly adhered to the skin of the abdomen. Because a normal person’s heart is inside the chest cavity, protected by the sternum and ribs, it is very safe, but when the heart is tightly attached to the abdomen, it is separated by only a thin layer of skin, and even a slight blow may damage the heart, leading to heart rupture and bleeding, which can endanger life at any time. Wang Pingshan said that the incidence of cardiac ectopia is below 5 per million today, with no more than 200 cases documented worldwide, and cases combining multiple malformations at the same time are extremely rare. The cause of this disease, which is not conclusive internationally, is an abnormality that occurs in the affected child in the mother’s body, possibly due to stimulation by drugs or radiation, and can usually be detected during monitoring of the fetal heart during pregnancy tests. Heart pressure is 2 to 3 times higher than normal For Hele, the most affected of the 7 congenital anomalies are atrial septal defect and ventricular septal defect. A normal person’s heart has four chambers, of which the left and right sides are completely separated. But with ventricular septal and atrial septal defects, a large part of the blood from the left side of the heart flows to the right side, resulting in more blood in the lungs, so the child will be short of breath and sweat a lot; on the other hand, the blood from the left heart decreases, and the blood output to the body also decreases dramatically, so the child’s development will be delayed and the heart burden will be very heavy. He Le’s heart burden is almost 2 to 3 times that of a normal person. In other words, when a normal person carries 10 kg, He Le carries the equivalent of 20 kg or 30 kg. Therefore, even if Hele just lies quietly, he will have the symptoms of fast breathing, sweating and easy fatigue. Wang Pingshan said that these two major deformities, if not corrected, can lead to repeated pneumonia, and then heart failure and eventually life-threatening conditions in children. All of these symptoms meant that Hele had to be treated surgically immediately, otherwise he would likely develop pulmonary hypertension by the time he was a year or two old, thus losing the opportunity for surgical treatment. As a result, the cardiothoracic surgery department set up an expert treatment team and organized a consultation with experts from pediatric surgery, anesthesiology and extracorporeal circulation to develop a well-thought-out surgical plan. On May 8, the hospital’s cardiothoracic surgery and pediatric surgery performed the surgery together. First, the pediatric surgery department repaired the hernia and sent the intestinal tube herniated from the abdomen back to the abdominal cavity, and then the cardiothoracic surgery experts corrected the deformity. After more than 4 hours of intense surgery, Wang Pingshan and other specialists finally repaired He Le’s deformity and successfully reset his heart. Today, He Le has been discharged from the hospital and can grow up as healthy as a normal child. It was difficult to peel off the “little egg” During the surgery, the most difficult step was to separate the closely adherent heart and abdominal skin without damaging the heart. “Because the baby’s heart is very small, only the size of a small egg, and the skin is very tightly attached, a little carelessness will damage the heart and blood vessels, in addition to taking care not to bleed as much as possible.” Wang said, although the heart and skin adhesion is very tight, but the two will still have layers, so he used electric knife, scissors and other instruments, the adhesion tape cut, slowly peeled out, “everything is still relatively smooth”. The whole process, Wang Ping Shan are very careful, very gentle movements. Because the baby’s heart is small, Wang also wears a magnifying glass, stitch by stitch to close the wound. “If there is damage to the child’s coronary artery, it will be difficult to repair, and the suturing will also lead to narrowing of the coronary artery.” Another difficulty with the surgery is that the malformed area is poorly revealed. The anatomical position was changed because the heart and blood vessels were substantially distorted, and the entire right atrium obscured the normal blood vessels, making the operation poorly visualized and requiring the surgeon to be more careful. Finally, after putting He Le’s heart back in place, Wang Ping Shan sutured the diaphragmatic defect and “reinforced” the heart’s shell so that the heart would not fall into the abdominal cavity when the child breathed again.