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The 13 -year -old boy "Heart Gate" was blocked, fainted 4 times a year, and the doctor faced the difficulty of difficult surgery

2024-02-23 22:57:31

Let each child with a critical heart have the opportunity to renew the "heart".

Source | Heavy Medicine Childrens Hospital

"嘭! "A loud sound sounded in the classroom, breaking the tranquility of the classmates.Xiaowei (pseudonym), who was lying on the desk, was lying on the desk, and suddenly fell to the floor sideways.

"Xiaowei, whats wrong!" The teacher rushed to the boy who was unconscious, shouting several times without response, no consciousness, no breathing ...

What is the problem with Xiao Weis body?This should start with heart function.

We know that the blood of the human body rely on the heart to pump the whole body, and the life can operate normally.If the heart is compared to the "water pump", then the "left ventricle" is the source of the power of the pump- "motor", and the "aortic valve" between the left ventricle and the aorta is the "valve" of the pump.Blood starts from the left ventricle and flows into the aorta through the "valve" to pump the whole body.

Imagine that if the "motor" and "valve" of the human "heart pump" are faulty, life health means that it cannot be guaranteed.

Xiaoweis heart is such a tricky problem.

Sihotia occurs in the boys sleep

4 times a year

13 -year -old Xiaowei is from Dazhou, Sichuan. Xiaoweis mother recalled that Xiaowei fainted in 2023, which occurred in sleep.There is no heartbeat in breathing. "When Xiaowei appeared syncope, the school teachers and husbands and wives would perform the chest and heart compressor for Xiaowei as soon as possible. Generally, they could slowly wake up after one to three minutes.No impression.In addition, Xiaowei usually has chest pain. After the activity, she has a breathless manifestation. Because she dares not speak loudly, does not dare to walk quickly, and she dares not to play with children of the same age, she also appears to be lonely in her character.

Facing Xiao Weis heart problems, parents have had warning in their hearts.Six years ago, Xiaowei found that "aortic valve deformities and narrowing", but due to the medical technology at that time and the symptoms were not particularly serious, parents decided to conservative treatment.After Xiaowei had a syncope, in the second half of 2023, his parents took Xiao Wei to go to different hospitals many times. They were diagnosed with severe complex congenital heart disease."Thick", requires surgical treatment.However, the husband and wife were informed that the difficulty of the operation was large and the surgical mortality rate was high. The two were worried that they could no longer see the child after entering the operating table, so they could not choose whether Xiaowei received the surgery.

In December 2023, Xiaowei fainted at home, and witnessed the childs "eyes stare, both hands rigid, no breathing and reaction", worried that the child will faint next timeAfterwards, the fear that could not wake up was shrouded in the hearts of the couple, so the couple took Xiaowei to the chest and heart surgery of Chongqing Medical University Childrens Hospital.

"Heart Gate" is narrow, "Heart Road" is blocked

Challenge to high difficulty surgery challenges

Due to the complicated condition of Xiaowei, cardiovascular department of chest and cardiac scholarship, neuroscience, anesthesia, intensive medical department, radiology, ultrasonic department, etc.consultation.

The child is diagnosed as "left ventricular outflow debut obstruction, including the aortic valve severity stenosis and the stenosis under the petals;

Back to the beginning of the article, which means that the children not only fail the "motor" and "valve" of the "heart pump", but also the "traffic channel" of the heart pumping the blood of the whole body to the whole body——The left ventricular debut (that is, the left ventricular to the aorta) "all the way" "all the way" occurred.

  • Active valve stenosis and valve under the valveSten

Chief Physician of the Chief Physician of the chest and heart surgery, the aortic valve is called the heart door of the heartThe normal aortic valve is three leaf flaps, while Xiaowei has only two leaves. When the valve is opened, the opening is obviously smaller. At the same time, Xiaoweis aortic valve ring diameter is only 11mm (normal peers 19-20mm); in addition, in addition, in addition,Xiaowei also exists under the aortic valve stenosis. It can be described as "blocking up and plus blocking".

  • Left ventricular myocardial hypertrophy

Due to obstruction of the left ventricular outfircular debut, the blood flow from the left ventricular to the aorta is blocked, forcing the heart to work harder to beat the pump blood, this additional additional onesEfforts will cause the muscles of the left ventricle to gradually increase the centripetality to cope with higher loads.

"Childrens room interval and left ventricular wall thickness nearly 20mm, normal value is 6-10mm;-50mm. "An Yong said," In short, there is only one gap left in the left ventricle of the child. "

It can accompany the left ventricular expansion and contraction dysfunction, and severe symptoms of heart failure occur.In addition, myocardial muscle itself also needs blood supply. As a coronary arteries for blood supply to myocardial muscle, when the left ventricular myocardial thickening is thickened, the blood supply is the same or weakened, "more monks and less porridge", and insufficient blood supply to myocardial cells, resulting in ischemia, hypoxia, and even fibrosis.Wave.

As for the reason for Xiaowei syncope, Ernst & Young explained that the left ventricular debut obstruction and the left ventricular myocardial thickness may cause syncope. "If there are not enough blood to the head, it may occur; and the myocardial blood supply is not good, the angina pectoris or even severe arrhythmia will also faint. "

The narrowing of the valve, high -speed blood flow spray from the aortic valve mouth to the aortic cavity, which leads to the expansion of the "ball -sample" of the aorta ascending the aorta.

"Condition is the command, leaving this child is not much."After the discussion of the multi -disciplinary team, the experts agreed that operation as soon as possible is the only way out.

Welcome to the challenge of difficulty surgery

Reconstruction of the boys life channel

Since "road narrowing" leads to "traffic obstruction", then "widen the road" to relieve traffic pressure.It sounds easy, but from the implementation of anesthesia to the end of the operation, every link is full of risks and challenges.

Chief physician of Ernst & Young introduced: First of all, the stimulus brought by anesthesia and surgery can cause cardiac arrest.

Second, the heart stops during the operation, and the doctor should infour the heart muscle protection solution for the heart. Due to the hypertrophy of the ventricular wall of the child, the blood supply and protective solution of the coronary arteries are limited.Myocystal cells cannot be effectively irrigated. If myocardial cells continue to be damaged or even necrotic during surgery, the heart function is lost, and it will not jump again.

Furthermore, children need to perform Konno‐lastan surgery (aortic ventricular formation) complex, great risk, and more difficult for childrens surgery.rare.The surgery needs to expand the left ventricular debut and rebuild. The surgical incision extends from the aortic valve to the middle of the interval. There is an important conduction system and coronary arteries around the incision.Be careful of any one, the consequences are self -evident.

The chest and heart surgery team knows the complexity and challenges of the operation. Before surgery, the chest and heart surgery once again organizes the entire hospital for discussions, conducts risk assessment, and formulates a thorough surgical plan.EssenceAt the same time, he also received the sufficient trust and support of the parents of the child.

On January 17, the operation officially started. With the assistance of the anesthesiology department, the surgery was carried out by the chief physician of An Yong.Relying on the skillful surgical skills of Doctor Master, the precision anesthesia management of anesthesiologists, precise irrigation techniques of in vitro circulation irrigation artists, nurses and team members perform their duties, complex anatomical structures, mutant blood vessels, severe damage and abnormal hypertrophic myocardial muscleThe difficulty of surgery was resolved one by one, and after more than 6 hours, the operation was completed and completed.

After surgery, under the close monitoring and care of the ICU and chest cardiac surgery CCU medical staff, the end of the child has a stable period of danger.Go to the general ward and fully recover.The hospital was successfully discharged on February 5.

Shop cardiologist medical staff always maintain awe and respect for life, go all out, so that every child with a critical heartOpportunities are giving birth to "heart" and returning to normal life.

*"The medical community" strives to publish the content and reliability of the content published, but do not promise the accuracy of the content;Essence

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