Zhejiang performs country's first minimally invasive artificial heart implant surgery

A hospital in East China's Zhejiang province announced Wednesday that they had successfully carried out the first minimally invasive artificial heart implant surgery in the country and the patient has been steadily recovering, Chinanews.com reported.

On Nov 28, 2022, Cui Yong, head of the cardiac and vascular surgery department of Zhejiang Provincial People's Hospital, and his team performed the surgery on Chen (pseudonym), who had severe heart failure. The surgery only required two incisions and caused no damage to his ribs.

Chen was successfully extubated on the first day after the surgery and could move around on the fifth day. He was transferred from the intensive care unit to a regular ward on the seventh day and was discharged on December 19.

"You can't see any difference when I'm wearing a coat, right? Technology and medicine have given me a new lease on life," Chen said, while showing his "constant companion" - a pack containing a power source, rechargeable batteries and a monitor, which provides sufficient power to his "artificial heart" through a fine wire inserted through a subcutaneous tunnel in his abdomen.

Seven years ago, Chen was diagnosed with severe heart failure and underwent aortic valve replacement surgery at the hospital. After the surgery, he had almost recovered. However, one year ago, his left ventricle began to enlarge again. He underwent cardiac resynchronization therapy and had a triple-chamber pacemaker implanted in the hospital's cardiovascular department. Unfortunately, several months ago, Chen again experienced symptoms such as limb weakness and shortness of breath.

"His heart function was in an end-stage state, with problems such as a giant left ventricle. Surgery was the only effective method to save his life," Cui Yong said. According to Cui, heart transplantation was supposed to be an option, but Chen's circulation was unstable. His condition could deteriorate rapidly while waiting for a matched heart donor, thus losing the chance of surgery. In this case, left ventricular assist device implantation became an important treatment option.

Cui introduced the device as an artificial instrument to replace or assist the heart function and promote the recovery of organ function. In other words, it is a kind of artificial heart. "We installed the artificial heart on the apex of the patient's left atrium. The internal pump removes the blood the original heart cannot deliver and then uses force to transport it to the whole body. The device has a diameter of only 47 millimeters and weighs 186 grams. It is a new generation of left ventricular assist devices with full-magnetic levitation, which has been listed in China with independent intellectual property rights."

For Chen's case, the hospital organized experts from relevant departments and invited Howard Todd Messey, chief expert of the left ventricular assist device at Thomas Jefferson Hospital in the United States, to conduct a comprehensive discussion and preoperative evaluation of Chen's clinical data.

Cui said that because Chen had previously undergone heart surgery, opening his chest from the original incision would increase the risk of cardiac injury during the separation process of the pericardium and mediastinal adhesions. Additionally, the risk of postoperative bleeding would also be greatly increased. In contrast, a minimally invasive surgery does not require cardiac exposure and causes less bleeding, making it a safer choice for patients.

According to the report, Cui's team completed three artificial heart implant surgeries between November and December, and all patients recovered well.