25-year-old boy has no heart for 555 days: artificial heart to maintain life to change heart

Release date: 2016-06-30

In the past 18 months, almost no one has noticed that Stan Larkin is a person without a heart.

The 25-year-old black guy is thick and likes to hang out with his younger brother. He always goes to the park with three young children. It looks like a very ordinary man.

The only thing special is that he always carries a gray backpack and never leaves for 24 hours. Going out, the bag is on the back, even if you sit down and have a haircut, you should put it on your feet.

Two pipes came out from the corner of the backpack, slid into the clothes of Lajin, buried under his ribs, and connected to his "heart". As early as 2014, Larkin's heart was removed and replaced by one made by the United States Xinca Diya Systems (Syncardia Systems, Inc) of the total artificial heart (Total Artificial Heart). The backpack is equipped with a portable drive that powers it.

Simply put, this backpack and the system of the entire artificial heart maintain the life of Lajin.

It wasn't until May 9 that he transplanted the heart from the donor at the Frankel Cardiovascular Center at the University of Michigan before finally unloading the backpack.

The Xinkadia full artificial heart handed out the baton and successfully ended its 555-day term.

“Many people may be afraid of using artificial heart, and what I want to tell you is that you need to overcome this fear because it will help you.” Before leaving the hospital, Larkin shared it with the public at a media meeting. In my own experience, I used the "roller coaster" to describe this process. He feels that he can recover quickly after surgery, thanks to waiting for the entire artificial heart to escort during the transplant.

"I feel like I can jog now." The man who had just "changed his heart" two weeks ago said with a smile.

A machine is going to be my heart, think about it, a machine

Lajin never thought that people could survive without heart, let alone happen to himself.

He was hesitated for half a month before agreeing to the doctor's treatment plan for installing a full artificial heart. "A machine is going to be my heart," he widened his eyes and made an incredible expression. "Think about it, a machine!"

But he had to accept this machine. At the age of 16, Lajin shocked the basketball court without warning. Soon, he was diagnosed with arrhythmogenic right ventricular cardiomyopathy.

In the human body, the heart pushes the blood circulation through the relaxation and contraction of the atria and ventricles. The disease of Lajin will replace the myocardium of the right ventricle with progressive fibrous adipose tissue, leading to enlargement of the right ventricle and failure to contract normally, leading to arrhythmia and even sudden death.

"The best option for him is to receive a heart transplant," said Jonathan Haft, a doctor at Larkin's attending doctor at the Frankel Cardiovascular Center at the University of Michigan. "But we also feel that his condition is changing very fast. May not wait for the day when the donated heart that matches him arrives."

According to Billy Cohen, director of the Center for Technology and Innovation at the Texas Heart Association, some patients with advanced heart failure often have to wait months or even years to get the right source of heart, because the heart is too weak, including the kidneys, Key organs such as the liver are likely to fail during this process. Many patients will die while waiting without some form of support such as an artificial heart. According to data from the US Organ Transplantation and Transplantation Network (OPTN), 49% of people on the heart transplant waiting list have to wait a year or more.

The situation of Lajin is getting worse. After right ventricular dysplasia develops into bilateral ventricular involvement with heart failure, his left and right ventricles are unable to effectively collect and pump blood. He is weak and he can hardly get into the car by himself.

Prior to this, the doctor implanted an automatic cardioverter defibrillator for him. When necessary, it transmits electrical pulses to "activate" the regular operation of the heart. However, after the illness has worsened, this commonly used cardiac assistive device is not enough to sustain the life of Lajin.

In November 2014, after a series of physiological tests, the doctor decided to remove the heart of Lajin and implant the entire artificial heart of the Xinkadia to replace the original left and right ventricles and four valves.

This new "heart" is a pneumatic two-ventricular pulsation pump. After connecting with Larkin's atrium, aorta, and pulmonary artery, it began to perform its duties. As a mechanical heart, it can pump 9.5 liters of oxygenated blood per minute, which is beyond the normal healthy heart and is similar to the level of athletes.

There is no sensor or engine in the body of Lajin. Through two pipes, an electric external drive delivers oxygen and creates a vacuum that controls the membrane of synthetic material that separates air and blood from the ventricles of the entire artificial heart, pumping blood to the body.

"Ticking... Ticking..." This machine is equipped with an all-day accompaniment for his life. Along with each precisely calibrated compressed oxygen pulse, the drive in the backpack emits a strong, steady, rhythmic sound that sounds like a fast horse galloping on a hard surface.

After a few weeks, Lajin, who has adapted to this noise, can finally fall asleep with it. "It is it that makes me alive," he said. "It is the voice of the heartbeat."

Larkin is challenging the limits of this device

Two days before Christmas in 2014, Larkin walked out of the hospital with his family and became the first person in Michigan to leave the hospital with a full artificial heart.

"Although there is a backpack connected to my body, it is like a real heart," Larkin joked. "I feel like I am carrying a backpack full of books, it is like going to school."

Like every ordinary person who celebrates Christmas, he went shopping in the mall, went to the church to participate in the event, and completed a long-awaited thing - carrying a basketball to maintain his life.

When he saw the photo of his dribble, the attending physician Haft couldn't help but take a breath.

"This all-artificial heart is not designed to fight street basketball," Haft said. "Lajin is really challenging the limits of this device."

Hu Shengshou, academician of the Chinese Academy of Engineering and dean of Fuwai Hospital, introduced in an article that the artificial heart generally includes ventricular assist devices and total artificial hearts, and the central chamber auxiliary device is mainly the left ventricular assist device.

Since the Soviet scientist Demikhov transplanted an artificial heart into a dog in 1937, human studies on artificial heart have gone through 80 years of history. In 1969, American doctor Curry completed the first successful human total heart transplant at the Texas Medical Institute. He assisted him with a full artificial heart for 64 hours before the patient underwent a heart transplant.

In China, Tianjin Teda Cardiovascular Hospital, Beijing Anzhen Hospital, Suzhou University and other units are developing related blood pumps are still in the animal experiment stage. In the development of total artificial heart, there is no breakthrough report in China.

The Xinkadia full artificial heart is the most recognized of the more than 10 types of artificial heart devices that have been introduced to date. Ten years ago, it was approved by the US Food and Drug Administration (FDA) as an adjuvant treatment for heart transplantation. It is also the only fully artificial heart that is clinically approved in the United States, Canada, and Europe.

Although Lajin, who is home to the Xinkadia artificial heart, can't move completely freely. For example, the electric drive connected to him makes him unable to stand under the nozzle to enjoy the shower, can't pick up the child, or put it as usual. They are lying around their necks, but it is very rare.

When the entire artificial heart was implanted, the two pipes drilled from the left rib of Lajin were connected to a drive called the "Blue Giant."

It weighs 188 kilograms and looks like a washing machine. This means that before the doctor spends months or even years finding a matching donor for his heart, Larkin can only be tied to the hospital by this bulky machine.

Fortunately, in June of that year, the small, portable, all-artificial heart-drive device newly developed by Xinkadia Systems was approved by the US Food and Drug Administration. Lajin’s “washing machine” was replaced by a “backpack” and he no longer had to be trapped in the hospital.

“When eligible patients stabilize, they can switch to a portable drive,” the production company said. “It gives patients a greater range of activities, allowing them to return to the home and community to wait for a matching donation heart. "It is powered by two Li-Ion batteries and can be recharged with a standard power outlet or an automotive adapter.

This 6 kg device was named "free".

To permanently replace the human heart, it will also overcome many technical difficulties.

It seems that Lajin is doing well with the help of a full artificial heart. At home, he does not need to do more treatment, as long as he is healthy with a low-sodium diet and blood-diluting medication. Of course, as a person with a full artificial heart, he has to be like a robot, can not leave the power for too long - the lithium battery in the device is enough to run for 3 hours.

However, the total artificial heart is currently only used as an alternative transitional therapy before heart transplantation and cannot be maintained for a long time. The Xinkadia full artificial heart running at the front end of the industry is also starting to be a clinical trial of permanent artificial heart transplantation.

Academician Hu Shengshou introduced that although heart transplantation is the best treatment for many patients with end-stage heart failure who cannot be treated with drugs or surgical methods, it is used because of limitations in heart rate and heart transplantation is not suitable for patients under 40 years old. The replacement of the natural heart by an artificial heart is still the goal pursued by the medical profession for many years.

Although the current research is becoming more and more advanced, in order to permanently replace the human heart, the entire artificial heart has to overcome many technical difficulties. For example, as an artificial mechanical device, it does not have the self-repair function of the human heart, and it is impossible to stably simulate the heart's more than 100,000 beats per day without wear.

"Lajin is still waiting for a heart transplant. We hope to transplant him if there is a suitable donor. During this time, he can recover from some normal life at home. When the opportunity comes, he will be the most A good state accepts the transplant," said Dr. Jonathan Haft.

In order to serve the heart of this shift, Lajin’s family took over most of the nurse’s work. The mother who was initially scared when she touched two tubes was used to helping her son replace the bandage that covered the entrance to the pipe.

"We have to be careful so that he won't get infected," she said. "Now, I am already very professional."

After 555 days with the Xinkadia full artificial heart and "free" drive, Larkin finally got a heart from the donor.

Today, in his chest, a fresh human heart beats steadily.

This is the third heart he experienced, which made him feel "reborn". "You don't have to worry about tiny things, do a lot of things that you thought you could never do again."

Includes three children who hug him again.

"They will attack me," the father smiled. "They can't wait. They will hang in front of my neck, hit me on my back, ride on my neck, and always on me." Going around."

Source: China Youth Daily

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