Three years ago, a17-year-oldgirlXiaomin (alias) was unfortunately diagnosed with “idiopathic pulmonary artery hypertension" (IPAH) by the Cardiac Pediatrics Department of our hospital with symptoms of anhelation and dyspnea. IPAH is an extremely rare disease in a condition where the bloodpressurein pulmonary artery is increased continuously due to the increased pulmonary vascular resistance with unknown causes, and excludes all secondary factors causing pulmonary artery hypertension. This disease is a progressive disease with poor prognosis, and may cause right heart failure, pulmonary infection, pulmonary embolism, syncope and other complications, or even sudden death.
God had played such a big joke on Xiaomin. Unyielding as she was, she wanted to survivetocontinue to pursue her dreams, and help more others like her suffering from similar disease. Therefore, she registered for the medical college and chose medical specialty. She lived sturdily without any choice, witha hope that she could engage in primary medical service after graduation.
She had taken medicine against the disease for a longtime. However, the expensive targeted drugs for lowering pulmonary pressure could not stop the disease progression. In August this year, while Xiaomin was still expecting for the opening ceremony of the university, her condition got worsein such a way that she had difficulty in walking, unable to breathe normally, and even suffered from hemoptysis. Pulmonary hypertension and cardiac shock might occur at any time and her life hung by a single thread.
At this moment, President Yu Xueqing of our hospital attached great importance to her disease after hearing her story, and initiated the multidisciplinary collaborative treatment consultation process (MDT). Director Chen Jimei and Vice Directors, Zhang Zhiwei and Yao Hua from Guangdong Cardiovascular Institute, Director Huang Jingsong from the Transplantation Team of the Cardiac Surgery Department and other experts participated in the discussions. They thought that Xiaomin had the indication for combined heart and lung transplantation surgery, so they suggested Xiaomin to accept surgical treatment. Xiaomin and her family learned that the Transplantation Team of the Cardiac Surgery Department of our hospital had ranked in the third place in China for three consecutive years in terms of the amount of transplantation surgeries, with postoperative survival rate and incidence of complications being at the international level. On top of that, our Cardiac Surgery Department successfully completed the first combined heart and lung transplantation surgery in Guangdong Province as early as 2006. These successful examples greatly enhanced the confidence of Xiaomin and her family, so they agreed to accept surgical treatment. In the process of waiting for donor allocation, Director Xueqing Yu once again carried out MDT for Xiaomin’s surgical treatment plan and postoperative care treatment.
On August 17, 2020, upon receipt of the notice from the China Organ Transplantation Response System (COTRS) about successful allocation of suitable heart and lungs to Xiaomin, the combined heart and lung transplantation surgery was initiated by our Heart Transplantation Team in an urgent and orderly manner. By nightfall, the operation ended successfully. Then Xiaomin was moved back to ICU and came to her senses at the same night.
After perioperative care, cardiopulmonary function maintenance, anti-infection treatment, anti-rejection treatment, nutritional support treatment, cardiopulmonary rehabilitation exercise and other treatments, Xiaomin recovered well postoperatively. She could sit on the bed to read magazines, eat and dress, and even get out of bed and stand by herself. So she was moved back to the general ward successfully. The long missing smile appeared again on the faces of Xiaomin and her family. Recently, President Yu Xueqing came to the cardiac pediatrics general ward to check Xiaomin’s postoperative recovery.
In recent years, with the care and support of the leaders of our hospital and Guangdong Cardiovascular Institute, the Cardiac Surgery Department of our hospital has developed the heart transplantation surgery rapidly, with the total number of transplantation surgeries ranking in the third place in China for three consecutive years, joining the top 10 heart transplantation centers in the world. The average in-hospital survival rate of heart transplantation is 92.4% and the incidence of perioperative complications is 6.67%, far lower than the national average complication rate of 18.1%. The Cardiac Surgery Department has been bold to make innovations and brave to be the first. It has taken the lead to use the “right heart assistance technology” after heart transplantation surgery nationwide for the first time to help the patients get through the perioperative period smoothly. In addition, it has successfully completed extremely difficult surgeries that are rarely seen in China, including “heart transplantation + dissection of aorta one-stop surgery”, “heart transplantation fast-track resuscitation” and “heart transplantation after multiple heart operations”. Even during the epidemic period this year, it did not stop, and completed successfully “the first cross-blood type heart transplantation surgery with ABO different and incompatible types of blood in the whole country” and “the first heart transplantation surgery with the biggest difference in the weight of the donor and the receptor in China”. Not onlyis the Transplantation Team of the Cardiac Surgery Department of our hospital committed to improving their own level and dares to make breakthroughs, but also understands that it is always better to teach a person who is hungry to fish than to give him some fish. In July this year, it successfully became one of the four "national heart transplantation physician training bases", being the only medical institution in South China that has obtained this qualification.
Correspondent: Wu Meifen, Cardiac Surgery Department
