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Heart
Main article: Heart
Heart surgery
Main article: Heart surgery
2023
The world's first artificial heart valve has been released to treat the most popular heart disease
On October 19, 2023, Edwards Lifesciences announced the release of a system called Evoque to replace the tricuspid valve. The product is intended for the treatment of tricuspid regurgitation - one of the most common heart defects. Read more here.
A prosthesis has been developed in Russia to help reduce the number of operations in children with heart defects
In June 2023, cardiac surgeons at the E. N. Meshalkin National Medical Research Center announced the creation of a conduit for pulmonary artery valve prosthetics in children with congenital heart defects. The prosthesis has anticalcial protection, and this will minimize the number of repeated operations.
As the surgeon of the Department of Congenital Heart Defects, researcher at the Center for New Surgical Technologies of the Cardiocenter Tatyana Nechay explained to reporters, the usual conduit that was installed for a newborn child often has to be changed after a year due to the accumulation of calcium. But a prosthesis with an anticalcium coating will need to be changed by the age of three, since the child will grow by that time.
 | The child grows, develops, gains weight and outgrows the valve, plus the active metabolic processes that occur in the child's body during its growth and development, primarily this active calcium metabolism, lead to the fact that calcium accumulates in the conduit, which leads to an acceleration of the process of degeneration of the prosthesis and leads to dysfunction of the prosthesis. We set ourselves the task - to develop a prosthesis, a valve conduit, for prosthetics of the pulmonary artery, which ideally would not accumulate calcium at all, or minimal, - said Nechay, whose words are quoted by TASS. |  |
Alexander Romanov, deputy director for scientific work of the National Medical Research Center, told reporters that the production of conduit is planned to be launched in 2024, the clinic has an industrial partner who is ready to start production in Novosibirsk.
In the Siberian Federal District, the prevalence of congenital heart defects, according to the National Medical Research Center named after E.N. Meshalkin, by mid-2023 is more than 400 cases per 100 thousand children, more than 250 patients are operated on annually in the Siberian Federal District who require pulmonary artery prosthetics.[1]
In Russia, created a prosthesis for the correction of heart disease in newborns
At the National Medical Research Center of Cardiovascular Surgery named after A.N. Bakuleva, the Ministry of Health of Russia has developed and patented a new method of surgical treatment of congenital heart disease, in which the patient's own tissues are used. The press service of the center announced this on January 23, 2023.
The essence of the new method is to create a special combined prosthesis for the correction of life-threatening heart disease in newborns using the patient's own tissues. The method allows not only to restore normal hemodynamics, but also reduces the risk of subsequent complications and delays the duration of repeated interventions.
Aortic arch interruption refers to severe heart abnormalities with high mortality and requires emergency surgical correction. It is a congenital vascular defect that represents a lack of communication between the ascending and descending parts of the main main artery. The clinical picture includes disorders of respiratory function, insufficient work of the kidneys, liver, myocardium.
Surgical treatment of the aortic arc break to date is carried out according to several methods, including the application of an anastomosis or the use of biological conduit. However, both methods have certain disadvantages. In the first case, the risk of stenosis, compression of the bronchi and other vessels extending from the aorta remains. The use of a conduit homograph, in turn, can be associated with difficulties in its manufacture, as well as repeated operations as the child grows older and the diameter of the aorta increases.
Surgeons at the Bakulevsky Center have come up with their own way to solve this problem. Without abandoning the use of conduit, they used patches from the patient's own tissues, namely from the dilated trunk of the pulmonary artery, in prosthetics. In newborns with aortic arch abnormalities, the pulmonary artery trunk increases in size. The excess tissue of the vessel just becomes the necessary autograph that has the ability to grow, thereby increasing the life of the biological conduit and postponing the subsequent correction.
During the operation, surgeons take the flap in the area of the anterior and lateral walls of the pulmonary artery trunk and use it to form the posterior semicircle of the aortic arch in the "bridge" type. The second patch cut out of the homograph creates the anterior wall of the anastomosis with fixation with a continuous vascular suture. A combined prosthesis of the aortic arch is obtained, the ability to grow along the posterior wall is preserved.
| | Thus, we corregulate a complex defect and leave the ability to grow, - explains the essence of the author's technique, cardiovascular surgeon Alexei Chernogrivov. - Technical result of proposed method consists in elimination of aortic arch break at initial significant break length and achievement of hemodynamic indices close to normal.[2] | |
2022: Survival rate of children with congenital heart disease with new Abbott Ocluder exceeds 95%
In early September 2022, Abbott submitted updated data on the treatment of premature babies with heart disease, showing that 95.5% of patients were alive after three years. The company's follow-up data on the use of the Amplatzer Piccolo Occluder device shows that the self-expanding mesh device provides positive long-term results, giving Abbott further evidence to position the product as an alternative to medical treatment or surgical ligation. Read more here
2021
Russia carried out the world's first operation on the aortic valve of the heart without a chest incision
Cardiac surgeons Meshalkin National Medical Research Center Novosibirsk in performed the world's first valve operation aortas hearts without a chest incision. This was reported in the clinic in September 2021. More. here
The first operation "Russian conduit" to a child was carried out in Russia
At the end of April 2021, Moscow surgeons carried out the first Russian conduit operation in Russia on the child's heart. It was held at Sechenov University. Read more here.
2020: Doctors start seeing baby's heart in the womb in 4D format
At the end of October 2020, researchers from King's College London presented a new MRI-based examination technique that will allow clinicians to see the heart of an unborn child in 4D format. Specially developed mathematical models of motion correction eliminate the problems that doctors face when conducting a traditional ultrasound of large vessels and the heart of the fetus.
Ultrasound is the main tool for fetal screening and diagnosing congenital heart defects before the baby is born, as it is sufficiently effective and relatively cheap. Fetal MRI is an additional and more reliable imaging method. However, fetal movement can interfere with accurate measurements in both ultrasound and MRI. Using mathematical methods and motion correction models, the researchers were able to combine a series of images into a single four-dimensional format that allows accurate assessment of the anatomy and physiology of the fetal heart.
Although such an image is often used in the diagnosis of adult patients, fetal heart imaging in 4D format is presented for the first time. Although usually prenatal diagnosis is carried out to assess anatomical structures, the new approach will allow clinicians to evaluate the very work of the heart. Thanks to this, it will be possible to diagnose a wide range of pathologies, which means that doctors will be able to prepare appropriate assistance in advance and even save a child's life.
In addition, the new technology opens many doors to hemodynamic researchers who previously could not fully visualize blood flow to the fetal heart. So far, the method of 4D-imaging of the heart in fetal MRI is under active development and refinement. The researchers note that the MRI technologies behind this method are available on most MRI scanners, so in the future the technique can be introduced into everyday clinical practice.[3]
Notes
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