Unicum named Akchurin

"You know how strong a human heart? - He said after the drawn unique heart surgery world famous heart surgeon Renat Akchurin. - Hold hands it can not be. " He said it casually, as if it was not about the living human body, and about any subject. Fortunately, I never held in the hands of the heart - was enough for me to stand on the operation near the brilliant surgeon and see the process of saving a hopeless patients who have no other chance to survive than a "hybrid operation", it was not. I saw the edge of a beating heart. And he listened to the quiet but clear command maestro "reduce pressure" "suction", "give top light" ... and the skin feel tense moment, what would later say Renat Suleimanovich.

	Photo: Natalia Gubernatorova

- Have you noticed that the very setting of the aortic valve in less than one minute? - Said Renat Akchurin. - But we are ready for it 40 minutes: wash off valve (it is made from bovine heart and comes to us in a preservative); then it was put into a special catheter to for delivery to the installation site does not damage the function of the heart. I served a valve in a compressed form, I insert it into the artery, go to the level setting, inflate it. And yet. Worn valve is replaced with a new one. The heart begins to work as a normal healthy. Procedure although lasts only an hour, it is very tense. Everything you saw on operations - tip of the iceberg. And before that, we carefully survey the patient, identify contraindications to surgery, clearly calculate all the possible pros and cons.

Speech - about elderly patients who far in 70 years, with critical aortic stenosis (illness of one of the main valves of the heart) .  In these patients, the aortic valve acquires all the calcium remains a small hole .  Through this gap, and the heart has to push blood .  After years of fighting the heart muscle becomes several times thicker than the norm .  And at one point there is pulmonary edema, the patient dies .  The only way - to replace the worn valve on the new .  Previously it was done by open way - the chest was cut, the operation is very traumatic .  Not all patients can move it, especially elderly patients with serious co-morbidities (diabetes, previous bypass surgery, radiation therapy, renal failure) .  The only chance of salvation - "hybrid operation" .  The technology allows, without a large incision to get close to the heart in two ways: through the groin vein and through a small incision in the intercostal space .  In the exact calculation is transformed into a procedure such as coronary angiography .  If all goes well, the patient can be discharged after 2-3 days .

	Photo: Natalia Gubernatorova

I was also surprised when clinics and mothers of children with cancer with an outstretched hand collect money on something to send a sick child for treatment abroad .  This is nonsense! Yes, these patients can be treated successfully in Russia .  At the worst, much cheaper here invite surgeons from abroad and do the operation in Russia .  Touches me and the people who come to the country's leadership, saying that in a single area in the extended average life of the Russians 70 years .  It is unrealistic .  Healthcare in Russia must set ourselves the task: get to a certain level of costs, for example in the treatment of cardiovascular diseases, which should count economists .  For example, the introduction of new operations for the 3 years to reduce deaths in young children to such a level .  But such problems are not put .  In general, the Ministry of Health to be the richest of all the ministries of Russia, if we set ourselves the goal to extend the life of a person, and not to reduce the population .

- But back to the "hybrid technology." Why do you have no one applauds surgeon for successful operation, such as a pilot during the landing of the aircraft?

- I think that is nonsense. After the operation I was wet through and had to change not only the hat, but the whole clothes. This is normal, this is our profession. And I do not think this is a feat.

... At the present operations and foreign experts. They appreciated the professionalism of Russian doctors.

Richard Levy, a professor, a surgeon from Manchester (United Kingdom):

- "Hybrid operation" - a new technology in the UK began to apply it five years ago. And already it has done more than a thousand such operations. Of all patients with aortic stenosis, 25% is subjected to this procedure. The population of the UK - about 60 mln. People in 17 medical centers make "hybrid operation". Accuracy - less than 1%. Without surgery - 30% risk of mortality with the operation - 8%. That is many times smaller. The cost of the operation of the order of 20 thousand euros. But the patient does not pay - the state takes care of all the expenses. We also have private patients who are willing to pay money, but it's mostly rich people from the United States.

I am happy that I have the opportunity to attend the maestro Akchurina operations. Certainly, this is one of the most famous surgeons in the world. And what I see on its operations (this teamwork) - a very high professionalism of the team Akchurina.

Vladimir Sapozhnikov, representatives of international companies in Russia, which is helping to implement "hybrid operation":

- Operation of the installation of the valve can only be performed in the clinic certain level. It is important to train the surgeons of this operation. For this we export physicians in one of the three training centers in Europe: France, Germany and Switzerland. Doctors held a two-day training and returned to Russia. Begin to work here, but first under the supervision of an experienced doctor from Europe.

Such operations in Russia can go on stream .  Prospects of her great - in Russian, according to conservative estimates, such an operation can be performed in the year from 500 to 1,000 patients .  But not everyone knows that they have a chance .  The only chance .  Of course, it should be a state program .  Here, in the center of it .  Myasnikov, the waiting list for such an operation are now more than 100 patients .  By the way, in Europe, already made about 30 thousand such operations .  In Germany alone this year, about 8 thousand transplanted biological valve .  Now Russia is built into the latest in cardiac surgery .  In the EU, this technology is considered as a public health priority .  In Germany and France adopted the federal program .  Studies prove the enormous advantage of this technology over traditional methods .  It is a powerful breakthrough in cardiac surgery, especially for the category of elderly people when there is no need to use cardiopulmonary bypass .

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