Cardiothoracic surgeon finds field 'most delicate ... most challenging'

Ancient Western philosophers such as Aristotle promoted the cardiocentric hypothesis which puts the heart at center of human emotions and intellect. The Chinese phrase xin ling, heart and soul, indicates a similar idea.

Modern science gives the brain a more important role, while the heart, roughly the size of a fist, remains one of the most delicate human organs to operate on.

"That's exactly why I chose this major more than 20 years ago, when I was in the medical school. It is the most delicate, hence the most challenging," Dr Ding Fangbao, head of the cardiothoracic surgery department at Xinhua Hospital, told Shanghai Daily.

"It is also a relatively more recent medical field, since cardiac surgeries only became more common after the heart-lung machine was invented and improved."

He added, "That means we weren't lagging behind our colleagues in Western hospitals too much to start with. It also means the technology developed very rapidly over its short history, and is still continuing."

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Cardiovascular diseases (CVDs) take an estimated 17.9 million lives each year, according to the World Health Organization. CVDs are a group of disorders of the heart and blood vessels including coronary heart disease, cerebrovascular disease, rheumatic heart disease, and other conditions.

China is home to 330 million people with CVDs. Last year, the Chinese government released a 2023-2030 plan for CVDs prevention and cure, aiming to build a comprehensive early diagnosis and early treatment system to further improve national awareness, the relevant technology, and reduce the death rate from CVDs.

In many cases, that possibility of death also has to do with how quickly the patient is treated. Ding gave the example of a surgery two years ago, when an elderly patient diagnosed with type A aortic dissection was immediately transferred from Chongming Island to the hospital and underwent surgery.

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"Type A aortic dissection has a mortality in the first 48 hours of 1-2 percent per hour, meaning half of the patients would die if they don't get operations within the first 48 hours," Ding explained.

"That's why we make sure such patients get a surgery within the first six hours after diagnosis."

When Ding just started his career in the 1990s, such surgeries were not yet common, and he was still a little nervous over heart bypass operations that repair blocked and narrowed arteries. Today, advanced technology has given doctors much clearer views of the arteries and heart bypass operations are very common for cardiac surgeons.

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"I have basically witnessed the rapid development of this field in my career time," he said. "Chinese surgeons of the previous generation made many breakthroughs little known to the world, and we were able to stand on the shoulders of the giants and take advantage of rapidly technology development today."

To the surprise of many, Chinese surgeons performed the first successful mitral valve replacement with a locally made ball and cage mechanical prosthesis in June 1965 in Shanghai, only five years after the world's first mechanical heart valve implantation.

Ding's mentor in the university took part in the operation, which inspired and encouraged him since a young age.

The vast number of surgeries, due to China's large population, has also pushed Chinese doctors to sharpen their skills and improve operation methods for patients' better recovery.

The surgeon now eyes the latest technologies like artificial heart products that could further help with operations and save more patients.

Ventricular assist device, or VAD, an electromechanical device that provides support for cardiac circulation was previously used as a bridge to heart transplantation. Since 2019, several made-in-China artificial hearts have got the green light to go on the market.

Ti Gong