Changing hearts and minds

Mimicking the sounds of motor vehicles, a boy was playing with a toy motorcycle in a corridor of the inpatient ward in Beijing Huaxin Hospital. His parents were watching intently, their eyes filled with worry. At a glance, people would notice the bluish color in the boy's skin, lips and fingertips.

The boy, Wu Muliang, was born with complex heart defects. He had other complications, such as a large cyst in his kidney, says Dr Yu Wenwen, of the Huaxin, which is also the First Hospital of Tsinghua University.

But Wu's parents still held high hopes, after traveling to Beijing from South China's Guangdong Province to check into the Huaxin in early May. They saw mothers hum lullabies to their babies as they cradled them in their arms. Boys and girls, and elderly men and women walked slowly but steadily along the corridor.

Luo Xiaoxin was checked into the hospital in early May. A little more than two months old, she appeared dark and weak. She was born with the heart defect in which her pulmonary veins that bring oxygen-rich (red) blood from her lungs back to her heart were not connected to her left atrium.

Instead, the pulmonary veins drained through abnormal connections to the right atrium. As a result, her body did not receive enough oxygen, and she could easily die from any vital organ failure.

But 22 days after the corrective surgery on May 30, she was discharged from the hospital, with normal heart functions and a good promise in living a full life. "She is gaining weight and looks much prettier than before," Luo's mother says.

The hospital in no way looks as imposing as other leading hospitals in Beijing. But since a new center for treating coronary heart diseases opened here in 2004, it is gaining a reputation day by day.

Many of the patients have been referred to the Huaxin by doctors of other hospitals, including leading hospitals specializing in treating coronary heart diseases. They are told that Dr Wu Qingyu, president of the Huaxin Hospital, and his assistants are able to do better jobs than elsewhere.

Between March 2004 and July 17 this year, 1,415 patients - ranging in age from 26 hours old to age 80 - have undergone surgical treatments there. The corrective surgeries have given babies and young children a new and healthy start to their lives and have helped the middle-aged and the elderly regain their health and live to ripe old ages.

"The surgeries for the referred patients are all technically complex, with high-risk factors," Dr Wu explains.

For instance, they have to perform both bypass and heart-valve repairs and replacements during a single operation. When Dr Wu called at 8:30 pm last Wednesday, he said he'd just finished surgery on a patient who had already undergone two previous operations.

"His heart stopped beating when we opened his chest," he says. "We were able to save him. After all, our job is to save lives."

Dr Wu remembers almost all of the patients he has treated. Many patients have kept in touch and continued sharing their family stories with Dr Wu after their surgeries.

For a while, Dr Wu had posted a quotation from former American president, Theodore Roosevelt, which reads:

"The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly; who errs and comes short again and again, because there is no effort without error and shortcomings; but who does actually strive to do the deeds who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that this place shall never be with those cold and timid souls who neither know victory nor defeat."

Dr Wu says: "I am mostly concerned not only with the safety of my patients during their surgeries and their recoveries but also with their whole lives, if possible. And their lives have an effect upon the happiness and lives of their whole families."

So, he keeps researching to discover the best possible surgical procedures to treat multiple heart defects and encourages his assistants to do so as well.

In fact, about 70 percent of the patients have come to Dr Wu and his colleagues for treatment of congenital heart diseases, which involves the interior walls of the heart, valves inside the heart or the arteries and veins that carry blood to the heart or out to the body. The defects disrupt the normal flow of blood through the heart, slowing it down or causing it to go in the wrong direction or to the wrong place, or to be blocked completely.

Over the years, Dr Wu has won four national science and technology progress awards from the State Council in addition to several awards from the Ministry of Health for his innovations in the field of surgical repair of complicated congenital heart defects.

Of those, one is for Tetralogy of Fallot, in which the heart has four components of defects. Children born with the defect who never undergo corrective surgery have a death rate of around 95 percent under the age of 10.

Dr Wu conducted the most recent repair surgery for Tetralogy of Fallot on July 5 on 8-year-old Ji Jiali. The girl looked like a 5-year-old.

Dr Wu's continuous exploration of treatments that reap the best possible results for his patients has also drawn a following of younger colleagues.

Dr Pan Guangyu left his position as a heart surgeon in Jinzhou, in Northeast China's Liaoning Province, six years ago to pursue a doctorate under Dr Wu in Beijing. "If I'd stayed, I would have only walked on a beaten path that others have traveled," Pan says.

"At Huaxin, however, we are able to see and study some of the rare heart defects along with other complex symptoms that heart surgeons elsewhere may not see in their lifetime," Dr Pan says.

"The heart center was in its early phases of development when I visited him (Dr Wu) last (in 2004)," says Joseph A Dearani, a cardiovascular surgeon at Mayo Clinic, an internationally renowned medical practice based in Rochester, Minnesota, in the United States. "My impression was that he had a dedicated and committed team. Since my visit, I understand that the practice has continued to grow and that they were obtaining very good results."

The case of Wu Muliang was especially daunting, even for Dr Wu and his team. The boy's parents felt the intensity with which the surgeons and doctors invested their time and effort on a detailed plan that took into account all of the potential complications and complexities of their son's surgery.

Dr Wu's surgeries on the boy, which repaired his heart and removed his kidney cyst, produced the best possible results. And he will check out of the hospital later this week.

Dr Wu's achievements have enabled him to become a member of the prestigious American Association for Thoracic Surgery in June. He is the second Chinese doctor on the mainland to win the honor, after the late Dr Wu Yingkai (1910-2003).

Despite the laurels, Dr Wu has set for himself several major goals for the progress of, and overall improvement of, surgical treatment of heart diseases in China.

For instance, he believes that although early detection of congenital heart defects in babies is now possible across China, accurate diagnosis is far from where it should be, he says.

In China, about 6.7 percent of the newborns, or 200,000 babies, are found to suffer from congenital heart defects. Without being able to obtain timely and correct diagnoses, many children simply miss the optimal window for surgical repairs.

Even with correct diagnoses, there are too few heart centers able to deal with complex corrective surgeries in China, such as Huaxin and a few others in major urban centers, Dr Wu says. The overall success rate of corrective surgeries is still low by international standards for 2 to 6-month-old babies who weigh less than 5 kilograms.

"I hope that the Huaxin center will become a national and international platform for the exchange of new ideas, new techniques and new procedures for the most difficult and complex cases," he says.

(China Daily 07/25/2007 page19)