Doctor Q&A: Georg Wieselthaler
What attracted you to medicine? I read that you initially studied electrical engineering.
在整个童年时期,我都想成为一名电气工程师——对我来说没有别的选择. 但当我大学毕业,开始在一家电力公司工作时,我感到非常失望. It was boring!
我有医学背景,因为我爸爸是兽医. 我们养了很多动物,我和哥哥有时会帮忙. 半年后,我告诉爸爸我想从医. He said, "Great, do you want to take over my business?" I said, "Well, no, I want to work with humans."
你是如何十大赌博靠谱网络平台机械循环支持装置的工作的?
一位医学院的朋友打电话给我,告诉我有一个项目需要医学院的学生在大型动物身上测试人工心脏. 动物在隔离室呆几天,你做重症监护室护士的工作.
很快我就问了很多工程方面的问题. They asked, "How come you know all this?" I said, "Because I'm an engineer.他们说:“我们需要工程师来负责生物工程实验室正在开发的驱动装置。." So I moved to that lab. It was fascinating. Everything was being developed brand-new.
What is a driving unit?
它是[心脏]泵的控制器——如果你愿意的话,它是设备的大脑.
当第一批人造心脏被植入人体时发生了什么?
我看到了病人是如何康复的,也看到了一些没有成功的事情. 当时的人工心脏和泵都很大. It's a big surgery and very traumatic to the patient. 体型较小的个体,女性和儿童,不能使用这些泵. So, together with a bioengineer who became my closest friend, we said, "We have to do something completely different. How can we make pumps that are smaller?"
为了使泵更小,它们的工作方式也需要改变——你能解释一下吗?
多年来,我们一直认为病人必须有脉搏. 我们决定把重点放在能让血液持续流动的泵上, instead of pumps that mimic the human pulse.
你最终成为第一个成功植入连续血流装置的外科十大赌博平台排行榜?
Yes. 我成为MicroMed泵的第一个临床试验的项目主管[由著名心脏外科十大赌博平台排行榜Dr. Michael DeBakey]. We had the first patients in the world with no pulse.
我的系主任告诉我,“当你遇到第一批病人时,他们是独一无二的. I expect you to be there 24/7." Initially, I slept in the rooms with the patients. I was with them around the clock. They recovered and became stronger. It was really amazing.
当时的想法是,泵将是一个“移植的桥梁”——一种让病人活到心脏可用的方法——而不是一个长期的解决方案?
是的,因为当时没人知道这些水泵能用多久. 我们也不知道人体能忍受非搏动性血流多久. I transplanted both patients successfully, 第一次是在植入后四个半月第二次是在植入后六个半月. The very first patient is still alive and he's doing great.
现在一些心力衰竭患者可能根本不需要移植,一旦泵被植入. What kind of patient is a good candidate for this?
The oldest patient ever implanted was 89 years old. He is still alive at 95. He was pretty sound and healthy and went into heart failure.
Patients like that — where you can rule out major kidney, liver and lung failure, as well as strokes — would be ideal candidates. 可以说,你所要做的就是支持引擎,身体的其他部分就没问题了.
What is it like to transplant a heart?
I‘ll tell you the truth, for me it was always a miracle. You have a piece of meat, of flesh, that is not moving, that is cold, and you take it from one person to the other, and just suture it in, 用温水冲洗一下,它突然开始跳动. Something that's lifeless comes into life once again. It's like a phoenix rising from the ashes.
你能把一个典型的心衰病人在你职业生涯初期和现在的情况进行对比吗?
It is like night and day. We know a lot that we didn't know in the old days.
今天我看到一个坐在椅子上不能走路的病人. She's in her 60s, very smart, and still wants to work. 她的腿肿了,呼吸困难. She has been in that state for several months. 对她来说,虽然你不能保证什么,但你可以假设她会受益匪浅, to where she can go back to a normal life, 包括户外活动和度假.
最重要的是,一旦病人表现出明显的心衰症状——比如呼吸短促, 运动能力的限制-他们应该联系专门的中心. The earlier people get referred, the better.
这些患者来加州大学旧金山分校而不是其他中心有什么好处?
我们有一个由心脏病专家、外科十大赌博平台排行榜和机械循环支持协调员组成的非常稳固的团队. 此外,因为我们是一个学术中心,我们真的很努力地走新的路线. 当我来到这里,我们做了第一个微创植入 HeartWare pump in the U.S. 现在我们的大多数病人都采用这种微创方法.
What does that mean for recovery time?
It's faster. 因为很多都是移植的桥梁,所以移植要容易得多. They are in better shape, 因为你不需要打开整个心包(心脏周围的囊)和胸骨, their anatomical situation is easier to approach.
Currently, MCS患者必须佩戴一个外部电源,通过切口连接到设备上. Will we see wireless power sources soon?
Yes. 在这一点上,有很多小问题阻止我们将它们应用于人类, but I think it will be possible in four to six years.
What is your primary motivation to keep innovating?
你必须有一种心态,你想要以不同的方式做事. 当我来到这里做第一个微创植入手术时,人们说,“这里没人这么做.但我说:“这里是旧金山湾区,这里的人都能跳出思维定势。. If not here, then where?“这是我来这里的原因之一——我被这种与众不同的精神所打动.