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Another Cardiac Surgeon from Abroad Flying to Tongji Hospital

“I believe this place will soon develop into an internationally renowned medical center," remarked by Dr. Juan Grau, Chief of Cardiac Surgery at Valley Hospital in New Jersey, USA.  On April 11, he just finished his "experience" tour at Tongji Hospital of Huazhong University of Science and Technology. Before boarding the plane back to the U.S, he expressed his sincere wishes to Prof. Wei Xiang, Director of Cardiothoracic Surgery of Tongji Hospital.

Prof. Wei Xiang(R1) and Dr. Grau (M) in the ward. Photo by Qi Jiandong

Dr. Juan Grau, who is also a collaborating faculty member of the Cleveland Clinic Foundation in the U.S. and Professor of Surgery at the Heart Institute of the University of Ottawa in Canada, came to Tongji to learn myocardial rotational excision surgery. This technology, which includes both the procedure and the instruments, is specially used for the treatment of hypertrophic cardiomyopathy, independently developed by Prof. Wei Xiang, and is the first of its kind in the world, which can minimally invasively and accurately excise the excess hypertrophic myocardial tissue from the patient's heart without opening the chest and stopping heartbeat and has been awarded more than 20 patents both at home and abroad.

"The treatment of hypertrophic heart disease is a difficult problem worldwide," Dr. Juan Grau said. Drugs can only temporarily relieve the symptoms, but cannot solve the cause of the "obstruction". Traditional surgery requires sawing about 20 centimeters in the sternum and performing the surgery under cardiac arrest and extracorporeal circulation, which is traumatic and slow to recover, and the field of view of the surgery is very narrow, and the amount of cutting highly depends on the experience of the surgeon, so the number of surgeons who can perform the surgery and patients who are willing to have the surgery is relatively low.

According to Professor Wei Xiang, hypertrophic obstructive cardiomyopathy (referred to as "hypertrophic cardiomyopathy") is a congenital heart disease. Patients’ heart will be fattening just like taking hormone in as time goes by. To their puberty or early adulthood, the hearts are more than two times thicker than the people of the same age. They will suffer from chest pain and chest tightness when exercising, which is the main cause of sudden death among teenagers and athletes.

Based on the incidence rate, it is projected that more than 2 million people in China suffer from the disease, but less than 1,000 patients have undergone surgery each year. However, since the first clinical application of observe transapical beating-heart septal myectomy (TA-BSM) in 2022, more than 700 patients from more than 30 provinces and cities across China have been successfully operated in Tongji so far.

Last October, Prof. Wei Xiang was invited to attend the annual meeting of EACTS in Vienna, where he introduced his TA-BSM techniques in detail. Dr. Juan Grau happened to be at the conference, and after listening to Prof. Wei Xiang’s lecture, he had the idea of coming to Wuhan to study.

"Seeing is believing," Dr. Juan Grau said. Although he had read the paper and watched the demonstration video, Dr. Juan Grau was still shocked by what he had seen. " Such complex problems can be solved in a minimally invasive way! Four or five surgeries can easily be done in a day, whereas with traditional way, it takes at least four hours to finish just one."

During his 12 days in Wuhan, in addition to making the rounds of the wards and participating in surgeries with Prof. Wei Xiang's team, Dr. Juan Grau visited the labs, factories, and incubators for R&D instruments, and marveled at Wuhan's ability to build a cross-platform for the medical-industrial sector. "I was actually skeptical before coming to Wuhan. But after this tour, I understand that you not only have nice patients, great medical team, and the support from the government and the hospital but also the environment to create this new technology. Your hospital stands out as a center of excellence for cardiomyopathy treatment."

Dr. Juan Grau plans to introduce this advanced technology to his medical institution and looks forward to its global adoption and expansion. Up to now, cardiac surgeons from the United States, Spain, Canda, South Korea, South Africa, and Switzerland have come to Tongji to learn this surgery.

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