事件记录
克雷格Selzman: 我是克雷格·塞尔兹曼. I am an Associate Professor of Surgery in the Division of Cardiothoracic Surgery here at the University of Utah, and I am the surgical director of our Heart Transplant Program and our Mechanical Circulatory Support and Artificial Heart Program.
主持人: In the news, we've heard Randy Travis had something called cardiomyopathy. 我的发音对吗?
克雷格Selzman: 正确的.
主持人: 这到底是什么?
克雷格Selzman: 心肌病是一个广义的词. 有氧运动,心脏. Myo,肌肉. 病态，不太管用. So basically it means that the heart muscle itself is not working so well.
主持人: 有一种病毒会导致这种情况. 对吗？?
克雷格Selzman: There are a lot of different things that can cause a cardiomyopathy. So the word that leads before cardiomyopathy describes why it had happened. 可能是因为血流不畅. 大发娱乐称之为缺血性心肌病. It could be because of something that we have no idea, 大发娱乐称之为特发性心肌病. But if we think it's a virus, 然后 we'll call it a viral cardiomyopathy.
主持人: 是的. 在兰迪·特拉维斯的案例中，确实如此.
克雷格Selzman: 好吧，这就是假设.
主持人: 好吧.
克雷格Selzman: To the best of my knowledge, it hasn't been confirmed. 我想大家都是这么想的.
主持人: 好吧. And this condition causes the heart to weaken, if I'm correct?
克雷格Selzman: 这是正确的.
主持人: 那么治疗方法是什么呢? 他们到底对他做了什么?
克雷格Selzman: Well, the cure for the majority of patients, 80, 85, 90% is absolutely nothing. 这只是支持性护理. But there is this very small group of patients that go into cardiovascular collapse. That means that the heart muscle is unable to pump enough blood around the body to get to the brain, 到肾脏, and to other organs and such that they need extra help. 很多时候, that extra help can be managed with medicines in the vein, 但如果这不起作用, sometimes you actually have to use mechanical means to do that. 这就是兰迪·特拉维斯的遭遇.
主持人: 这是侵入性手术吗? 他们必须打开他的胸腔才能把它放进去吗?
克雷格Selzman: No. 这不是真正的手术. What it is is basically a catheter that's snaked up through one of the blood vessels that's easily accessible through the skin in the groin. 所以大发娱乐称之为经皮心脏泵. 这不是传统意义上的手术.
主持人: But you're hosing that thing up through the groin all the way to the heart. 这个过程有多难?
克雷格Selzman: Just like a lot of things in life, 85% is very straightforward, and 10 to 15% can be challenging.
主持人: 确定. 但在大多数情况下 . . .
克雷格Selzman: 从概念上讲，这很简单. Technically, it's very straightforward, for the most part.
主持人: 如今，这已经相当普遍了?
克雷格Selzman: 相当普遍. 大发娱乐周一做了一次.
主持人: 好吧. The device that they placed, is he going to have to have that in him for the rest of his life?
克雷格Selzman: No. 这是一个临时装置. It's actually meant for really short periods of support. 可能是几个小时或几天.
主持人: 好吧.
克雷格Selzman: 希望在大发娱乐, 和他这种情况的人在一起, 用这个泵来支撑他的器官吗, giving them blood flow while the doctors down there figure out is his heart muscle going to get better or not.
主持人: 问题.
克雷格Selzman: And what this pump does or what any mechanical pump does is it allows the heart to just rest because it takes over, 将血液输送到身体的其他部位. If you don't have it, his heart is having to work so hard and it's just tired. 通过这样做, it allows the heart to relax and just kind of get a little bit of rest, 获得新的能量.
主持人: Kind of like any other muscle, you're just giving it a chance to recover?
克雷格Selzman: 这是正确的. 通过这样做, it gives the physicians a chance to see whether or not his heart will recover or not. 如果心脏恢复了, 大发娱乐来看第一种情况, 你可以把这东西拔出来, 然后继续. The majority of patients that have this problem can go onto live normal, active lives. A subgroup of those patients that won't get better will kind of limp along a little bit and become heart failure patients. And 然后 there's this other category of patients that maybe will not be able to survive without a pump like this. 在这种情况下, what we would do is we would switch this percutaneous pump to something that's a little bit more durable.
主持人: 好吧. So is he looking at some lifestyle changes if he recovers?
克雷格Selzman: 我不太了解他，我可以想象.
主持人: 有一些饮酒记录.
克雷格Selzman: He's lived a hard life in many ways, and that could be contributing to this. 当然，如果你过着清洁的生活, 有时候你可以逆转很多东西, 尤其是用心.
主持人: Would a lifestyle change have prevented this from happening in the first place?
克雷格Selzman: 潜在的. But if it's truly viral cardiomyopathy, this can attack anybody. I mean, in the pediatric community, you see this much more frequently than in the adult community. 这是一种混杂性很强的疾病. 病毒不在乎攻击的是谁. 是不是你的心脏更容易受到影响? 是不是有些人的心脏更容易受到影响? 可能.
主持人: 是什么导致的呢？?
克雷格Selzman: Let's say he had lived a hard life and had an alcoholic cardiomyopathy, 哪一种情况会发生. 对其他人来说, after pregnancy have a thing called peripartum cardiomyopathy that makes their heart a little bit weaker, so they're more susceptible to having other insults attack their heart.
主持人: What kind of recovery time would you look for after a procedure like Randy Travis had?
克雷格Selzman: I would hope that in the next three to five days that they'll have a sense of whether or not the left ventricle, 心脏有两个主要的泵腔, 左心室和右心室. 这个泵支撑着他的左心室. 希望是, 然后, 在三到五个周期内, that they would have some idea of which of those tiers he's in. Is he going to be somebody that's going to get completely better and pull the pump, not really better but let's pull the pump and see how he does without the pump, and 然后 the third one being it isn't going to work and we're going to have to do something else. But usually within three to five days, you have an idea of what's going on.