A Heart Surgeon’s Stories of life by **Stephen Westaby (**Dr. Westaby) 打开一颗心 [英] 斯蒂芬·韦斯塔比
Foreword
mitral valve [二尖瓣](<https://zh.wikipedia.org/wiki/%E4%BA%8C%E5%B0%96%E7%93%A3>)。得名于其形状与主教的法冠(mitre)像。是一对位于左心房和左心室之间,可上下拍动的心瓣。
在心舒期(the heart's illing phase, or diastole),正常工作的二尖瓣因左心房充血加压而打开。左心房压高过左心室压的时候二尖瓣开启,使血液被动流入左心室。
心舒期结束于心房收缩(entricular contraction, or systole),最终从心房喷出20%的血液到心室。同时二尖瓣关闭防止心房收缩后血液回流。
ventricular septum ((左、右心室之间)室间隔)
Chapter 1. the ether dome (ether: 以太;上空)
8-9 ‘’Tis bitter cold,/And I am sick at heart’ – Shakespeare adds to the atmosphere. Francisco simply means that he is in low spirits, but his ‘sick at heart’ is the first indication that something is wrong more generally: a more serious ‘sickness’ or ‘disease.’
[Grim Reaper](<https://en.wikipedia.org/wiki/Death_(personification)>): a personification of death. 死神。
left ventricle -> body
right ventricle -> lung
Chapter 2 Humber Beginning
[Charing Cross Hospital](<http://en.wikipedia.org/wiki/Charing_Cross_Hospital>) Medical School. 查靈十字醫院。校友包括:
[托马斯·亨利·赫胥黎](<https://zh.wikipedia.org/wiki/%E6%89%98%E9%A9%AC%E6%96%AF%C2%B7%E4%BA%A8%E5%88%A9%C2%B7%E8%B5%AB%E8%83%A5%E9%BB%8E>)
[戴维·利文斯通](<https://zh.wikipedia.org/wiki/%E6%88%B4%E7%BB%B4%C2%B7%E5%88%A9%E6%96%87%E6%96%AF%E9%80%9A>) David Livingstone。19世纪英国探险家、传教士,维多利亚瀑布和马拉维湖的发现者,非洲探险的最伟大人物之一。
Chapter 3. Lord Brock’s Boots
[Lord Brock](<https://en.wikipedia.org/wiki/Russell_Brock,_Baron_Brock>) 英国手术医师。现代心脏外科手术的先驱者。
右心房接受上下腔静脉的含氧量低的静脉血。心脏收缩泵出右心室中的血液后舒张,会造成右心室(左心房和左心室一样)负压,使得右心房的血液通过三尖瓣流入右心室。这些血液在然后在心脏收缩的时候被射到肺动脉,进入肺循环。肺动脉瓣会防止血液倒流。在肺进行过气体交换后,含氧量高的血液会顺着肺静脉流到左心房。然后经过二尖瓣流入左心室。左心室内的血液会在心脏收缩时被射到主动脉,进入体循环。
心脏负责了全身的血液循环,循环又分为体循环和肺循环两种。静脉运输血液到心脏,而动脉则运输血液离开心脏。
肺循环:上下腔静脉(latin: Venae cavae)的含氧量低的静脉血 -> 右心房(right atrium) -三尖瓣(tricuspid valve)-> 右心室(right ventricle) -> 肺动脉(pulmonary artery) -> 肺循环(氧合) ->
体循环:肺静脉的含氧量高的静脉血 -> 左心房(left atrium) -二尖瓣(mitral valve) -> 左心室(left ventricle) (射血) -主动脉瓣(Aortic valve)> 主动脉(Aorta) -> 全身
Great vessels: [大血管](<https://zh.wikipedia.org/wiki/%E5%A4%A7%E8%A1%80%E7%AE%A1>)
* 上腔靜脈 (latin: superior vena cava) 将无氧血从身体上半部分(上肢、眼睛和颈部)运输至右心房。
* 下腔靜脈 (french: Inferior vena cava) 连接身体的中部和下半部分与右心房。
* 肺動脈(pulmonary artery)。分叉为左、右两支:left / right pulmonary arteries
* 肺静脉(pulmonary vein):共4条。血液从肺部流向心脏。
* 主動脈(Aorta)
valves: 心脏有4个
When the heart squeezes (contracts), the valves opens and lets blood flow. When the heart relaxes, the aortic valve closes to prevent blood from moving backward.
补充说明:
* 左、右心房合称 atria
* 冠状动脉 (coronary arteries):分左、右冠状动脉,由主动脉的根部发出。为心肌自身供血。
* [atrial septum](<https://en.wikipedia.org/wiki/Interatrial_septum>) 心房中隔。隔开左、右心房。
* diastole 扩张期。心室血液充盈。
* systole 收缩期。心室收缩排出血液。
Chapter 5. The Girl with No Name
震撼人心的悲剧。
Chapter 7. Saving Julie’s Heart
Viral myocarditis 病毒性心肌炎
myocardial 心肌(相关的)
患者是 Julie Mills。 设备 AB-180
当时的新闻报道:[New Artificial Heart Saves Lives](<https://www.cbsnews.com/news/new-artificial-heart-saves-lives/>) (1998-11-03)
Chapter 8. The Black Banana
ALCAPA: 左冠状动脉起源于肺动脉。是一种非常少见的先天性心脏病,发病率为1/30万,占先天性心脏病的0.26-0.50%,90%的患儿在1岁内死亡。诊断本病的金标准为经心脏导管插入(Cardiac catheterization)的心血管造影,
患者是 Kirsty Collier。
当时的新闻(2008,手术9年后): The heart that grew back: ‘Miracle’ of girl whose heart healed itself after a third was removed in emergency operation
Kirsty was linked up to a heart lung bypass machine for the surgery – and when the surgical team attempted to get the heart to take over once again, they found it was so badly damaged that it was unable to pump blood again.
'We felt there was no hope at all,' Professor Westaby told Sky News.
A message was even sent to Kirsty's parents to warn them 'it was not going well'.
'She was essentially dead and was only resurrected by what I regarded at the time as a completely bizarre operation,' added Professor Westaby.
However, the surgeon had a hunch that reducing the size of Kirsty's heart would ease the pressure on the muscle, allowing it to contract properly.
And using scissors, he removed a large section of the muscle wall, stitched it back together, and hoped for the best.
'I have to confess I never thought it would work. It was an awful lot smaller.' But the baby's heart began beating again.
Kirsty Collier 和母亲,2008:
Chapter 9. Domino Heart
heart-lung transplant