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June 23, 2017

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A man lived 16 days without heart

TAIPEI, Taiwan -- A man who had lived 16 days without a heart left the hospital yesterday.

The "heartless" survivor, named Mr. Chen, was given a send-off party at the National Taiwan University Hospital in the morning.

Chen cut his "new birthday" cake with the help of a cardio-surgeon who transplanted a "new" heart in the 60-year-old retired public functionary.

For the 16 days Chen was "heartless," he was hitched to a special heart-lung machine to wait for his new heart.

It was in mid-January when Chen caught a cold. He hadn't recovered. He began coughing immediately after Chinese New Year's Day, which fell on February 7. He couldn't sleep.

So he was sent to the Chi Mei General Hospital in Tainan, where he was diagnosed with infective endocarditis, inflammation of the membrane (endocardium) lining the inside of the heart and the heart valves.

It was caused by a bacterial infection. Symptoms included fever and changes in heart rhythms.

Damage to his heart valves occurred. Chi Mei doctors decided on surgery to treat the damaged valves as the only treatment.

Surgery was performed at Chi Mei on February 13. But surgeons found the damage to the heart valves couldn't be treated. The whole heart was removed. Chen was connected to an ECMO (extra-corporeal membrane oxygenation) machine. His "heartless" days began.

On the following day, Chen was transferred to the Taiwan University Hospital in Taipei at the request of his family.

Dr. Chi Nai-hsin, a chief resident cardio-surgeon at the Taipei hospital, was convinced one ECMO machine wasn't enough for his patient to survive.

ECMO is a temporary life support technique. It involves connecting the internal circulation to an external blood pump and artificial lung. A catheter placed in the right side of the heart carries blood to a pump, then to a membrane oxygenator, where the exchange of oxygen and carbon dioxide takes place.

The blood then passes through tubing back into the patient's veins or arteries. He is given a anticoagulant to prevent blood clotting in the external system.

At first, Dr. Chi wanted to give Chen an artificial heart, which was very expensive. The patient could not afford a NT$7 million man-made heart. So he was given another ECMO system to survive until a right heart could be found for transplant. He began the long wait.

It was on February 29 when that right heart was donated. That heart was transplanted successfully 16 days after his own heart had been removed.

Chen's "heartless" days were over.

"There wasn't rejection," Dr. Chi said. Chen fully recovered one full month after the heart transplant.

So far as he knows, Dr. Chi said, Chen is the world's first man surviving without a heart as long as 16 days.

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