ah ah hello and welcome to so if you go visionaries, me sophia shevardnadze. technology is promising to stave off old age. and scientists are working very hard to increase the sustainability of our organs, including the most vital one our heart. what has change? what is real and what's not? well, i talk today to world renowned heart surgeon, dr. low book area yan, thanks. yup, doctor no more katie, i'm so happy to see you and we haven't seen each other for such a long time. so much has happened since think and just like to discuss all the

changes that have happened in the past 10 years, including in your field of expertise received each of his thoughts whether it is so . yeah, i just can't seem to solve this puzzle question. good medical science and technology have advanced and methods of diagnoses are getting better of beauty. medication is more effective and targeted to day bullet. that gets you and still you say that heart diseases are the plague of the 21st century, while american say that i 2030, the mortality rate will reach 23000000 people the what's due to me, i don't really understand how that's possible, daniel remarked, was wasn't that this point to medical science and pharmacology just can't keep up is, is we're talking about the entire world is c, v. s and there are developed countries that have managed to significantly reduce the risks. we took muscle, gerda in for in russia. people say myocardial infarction nor occurs in younger people, said it's the opposite. your sources, the average age has even risen a little more. those, um,

let me give you some figures that make me happy in your new york, even though it's not about our country, but was learning. i'm part of the dartmouth dialog, willa, you know, the format that started back in eisenhower as time who had yeah, when relations between our leaders was strained as you then you guinea, prima cough. and henry kissinger revived her teacher wore. so there was this figure, oh, there should be a good 137000 people in the us that are over 100 years old sergeant. could i 2040 should. that number is expected to reach almost 400000 today. wow. it the good. what does that tell us? sure. that there are very many people who are now 9095 or 85 years old man. the state of the hills indicates a good chance that many of them will live to be a 100 or more. it is changing the social structure. to day we perform a lot of open heart surgeries in russia with us the renewable issues on patients

aged between 75 and 80 by new. got to put that in perspective just 20 years ago. we wouldn't operate on a 50 year old patient, isn't it? the glass with regard to your question about technological advances, you know, it's madison was we hadn't seen each other for 10 years and an alarm has change in medicine and technology. i've compiled list of things i want to go through with you me item by item. you have mentioned some of the things that sound like raisins fiction, some not and it will be great to hear your professional opinion. and my son plays, for instance, in 2016 the united states. so the 1st surgery performed entirely using a surgical robot. and the me to the advantages are clear. roberts, on have shaky hands can do precision work and use finer tools, making the smallest incision. so yes, but the surgeon is still directing the entire procedure. moving i've been thinking since will leave in a time of rapid change and technological breakthroughs. is it possible that one day all surgeries will the robot assisted? that is, when was the issue lose originally?

were the idea was to use robots warmer as assistance to medical professionals. so we'll soil after work doing under challenging conditions from schools in a variety of emergency situations. like though it was net sheet on submarines to aircraft in the mountains delivers the wood. that's what robots were created for. with this as though alice, those when robots started trending wassner, they started to develop them further. okay. giving them 3 arms or 4 arms. and so on to her, but like the da vinci jekyll system would, ah, no, some of dooley chill out. people have always strived for and hands, surgical precision deal using magnifying lenses and microscopes. we cheated an image. it's important because there are surgeries, especially in pediatrics, where you can make a patient and permanently disabled if you miss a cut by a millimeter. or you can give a patient a heart attack by puncturing

a tiny vessel with a stitch seal. so soon i can speak about that because i have experience all of it as a surgeon or the but the also robot assisted surgery is extremely costly in all respects . will it? the robots are expensive, which in burg and operating them is also expensive in yeah, in the united states which has the highest number of robot assisted surgeries or more people are refusing robotic surgeries for many reasons, which i won't go into years. mm hm. in the patients are refusing. yep. cause i mean both patients and surgeons there's a lot of talk about the so called g 5 revelation and they say that it will give us high performance connections never seen before. so that can you sailing genius surgeon, dr. mccary i would be able to operate on patients virtually anywhere in the world without even leaving the office slowly. but you meet with them with the media? yes, that's exactly what i said is nature live. that was the original idea behind robotic surgery. the work to have said the da vinci surgical system in every city and town

up so that one surgeon would be able to help an operating surgeon on site one. the surgeon would 1st open the patient's chest and put the patient on a bypass in the order to get those. and when that's done, we could all de surgeon working from another city, say moscow one could take over and perform the procedures using robotic hands forums. but let's say you are performing a coronary artery bypass surgery. done, premier procedure performed most often. it gave you the surgical thread we use in such proceed is, is either $8.00 to 0 or $9.00 to 0. you groom it, though, it's almost invisible, impossible, and a surgeon's tactile perception borrower, you could, as well as his or her eyesight helps a lot. ugh, because you need to make sure you don't break the thread while placing the switches you when you, when robotic hands can't do that. not now sweet and i believe not ever programs.

you can write software for the machine, but you cannot give a human tactile perception humor as it allows you to tie 7 to 8 knots to secure your suture. lawyers are pretty low. so when we talk about robotic surgery, yes, it is justified. in some cases that say, but i can guarantee you 100 percent, that robotic technologies will never take over surgery from cardiac surgery. in particular, me has wherever black tactile percept? no, that's just one of the reasons you see cardiac surgery requires the participation of a whole team of professionals when you use every surgery with cardiac bypass is performed by a surgical tame and way perform say, $150000.00 such surgeries every year. you still to do that, you need to have all these people properly trained or used a robot did the and even out of them only the most experienced can be put in charge of robot assisted or minimally invasive techniques. you otherwise, you risk fatalities and other misfortunes unless they so you don't believe that

full robotic surgery without human involvement will ever be possible motions. i'm no, absolutely not. almost a robot can break a leg or a hand so blurred, but those you can't imagine a robot and was putting some, either in on the wound or scrubbing hands before surgery. can you be a rule at creek or putting all these sterilized robes on examining the scope of work as to what the she had enough and i think i understand another innovation. i want to ask you. that is something i'm fine, almost unbelievable. she n, these are the so called nana roberts. yeah. how real is that? i mean, if i understand correctly, we're talking about what would molecule size rather that can enter blood vessels. and even the smallest ones are where they can repair tissues or destroy pathogens. some command and so on back how real is that monkey are and is it is what happens to this tiny bad when it's done with whatever it's doing. how does it get out to out? is it clean? i'll explain you as soon as any foreign object or agent and as a human body,

it gets literally covered with all types of tissues human, because that's how our system protects itself from intruders. so if we consider this idea, the way you just told me, i find it very unlikely that any robot could just move about freely inside a human body. it sounds very much like all those people recommending you use herbal medicine, only neuralgia, garlic herbs, the cam hill and so on. would the so would you let me tell you how it works? would you look at them? would be in every pill. there are active agents that are carried by the bloodstream, the horn, you put that to the area where they are needed back on the brake, it gets there with the blood war. it's the only way she by now, thanks to the mechanism of the blood pressure gradient, who are not the whole they can reach the infected or otherwise affected area damage and do their job with time. with old. however, almost when people decide they want a herbal remedy or but it says up quench and cut that chilli cook contain next to 0

quantities of such useful agents as, while also increasing the load on the stomach causing the liver and so on. so by analogy, if we talk about these nano robots use the war even if the blood stream takes them to the affected area. well, that's just half of the problem. another. the other half is that these robots need to be designed in such a way, right? joseph, that they wouldn't form a clot studios. it's very serious. i can give you lots of examples on this topic. guy. okay, let's talk about the artificial heart. it's also something that's brought up a lot. would you say something like a pacemaker? no, it's not. i can tell you what it is. well, it's a, you know, the 1st thing outside of what happens if it breaks it smoother. he artificial heart is something very different. it's not, it's basically a pump that performs the functions of a human heart fully or partially don't about child personally installed

a large number and variety of these pumps. would i believe this technology has a promising future? no. the corporate to give you an example here. half a 1000000 people in the united states are in a heart failure, risk groups that, as you mentioned, we won't find that many transplants for one risk of serious have good period. secondly, no good you, not, all of them can have a transplant because of their age new. and thirdly, that it's very expensive and not covered by regular insurance. a the, my lucent. and this was where, as you saw, the left ventricle gets only half of the $3.00 or 4 liters of blood that it has to pump out per minute that she was believe in the liter kroger. meanwhile, e on the but it is new with this lesson strain, it starts functioning better and can even regenerate, to some extent, down the road in what really it's the left ventricle that's responsible for her

arterial pressure at this point. unfortunately, it turns out that heat exchange is still an issue, she's grab some job. now what does this mean? the temperature of blood is $36.00 degrees celsius. it's warm, and the devices placed right next to the loan, which is hot. so it gets closet, so the yeah, i think that together. so all of us, yeah. developers and doctors which you right she and we will figure it out. it and then people will certainly be able to live very long lives when she, which is a very small surgery. we put one candler in the left atrium virus small incision and attach another cannula, to say, an archery, and that's it. so i'm definitely all for quite the yeah. of salut. zach i was stump you described. does it recharge on its own? does it need that is charging when you look up at near the moon or moves in moon? yes, it needs charging lead for now. unfortunately, the device is powered by

a battery of much demean centers to shoe, but the chargers external, it is very light and so on. restore catherine the who is so veneer on renewed his role is to what i what is impossible. in theory that is artificial heart would recharge simply through movement which you know, like a good mechanical swish watch. it doesn't need a battery. does it something like that. i can answer that they should do this, a professor called olga book area who created an epa cardio electronic pacemaker credit to me. now, how does that work to them? we stay when we implant pacemakers that get the we now have tens of thousands of people going about their lives with pacemakers was a little, there's always a small chance of electrode thrombosis or infection. you can still, in addition, the electrodes go through the tri cost, but valve and can to an extent with, depending on its exact position, it can prevent the tri, cosper dow, from closing all the way, lay because script. so she got

a grant from the ministry of education and science and created an epa cardio electrode that can be put directly on the heart through thorough accost copy, which, unless, which involves a very small incision. the device is 18 millimeters in diameter and it works just as well is now now they're finishing with their 2nd grad research. and initially the pacemaker has a battery, of course, a tiny one. but now they're finishing up with their research aimed at using the energy of the hot contractions to recharge it. if they put that there, take a short break right now. when we're back, we'll continue talking to a world renowned heart surgeon, low located stay with us. when europe is mentioned to what do you think a place an idea,

a common place with diverging ideas? maybe you think of the european union think what you wish, but europe is in crisis. it must choose between being in ideological construct or a place with real people. and we'll meet with them and say that i feel that believes go. he did, who bought? i bought a dial tomorrow, a couple of reviews on your quote, but i don't think all additions to athletes and movies. does the musicals? does it seems every big name in the world has been here. let's see, are copa bismark office goes to school? ah, what do i say? budget when you get the course, but i need to show you who does not give me a glover you spoke with said basil makes dreams come true. that every one who falls

in love with people luck with people. and we're backwards world renowned heart surgeon, dr. low bulgaria, talking about what's real in terms of heart replacement and heart surgery those days. and what's a fantasy doctrine located in the article. you said the earth and heart donors for everyone, apart from artificial human hearts, there's

a lot of talk about transplanting when pigs hearts into used to as an alternative. i mean, as far as i know in china, they already grow the genetically modified picks of she. i don't know those pigs hard as suitable replacement. let you hard at g. in 1960 for the 3 years before doctor christian barnard performed the 1st human to human heart transplant. you all american surgeon, doctor hardy young, transplanted the heart of a chimpanzee into a dying patient, a bottle. at 1st everything was going fine. oh it's in about 24 hours. the heart gave out what it is. so you see of course there are inter species differences, minutes, but a heart is essentially a pump reesha with it. and i need to understand that if a person weighs 80 killers and has this little heart with the poor, and it will start wearing out as well, unless the weight is dropped to 60 kilos. on the day before yesterday we had

a surgery and we were looking for a heart don't a patient number to serious when we learned there was a donor cousin, we choose a patient about the same size. so all that talk about transplantation remains on paper. at least for now water of e. that's why i focused mainly on artificial hearts for you and then the fringe, the shirt crash. i sure yes is throwing up at people also talking about 3 d printers which allegedly can work miracles just a few weeks ago as to when i read about a neighborhood in mexico that was entirely 3 d printing. and in israel, they print a heart with human tissue. oh, a tiny heart for sure, but still it's a hocking. is it possible that a patient one have to wait for a donor heart or an animal transplant me? we'll just have a 3 d printer at your hospital and print hearts was cleaning, keep list of them being, what am i supposed to make a living hard from? they say it can be made from living tissue, but i don't really know what that means from past is that section, i don't know, they are radically possible. hewlett. however, having spent all my life working in the field of cardiovascular surgery,

i can say that this would be the end for my field. so if they manage to do that, there'll be nothing else left to learn. what is to your shows known, we're still treating them, not as it for now. like i said, and wishing take it serious them attract. let's be real. every day when we say real people who are ill union, but in the her g. lots of them. so you've just everything that there is to try. we've tried all of it for all one. and things that have been proven to work have become standard procedure. unfortunately, there's nothing better than a donor half. in 2016, a team of researchers in united states successfully grew hearty sheer from stan south. here. is that possible? where was one? which one did it look right now? made sure that your inside the building that has seen more stem cell research than any other place in the world. who in your solo escalator i measured some 20 years

ago. moses with the brit americans came here with their stem cells, which could be implanted in anyone a human or a dog which, but that's how pure they were. she's, yes, it was. so i got all the necessary permissions, cooking and implanted those stem cells and several patients with coronary artery disease or that will actually stood she, one of them died a couple of years after that it got done. we examined the body and saw that those cells took very well. you know, i need to over, i didn't fully assimilate. i had formed a strip of sauce, you, cookie mormonism, the cell simply didn't connect to the cardiac muscle. but since then, you got there later. i discussed this case with my colleagues and everyone agreed with my conclusion, including those who brought those cells, it magically it, these cells have no nerves and no blood supply. you cross, no virginia by. that's why we now use a mixture of cells to ensure innovation. just know glad you are pretty new. serious

little some children are born with one artery. i mean they have to get you to cut doretha. one of them stems from the pulmonary artery. d cut doris. and yes, this is the american american american not not hold you to this artery carries venus blood on the one that's blue cro, senior white as a result of this, that child may develop extensive myocardial infarction at the age of only 4 months . so mature was land, we have to do the same kind of surgery as we do with people of any other age. are you my, you know, i knew that the problem is that there is very little cardiac tissue to work with. well, that's why i wanted to try stem cells and the results that we got were very impressive . looks goes and since then the way surgeries are done on such children have changed drastically. it has improved to wouldn't. today we don't use stem cells for that, but we did experiment with them in the past started shoot artie when it comes to

children, you're fine. yeah, i know how it happens as to which they bodies are growing when you will. they are very responsive to all kinds of interventions and adapt easily what to suffer, less local, none of them can them. as for adults, wellness stem cells work differently and you have to be extremely cautious, you know, the recurring your corporate to get that it's yeah, i'd like to ask you about gadgets. all these devices, small watches, phones, et cetera. if they can now count your steps in monitor your heart rate and before it was saying, also as again a parent, you could just recently an elderly lady in new york on a smart watch as a present from her grandchildren to me at that it actually helped her avoid a heart attack by analyzing her condition. if you, i mean, i thought to myself, studies can't be real. i mean, you no longer need to go for a checkup. you can self diagnose at home and then go to a doctor for treatment if need it was, is that so that was delicious. so dr. nguyen,

this really is a breakthrough because it can have a massive impact. members, you can buy a blood pressure monitor and check your blood pressure twice a day for it to see whether there are any spikes already in there. dumb dwell as the genius miriana is the was his for the on with are in those to were for i. and that may help you with adjusting the dosage of a particular drug or less talk school can will. so that you would take as much as you really need was not as much as he prescribed up. we're doing it so on those devices, like the one you mentioned have revolutionized our lives. oh no, i'm all for them. it. but almost here's what i can tell you just to my close friends, son designed a device that can measure and record your hearts activity. not for one day, little cocora, but for a week graduate. you know, so you are need you or her like a it's like a whole to monitor. no. so is nadine, you can wear it for one day for 3 days or for a week. we're in this case, it's on

a watch, a chill, i vehicle cut or gadgets like these allow people who are worried about their health to take action. smart, do you do? so that's how i say this idea. i don't think that everyone should be wearing these devices niche in the, at near and you see your heart rate go up. you can alarmed that raises your heart rate even further and so on, you know, but horton, so it's a huge step forward with these devices. and now lots of companies are working on smart watches, or similar devices to monitor uses health. it's a good thing or those through stroke during the kid them early. it, which has no he but al, again the engine in their genetic engineering. i mean, i don't know how you'd react to that in more than a week. there now saying that you can identify a heart disease related gene that was passed to a child and replace it until the child won't suffer from any heart problems. and a teacher belizean bretzkey that there is no practical implementation yet, you know which mortgages. of course, there is a lot of research and we welcome it because you won't find

a solution if you don't look for what nor, or in. but i don't think it's that easy, what bureau to be able to diagnose it so that the a lab has to have the necessary time tested equipment rejected and qualified specialists that is to share baldwin and report and re doctors have to know about it. so they could refer the patients their so called tori, the hardest was in there will be patiently waiting for it. rach snyder with trouble, not private folder would. would you say that you feel you? yeah, i just know that in friends to reduce the number of children born with down syndrome to almost 0 because they came to terminate from all advanced missouri. so i thought maybe it was possible for the heart disease as well, which is good to return. here's what i have to say on the subject. lead about 15 or maybe 20 years ago. c u. k wants to forbid births of children with hyper plastic lift heart syndrome. you don't, regardless of the gestational age,

you and french doctors actively supported them. marijuana so okay, but um, well we didn't have any effective methods of treating it back then. your was, she said that you said you cancelled the chic brown. what is hyper plastic? let heart syndrome. there are no, it means the heart only has the right ventricle, while the left one is virtually non existent. and there is no material valves, no iota is just lonely, 2 millimeters long. so ideally the child would have to undergo 3 operations in its 1st year of life. gone. of course, with 3 operations. adverse outcomes are quite common shades each. now, together with the americans, we convinced them not to proceed with his ban or women giving birth to children like that. when they, for me, the best argument was the mothers whose children with a chill, a chest grew up ross. there was a book, i've read it twice, i think it was just incredible. as these children are very attached to their

parents because the parents don't normally would. so they probably mean these children are and the french probably managed to push this lord and make it mandatory for a woman pregnant with a child who has h l. a chest to get an induced abortion you. it's. and what would this would weigh at the more my remember it very well because i was strongly against what are you k colleagues were doing at this time for both of those to deal with marcia. they later congratulated me on winning this battle for too many me up there released him . some will provide you basil grandma, thank you so much for his educational and really insightful talk. and i've learned so many new things for grace fuels. now please take care of yourself and with you. we have nothing to fear. dad, thanks a lot. again with happy to hear it. thank you very much with

ah, [000:00:00;00] ah well the panoramic no, no borders lie nationalities and you as a merge, we don't have with the we don't on the back seat. the whole world needs to take action and be ready to people are judgment. common crisis with we can do better, we should be better. everyone is contributing each in their own way,

but we also know that this crisis will not go on forever. the challenge is great, the response has been met. so many good people are helping us. it makes us feel very proud that we are in it together with ah, these people learn from their own experience, how vulnerable of business is to the bank. so he pushed my business over the age, pushes me right to the edge, bankruptcy. now i realize we will go this isn't just the back that may be involved in this is the concept. see, thumbs. it is the lawyers. these people have got you want all this stories? ottawa can a whistle blower. tell people's marriages have broken up. it lost their family

homes. it is spectacularly devastating for people's lives. we have committed suicide, but left behind north, the explicitly state that it was the constant intimidation and billing by buying coffee sauce that late them to i took the spy is obscene. these people up nor sold with here with the british m p is stabbed multiple times by a member of the public wild meeting, his constituents, an air ambulance is now at the scene with no details on his condition. really disturbing images from afghanistan were a blast at