strategic, this is each new historian, mother. so yeah, i just can't seem to solve this puzzle practical medical science and technology have advanced and methods of diagnoses are getting better of feeding. medication is more effective and targeted to day bullet. that gets you and still you say that heart diseases are the prego to 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 level 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 gorda in for, in russia, more people say myocardial infarction, nor occurs in young people because it's the opposite. you're close to the average age has even risen a little more. 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 a year 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 that should the good 137000 people in the us that are over 100 years old sergeant. could i 2040 she. that number is expected to reach almost 400000 today. wow. it the good that what does that tell us through 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 noon. 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 have one compiled list of things i want to go through with you me. item by item. you've mentioned some of the things sound like raisins fiction, some not and it will be great to hear your professional opinion. and last, someplace, 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 switching. 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 warmers 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 with giving them 3 arms or 4 arms and so on to, for all. but like the da vinci jekyll system would, ah, no, some of julie chill, i, people have always strived for and hands, surgical precision, zeal 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 barrel and operating them is also expensive in, 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. her lithium in the patients are refusing yet because i mean both patients and surgeons there's a lot of talk about the cell call g 5 revelation and they say that it will galas high performers connections never seen before, so that in sailing genia surgeon, dr. mccary i would be able to operate on patients virtually anywhere in the world without even leaving the office solely. 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 give you the surgical thread we use in such proceed is, is either 8 to 0 or 9 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 as wherever that black tactile percept? no, that's just one of the reasons you see cardiac surgery requires the participation of a whole team of professionals renew. yes, every surgery with cardiac bypass is performed by a surgical tame and wave perform say $150000.00 such surgeries every year. you start to do that and you need to have all these people properly trained values. 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 solution. i'm

no, absolutely not. when was the robot can break a leg or a hand. some blurb, what does he 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 the, examining the scope of work. question what the she said nothing. 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 on command and so on back how real is that monkey run is it is what happens to this tiny bad when it's done with whatever it's doing, how does it get out to life? is it clean? i'll explain just as soon as any foreign object or agent and as

a human body, it gets literally covered with all types of tissues. him it 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. not old. she's garlic herbs, the cam hill and so on. would the so would you let me tell you how it works when you look at them will 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 around the the who they can reach the infected or otherwise affected area damage land do their job with tammy told, however, on was when people decide they want a herbal remedy or but it says up quench and cut that chilli cook contain next

a 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 on the other half is that these robots need to be designed in such a way radius of that. they wouldn't form a clot studios and 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. whether it's a, you know, the 1st thing at styles, what happens if it breaks it smoother. he artificial heart is something very different. it, them, nothing. it's basically a pump that performs the functions of a human heart fully or partially don't. well, i've personally installed

a large number and variety of these pumps, or i believe this technology has a promising future nor the corporate to give you an example here. half a 1000000 people in the united states are in a heart failure risk groups that mr. mentioned, we won't find that many transplants for one. let's get serious. have to peer. secondly through no good. you. not all of them can have a transplant because of their age. no. and thirdly, that it's very expensive and not covered by regular insurance. it my lucy genesis for as me. so the left ventricle, he gets only half of the $3.00 or 4 leaders of blood that it has to pump out per minute mission worse, believe in your lead, the recruitment e or an operation you with this lesson strain what it starts, functioning better and can even regenerate, to some extent, to down a building what sicily, it's the left ventricle that's responsible for our arterial pressure at this point

. unfortunately, it turns out that heat exchangers still an issue. she's grab some at your pool. now, what does this mean? the temperature of blood is $36.00 degrees celsius. it's warm low, and the device is placed right next to the lung, which is hot. so it gets closet. so the yeah, i think that together. so all of us, your developers and doctors, which you regime, we will figure it out, it and then people will certainly be able to live very long lives. well, it should, which is a very small surgery. we put one cannula in the left atrium, virus mall incision and attach another cannula, to say, an artery, and that's it. so i'm definitely all fours. okay, why don't we yeah. of salute. zach i will stump eunice scribes. does it recharge on its own? does it need that is charging when you look up at near, on all moves in moon? yes, it needs charging lead for now. unfortunately, the device is powered by a battery of mesh demille centers to shoe. but the chargers external,

it is very light and so on. we're still catherine. the hood, so veneer on winter's role is, is worth an hour. is it possible in theory that is artificial heart would recharge simply through movement, which you know, like in good mechanical, a swiss watch, it doesn't need a battery, does it? something like that. so if 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 should 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 cosper valve and can to an extent with the, depending on its exact position, it can prevent the tri, cosper dow, from closing all the way will 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 grant research. and then 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. they put it there, take a short break right now when we're back, we'll continue talking to a world renowned heart surgeon located, stay with us. ah, the rescheduled ocean with what is a middle august or still bulk of what again initially annoies the beautiful

i fresh which don't don't love who did they got that with because if that's something you would greet them with the quote that that's meant to send over your properties was for what fin the pot on with that to the what like you like with i think some of them when he's got the west when like holding so want to show post apocalyptic come from from the news or kind of what the stuff that the thing monthly media says global, oh gosh. slate to 3 years old. continue to one wonderful, scared little squiggly with john coach if it but our one. why do you think that us

them, i mean, on i, besides that we still do ah ah ah, oh, when europe is mentioned, what do you think a place an idea, a commonplace with diverging ideas? maybe you think of the european union, think what you wish, but europe is in crisis. it must choose between being an ideological construct or a place with real people and real meat.

and we're backward world renowned heart surgeon, dr. leo, bulgaria, talking about what's real in terms of heart replacement and heart surgery these days and what's a fantasy? doctor more kit im though i think you said the urn and i'm heart donors for everyone. but then apart from artificial human heart, there's a lot of talk about transplanting when peaks, hearts into use years as an alternative. i mean, or shoot that as far as i know in china they already grow their genetic re modified, picks it up. she, i don't know though is a pigs hard, a 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. it looks 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 this unless the weight is dropped to 60 kilos or 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 through, 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? we'll just have a 3 d printer at your hospital and print hearts, less cleaning. keep with that, 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 that 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 worship truman? that is it for now, like i said, shane and wish and take it serious them attract. let's be real with every day when we say real people who are ill do region, but in the her g, lots of them. so you 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 he 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 solar, with clip i mentioned some 20 years ago. moses with the americans came here with their stem cells, which could be implanted in any one, 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 bullet, sheila stuart you. 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 soon then, you got there later, i discussed this case with my colleagues and everyone agreed with my conclusion, including those who brought those cells. zip magically. 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 is just not clear that you are pretty new serious little some children are born with one artery. i mean, they have to get you to cut the river. one of them stems from the pulmonary artery . you 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 that 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 bucks 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. most wish they bodies are growing when you will. they are very responsive to all kinds of interventions and adapt easily. what is the perilous 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 it, but that's it's, yeah, i'd like to ask you about gadgets. all these devices, small watches, phones, et cetera, with the food they can now count your steps even more into your heart rate. and before it was saying, also as a gimmick,

you could just recently an elderly lady in new york got a smart watch as a present from her grandchildren. she made a penny actually helped her avoid a heart attack by analyzing her condition. if you can find, 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 she was delicious? so dr. nguyen, this really is a breakthrough because it can have a massive impact on numbers where you can buy a blood pressure monitor and check your blood pressure twice a day wired to see whether there are any spikes already in there. dumb dwell as the genius marietta is the was his for doing with over 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 we're doing it so on 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 or chill area code 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 a at near and you see your heart rate go up. you can alarmed that raises your heart rate even further and so on unit, but holding. 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 story stroke during the kid them early. it which has laurie basil.

again, the engine in their genetic engineering, i mean, i don't know how you'd react to that in more than a week. they're 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, wellington bretzkey that there's no practical implementation yet, you know, which, you know, got as of course, there is a lot of research and we welcome it. so because you won't find a solution if you don't look for it, 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 hottest was there, will be patiently waiting for it. rach snyder with trouble. now prior to that would, would use that kill 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. say you k wanted 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 here said the new surgeons will the chick brown what is hyper plastic? let heart syndrome it. 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 on that course, with 3 operations adverse outcomes, a quite common hedge, east them together with the americans. we convinced them not to proceed with this 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, right. these children are very attached to their parents because the parents don't on them really worked. so they probably main these children now 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. it's. and what would this that would wait? the more my remember it very well because i was strongly against what are you. k colleagues were doing at this time ballpark of those to deal with marcia. they later congratulated me on winning this battle. he but so many me up as that are

released him some over b, pursue all grandma, thank you so much for his educational and really insightful talk and i've learned so many new thinks a great deal with now. please say, 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. my ah ah, ah.

ah, ah. these people learn from their own experience how vulnerable of business is to the bank. so he pushes my business over, the age, pushes me right to the edge, bankruptcy. now i realize we will good. this isn't just the back that may be involved in this is the concept. see, firms is, is the lawyers. these people have got want on their stories at a wall, can a whistle blower tell people's marriages have broken up, lost their family homes. it is the spectacularly devastating for people's lives.

they have committed suicide, but left behind norwich. they explicitly state that it was the constant intimidation and billing by buying cough resource that late them to i talked to spy . it's obscene. these people up nor saw look forward to talking to you all. that technology should work for a robot must obey the orders given by human beings, except where such order is a conflict with the 1st law show your identification. we should be very careful about our personal intelligence. and the point obviously is to create a truck rather than fear, a very job with artificial intelligence, real summoning with a robot last protect its own existence with

a british m. p is stub to death while meeting his constituents, that 25 year old man has been arrested on suspicion. so ahead are you freeze this hour a us marine officer plead guilty to criticizing the military leadership for they? chaotic withdrawal from afghanistan remains defiant. however, that senior leaders need to be held to account as disturbing images of the latest terror attack. this friday emerges from the country a blast of a mosque, leaving dozens of people dead. it is the latest in a space of legal attack. since the u. s. exit the former us national security advisor, john bolton has taken aim

a president biden claiming he disregarded all advice about the.