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September 2, 2011

At first, Jennifer wasn’t very concerned, but as she was pushed into radiology, with its big steel door, she became a little apprehensive. Still dressed, she was slid into a machine. Dr. Yi pushed some buttons, and the machine began to give Jennifer commands in English. “Don’t move,” it said, and as she closed her eyes, it whirled around her.

It took only five minutes to diagnose Jennifer, and as soon as it was over, Dr. Yi made a call to the head of cardiology, Dr. Qu Peng. To say that Jennifer’s case was severe is to put it mildly. Her left descending artery was 99 percent blocked, and her left circumflex artery was totally occluded. The doctors told her she’d have to have surgery right away.

“In China?” she protested. She wanted to consider other options, including going to a Western hospital.

Dr. Qu Peng wouldn’t hear it. “You shouldn’t be walking around,” he told her, so flying would be even more dangerous. Faced with this news, Jennifer relented. She went home, packed things for her stay at the hospital, and returned the next day. What else could she do?

But she was about to receive some of the most advanced care in the world.

“When I was a young doctor,” said, China “didn’t have many procedures for cardiovascular problems. Since ’99, treatments and techniques have progressed very fast. Equipment has become advanced.”

According to Dr. Qu Peng, rheumatic heart disease was more common in China twenty to thirty years ago, when the standard of life was lower and malnutrition, infections from the streptococcus bacterium and tonsillitis were more prevalent. But the type of heart disease has changed. With the opening up and modernization of China, there’s more pressure on people as their jobs change. Stress, diet, smoking, and pollution have contributed to the rise in cases of coronary heart disease.

With bypass surgery, developed countries already had a way to treat coronary heart disease. The procedure was easy, popular and highly successful. In developing countries, however, the technology it required was too advanced, and the rate of success was too low, so doctors had to find a new way.

What they found was percutaneous coronary intervention (PCI), a minimally invasive form of microsurgery. A catheter the thickness of a human hair is pushed through the radial artery, leaving only the smallest circle of a scar on the wrist. On the end of the catheter are tiny instruments used to clear away plaque. A balloon is then inflated to 250 atmospheres of pressure to make room for a stent, a small support that keeps the blood vessel open. The stent, imported from America or Europe, is made out of chromium and titanium, on top of which is a drug that prevents infection. Jennifer’s case was so extreme that she required five such stents, two of them for reinforcement.

The doctor performs the operation from a control room, using computer monitors to view inside the arteries. Although the patient is awake during the surgery, there isn’t much pain—“like little stings,” according to Jennifer. The recovery time is short, and no anesthetics are involved. The rate of recurrence is low, only about 5 to 8 percent, sometimes related to the patient’s life choices after the surgery.

The group of machines used to diagnose and perform PCI is called the Zeego System, made by the German company Siemens. The machines provide detailed three-dimensional images of anatomical structures. Without these machines, PCI would be impossible. There are fifteen of these systems in China, each costing fifteen million RMB. Dalian was the third city in China to buy this innovative machinery.

Since 1995, China has used PCI. On average, Dr. Qu Peng performs ten surgeries a day. Confident in the procedure, he spends a great deal of time lecturing all over the world on its benefits, technicalities, and superiority over open-heart surgery. In 2006, he went to the American Coronary Conference. At that time, only 60 percent of patients in America received PCI. When he told other doctors that 90 percent of his

patients received PCI, “they said amazing or crazy,” he recalled, but now it’s being used for more cases in America. China—and especially Dalian, with over one hundred cases a year—is leading the world in this area of medicine. Dr. Qu Peng said that nine out of ten doctors in the States would have preferred to perform a bypass on Jennifer because it would have been easier than PCI. Here, though, he had no doubt, not only that he could successfully perform the operation but also that it would be more beneficial for her.

Paul watched his wife’s operation on a computer screen. “It was so cool,” he said. “That was the most expensive movie I’ve ever been to.” The procedure took less than two hours. Afterward, the doctors wheeled Jennifer into the control room, where it was her turn to watch the entire procedure.

Watching the removal of the blockage was amazing. In the black-and-white video, the black suddenly took over the white as blood flowed into areas that had lacked it for so long.

“I felt like life was being pumped into me. I’m a new person. I thank the medical team at No. 2 Hospital.” The cost of Jennifer’s surgery was fractions of what it would have cost elsewhere, and after only three days recovering in the hospital, she was able to go home. She has since given up smoking, cut back on foods with high cholesterol, and begun exercising every day.

Jennifer pointed out that it’s important to do some research first before being treated. The phone number for No. 2 Hospital is 0411-84671291. Also, although doctors are likely to speak English, reception isn’t, so take a Chinese-speaking friend to help you get through the paperwork. “I just want people to know don’t be afraid,” said Jennifer. “There’s no way I would hesitate.”

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September 2, 2011

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