A Life-Changing Journey: A Singaporean Patient’s Heart Treatment in Beijing

“I used to feel so breathless after climbing just two flights of stairs, and now I’ve fully recovered!” On October 29, Mr. Wang, who was finalizing his discharge paperwork, reflected on his remarkable recovery journey with deep gratitude.

For years, Mr. Wang, a Singaporean national, had been suffering from unexplained severe palpitations. After visiting numerous hospitals both locally and internationally, he was diagnosed with a rare heart condition by the experts at Fuwai Hospital in Beijing. Just days ago, after a thorough examination, Dr. Zhao Jian, Associate Director of the Adult Cardiac Surgery Department, and his team successfully performed a complex surgery — “tricuspid valve repair with right atrial volume reduction” — restoring his heart's normal rhythm.

Mr. Wang had long struggled with palpitations and visited multiple hospitals across Singapore and abroad, yet no clear diagnosis was found. Eventually, he walked into Fuwai Hospital in Beijing, where he met Dr. Zhao, who immediately recognized the complexity of his condition.

“When Mr. Wang arrived, we knew something unusual was at play,” said Dr. Zhao. Upon reviewing Mr. Wang’s heart examination reports, it was evident that his right atrium appeared abnormally enlarged, resembling a balloon. The next step was to quickly determine whether this was due to a tumor-like expansion or a congenital malformation.

Fuwai Hospital immediately initiated a multidisciplinary consultation. After thorough evaluations and repeated assessments of the ultrasound images, the team finally identified the cause: it wasn’t Ebstein’s anomaly, but rather a rare right atrial appendage aneurysm-like expansion. The expansion, which had grown to 10 cm in diameter, had nearly tripled the size of the normal right atrium!

More dangerously, the enlarged atrium was compressing the tricuspid valve, leading to severe tricuspid regurgitation. The regurgitation area reached 18 cm², meaning that with every heartbeat, a large amount of blood flowed backward into the right atrium, which was the root cause of his palpitations and shortness of breath.

With a clear diagnosis in hand, the surgery presented several daunting challenges. Dr. Zhao and his team listed three major hurdles they would need to overcome.

Firstly, Mr. Wang weighed 90 kg, and his broad chest made accessing the tricuspid valve deep within the thoracic cavity even more difficult. The limited space and vision posed a significant challenge, likened to “embroidering inside a narrow drawer,” where every movement had to be precise to the millimeter.

Secondly, the prolonged expansion of the right atrium had thinned its walls to the point where it resembled “the wings of a cicada.” Any undue pressure could cause rupture, and even small holes made during suturing would cause bleeding. If not managed promptly, this would dramatically increase the risk during the procedure.

Most critically, the expanded atrium was tightly adhered to the right coronary artery. Even slight manipulation during surgery could twist the artery, triggering arrhythmias or even myocardial infarction.

On the day of surgery, the operating room was filled with palpable tension. Dr. Zhao and his team, including Dr. Liu Peng, used a minimally invasive incision to carefully insert instruments. They painstakingly separated the adhered tissues and gently released the pressure from the enlarged atrium, all while closely monitoring the heart rate and blood pressure on the monitors.

When encountering the paper-thin atrial wall, the team switched to special, fine needles and employed an internal inversion suture technique, treating the tissue like fragile silk and ensuring each bleeding point was reinforced. In the most critical step, the team precisely located the deformed tricuspid valve, skillfully closed the abnormal chamber, and securely placed a 28-mm tricuspid valve ring.

The success of the surgery was confirmed when the post-surgery ultrasound showed no regurgitation and the right atrium had returned to its normal size. Mr. Wang’s palpitations were completely alleviated, and he could easily walk for 30 minutes. “It feels like I’ve been reborn!” he said with a smile.