Horst Sievert:感知中国结构性心脏病事业发展脉搏|CHINA VALVE(HANGZHOU)2021专访


从国际结构性心脏病大会CSI创始人,到CHINA VALVE(HANGZHOU)联合发起人之一,再到心脏介入器械的创新推广者,Horst Sievert教授的大名已为越来越多心血管医师所熟知。

“中国是未来结构性心脏病领域新的世界中心。”Horst Sievert教授早已与中国心血管学界结下了不解之缘,并对其未来发展抱有高度期待。

他与CHINA VALVE(HANGZHOU)缘起何时?
他如何看待中国医疗创新发展?

他眼中的下一个世界前沿在哪里?

2021年7月19-25日,第七届CHINA VALVE(HANGZHOU)即将召开。严道医声网通过云端采访的形式连线到德国法兰克福心血管中心Horst Sievert教授,深度挖掘了这位国际心脏病学领域的“重量级”学者与CHINA VALVE(HANGZHOU)的渊源,畅谈他对心脏瓣膜病的理解与展望。


No.1

  Why not ?  

谈及最初决定与CHINA VALVE(HANGZHOU)大会执行主席、浙江大学医学院附属第二医院王建安书记共同办会的契机,Horst Sievert教授仍是记忆犹新。

“6年前也就是2014年,当时王建安教授联系了我,问我是否愿意和他一起在中国组织一个和欧洲CSI会议一样概念的会。我回答说,为什么不呢?”

起初,Horst Sievert教授和王建安教授都无法预测到CHINA VALVE (HANGZHOU)会发展为今天如此规模的国际性学会盛会。

刚起步的时候,最重要的就是把握当下,努力完善会议的每一个细节、稳步前进。

“我还记得第一次开会是在浙大二院医院里,现场参会人数70人左右,现在,这个数字变成了1000以上。现在虽然无法预测参会人数, 但我预计会有超过百万观众收看会议。”

“CHINA VALVE (HANGZHOU)真正引领了中国结构性心脏病整个行业的发展,它的成功超出了我的想象。”

透过CHINA VALVE (HANGZHOU)的成长,他清晰地看到了中国结构性心脏病事业的快速发展,同时对充满热忱与行动力的中国同行给予了高度评价。
相信王建安教授在最初创办CHINA VALVE (HANGZHOU)时,就立志将其发展成为中国医学会议的翘楚。

中国医生敢勇当先的果断和魄力,是一些德国医生身上缺乏的特质,也正是德国医生需要借鉴和学习的地方。”

No.2

CSI和CHINA VALVE(HANGZHOU)一脉相承,殊途同归

作为CSI的创始人,Horst Sievert教授在参与CHINA VALVE(HANGZHOU)建设的过程中,自然融入了CSI的先进经验和会议特色。

Horst Sievert教授指出,CSI始于上世纪九十年代中期。创立的初衷是为房间隔缺损封堵术开设一门很小的课程,后来慢慢覆盖到更多的领域。

“CHINA VALVE(HANGZHOU)和CSI有着相同的办会目的——为该领域心血管医师提供具有实操性的建议。”

区别于国际上专注于学术研究的医学会议,CSI和CHINA VALVE(HANGZHOU)的参会者大多本着“学习日常临床诊疗上可以应用到的先进知识”这一目标而来。“这是CSI和CHINA VALVE(HANGZHOU)有别于其他会议的关键点。”

他认为,专注于学术研究的医学会议所探讨的内容信息,普遍可以通过网络或其他渠道获得,而并非一定要通过参加医学会议才能深度掌握和了解。

CSI和CHINA VALVE(HANGZHOU)则是以一种“理论与实践并举”的方式,让参会医生可以直观且深入地了解心血管疾病手术实操细节及其他前沿知识,方便他们后期在临床上加以运用,造福患者。这样的实践机会,是其他渠道难以替代的。

No.3

介入心脏病学的下一个重要前沿:用介入疗法治疗心衰

2005年CSI会议上,Horst Sievert教授对“structural heart disease”这一学术概念进行了系统定义,好比原本平静的湖面扔进一颗石子,泛起层层涟漪。

当时的心脏病学界有冠脉介入、外周血管介入、先天性心脏病介入等概念,但心脏病领域其他的诊疗手段如卵圆孔未闭封堵术,显然无法划入上述介入手术的范畴,而被称之为“non-something-else”。

“这种形式的概念并不好;所以我当时决定引入这一新定义。

Horst Sievert教授强调,历经多年发展,结构性心脏病的领域不断拓展,我们应该更多地去关注领域内的新事物,而不是单纯拓展对这个概念的认识和理解。

伴随着生物材料创新和科技进步所带来的医疗器械领域的发展,未来结构性心脏病乃至整个介入心脏病学将会迎来一次重大变革;Horst Sievert教授则认为,未来的介入心脏病学领域的下一个重要前沿将会是用介入疗法治疗心衰。

在2019年法兰克福的会议上,Horst Sievert教授看到了约75个心衰治疗领域的创新。这也从另一方面彰显了继冠脉介入治疗、外周血管介入治疗和瓣膜介入治疗之后另一潜力巨大的领域。


No.4

  思考+实践=创新 

谈及一位临床医生如何始终保持创新活力这一问题,在Horst Sievert教授看来,“创新”是一个顺势而为的过程。一位用心的临床医师在诊疗过程中,总能发现问题进而展开深入思考,从而碰撞出新的思想火花;而创新则是把这些思想付诸实践,将自己捕捉到的思想火花转为实物,如此而已。

Horst Sievert教授认为,真正难能可贵的是数十年如一日,对创新的始终如一的坚持。

“因为世界需要发展,这个领域需要进步,没有什么特殊的原因。我希望能够协助创新,致力于帮助更多的患者。”

近年来,Horst Sievert教授一直与我国国内多名专家、企业在结构性心脏病技术研发和创新方面保持着多层次的交流和合作。

在他看来,现阶段中国原创性技术和“中国制造”呈现出“井喷式”爆发正反映出中国在结构性心脏病领域巨大的创新潜力。其中最令他印象深刻的是“Liwen术式”,一种全新的肥厚性心肌病治疗方法,它为心脏病学其他介入领域打开了一扇新窗口。

Horst Sievert教授更是给予了这项创新型技术高度评价,“我认为这是真正的突破。”

此外,中国近年来涌现出大量优秀器械,如ValveClamp、启明Venus系列瓣膜、DragonFly™、MitralStitch®、生物可降解器械等都在从概念走向临床,这些都是Horst Sievert教授所看到的中国医疗创新领域近几年较为重要的创新成绩。

全球化的大势下,Horst Sievert教授也期待着有一天,医疗创新领域能如同德国的汽车制造业一般,国家与国家之间精诚合作,有一份热,发一份光,最终造福全球的患者。

附:采访实录

01


To serve as the executive chairman of CHINA VALVE(HANGZHOU) ,could you please let us know the reason and recall the scene at that time ?

作为CHINA VALVE (HANGZHOU) 的执行主席,能请您还原一下当时创立CHINA VALVE (HANGZHOU) 的场景和初衷吗?

Well, Jian’an Wang approached me at that time and asked me whether I could help to start a conference in China like the same concept as our conference in Europe ,in Germany here, which is the CSI conference.  And I said why not ?

So we joined our forces and established CHINA VALVE (HANGZHOU)  that was I think six years ago, must be in 2014. That was the start of this project.

当时王建安教授联系了我,问我是否愿意帮助他在中国组织一个和欧洲CSI会议一样概念的会。我回答说,为什么不呢?于是我便决定加入并创立CHINA VALVE (HANGZHOU) 。没记错的话应该是6年前也就是2014年;这就是CHINA VALVE (HANGZHOU) 的缘起。

02

Has CHINA VALVE (HANGZHOU) met your original expectations at present?

CHINA VALVE (HANGZHOU) 是否达到了当时您的预期呢?

Well, at that time, we did not know how it goes. I was confident that it will become a big success and yes, indeed,it has  grown tremendously. When I remember the first conference, I think that was in the hospital of Dr. Wang and we had maybe 70  attendees. And that of last year and the year before that there was more than a thousand attendees. So it's a tremendous success.

那个时候,我们也不知道到底会做成什么样。但是我对这个会议取得巨大成功是很有信心的,而且CHINA VALVE (HANGZHOU) 确实成长飞速。我还记得第一次开会是在浙二医院里,参会人数就70人左右,而去年和前年都超过了1000人参会。

03

Today the conference is about to be held. We know that you have witnessed the growth and expansion of CHINA VALVE (HANGZHOU)  over the years. How do you evaluate on the development and changes for the conference through the years.

今天大会就要召开了,作为CHINA VALVE (HANGZHOU) 多年来成长的见证者,您如何评价这些年大会的发展和变化。

 I mean the growth of the conference was in parallel to the growth of structural and especially the valvular or TAVR programs in China. And this conference facilitated the growth of this procedure, this field in China at large. So  it’s the combined effort of many people in China. But this conference is really leading the field in China. It is a biggest success than I can imagine.

CHINA VALVE(HANGZHOU) 这些年来可以说是和中国的结构性心脏病诊疗,特别是TAVR项目共同成长的。大会促进了这个疗法的发展,也推动了中国该领域的进步。我认为这是很多中国同仁同心众力的结果,而且CHINA VALVE (HANGZHOU) 现在无疑已成为中国行业的顶会;它的成功超出了我当时的想象。

04

What do you think are the similarities and differences between CHINA VALVE (HANGZHOU)  and other medical conferences you have contacted or held?

CHINA VALVE (HANGZHOU) 和您接触的或发起的其他医学会议相比有哪些相似之处和哪些不同?

CHINA VALVE(HANGZHOU)  is following the same structure as CSI which means the aim of this type of conference is to give practical advise to cardiologist working in that field. So attendees of CSI and CHINA VALVE(HANGZHOU)  want to learn something for their daily practice. We also have in our conferences/sessions about science, about studies. But we believe this information can also be obtained by other sources like by the internet or somewhere else. Whereas attending CSI and CHINA VALVE (HANGZHOU)  conferences is about to learn the procedure, to learn technical details and to learn knowledge that can help colleagues in their practice  to help patients. That’s the differences to other conferences, for example, AHA in the United States is a scientific conference and that is not a primary goal of our conferences.

CHINA VALVE(HANGZHOU) 采取的是和CSI一样的结构。也就是说,会议的目的是:给该领域的心血管医师提出具有实操性的建议。所以CSI和CHINA VALVE(HANGZHOU) 的参会者都是以学习可以在平时执业中应用的先进理念为目的前来参会的。我们会组织一些专注于学术研究的会议,但是我认为这些信息在网上和其他渠道都可以获取到。而在CSI和CHINA VALVE(HANGZHOU) ,参会医师可以深入了解手术,实操细节以及前沿知识,并加以运用帮助病患。这是有别于其他会议的点;比如美国举办的AHA就是一个学术会议,而这并不是我们的主要目标。

05

As we know, you have formally proposed the concept of“structural heart disease” at the 2005 CSI conference, and before that, the diagnosis and treatment of congenital heart disease, heart valve disease, cardiomyopathy and other diseases had already appeared in the clinic, why did you decide to group these diseases together and proposed the concept of “structural heart disease”?

2005年CSI会议上,您正式提出了“结构性心脏病”这一概念,而在您定义这类疾病之前,先心病、心脏瓣膜疾病、心肌病等疾病的诊断和治疗早已在临床中出现,您是出于什么原因决定将这些疾病归纳到一起并提出这一概念?

I’m not sure who really proposed the term of “structural heart disease”. But we all at that time had kind of a problem that we had coronary interventions, we had peripheral interventions and then congenital interventions. But there was these other fields of procedures like PFO closure, for example, which doesn’t really fit into these categories and before we invented the term structural heart disease, because these interventions are non-coronary interventions, which is not very nice term to define something as being non-something-else. So that was the reason that there was need for a new word/a new term. Again I don't remember who actually proposed the term structural heart disease.

我不确定是谁最先提出了“结构性心脏病”的概念,但是那个时候我们我们面临这样一个问题,我们有冠脉介入的概念,有外周血管介入的概念也有先天介入的概念,但是其他一些诊疗手段如:卵圆孔未必封堵术又显然不属于这些范畴。在引入结构性心脏病这一概念之前,这些诊疗都统一纳入非冠脉介入范畴,但以“非+”定义某一概念并不好。所以这是当时引入这一新定义的初衷。具体是谁先提出的这个术语我记不得了。

And now over the years, it is used in slightly different ways. Some people count the structural heart disease (as) interventions,all interventions including congenital and vavular heart disease, and others , keep it separate. So it means we have vavular, we have congenital and structural. Structural , for example,  isn’t an closure, it has nothing to do with the congenital heart defect, and nothing to do with valves. So it’s a separate entity. And most often is used separately from vavular and congenital  and the structural as an additional.

在过去的几年, 其定义与起初有所不同。有些人认为结构性心脏病是介入,所有的介入包括先心,瓣膜性心脏病和其他人认为是分开的领域。这样的话,就意味着,我们有瓣膜, 先心和结构性心脏病。比如,结构性心脏病就是封堵,它和先天性的先天性心脏缺陷无关,和瓣膜无关,是一个独立的分支。大多数时候,结构性心脏病的概念和瓣膜,先心分开,就是,瓣膜,先心加结构。

06

What Chinese original technologies and devices have left you a deep impression at this stage?

现阶段有哪些中国原创性技术和中国制造的产品给您留下了深刻印象?

Oh ,there are,over the years,many different devices, if you ask me the most impression device,probably,it is the  Liwen technology to treat hypertrophic cardiomyopathy which is a completely different approach to treat hypertropic cardiomyopathy and which also opens the door to other interventions. It is a percutaneous  technique that coming from the apex of the heart and then inserting a radiofrequency needle into the muscle of the septum . I think this is really a breakthrough. But there are many other devices like the Venus A-Valve , like the mitral repair techniques, many different things where from concept to work ,bio-absorbable devices, PFO closure, ASD closure, so all these are very important achievements which have been made in the last couple of years.

过去这些年有很多不同的器械。如果你要问我印象最深刻的 ,或许的Liwen术式,它是一种全新的肥厚性心肌病的治疗方法。同时,它也为其他的介入领域打开了大门。这是从心尖的经皮技术,将射频消融针置于间隔部肌肉处。我认为这是真正的突破。当然,还有很多其他不同的器械,比如启明venus系列瓣膜, 二尖瓣修复技术,都从概念走向临床。还有比如, 生物可降解器械,PFO封堵, ASD封堵等。这些都是过去几年很重要的成就。 

07

In the mean time, we know you are always at the forefront of medical innovation. What are the reasons for your insistence on innovation?

与此同时,您一直以来都走在医学创新的前沿,为何如此致力于创新?

My reason to work in this field is the world has to be developed. It’s something which has to move forward. So there is no special reason other than that I just want to help to develop new things to help patients to make progress.

因为世界需要发展,这个领域需要进步;没有什么特殊的理由,我只是希望能够协助创新,致力于帮助更多的患者。

08

In your opinion, on the path of medical innovation, which areas of support are needed to form a benign development?

您认为在进行医学创新的道路上,需要哪些领域的共同支持才能形成良性发展?

Of course. Some of us have to have good idea where is the clinical need for. But then actually very important is let's say financial support and structural support from governments, which is different in different countries . So , for example, China is very good in that, Isreal is very good in that, United States is very good in that . It needs an infrastructure of , let’s say, an environment where companies can develop and grow, which is not strength of European.

的确,有些人有很好的想法,很了解临床的需求。但更重要的,应该是来自政府的财力和架构上的支持,每个国家都有差异。比如,中国,以色列,美国在这些方面都做的很好。他们有大环境,基础设施来助力公司研发,发展,可惜这并不是欧洲的强项。

09

Can you introduce the specific process of innovative medical device from idea to its implementation in German?

您可以介绍一下德国创新医疗器械从想法的提出到落地,具体是个什么样的流程?

 That’s a problem in Germany. Let’s say Europe . In the last decades many things have been innovation in Europe then moved out mainly to the United States and in the future to China because we don't have the infrastructure . We are good in  automobile industry but not the medical devices industry and many procedures we do in our Cathlab everyday originally came from Europe. And, for example, TAVR,PCI PTA pacemaker. All these are innovations which originated in Europe and then moved out because United States had the infrastructure and now Israel and China have the infrastructure to move things forward to really develop a product which can be used in patients.

德国在这一方面做的并不好, 让我们放眼欧洲。在过去的十几年,欧洲有很多创新项目,后来却在美国发展,未来可能还会在中国落地生根,不断发展。这是因为我们没有相应的基础设施建设。汽车业是德国的强项,但并非医疗器械行业。我们现在导管室所做的很多手术, 如TAVR, PCI, PTA, 起搏器等都源于欧洲,然后传到了美国, 以色列,和中国。因为这些国家有相应的基础设施,能够推动创新的发展,生产相应的产品,真正造福患者。

10

Could you please talk about your thought of the future development for structural heart disease?

在您看来,未来结构性心脏病将形成怎样的发展趋势?

 As I mentioned earlier, I believe the next big field is the device of designed to treat heart failure and at our conference in Frankfurt, we had last year, in 2019 acutally, We had about 75 different new innovations to treat heart failure . Also this shows all this field is growing and this will be after coronary interventions. Peripheral interventions and vavular interventions. This will be the next big field to explore and to develop new technologies.

正如我之前所提到的, 我认为未来的发展领域应该是用介入疗法治疗心衰。去年, 其实是2019年, 我们在法兰克福的会议上看到约75个心衰治疗领域的创新。这也彰显了继冠脉介入治疗,外周血管介入治疗和瓣膜介入治疗之后另已不断发展的领域。这将是未来值得聚焦深耕发展新技术的一个重要领域。 

11

We know that German generally have excellent qualities of rigor and discipline, and this reflects the same in the German cardiology field, through your contact with Chinese cardiologists, what do you think are the different outstanding qualities between Chinese cardiologist and German ?

我们知道,德国民众普遍具有严谨、守纪的优秀品质,这点折射到德国心血管学界也是如此,通过您与中国心脏病医师的接触,您认为我们分别有哪些不同的优秀品质值得相互借鉴学习?

Well, the language of course. Beside that i don’t really think there are big differences.  The only thing which comes into my mind is that we can learn from the Chinese to think big because if Chinese colleagues, Prof. Wang,  for example, if he starts something,it is designed to become big from the very beginning where Germans are a little bit more careful and do it a step wise so this may be something we can learn from the Chinese. The other around, I don't think that the Chinese have to learn something from the Germans。

当然,首先是语言。除此之外,我真不觉得中德心血管界的医生有很大差别。我头脑中能想到的就是我们可以学习中国同道做大做强的思维。比如,王教授想创立这个会议之时, 就立足将此会议发展壮大。而德国人, 我们相对更谨慎, 走一步,看一步,所以这是中国医师值得我们学习的地方。反言之,我认为德国医生身上没有特别需要中国医生学习借鉴的。

12

Do you have any words to say for the CHINA VALVE (HANGZHOU) 2021?

对于CHINA VALVE (HANGZHOU) 2021,您有什么想说的吗?

this would be a challenge because as you all know, this will be virtual, so it is a totally different experience. But I'm very confident that the organizers will manage this and this will become a big success . I don't know , but I expect there will be millions attendees and I'm looking forward to see how it goes.

线上会议的全新模式会带来一定的挑战, 因为线上会议是一种别样的体验。但是我有信心,主办方一定会尽心尽力将此次大会办好, 我也相信大会一定会取得成功。现在还无法预测人数, 但我预计会有超过百万观众收看会议!让我们一起期待!


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