{"id":3719,"date":"2015-11-10T20:09:18","date_gmt":"2015-11-10T20:09:18","guid":{"rendered":"https:\/\/lpfch.org\/thinking-outside-the-box\/"},"modified":"2024-02-14T14:07:11","modified_gmt":"2024-02-14T14:07:11","slug":"thinking-outside-the-box","status":"publish","type":"post","link":"https:\/\/lpfch.org\/vi\/impact-stories\/thinking-outside-the-box\/","title":{"rendered":"Suy ngh\u0129 v\u01b0\u1ee3t ra ngo\u00e0i khu\u00f4n kh\u1ed5"},"content":{"rendered":"

V\u1edbi m\u1ed9t s\u1ed1 nh\u00e0 nghi\u00ean c\u1ee9u tim m\u1ea1ch nhi khoa s\u00e1ng t\u1ea1o nh\u1ea5t c\u1ea3 n\u01b0\u1edbc, Trung t\u00e2m Tim m\u1ea1ch Tr\u1ebb em \u0111ang c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe v\u00e0 h\u1ea1nh ph\u00fac c\u1ee7a tr\u1ebb em m\u1eafc b\u1ec7nh tim trong c\u1ed9ng \u0111\u1ed3ng c\u1ee7a ch\u00fang ta v\u00e0 tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.<\/p>\n

Ti\u1ebfn s\u0129 Doff McElhinney<\/h2>\n

Gi\u00e1m \u0111\u1ed1c, Ch\u01b0\u01a1ng tr\u00ecnh nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng v\u00e0 chuy\u1ec3n d\u1ecbch, Trung t\u00e2m tim m\u1ea1ch nhi khoa t\u1ea1i B\u1ec7nh vi\u1ec7n nhi Lucile Packard Stanford<\/em><\/p>\n

S\u1ebd th\u1ebf n\u00e0o n\u1ebfu b\u1ea1n c\u00f3 th\u1ec3 t\u1ed5ng h\u1ee3p t\u1ea5t c\u1ea3 c\u00e1c ghi ch\u00fa c\u1ee7a b\u00e1c s\u0129, t\u1ea5t c\u1ea3 c\u00e1c phim ch\u1ee5p MRI, t\u1ea5t c\u1ea3 c\u00e1c phim ch\u1ee5p X-quang v\u00e0 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m m\u00e0 b\u1ec7nh nh\u00e2n \u0111\u00e3 thu th\u1eadp \u0111\u01b0\u1ee3c t\u1ea1i c\u00e1c ph\u00f2ng kh\u00e1m v\u00e0 b\u1ec7nh vi\u1ec7n kh\u00e1c nhau, r\u1ed3i t\u1eadp h\u1ee3p ch\u00fang l\u1ea1i v\u1edbi nhau? C\u00e1c b\u00e1c s\u0129 v\u00e0 nh\u00e0 nghi\u00ean c\u1ee9u c\u00f3 th\u1ec3 r\u00fat ra nh\u1eefng hi\u1ec3u bi\u1ebft v\u00e0 m\u00f4 h\u00ecnh n\u00e0o th\u00f4ng qua vi\u1ec7c ph\u00e2n t\u00edch d\u1eef li\u1ec7u quy m\u00f4 l\u1edbn?<\/p>\n

Ti\u1ebfn s\u0129 Doff McElhinney, gi\u00e1o s\u01b0 ph\u1eabu thu\u1eadt tim l\u1ed3ng ng\u1ef1c t\u1ea1i Tr\u01b0\u1eddng Y khoa \u0110\u1ea1i h\u1ecdc Stanford, \u0111ang th\u00fac \u0111\u1ea9y ti\u1ebfn tr\u00ecnh t\u00ecm hi\u1ec3u c\u00e1ch ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n trong th\u1ebf gi\u1edbi k\u1ebft n\u1ed1i \u0111\u00f3 s\u1ebd nh\u01b0 th\u1ebf n\u00e0o. <\/p>\n

Nh\u01b0 McElhinney gi\u1ea3i th\u00edch, d\u1eef li\u1ec7u b\u1ec7nh nh\u00e2n \u0111i\u1ec7n t\u1eed v\u00e0 c\u00e1c thi\u1ebft b\u1ecb thu th\u1eadp d\u1eef li\u1ec7u \u0111ang tr\u1edf n\u00ean ph\u1ed5 bi\u1ebfn, t\u1ea1o ra m\u1ed9t c\u01a1 h\u1ed9i tuy\u1ec7t v\u1eddi \u0111\u1ec3 s\u1eed d\u1ee5ng ph\u00e2n t\u00edch th\u00f4ng l\u01b0\u1ee3ng cao nh\u1eb1m thu th\u1eadp nh\u1eefng th\u00f4ng tin quan tr\u1ecdng v\u00e0 cho ph\u00e9p ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe ch\u00ednh x\u00e1c, c\u00e1 nh\u00e2n h\u00f3a v\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n. Nh\u1eefng ti\u1ebfn b\u1ed9 n\u00e0y \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng nh\u1ea5t m\u1eafc c\u00e1c b\u1ec7nh l\u00fd m\u00e3n t\u00ednh ph\u1ee9c t\u1ea1p, ch\u1eb3ng h\u1ea1n nh\u01b0 tr\u1ebb em b\u1ecb d\u1ecb t\u1eadt tim \u0111\u01a1n t\u00e2m th\u1ea5t.<\/p>\n

M\u1ed9t n\u0103m tr\u01b0\u1edbc, McElhinney \u0111\u00e3 chuy\u1ec3n \u0111\u1ebfn Stanford \u0111\u1ec3 \u0111\u1ea3m nh\u1eadn v\u1ecb tr\u00ed gi\u00e1m \u0111\u1ed1c Ch\u01b0\u01a1ng tr\u00ecnh Nghi\u00ean c\u1ee9u L\u00e2m s\u00e0ng v\u00e0 Chuy\u1ec3n d\u1ecbch m\u1edbi c\u1ee7a Trung t\u00e2m Tim m\u1ea1ch Tr\u1ebb em. Ch\u01b0\u01a1ng tr\u00ecnh m\u1edbi l\u1ea1 n\u00e0y, m\u1ed9t trong s\u1ed1 \u00edt ch\u01b0\u01a1ng tr\u00ecnh t\u01b0\u01a1ng t\u1ef1 tr\u00ean to\u00e0n qu\u1ed1c, cung c\u1ea5p c\u01a1 s\u1edf h\u1ea1 t\u1ea7ng quan tr\u1ecdng cho nghi\u00ean c\u1ee9u tim m\u1ea1ch nhi khoa h\u1ee3p t\u00e1c t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi \u0111\u1ed3ng Lucile Packard Stanford, \u0111\u1ed3ng th\u1eddi k\u1ebft n\u1ed1i c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng v\u00e0 nh\u00e0 nghi\u00ean c\u1ee9u \u0111\u1ec3 \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh chuy\u1ec3n \u0111\u1ed5i c\u00e1c ph\u00e1t hi\u1ec7n khoa h\u1ecdc c\u01a1 b\u1ea3n th\u00e0nh nh\u1eefng ti\u1ebfn b\u1ed9 y h\u1ecdc.<\/p>\n

Th\u00f4ng qua nh\u1eefng h\u1ee3p t\u00e1c n\u00e0y, McElhinney r\u1ea5t mong mu\u1ed1n kh\u00e1m ph\u00e1 nh\u1eefng l\u0129nh v\u1ef1c nghi\u00ean c\u1ee9u m\u1edbi. \u00d4ng nh\u1eadn \u0111\u1ecbnh: \u201cM\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 nh\u1eefng ti\u1ebfn b\u1ed9 v\u01b0\u1ee3t b\u1eadc trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh tim b\u1ea9m sinh \u1edf tr\u1ebb em v\u00e0 ng\u01b0\u1eddi l\u1edbn, nh\u01b0ng v\u1eabn c\u00f2n nhi\u1ec1u v\u1ea5n \u0111\u1ec1 ch\u01b0a \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft v\u00e0 nhi\u1ec1u c\u01a1 h\u1ed9i \u0111\u1ec3 th\u00fac \u0111\u1ea9y l\u0129nh v\u1ef1c n\u00e0y ph\u00e1t tri\u1ec3n\u201d.<\/p>\n

Ch\u01b0\u01a1ng tr\u00ecnh Nghi\u00ean c\u1ee9u L\u00e2m s\u00e0ng v\u00e0 Chuy\u1ec3n d\u1ecbch \u0111ang ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tra v\u1ec1 b\u1ec7nh l\u00fd sinh l\u00fd c\u01a1 b\u1ea3n, \u0111\u00e1nh gi\u00e1 v\u00e0 ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n; ph\u00e1t tri\u1ec3n c\u00e1c thi\u1ebft b\u1ecb v\u00e0 c\u00f4ng ngh\u1ec7 y t\u1ebf m\u1edbi; v\u00e0 s\u1eed d\u1ee5ng d\u1eef li\u1ec7u l\u1edbn \u0111\u1ec3 ph\u00e2n t\u00edch th\u00f4ng tin t\u1eeb h\u1ed3 s\u01a1 b\u1ec7nh nh\u00e2n v\u00e0 n\u00e2ng cao hi\u1ec3u bi\u1ebft c\u1ee7a ch\u00fang t\u00f4i v\u1ec1 c\u00e1c qu\u00e1 tr\u00ecnh l\u00e2m s\u00e0ng v\u00e0 b\u1ec7nh l\u00fd ph\u1ee9c t\u1ea1p.<\/p>\n

McElhinney mu\u1ed1n l\u00e0m s\u00e1ng t\u1ecf c\u00e1ch th\u1ee9c y h\u1ecdc c\u00e1 nh\u00e2n h\u00f3a c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng v\u00e0o ch\u0103m s\u00f3c tim m\u1ea1ch. "C\u00e1c b\u00e1c s\u0129 ung th\u01b0 s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c nhau d\u1ef1a tr\u00ean lo\u1ea1i \u0111\u1ed9t bi\u1ebfn, v\u00e0 \u0111i\u1ec1u \u0111\u00f3 cho ph\u00e9p \u00e1p d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u0103m s\u00f3c kh\u00e1c nhau", \u00f4ng n\u00f3i. "C\u00f3 l\u1ebd \u0111i\u1ec1u n\u00e0y c\u0169ng t\u01b0\u01a1ng t\u1ef1 v\u1edbi b\u1ec7nh tim b\u1ea9m sinh. Hi\u1ec3u bi\u1ebft r\u00f5 r\u00e0ng v\u00e0 s\u00e2u s\u1eafc h\u01a1n v\u1ec1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 cho ph\u00e9p \u0111i\u1ec1u ch\u1ec9nh thu\u1ed1c ph\u00f9 h\u1ee3p h\u01a1n." Li\u1ec7u ph\u00e1p t\u1ebf b\u00e0o g\u1ed1c l\u00e0 m\u1ed9t l\u0129nh v\u1ef1c kh\u00e1c m\u00e0 McElhinney mong mu\u1ed1n nghi\u00ean c\u1ee9u nh\u01b0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7y h\u1ee9a h\u1eb9n cho c\u00e1c khuy\u1ebft t\u1eadt tim b\u1ea9m sinh - m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e1 nh\u00e2n h\u00f3a theo nhu c\u1ea7u c\u1ee7a t\u1eebng b\u1ec7nh nh\u00e2n. <\/p>\n

May m\u1eafn thay, McElhinney \u0111ang \u1edf \u0111\u00fang v\u1ecb tr\u00ed ho\u00e0n h\u1ea3o \u0111\u1ec3 t\u00ecm ra c\u00e2u tr\u1ea3 l\u1eddi cho nh\u1eefng c\u00e2u h\u1ecfi quan tr\u1ecdng n\u00e0y. Ch\u01b0\u01a1ng tr\u00ecnh Nghi\u00ean c\u1ee9u L\u00e2m s\u00e0ng v\u00e0 Chuy\u1ec3n d\u1ecbch c\u00f3 v\u1ecb tr\u00ed l\u00fd t\u01b0\u1edfng t\u1ea1i \u0110\u1ea1i h\u1ecdc Stanford, m\u1ed9t t\u1ed5 ch\u1ee9c nghi\u00ean c\u1ee9u chuy\u00ean s\u00e2u \u0111ang d\u1eabn \u0111\u1ea7u trong vi\u1ec7c s\u1eed d\u1ee5ng d\u1eef li\u1ec7u l\u1edbn \u0111\u1ec3 gi\u1ea3i quy\u1ebft c\u00e1c th\u00e1ch th\u1ee9c trong y sinh h\u1ecdc v\u00e0 t\u1ea1o ra t\u00e1c \u0111\u1ed9ng to\u00e0n c\u1ea7u trong c\u00e1ch ch\u00fang ta ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u00f2ng ng\u1eeba b\u1ec7nh t\u1eadt.<\/p>\n

\u201cStanford c\u00f3 m\u1ed9t n\u1ec1n v\u0103n h\u00f3a n\u0103ng \u0111\u1ed9ng, \u0111\u1ed5i m\u1edbi trong vi\u1ec7c x\u1eed l\u00fd th\u00f4ng tin theo nh\u1eefng c\u00e1ch s\u00e1ng t\u1ea1o v\u00e0 ti\u1ebfn b\u1ed9,\u201d McElhinney n\u00f3i. \u201cCh\u00fang t\u00f4i hy v\u1ecdng s\u1ebd t\u1eadn d\u1ee5ng n\u1ec1n v\u0103n h\u00f3a \u0111\u00f3 \u0111\u1ec3 t\u1ea1o ra nh\u1eefng \u0111i\u1ec1u \u0111\u1ed9c \u0111\u00e1o trong ch\u01b0\u01a1ng tr\u00ecnh tim m\u1ea1ch. Ch\u00fang t\u00f4i th\u1ef1c s\u1ef1 \u0111ang \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u01b0\u1edbc ti\u1ebfn v\u00e0 k\u1ebft n\u1ed1i \u0111\u01b0\u1ee3c nhi\u1ec1u ng\u01b0\u1eddi l\u1ea1i v\u1edbi nhau.\u201d<\/p>\n

McElhinney cho bi\u1ebft m\u1ed9t trong nh\u1eefng \u0111i\u1ec3m h\u1ea5p d\u1eabn c\u1ee7a ng\u00e0nh tim m\u1ea1ch nhi khoa \u0111\u1ed1i v\u1edbi \u00f4ng l\u00e0 nh\u1eefng th\u00e1ch th\u1ee9c v\u1eabn c\u1ea7n \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft, x\u00e9t \u0111\u1ebfn s\u1ef1 ph\u1ee9c t\u1ea1p v\u1ec1 m\u1eb7t gi\u1ea3i ph\u1eabu v\u00e0 sinh l\u00fd m\u00e0 c\u00e1c b\u00e1c s\u0129 tim m\u1ea1ch nhi khoa ph\u1ea3i \u0111\u1ed1i m\u1eb7t. "Trong r\u1ea5t nhi\u1ec1u kh\u00eda c\u1ea1nh, v\u1eabn c\u00f2n nhi\u1ec1u \u0111i\u1ec1u ph\u1ea3i h\u1ecdc. C\u00f4ng vi\u1ec7c n\u00e0y kh\u00f4ng c\u00f2n gi\u1ed1ng nh\u01b0 l\u00fac t\u00f4i m\u1edbi b\u1eaft \u0111\u1ea7u n\u1eefa", \u00f4ng n\u00f3i. "V\u00e0 n\u00f3 s\u1ebd kh\u00f4ng c\u00f2n gi\u1ed1ng nh\u01b0 v\u1eady sau 10 n\u0103m n\u1eefa."<\/p>\n

Alison Marsden, Ti\u1ebfn s\u0129<\/h2>\n

Ph\u00f3 Gi\u00e1o s\u01b0 Nhi khoa (Tim m\u1ea1ch) v\u00e0 K\u1ef9 thu\u1eadt sinh h\u1ecdc<\/em><\/p>\n

M\u1ed9t th\u1eadp k\u1ef7 tr\u01b0\u1edbc, Ti\u1ebfn s\u0129 Alison Marsden \u0111\u00e3 thi\u1ebft k\u1ebf c\u00e1nh m\u00e1y bay \u00eam h\u01a1n. Nh\u01b0ng khi ho\u00e0n th\u00e0nh lu\u1eadn \u00e1n v\u1ec1 t\u1ed1i \u01b0u h\u00f3a c\u00e1nh cho ch\u01b0\u01a1ng tr\u00ecnh Ti\u1ebfn s\u0129 K\u1ef9 thu\u1eadt C\u01a1 kh\u00ed t\u1ea1i Stanford, c\u00f4 bi\u1ebft m\u00ecnh mu\u1ed1n theo \u0111u\u1ed5i m\u1ed9t \u0111i\u1ec1u g\u00ec \u0111\u00f3 th\u1ef1c t\u1ebf h\u01a1n cho ch\u01b0\u01a1ng tr\u00ecnh nghi\u00ean c\u1ee9u sau ti\u1ebfn s\u0129 c\u1ee7a m\u00ecnh.<\/p>\n

Th\u1ef1c ra, n\u1ec1n t\u1ea3ng v\u1ec1 k\u1ef9 thu\u1eadt c\u01a1 kh\u00ed v\u00e0 h\u00e0ng kh\u00f4ng v\u0169 tr\u1ee5 c\u1ee7a c\u00f4 \u0111\u00e3 t\u1ea1o n\u00ean n\u1ec1n t\u1ea3ng ho\u00e0n h\u1ea3o cho vai tr\u00f2 hi\u1ec7n t\u1ea1i c\u1ee7a c\u00f4 - thi\u1ebft k\u1ebf c\u00e1c ca ph\u1eabu thu\u1eadt t\u1ed1t h\u01a1n cho tr\u1ebb em m\u1eafc b\u1ec7nh tim b\u1ea9m sinh.<\/p>\n

\u201cT\u00f4i quan t\u00e2m \u0111\u1ebfn vi\u1ec7c nghi\u00ean c\u1ee9u m\u1ed9t th\u1ee9 g\u00ec \u0111\u00f3 c\u00f3 t\u00ednh \u1ee9ng d\u1ee5ng cao h\u01a1n cho con ng\u01b0\u1eddi,\u201d c\u00f4 n\u00f3i. \u201cV\u00e0 t\u00f4i th\u1ea5y vi\u1ec7c nghi\u00ean c\u1ee9u c\u00e1c v\u1ea5n \u0111\u1ec1 y t\u1ebf \u1edf tr\u1ebb em th\u1ef1c s\u1ef1 l\u00e0 \u0111\u1ed9ng l\u1ef1c to l\u1edbn.\u201d<\/p>\n

H\u1ee3p t\u00e1c v\u1edbi Jeffrey Feinstein, MD, MPH, b\u00e1c s\u0129 tim m\u1ea1ch nhi khoa v\u00e0 Gi\u00e1o s\u01b0 Nhi khoa Dunlevie Family (Tim m\u1ea1ch) t\u1ea1i Stanford, Marsden \u0111\u00e3 d\u00e0nh nhi\u1ec1u gi\u1edd \u0111\u1ec3 t\u00ecm hi\u1ec3u v\u1ec1 tim m\u1ea1ch v\u00e0 theo d\u00f5i Feinstein trong c\u00e1c chuy\u1ebfn th\u0103m kh\u00e1m c\u1ee7a \u00f4ng t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Lucile Packard
Stanford. \u201c\u00d4ng \u1ea5y h\u1ecfi t\u00f4i nh\u01b0 th\u1ec3 t\u00f4i l\u00e0 sinh vi\u00ean y khoa v\u1eady,\u201d Marsden nh\u1edb l\u1ea1i v\u00e0 c\u01b0\u1eddi.
Cu\u1ed1i c\u00f9ng, Marsden v\u00e0 Feinstein \u0111\u00e3 tr\u1edf th\u00e0nh nh\u1eefng c\u1ed9ng s\u1ef1 ch\u00ednh.<\/p>\n

Marsden, ng\u01b0\u1eddi v\u1eeba tr\u1edf l\u1ea1i Stanford v\u1edbi t\u01b0 c\u00e1ch ph\u00f3 gi\u00e1o s\u01b0 nhi khoa tim m\u1ea1ch sau nhi\u1ec1u n\u0103m gi\u1ea3ng d\u1ea1y t\u1ea1i \u0110\u1ea1i h\u1ecdc California, San Diego, \u0111\u00e3 \u00e1p d\u1ee5ng ki\u1ebfn th\u1ee9c v\u1ec1 c\u01a1 h\u1ecdc ch\u1ea5t l\u1ecfng \u0111\u1ec3 t\u00ecm hi\u1ec3u c\u00e1ch m\u00e1u ch\u1ea3y qua tim v\u00e0 m\u1ea1ch m\u00e1u c\u1ee7a tr\u1ebb em m\u1eafc b\u1ec7nh tim b\u1ea9m sinh. C\u00f4 b\u1eaft \u0111\u1ea7u b\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng m\u00f4 ph\u1ecfng m\u00e1y t\u00ednh \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 hi\u1ec7n nay c\u00f2n s\u1eed d\u1ee5ng c\u00e1c m\u00f4 h\u00ecnh m\u00e1y t\u00ednh \u0111\u1ec3 t\u00ecm c\u00e1ch c\u1ea3i thi\u1ec7n c\u00e1c quy tr\u00ecnh ph\u1eabu thu\u1eadt.<\/p>\n

Feinstein gi\u1ea3i th\u00edch r\u1eb1ng c\u00e1c nh\u00f3m x\u00e2y d\u1ef1ng gi\u1ea3i ph\u00e1p k\u1ef9 thu\u1eadt cho c\u00e1c v\u1ea5n \u0111\u1ec1 y t\u1ebf t\u01b0\u01a1ng \u0111\u1ed1i ph\u1ed5 bi\u1ebfn, nh\u01b0ng vi\u1ec7c \u0111\u1ea3m b\u1ea3o nh\u1eefng thi\u1ebft k\u1ebf l\u00fd thuy\u1ebft \u0111\u00f3 c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng trong m\u00f4i tr\u01b0\u1eddng l\u00e2m s\u00e0ng, nh\u01b0 Marsden \u0111\u00e3 l\u00e0m, l\u00e0 m\u1ed9t r\u00e0o c\u1ea3n l\u1edbn h\u01a1n. "Ch\u1ec9 m\u1ed9t nh\u00f3m nh\u1ecf nh\u1eefng ng\u01b0\u1eddi l\u1ef1a ch\u1ecdn l\u00e0m nh\u1eefng g\u00ec c\u00f4 \u1ea5y l\u00e0m, v\u00e0 l\u00e0m t\u1ed1t nh\u01b0 c\u00f4 \u1ea5y", Feinstein n\u00f3i. "Vi\u1ec7c c\u00f3 c\u00f4 \u1ea5y l\u00e0 th\u00e0nh vi\u00ean c\u1ee7a khoa tim m\u1ea1ch nhi khoa c\u1ee7a ch\u00fang t\u00f4i l\u00e0 m\u1ed9t t\u00e0i s\u1ea3n v\u00f4 gi\u00e1 khi ch\u00fang t\u00f4i n\u1ed7 l\u1ef1c c\u1ea3i thi\u1ec7n h\u01a1n n\u1eefa vi\u1ec7c ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n c\u1ee7a m\u00ecnh."<\/p>\n

C\u00f4ng tr\u00ecnh c\u1ee7a Marsden cung c\u1ea5p m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p th\u1eed nghi\u1ec7m c\u00e1c thi\u1ebft k\u1ebf ph\u1eabu thu\u1eadt m\u1edbi tr\u00ean m\u00e1y t\u00ednh tr\u01b0\u1edbc khi \u00e1p d\u1ee5ng tr\u00ean b\u1ec7nh nh\u00e2n, t\u01b0\u01a1ng t\u1ef1 nh\u01b0 c\u00e1ch c\u00e1c k\u1ef9 s\u01b0 s\u1eed d\u1ee5ng m\u00e3 m\u00e1y t\u00ednh \u0111\u1ec3 th\u1eed nghi\u1ec7m c\u00e1c thi\u1ebft k\u1ebf m\u1edbi cho m\u00e1y bay ho\u1eb7c \u00f4 t\u00f4. Marsden v\u00e0 nh\u00f3m c\u1ee7a b\u00e0 \u0111\u00e3 m\u00f4 ph\u1ecfng qu\u00e1 tr\u00ecnh c\u1ea3i ti\u1ebfn c\u1ee7a m\u1ed9t quy tr\u00ecnh ph\u1eabu thu\u1eadt g\u1ecdi l\u00e0 Fontan\u2014b\u01b0\u1edbc cu\u1ed1i c\u00f9ng trong chu\u1ed7i ph\u1eabu thu\u1eadt m\u00e0 tr\u1ebb em b\u1ecb d\u1ecb t\u1eadt m\u1ed9t n\u00e3o th\u1ea5t ph\u1ea3i tr\u1ea3i qua \u0111\u1ec3 s\u1ed1ng s\u00f3t.<\/p>\n

Trong ph\u1eabu thu\u1eadt Fontan, c\u00e1c t\u0129nh m\u1ea1ch l\u1edbn \u0111\u01b0a m\u00e1u t\u1eeb c\u01a1 th\u1ec3 tr\u1edf v\u1ec1 tim \u0111\u01b0\u1ee3c k\u1ebft n\u1ed1i tr\u1ef1c ti\u1ebfp v\u1edbi c\u00e1c \u0111\u1ed9ng m\u1ea1ch \u0111\u01b0a m\u00e1u \u0111\u00e3 kh\u1eed oxy \u0111\u1ebfn ph\u1ed5i, t\u1ea1o th\u00e0nh m\u1ed9t kh\u1edbp n\u1ed1i h\u00ecnh ch\u1eef T \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh. \u0110i\u1ec1u n\u00e0y b\u1ecf qua tim \u1edf m\u1ed9t b\u00ean, do \u0111\u00f3 tu\u1ea7n ho\u00e0n m\u00e1u t\u1ea1o ra s\u1ebd t\u1eadn d\u1ee5ng t\u1ed1i \u01b0u bu\u1ed3ng b\u01a1m duy nh\u1ea5t. S\u1eed d\u1ee5ng c\u00e1c m\u00f4 h\u00ecnh thu \u0111\u01b0\u1ee3c t\u1eeb d\u1eef li\u1ec7u h\u00ecnh \u1ea3nh MRI, Marsden \u0111\u00e3 s\u1eed d\u1ee5ng c\u00e1c m\u00f4 h\u00ecnh m\u00e1y t\u00ednh \u0111\u1ec3 thi\u1ebft k\u1ebf v\u00e0 t\u1ed1i \u01b0u h\u00f3a m\u1ed9t lo\u1ea1i k\u1ebft n\u1ed1i m\u1edbi cho quy tr\u00ecnh Fontan theo h\u00ecnh ch\u1eef Y (\u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 Fontan gh\u00e9p ch\u1eef Y). C\u00e1c m\u00f4 h\u00ecnh m\u00e1y t\u00ednh c\u00f3 th\u1ec3 gi\u00fap c\u00e1c b\u00e1c s\u0129 ph\u1eabu thu\u1eadt nhi khoa x\u00e1c \u0111\u1ecbnh li\u1ec7u quy tr\u00ecnh n\u00e0y c\u00f3 mang l\u1ea1i l\u1ee3i \u00edch cho b\u1ec7nh nh\u00e2n hay kh\u00f4ng, c\u0169ng nh\u01b0 tim c\u1ee7a b\u1ec7nh nh\u00e2n s\u1ebd ho\u1ea1t \u0111\u1ed9ng nh\u01b0 th\u1ebf n\u00e0o trong qu\u00e1 tr\u00ecnh v\u1eadn \u0111\u1ed9ng v\u1eeba ph\u1ea3i.<\/p>\n

Marsden cho bi\u1ebft: "M\u00f4 h\u00ecnh m\u00e1y t\u00ednh cho ph\u00e9p th\u1eed nghi\u1ec7m c\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u00f3 r\u1ee7i ro cao nh\u01b0ng hi\u1ec7u qu\u1ea3 cao. N\u00f3 cho ph\u00e9p ch\u00fang t\u00f4i th\u1eed nghi\u1ec7m c\u00e1c \u00fd t\u01b0\u1edfng \u0111\u1ed9t ph\u00e1 m\u00e0 kh\u00f4ng g\u00e2y r\u1ee7i ro cho b\u1ec7nh nh\u00e2n."<\/p>\n

Vi\u1ec7c tinh ch\u1ec9nh gh\u00e9p ch\u1eef Y g\u1ea7n \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m th\u00e0nh c\u00f4ng trong m\u1ed9t nghi\u00ean c\u1ee9u th\u00ed \u0111i\u1ec3m tr\u00ean s\u00e1u b\u1ec7nh nh\u00e2n v\u1edbi k\u1ebft qu\u1ea3 l\u00e2m s\u00e0ng kh\u1ea3 quan. Marsden hi\u1ec7n \u0111ang b\u1eaft \u0111\u1ea7u ph\u00e1t tri\u1ec3n c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tinh ch\u1ec9nh v\u00e0 ph\u01b0\u01a1ng ph\u00e1p ti\u1ebfp c\u1eadn m\u1edbi cho c\u00e1c ca ph\u1eabu thu\u1eadt tim nhi khoa kh\u00e1c.<\/p>\n

"C\u00f4ng tr\u00ecnh c\u1ee7a Alison cho ph\u00e9p ch\u00fang ta nh\u00ecn nh\u1eadn nh\u1eefng \u0111i\u1ec1u m\u00e0 ch\u00fang ta kh\u00f4ng th\u1ec3 nh\u00ecn nh\u1eadn theo b\u1ea5t k\u1ef3 c\u00e1ch n\u00e0o kh\u00e1c", Feinstein n\u00f3i. "To\u00e0n b\u1ed9 kh\u00e1i ni\u1ec7m y h\u1ecdc d\u1ef1a tr\u00ean m\u00f4 ph\u1ecfng mang \u0111\u1ebfn c\u01a1 h\u1ed9i th\u1eed nghi\u1ec7m nh\u1eefng \u0111i\u1ec1u kh\u00f4ng g\u00e2y r\u1ee7i ro cho b\u1ec7nh nh\u00e2n. V\u1edbi lo\u1ea1i m\u00f4 h\u00ecnh m\u00e1y t\u00ednh n\u00e0y, b\u1ea1n c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n 100 l\u1ea7n m\u00f4 ph\u1ecfng tr\u01b0\u1edbc khi \u00e1p d\u1ee5ng tr\u00ean b\u1ec7nh nh\u00e2n."<\/p>\n

Ti\u1ebfn s\u0129 Sushma Reddy<\/h2>\n

Tr\u1ee3 l\u00fd Gi\u00e1o s\u01b0 Nhi khoa (Tim m\u1ea1ch)<\/em><\/p>\n

Li\u1ec7u nh\u1eefng s\u1ee3i RNA nh\u1ecf x\u00edu c\u1ee7a chu\u1ed9t c\u00f3 th\u1ec3 gi\u00fap ch\u00fang ta bi\u1ebft c\u00e1ch gi\u00fap tr\u1ebb em m\u1eafc b\u1ec7nh tim b\u1ea9m sinh s\u1ed1ng l\u00e2u h\u01a1n v\u00e0 kh\u1ecfe m\u1ea1nh h\u01a1n kh\u00f4ng? Ti\u1ebfn s\u0129 Sushma Reddy, ph\u00f3 gi\u00e1o s\u01b0 nhi khoa tim m\u1ea1ch, kh\u1eb3ng \u0111\u1ecbnh l\u00e0 c\u00f3, v\u00e0 \u0111ang kh\u00e1m ph\u00e1 ra nh\u1eefng t\u00edn hi\u1ec7u trong m\u00e1u chu\u1ed9t c\u00f3 th\u1ec3 c\u1ea3nh b\u00e1o c\u00e1c b\u00e1c s\u0129 v\u1ec1 nguy c\u01a1 suy tim s\u1eafp x\u1ea3y ra.<\/p>\n

Reddy b\u1eaft \u0111\u1ea7u quan t\u00e2m \u0111\u1ebfn tim m\u1ea1ch khi c\u00f2n l\u00e0 sinh vi\u00ean y khoa. T\u1ea1i sao l\u1ea1i ch\u1ecdn tim m\u1ea1ch? "Ch\u00ednh sinh l\u00fd h\u1ecdc khi\u1ebfn n\u00f3 tr\u1edf n\u00ean v\u00f4 c\u00f9ng th\u00fa v\u1ecb v\u00e0 th\u00f4i th\u00fac b\u1ea1n ph\u1ea3i suy ngh\u0129 nhanh nh\u1ea1y", Reddy n\u00f3i. K\u1ec3 t\u1eeb \u0111\u00f3, \u0111\u00e3 c\u00f3 nh\u1eefng b\u01b0\u1edbc ti\u1ebfn v\u01b0\u1ee3t b\u1eadc trong \u0111i\u1ec1u tr\u1ecb c\u00e1c d\u1ecb t\u1eadt tim b\u1ea9m sinh, v\u00e0 b\u1ec7nh nh\u00e2n \u0111ang s\u1ed1ng s\u00f3t v\u00e0 c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe t\u1ed1t h\u01a1n so v\u1edbi 20 n\u0103m tr\u01b0\u1edbc.<\/p>\n

B\u00e0 n\u00f3i: \u201cCh\u00fang t\u00f4i \u0111ang ti\u1ebfp t\u1ee5c m\u1edf r\u1ed9ng ranh gi\u1edbi c\u00f4ng ngh\u1ec7 \u0111\u1ec3 h\u1ed7 tr\u1ee3 b\u1ec7nh nh\u00e2n\u201d, \u0111\u1ed3ng th\u1eddi l\u01b0u \u00fd r\u1eb1ng v\u1eabn c\u00f2n nhi\u1ec1u c\u00e2u h\u1ecfi ch\u01b0a \u0111\u01b0\u1ee3c gi\u1ea3i \u0111\u00e1p. <\/p>\n

B\u00e1c s\u0129 Reddy \u0111\u1eb7c bi\u1ec7t quan t\u00e2m \u0111\u1ebfn nh\u1eefng tr\u1ebb sinh ra v\u1edbi m\u1ed9t t\u00e2m th\u1ea5t ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng\u2014m\u1ed9t t\u00ecnh tr\u1ea1ng g\u1ecdi l\u00e0 d\u1ecb t\u1eadt tim m\u1ed9t t\u00e2m th\u1ea5t. Ngay c\u1ea3 sau m\u1ed9t lo\u1ea1t c\u00e1c ca ph\u1eabu thu\u1eadt ph\u1ee9c t\u1ea1p \u0111\u1ec3 c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng, nh\u1eefng tr\u1ebb n\u00e0y v\u1eabn ch\u1ec9 c\u00f3 m\u1ed9t bu\u1ed3ng b\u01a1m m\u00e1u thay v\u00ec hai bu\u1ed3ng, v\u00e0 do \u0111\u00f3, s\u1ee9c kh\u1ecfe c\u1ee7a c\u00e1c em kh\u00f4ng b\u1eb1ng nh\u1eefng tr\u1ebb c\u00f3 tim b\u00ecnh th\u01b0\u1eddng.<\/p>\n

\u201c\u0110\u1ebfn m\u1ed9t th\u1eddi \u0111i\u1ec3m n\u00e0o \u0111\u00f3, t\u1ea5t c\u1ea3 nh\u1eefng \u0111\u1ee9a tr\u1ebb n\u00e0y \u0111\u1ec1u b\u1ecb suy tim\u2014t\u1ea5t c\u1ea3 b\u1ecdn ch\u00fang,\u201d Reddy gi\u1ea3i th\u00edch. C\u00e1c b\u00e1c s\u0129 s\u1eed d\u1ee5ng si\u00eau \u00e2m tim v\u00e0 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim \u0111\u1ec3 theo d\u00f5i t\u00ecnh tr\u1ea1ng tim c\u1ee7a nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y, nh\u01b0ng nh\u1eefng d\u1ea5u hi\u1ec7u ban \u0111\u1ea7u c\u1ee7a b\u1ec7nh c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n b\u1eb1ng c\u00e1c k\u1ef9 thu\u1eadt h\u00ecnh \u1ea3nh n\u00e0y. \u0110\u1ebfn khi c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a suy tim xu\u1ea5t hi\u1ec7n, b\u1ec7nh \u0111\u00e3 ti\u1ebfn tri\u1ec3n n\u1eb7ng v\u00e0 h\u1ea7u h\u1ebft c\u00e1c li\u1ec7u ph\u00e1p y t\u1ebf \u0111\u1ec1u kh\u00f4ng hi\u1ec7u qu\u1ea3 trong vi\u1ec7c \u0111\u1ea3o ng\u01b0\u1ee3c qu\u00e1 tr\u00ecnh n\u00e0y. <\/p>\n

Reddy \u0111ang gi\u1ea3i quy\u1ebft v\u1ea5n \u0111\u1ec1 n\u00e0y b\u1eb1ng c\u00e1ch nghi\u00ean c\u1ee9u c\u00e1c khuy\u1ebft t\u1eadt tim \u1edf chu\u1ed9t, m\u00f4 ph\u1ecfng c\u00e1c v\u1ea5n \u0111\u1ec1 m\u00e0 b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh \u1edf ng\u01b0\u1eddi m\u1eafc ph\u1ea3i. C\u1ee5 th\u1ec3, b\u00e0 nghi\u00ean c\u1ee9u c\u01a1 ch\u1ebf \u0111i\u1ec1u h\u00f2a c\u00e1c gen v\u00e0 protein trung gian g\u00e2y suy tim. B\u00e0 ph\u00e1t hi\u1ec7n ra r\u1eb1ng c\u00e1c chu\u1ed7i RNA nh\u1ecf - microRNA - l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u c\u1ee7a suy tim s\u1eafp x\u1ea3y ra. "Ch\u00fang t\u00f4i \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ed9t nh\u00f3m microRNA m\u00e0 ch\u00fang t\u00f4i cho l\u00e0 quan tr\u1ecdng", Reddy n\u00f3i. "Ch\u00fang cung c\u1ea5p cho ch\u00fang t\u00f4i manh m\u1ed1i v\u1ec1 th\u1eddi \u0111i\u1ec3m tim b\u1eaft \u0111\u1ea7u m\u1ea5t b\u00f9, s\u1edbm h\u01a1n nhi\u1ec1u so v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p hi\u1ec7n t\u1ea1i m\u00e0 ch\u00fang t\u00f4i \u0111ang s\u1eed d\u1ee5ng. Ch\u00fang t\u00f4i c\u00f3 d\u1eef li\u1ec7u ban \u0111\u1ea7u \u1edf tr\u1ebb em m\u1eafc b\u1ec7nh tim cho th\u1ea5y nh\u1eefng d\u1ea5u hi\u1ec7u sinh h\u1ecdc n\u00e0y l\u00e0 nh\u1eefng y\u1ebfu t\u1ed1 d\u1ef1 b\u00e1o h\u1eefu \u00edch v\u1ec1 s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh."<\/p>\n

Hi\u1ec7n b\u00e0 \u0111ang h\u1ee3p t\u00e1c v\u1edbi c\u00e1c trung t\u00e2m kh\u00e1c \u0111\u1ec3 xem li\u1ec7u c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc m\u00e1u m\u00e0 b\u00e0 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c \u1edf chu\u1ed9t c\u00f3 xu\u1ea5t hi\u1ec7n \u1edf tr\u1ebb em tr\u00ean quy m\u00f4 l\u1edbn h\u01a1n hay kh\u00f4ng. B\u00e0 cho bi\u1ebft, c\u00e1ch ti\u1ebfp c\u1eadn t\u1ed1t nh\u1ea5t l\u00e0 k\u1ebft h\u1ee3p c\u00e1c x\u00e9t nghi\u1ec7m d\u1ea5u \u1ea5n sinh h\u1ecdc m\u00e1u v\u1edbi c\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh hi\u1ec7n t\u1ea1i \u0111\u1ec3 \u0111\u01b0a ra b\u1ee9c tranh to\u00e0n di\u1ec7n nh\u1ea5t v\u1ec1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh tim b\u1ea9m sinh.<\/p>\n

Nghi\u00ean c\u1ee9u c\u1ee7a Reddy g\u1ea7n \u0111\u00e2y \u0111\u00e3 nh\u1eadn \u0111\u01b0\u1ee3c s\u1ef1 h\u1ed7 tr\u1ee3 l\u1edbn khi c\u00f4 \u0111\u01b0\u1ee3c trao Gi\u1ea3i th\u01b0\u1edfng Ph\u00e1t tri\u1ec3n S\u1ef1 nghi\u1ec7p Nghi\u00ean c\u1ee9u d\u00e0nh cho Nh\u00e0 khoa h\u1ecdc L\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c C\u1ed1 v\u1ea5n, m\u1ed9t kho\u1ea3n t\u00e0i tr\u1ee3 K08 t\u1eeb Vi\u1ec7n Y t\u1ebf Qu\u1ed1c gia (NIH), kho\u1ea3n t\u00e0i tr\u1ee3 n\u00e0y s\u1ebd t\u00e0i tr\u1ee3 cho c\u00f4ng tr\u00ecnh nghi\u00ean c\u1ee9u c\u1ee7a c\u00f4 v\u1ec1 c\u01a1 ch\u1ebf suy tim v\u00e0 s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u00e1c d\u1ea5u \u1ea5n sinh h\u1ecdc trong n\u0103m n\u0103m t\u1edbi. Trong nh\u1eefng n\u0103m \u0111\u1ea7u t\u1ea1i Stanford, Reddy \u0111\u00e3 d\u1ef1a v\u00e0o c\u00e1c ngu\u1ed3n t\u00e0i tr\u1ee3 t\u01b0 nh\u00e2n nh\u01b0 t\u00e0i tr\u1ee3 t\u1eeb Qu\u1ef9 Tim m\u1ea1ch Tr\u1ebb em v\u00e0 m\u1ed9t kho\u1ea3n t\u00e0i tr\u1ee3 cho CVICU \u0111\u1ec3 t\u00e0i tr\u1ee3 cho nghi\u00ean c\u1ee9u c\u1ee7a m\u00ecnh. Nh\u1eefng kho\u1ea3n t\u00e0i tr\u1ee3 ban \u0111\u1ea7u v\u00e0 t\u00e0i tr\u1ee3 qu\u00e0 t\u1eb7ng \u0111\u00f3 \u0111\u00e3 cho ph\u00e9p c\u00f4 thi\u1ebft l\u1eadp d\u1eef li\u1ec7u s\u01a1 b\u1ed9, m\u00e0 hi\u1ec7n c\u00f4 \u0111\u00e3 t\u1eadn d\u1ee5ng th\u00e0nh c\u00f4ng \u0111\u1ec3 nh\u1eadn \u0111\u01b0\u1ee3c kho\u1ea3n t\u00e0i tr\u1ee3 danh gi\u00e1 c\u1ee7a NIH. C\u00f4 chia s\u1ebb: "Ch\u00ednh ngu\u1ed3n t\u00e0i tr\u1ee3 t\u01b0 nh\u00e2n \u0111\u00e3 gi\u00fap t\u00f4i \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed hi\u1ec7n t\u1ea1i".<\/p>\n

Reddy chia s\u1ebb r\u1eb1ng b\u00e0 r\u1ea5t ng\u01b0\u1ee1ng m\u1ed9 s\u1ef1 s\u1eb5n l\u00f2ng th\u1eed nghi\u1ec7m nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb m\u1edbi c\u1ee7a b\u1ec7nh nh\u00e2n. "Nh\u1eefng \u0111\u1ee9a tr\u1ebb v\u00e0 gia \u0111\u00ecnh t\u00f4i g\u1eb7p th\u1eadt tuy\u1ec7t v\u1eddi", b\u00e0 n\u00f3i. "H\u1ecd sinh ra \u0111\u00e3 mang trong m\u00ecnh c\u0103n b\u1ec7nh n\u00e0y v\u00e0 s\u1ed1ng chung v\u1edbi n\u00f3 su\u1ed1t \u0111\u1eddi. \u0110\u01b0\u1ee3c ch\u0103m s\u00f3c h\u1ecd l\u00e0 m\u1ed9t vinh d\u1ef1, v\u00e0 s\u1ef1 ki\u00ean tr\u00ec c\u1ee7a h\u1ecd l\u00e0 \u0111\u1ed9ng l\u1ef1c \u0111\u1ec3 t\u00f4i t\u00ecm ra ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u1ed1t nh\u1ea5t c\u00f3 th\u1ec3."<\/p>\n

B\u00e0i vi\u1ebft n\u00e0y l\u1ea7n \u0111\u1ea7u ti\u00ean xu\u1ea5t hi\u1ec7n trong \u1ea5n b\u1ea3n M\u00f9a thu n\u0103m 2015 c\u1ee7a Tin t\u1ee9c tr\u1ebb em Lucile Packard<\/a>.<\/em><\/p>","protected":false},"excerpt":{"rendered":"

V\u1edbi m\u1ed9t s\u1ed1 nh\u00e0 nghi\u00ean c\u1ee9u s\u00e1ng t\u1ea1o nh\u1ea5t c\u1ea3 n\u01b0\u1edbc v\u1ec1 tim m\u1ea1ch nhi khoa, Trung t\u00e2m Tim m\u1ea1ch Tr\u1ebb em \u0111ang c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe v\u00e0 tinh th\u1ea7n c\u1ee7a tr\u1ebb em m\u1eafc b\u1ec7nh tim\u2026<\/p>","protected":false},"author":17,"featured_media":3720,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[148],"class_list":["post-3719","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-in-the-news","health_topic-heart"],"acf":[],"yoast_head":"\nThinking Outside the Box - 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