I can see health

Chapter 807 Perivalvular Leakage!
Guanghai No. [-] Hospital, Cardiology Cath Lab.

The first TAVR operation in Wang Qingfeng's life is underway.

Wang Qingfeng completed the puncture, catheter entry, and valve push in an orderly manner.

Of course, all of this is due to Wang Qingfeng's several sessions of study in the TAVR class.

Let him grow rapidly from a TAVR novice to what he is today.

When the artificial valve was stably implanted in the patient's body, Wang Qingfeng breathed a sigh of relief and beamed with joy.

The successful completion of this operation marks that he has officially become a TAVR operator from now on.

Next, papers, scientific research, and funds came one after another.

Wang Qingfeng even thought of the picture of himself after he became famous.

……

On the side, Tang Zhanwei nodded with satisfaction.

The attending doctor in front of me named Wang Qingfeng, all kinds of methods and operations can be regarded as good.

If he can be trained well, he will definitely be an important member of the surgical team in the future.

"Xiao Wang, it's well done!" Tang Zhanwei nodded towards Wang Qingfeng with a smile, "After the valve is inserted, the next thing is to do a postoperative ultrasound. If there is no problem, you can step down."

"Ok."

Wang Qingfeng immediately rushed forward to push the heart ultrasound machine.

In a successful TAVR operation, there will be significant changes in the flow rate, size, and pressure of the valve orifice before and after the operation.

Ultrasound examination and evaluation of the heart can preliminarily judge whether the operation is successful or not.

Tang Zhanwei picked up the surgical probe, smeared gel on it, and began to perform the final echocardiographic examination on the patient on the hospital bed.

However, when the ultrasound probe was placed on the patient's heart, after just a few glances, Tang Zhanwei felt something was wrong.

Imaging after the implantation of the self-expanding valve showed that because the valve was implanted too high, it completely exceeded the annulus structure, causing the aortic blood to flow back into the heart chamber through the lower edge of the valve!
"The position of the valve is a bit too high!"

Tang Zhanwei said in a deep voice.

"Ah? High... High?" Wang Qingfeng looked confused, "No, I was clearly facing each other just now, so I definitely can't be high!"

"Xiao Wang, take a closer look yourself, the interventional valve is not fully attached to the native aortic root!" Tang Zhanwei pointed to the image.

Wang Qingfeng looked intently.

Sure enough, an abnormality was found.

Because the position of the valve is too high, it is not tightly combined with the aortic root.

"Director, what...how should I do?" Wang Qingfeng asked nervously, "Can it be remedied?"

Tang Zhanwei looked serious, and said in a deep voice: "I just checked with an ultrasound, it should be a paravalvular leak!"

Paravalvular leakage, that is, the valve is not fully adhered, resulting in blood regurgitation around the valve, and a large amount of regurgitation will seriously affect the patient's prognosis.

"Periovalvular leakage?" Wang Qingfeng's face turned pale when he heard this.

Paravalvular leak is one of the most serious complications of TAVR surgery.

This kind of problem appeared in the first surgery, so his future surgery path...

"The patient's hemodynamics is still relatively stable. Temporarily do an aortic root angiography to evaluate the regurgitation flow of the paravalvular leak." Tang Zhanwei immediately took remedial measures, "If there is only a small amount of regurgitation, it's okay, we don't have to deal with it for the time being .If it's medium to high volume..."

Tang Zhanwei didn't speak, but Wang Qingfeng already understood.

If moderate to large amounts of reflux really occur, then the next trouble will be inevitable!
……

Active root radiography is a relatively simple operation.

Tang Zhanwei immediately completed the angiography, and the angiography image projection visualized the proximal aorta and the entire left ventricle.

"Not too good, this is at least moderate reflux!" Tang Zhanwei said slowly.

As a result of the radiography, Wang Qingfeng was immediately sentenced to "death".

Wang Qingfeng stared blankly at the result in front of him, feeling dazed and self-blaming.

Tang Zhanwei glanced at Wang Qingfeng, "If you are still immersed in self-blame and unable to complete the next operation, then step down, call Yang Shuang over, and let him perform the stage."

Wang Qingfeng came back to his senses this time, and immediately stood beside Tang Zhanwei.

Because of the poor position of the valve, Tang Zhanwei chose the grabber to pull the valve.

"Xiao Wang, if you can use the grabber to lower the position of the valve, it is possible to save your operation." Tang Zhanwei said slowly from the side.

"Director, thank you, I will trouble you next." Wang Qingfeng stood beside Tang Zhanwei, staring at his operation very nervously.

Tang Zhanwei took a deep breath.

When he was studying in Kyoto, he also encountered this kind of situation. In the end, the surgeon successfully saved the operation with a catcher.

Recalling the operation in memory, Tang Zhanwei slowly pushed in the catcher and began to try to adjust the position of the valve.

……

10 minutes passed in a flash.

On Tang Zhanwei's forehead, there was already fine sweat.

This kind of delicate work is very difficult to master. Once something goes wrong, it is likely to affect the blood vessels.

"No!" Tang Zhanwei finally stopped his hands, "It is difficult to adjust the position of the patient's valve with the catcher."

"What... what should I do?" Wang Qingfeng was extremely anxious, "Should I switch to surgery?"

"This patient came to undergo TAVR surgery because he couldn't tolerate the thoracotomy. Do you want him to have the thoracotomy now?" Tang Zhanwei frowned, very dissatisfied with Wang Qingfeng's opinion.

Wang Qingfeng lowered his head and remained silent.

"There is another way, let's do balloon expansion."

Tang Zhanwei said slowly.

However, he has no confidence at all right now.

Balloon post-dilatation is mainly used for patients with valve incompetence.

However, the patients on the stage now mainly suffer from paravalvular leakage because the position of the valve is too high.

But now there is no other way but to try.

Tang Zhanwei pushed in the balloon and slowly expanded the balloon, trying to see if he could adjust the valve to the correct position.

……

Another 10 minutes passed.

Tang Zhanwei tried balloon dilation, but the paravalvular leak was still not resolved.

If the operation is stopped like this, it can only be regarded as a failed operation!
Once the family members of the patients are investigated, Guanghai No. [-] Hospital will definitely take great responsibility.

"Xiao Wang, hurry up and invite Director Zuo from the first district of your heart!" Tang Zhanwei said in a deep voice, "Let him come over and think of a way!"

"Okay!" Wang Qingfeng nodded, but he was slandering inwardly.

It's only been a few months for Zuo Yaoqun in the heart area to perform TAVR surgery?

Invite him over for wool?
However, Wang Qingfeng could only silently carry out Tang Zhanwei's orders.

He walked out of the cath lab and made a phone call to Director Zuo of the First Division of the Heart.

On the phone, Wang Qingfeng briefly explained the situation and invited Zuo Yaoqun to come for consultation.

After hanging up the phone, Wang Qingfeng was about to go back to the cath lab.

As soon as he reached the door, he stopped, took out his mobile phone, opened the address book, and landed on a strange but familiar phone.

Gritting his teeth, Wang Qingfeng mustered up his courage and made the call.

(End of this chapter)