medical road high rise

Chapter 276 Erecting Vascular Bridge ([-])

Chapter 276 Erection of Vascular Bridge ([-])

As Qin Feng freed the intercostal arteries and found that the intercostal arteries were not damaged, Li Xuewen felt relieved.

When Qin Feng is operating, it seems to be reckless, but in fact it is thick and thin, and the force will be much softer when it is moved.

However, many doctors may cause rupture of blood vessels or tearing of the aorta if they use inappropriate force during dissociation, making it difficult to control.

"Doctor Xiao Qin has a bright future!" Li Xuewen said.

Although he did not understand vascular surgery, Qin Feng's hands did not shake during the peeling. Every step was done as if it had been calculated, rigorous and precise.

"The separation is over." Qin Feng said.

Li Xuewen's eyes widened, is this the separation?
The chief physician of vascular surgery is nothing more than that, right?Even the chief physician may not have the speed of Qin Feng, from incision to separation, it took less than 5 minutes.

Because the blood vessels inside each person's body still have subtle differences, other doctors must carefully observe before performing surgery to prevent differences, which will cause the scalpel to break the blood vessels and cause surgical accidents.

But Qin Feng, it seems that there is no need to observe, just one stroke, everything, one pull, and the field of surgery is separated.

"Doctor Li, we are ready to build a temporary vascular bridge." Qin Feng reminded.

Li Xuewen woke up from the daze. Since he met Qin Feng, Li Xuewen found that he was traveling more and more often.

Handed over the artificial blood vessel bridge that had been prepared, after Qin Feng took it, he made an incision on the upper descending aorta, put one end of the artificial blood vessel on it for splitting, and then repeated the previous step on the lower end.

Check the anastomosis, dredge the blood vessels, and there is no problem with blood circulation.

"Don't you check the contraction and tension changes of blood vessels?" Li Xuewen asked.

"Before placing it, I checked it." Qin Feng said.

"..."

Li Xuewen could only scold the pervert in his heart, watching Qin Feng continue to perform the resection of coarctation of the aorta.

The vascular bridges have been erected, and the resection is naturally not a problem.

Qin Feng took 4-0 sutures and used needle forceps to penetrate the patient's skin for intermittent sutures.

Qin Feng was particularly cautious when suturing. Patients with aortic coarctation often have abundant collateral circulation. Many blood vessels are very fragile, and they may be sutured if not careful.

In addition to suturing, Qin Feng couldn't get up quickly, and it took a full half an hour to ligate all the bleeding points.

Qin Feng breathed a sigh of relief and was about to announce that the operation was completed.

"No, there is something wrong with the descending aorta." Li Xuewen called out.

Qin Feng looked over and found that the inner wall of the descending aorta actually began to ooze blood, and the suture area was infiltrated with fine blood beads. There are not many blood beads at present, and it is obvious that they just appeared.

Li Xuewen was always responsible for dissociating the descending aorta and opening up the surgical field with tissue scissors, providing Qin Feng with a good surgical field space.

However, because of the distraction, when the tissue near the descending aorta was stripped, the surrounding blood vessels were cut.

"What's going on here? How could the descending aorta have blood vessels besides itself?" Li Xuewen was a little puzzled.

The amount of blood is not large, not the blood of the aorta, but the peripheral blood vessels.

But how could there be other blood vessels around an aorta?

"Abbott artery." Qin Feng said.

Li Xuewen was stunned for a moment, not understanding.

"Normal people don't have this artery, but sometimes it exists in parallel with aortic coarctation. Its existence is extremely special and it is a useless blood vessel." Qin Feng continued, "It can also be understood as a companion vessel to aortic coarctation. , but the appearance of this blood vessel is still a mystery.”

Abbott's artery usually has a short distance to the cranium, then crosses the carotid artery or directly passes through the posterior wall of the aortic arch to the head and neck.

This kind of blood vessel is a kind of blood vessel that even Baidu Encyclopedia can't explain. It is harmless to the human body, and it is not very useful. Instead, it will cause a lot of obstacles to the operation.

After Qin Feng explained, he pressed his fingers around the descending aorta, and faintly felt that there was another artery around it. Qin Feng blindly pressed to find the artery bleeding.

"Thrombin stops the bleeding."

The reason why sutures are not used to stop bleeding is because the artery is hidden too deep, there is no surgical field at all, and it is inconvenient to enter with a needle holder unless the incision is made larger.

However, if the incision is larger, it will not be good for the patient's recovery.

It is the best and most practical to use thrombin to stop bleeding. The blood vessels themselves have the protective function of blood coagulation, and it is enough to use thrombin to activate the blood coagulation mechanism of blood vessels.

Qin Feng took the thrombin with his left hand and sprinkled it on the pressed part with his right hand. After waiting for a few minutes, the warm feeling disappeared, and Qin Feng let go of his hand.

"Doctor Xiao Qin, thanks to you this time!" Li Xuewen said.

"Doctor Li, it's okay. This is what I should do. Let's control my blood pressure first." Qin Feng smiled.

It's just the hemostasis of a blood vessel, and it's not a broken blood vessel. If the blood vessel breaks, Qin Feng may still be in trouble.

Return to the position of the chief surgeon, and continue the resection and anastomosis of the coarctation of the descending aorta.

Blood pressure needs special attention. Although the left ventricular return method is not used, aortic coarctation surgery itself may have the risk of high blood pressure, and blood pressure control must always be paid attention to during surgery.

Qin Feng released all the accumulated air in the aortic wall cavity with the last injection, because of the rupture and exposure to the air, some air remained in it.

Although some doctors may not care, the air is not evacuated, thinking that the gas dissolves in the blood.

It's just that Qin Feng wants to avoid this risk. There have been some fatal precedents before. Due to gas embolism caused by residual air, the air and blood in the heart cavity are stirred to form a large amount of foam, which blocks the pulmonary artery and leads to sudden death.

After completing the final exhaust work, Qin Feng quickly sewed and tied the knot.

Li Xuewen nodded again and again. When anastomosing blood vessels, ordinary doctors may need to cross the two parts of the skin together, and the edge area may be thicker, which can ensure the accuracy of suturing, but the disadvantages are also obvious. It will further shorten the blood vessels, and even lead to the formation of dead space in some marginal vascular tissues.

Generally speaking, doctors choose this method in order to restore the blood flow and prevent the anastomotic stoma from collapsing.

But Qin Feng seems to be different. The anastomosis he sewed will not collapse. After the anastomosis is completed, the blood flows through the blood vessels smoothly, and the suture is very good.

If you don't look carefully, you can't tell which part has just been stitched.

After confirming again that there was no bleeding, Qin Feng blocked both ends of the descending aorta.

This blockage is to remove the vascular bridge. The function of the vascular bridge is only to add a blood flow channel to avoid high pressure due to blood congestion.

Soon after it was removed, the blood supply was restored again. Qin Feng and Li Xuewen breathed a sigh of relief after watching the descending aorta, which originally had coarctation of the aorta, transport blood normally.

(End of this chapter)