world famous doctor

Chapter 155 Aortic Dissection Surgery

Zhou Chen took a deep breath, suppressed the excitement in his heart, and stood still on the operating table.

He carefully reviewed the patient's medical records and various inspection reports in his mind.

Before the operation, the surgeon must have a comprehensive grasp of the patient's physical condition.

The equipment nurse has adjusted all the equipment and connected them to Qin Sanye.

The other surgical instruments were also neatly placed beside Zhou Chen.

"Use endotracheal intubation, intravenous inhalation compound anesthesia, let's incision from the middle of the chest!"

After everything was ready, Zhou Chen immediately gave the order.

Several anesthesiologists nodded and administered anesthesia to Mr. Qin.

In the operating room, it was extremely quiet.

There was only the sound of surgical instruments, the dripping ECG monitoring and the cold sound of the ventilator.

A holographic projection appeared in Zhou Chen's mind from the famous doctor system.

In the projection, the specific process of simulating aortic dissection surgery is played.

Moreover, the simulated patient is exactly the physical condition of the patient lying in the hospital bed.

This is a virtual patient whose physical condition is exactly the same as Qin Sanye's after being scanned and reconstructed by the famous doctor system.

There are virtual surgeons, and there are virtual patients.

Zhou Chen only needs to follow the gourd drawing, learn every step in the holographic projection, and just follow it.

Zhou Chen turned his attention to director Xie Zhiwen again, and talked about his previous preoperative plan.

Xie Zhiwen nodded in agreement, no problem.

Zhou Chen exhaled again and officially started the operation.

First, he makes an incision along the center of the patient's chest.

During the operation, the anterior superior mediastinal thymus and adipose tissue were resected, and the left innominate vein and three major branches of the arch were exposed free and cuffed for use.

In the first series of operation steps, Zhou Chen did it very clearly and methodically.

Looking at it, Deputy Director Qin Hongfei's eyes widened in an instant.

He was envious and jealous.

At first, he was still smiling coldly in his heart, and had an extremely dark thought.

He was very much looking forward to seeing Zhou Chen miss on the operating table and cause the patient to die.

In this way, Zhou Chen's spirit can also be dampened, lest he be arrogant and always put on a look of looking down on others.

But at this point in the operation, Zhou Chen was so skillful, completely indistinguishable from their chief physician Xie Zhiwen.

It was even calmer, more relaxed, and faster than Xie Zhiwen's surgery in the past.

Looking closely, there was not even a trace of sweat on Zhou Chen's forehead.

All expectations were temporarily emptied.

Qin Hongfei couldn't help feeling somewhat disappointed.

However, this is only the beginning of the operation, and the difficult part is yet to come.

Qin Hongfei frowned, ready to wait and see Zhou Chen's good show.

He narrowed his eyes, his complexion was gloomy and cold, and his pupils were full of coldness.

Such a major surgery cannot be done carelessly.

Zhou Chen looked serious. He established extracorporeal circulation through the femoral artery or right axillary artery + right atrium bypass, and the parallel circulation slowly cooled the whole body, and the head was protected by an ice cap.

At moderate and low temperature of 26°C, the ascending aorta was blocked and incised, and the left and right coronary artery openings at the root were perfused with cold-blooded myocardial protection solution, while ice chips were placed on the surface of the heart to cool down locally.

As the director of the cardiovascular department, Xie Zhiwen, even though he was Zhou Chen's medical assistant, he stood by and watched silently.

However, among so many medical workers, he is the most responsible. Even if Zhou Chen's operation failed, it was his suggestion.

Although Xie Zhiwen said that he was Zhou Chen's medical assistant, but to be honest, he was on the sidelines, playing more of a supervisory role.

First, it was supervised that any operation performed by Zhou Chen during the surgery must be done correctly without any mistakes.

Secondly, with his presence, he can also formulate the most accurate emergency plan for any emergencies during the operation.

During the cooling period of the patient's cardiopulmonary bypass, Zhou Chen was going to rebuild the aortic root for him.

At this time, during the operation, it was detected that:

The aorta was thin and closed, the coronary arteries were not involved, and the sinus tube structure was normal.

Zhou Chen nodded, and confidently performed artificial blood vessel replacement for the patient's ascending aorta.

The thrombus and part of the middle layer in the dissection are removed and the intima is peeled off, leaving the adventitia. The dissection on the aortic valve is trimmed and a felt piece is inserted. At the same time, a layer of felt piece is added to the inside and outside of the aortic wall to form a "five-meiji" structure.

The operation plan played by the famous doctor system in Zhou Chen's mind was extremely slow, precise and clear.

In the picture of the famous doctor system, the next operation steps are: use 4-0prolene suture to continuously and uniformly suture and reinforce the artificial blood vessel and the proximal and distal aorta, and spray biological glue around the anastomosis.

Zhou Chen was going to continue to operate on patients according to the gourd painting, but he suddenly found a loophole in this operation plan.

Because the condition of the patient Qin Sanye is different, he belongs to the kind of patients with moderate or above aortic insufficiency, but the coronary artery ostium and sinus tube structure are not affected by dissection.

Therefore, Zhou Chen took it upon himself to boldly switch to Wheat.

Director Xie Zhiwen frowned suddenly when he saw this.

However, he soon understood Zhou Chen's intentions.

He secretly smiled and nodded:

"This young man is really extraordinary."

Zhou Chen preserved the aortic sinus and end ring of the patient during the operation, performed aortic valve replacement first, used interrupted sutures, then replaced the ascending aorta, and performed an anastomosis of the proximal artificial blood vessel 1.0cm above the coronary artery opening.

In the famous doctor system, thousands of miles of various surgical plans are stored.

Zhou Chen's operation method changed accordingly, and the system of famous doctors also changed accordingly, and at the same time, he gave a variety of treatment methods.

If the patient involves the right coronary sinus and the non-coronary sinus due to dissection, it is necessary to perform root reconstruction, that is, the modified Wheat operation.

Alternatively, patients with dissection involving the aortic valve leaflets and coronary arteries undergo the Bentall procedure.

The ascending aorta and aortic end were replaced with a feline artificial blood vessel, and the opening of the left and right coronary arteries was anastomosed to the wall of the artificial blood vessel by buttons.

David’s operation, that is, aortic root reconstruction with the aortic end preserved, the sinus wall was resected and sinus reconstructed along the 0.3cm above the ring and parallel to the ring, and the sinus was reconstructed. The opening of the coronary artery is button-shaped, anastomosing to the appropriate position of the artificial blood vessel.

The other cardiology doctors present were stunned for a moment.

They have also worked in the Cardiovascular Department of the Municipal Hospital for many years. At this moment, even if they are allowed to go, they will definitely not be able to complete 1/10 of the surgical tasks that Zhou Chen completed.

One by one couldn't help but exclaim in their hearts:
Is this...an ordinary medical student who just graduated from medical school?
Is this... a Gui Peisheng who just arrived?

Why does he know so much?

He is only in his 20s?

According to this speed of development, before the age of 30, Zhou Chen's name would probably shock the medical circles across the country, and even the whole world.

It's scary to think about.

(End of this chapter)