Chapter 639: Guidewire Resistance

This is Lu Chen's second surgery in Shanghai.

He recalled all the steps of atrial premature ablation in his mind, puncture, mapping, ablation!

The difficulty of atrial premature ablation lies in mapping!

The surgeon needs to map all possible areas of the atrium, try to find the origin of the atrial premature ablation, and then perform ablation.

Traditional point-by-point mapping requires the ablation catheter to sweep the entire atrium. Mapping 200-300 points takes at least 2 hours, and the surgeon's catheter operation is demanding.

Lu Chen decided to use the latest high-density electrophysiological anatomical mapping technology to complete the ablation of this atrial premature ablation.

"Let's get started."

Lu Chen stood in front of the operating table, with gloves and a hat already changed.

Normally, the assistant needs to prepare the surgical area for draping and disinfection.

However, this time the assistant was the mentor Zhang Shuqing, and Lu Chen really didn't dare to let him operate.

So, Lu Chen silently disinfected the patient's surgical area.

...

This time, Lu Chen chose the right femoral vein as the puncture path.

Enter from the femoral vein, through the inferior vena cava → right atrium → puncture the atrial septum, and finally reach the left atrium.

Lu Chen's puncture technique is the same as always.

Fast and accurate!

In the blink of an eye, Lu Chen's femoral vein puncture was completed.

The guidewire passed smoothly!

Zhang Shuqing, who was standing by, was the most intuitive to feel Lu Chen's puncture speed.

Too fast!

He really just blinked his eyes...

Lu Chen succeeded in puncturing and implanted the guidewire.

The doctors watching outside the catheter room all showed surprised expressions on their faces.

Judging from this puncture technique, Lu Chen's electrophysiological technology must be considered first-class.

Without many years of surgical experience, it is impossible to have such proficiency.

However, everyone was very curious.

With Lu Chen's age, how could he achieve such a high level of proficiency in a maximum of one or two years of interventional certification?

It was also the first time that Director Liu Jun saw Lu Chen's surgical operation.

"This young man is really good." Liu Jun said to Zou Yi on the side, "Vascular puncture is the starting point and the key point of our cardiac interventional surgery!"

"Lu Chen's puncture level is considered top-notch in any hospital in the country."

Zou Yi nodded slightly.

He was an outsider, watching the excitement, and didn't know the significance of this puncture.

Although Xiao Shikang praised Lu Chen so much, he had never seen such a young surgeon, and he was still a little worried.

Now he heard Liu Jun praise Lu Chen so much, he felt a little relieved.

...

In the catheter room.

Lu Chen gently pinched the guide wire and let it follow the blood vessels and slowly move towards the left atrium.

Suddenly, Lu Chen frowned.

He felt a little resistance!

"It shouldn't be?!" Lu Chen murmured, "It's just reached the inferior vena cava, how could there be resistance?"

Zhang Shuqing also saw Lu Chen's action paused for a moment, and asked in confusion: "What's wrong?"

"There is resistance!" Lu Chen frowned softly.

"Is there resistance now?" Zhang Shuqing was also very surprised.

The guidewire had just entered the femoral vein and reached the inferior vena cava at most!

At this time, there was no resistance.

Could it be that Lu Chen's operation was wrong?

Zhang Shuqing glanced at Lu Chen.

Everyone was watching outside, and he couldn't question Lu Chen like that.

Unexpectedly, Lu Chen said, "Teacher, why don't you try it?"

Zhang Shuqing didn't expect Lu Chen to be so calm.

Isn't he afraid that if he succeeds, everyone outside will see it?

Zhang Shuqing pondered for a moment, then nodded.

Patient safety comes first!

Lu Chen slightly turned sideways and gave up his position.

Gu Xi

...

Outside the catheter room.

Everyone saw the abnormality on the operating table.

"What's going on? Why did Lu Chen give way to Director Zhang?"

"I saw Lu Chen pause just now. Could it be that the guidewire can't pass through?"

"Impossible! How far has the guidewire reached? It's impossible that it can't pass through!"

"Hey, do you think that this guy's level is not up to par, so Director Zhang was asked to come forward temporarily?"

The behavior of Lu Chen and Zhang Shuqing aroused everyone's suspicion.

Zou Yi frowned and looked at Liu Jun, "Director Liu, what's going on?"

Liu Jun also frowned deeply. It was the first time he saw that when the puncture guidewire was inserted, it was necessary to change people.

There is only one possibility in this situation, that is, there is trouble!

Otherwise, it is impossible to change people easily.

"Director Zou, let's take a look. I don't understand it yet." Liu Jun laughed.

He was thinking about the possibility of this happening.

Zou Yi could only calm down and watch the changes in the operating room silently.

...

Zhang Shuqing took over Lu Chen's position and began to insert the guidewire.

As soon as he started, his face changed slightly. There was resistance!

And this resistance was not small.

How could it be?

The guidewire just reached the inferior vena cava and encountered resistance!

The blood vessels of the human body are very fragile, and brute force cannot be used, otherwise the blood vessels may be damaged.

If the blood vessels rupture or dissection occurs, it will be more trouble than gain.

So Zhang Shuqing did not dare to make any unusual movements!

"I'll try the left side." Zhang Shuqing said in a deep voice.

They just punctured the right femoral vein, and now they encountered resistance, so they could only try the left side.

"Okay." Lu Chen nodded slightly.

However, what they didn't expect was that.

The left femoral vein route, despite repeated adjustments to the angle, the guidewire still couldn't pass!

Now the blood vessels on both sides have encountered the same problem.

This situation is extremely rare, at least Zhang Shuqing has never encountered it before.

Sweat slowly broke out on his forehead.

This patient's identity is special, and his mentality is a little uneasy now.

If there is any problem, his future promotion will be difficult!

Zhang Shuqing turned his head to look at Lu Chen, and found that his student was still calm.

"Teacher, why don't we do angiography to see." Lu Chen suddenly said, "If there is resistance to the guidewire passing, it can only mean that the blood vessels may be narrowed or deformed!"

Through angiography, the specific situation of the blood vessels can be seen clearly.

"Well, that makes sense." Zhang Shuqing thought for a while, "Okay, then you do the angiography."

The guidewire cannot pass, but the contrast agent can pass.

This is also the only way at present!

Zhang Shuqing made way.

Lu Chen immediately stepped forward, took over the teacher's position, and began to perform angiography.

…

Seeing the two people's actions, the people outside also reacted.

"If I'm not mistaken, they just punctured the left side again?"

"I think it's probably because the guidewire is not passing smoothly and is blocked!"

"They switched positions again..."

"What is Lu Chen doing? Did he decide to do angiography first?"

As the angiography image appeared on the screen in front of the operating table.

Everyone inside and outside the catheter room was stunned.

The patient's azygos vein merges into the superior vena cava and then goes to the right atrium, which means that the liver segment of the patient's inferior vena cava entering the atrium is missing!

The inferior vena cava goes around the heart through the azygos vein and finally enters the right atrium.

In layman's terms, part of the blood vessels in the patient's normal path to the atrium do not exist!

.