Chapter 803: Perivalvular Leakage!

Guanghai First Hospital, Cardiology Department Catheterization Room.

Wang Qingfeng's first TAVR surgery in his life is in progress.

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

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

He has grown rapidly from a TAVR novice to what he is now.

When the artificial valve was firmly implanted in the patient's body, Wang Qingfeng breathed a sigh of relief and was overjoyed.

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

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

Wang Qingfeng even thought of the scene after he became successful.

...

On the side, Tang Zhanwei nodded with satisfaction.

The attending physician in front of him, Wang Qingfeng, has all kinds of techniques and operations.

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

"Xiao Wang, you did a good job!" Tang Zhanwei smiled and nodded at Wang Qingfeng, "After the valve is delivered, we will do a postoperative ultrasound. If there is no problem, you can leave the stage."

"Okay."

Wang Qingfeng immediately went to push the cardiac ultrasound machine excitedly.

A successful TAVR operation will have significant changes in the flow rate, size, and pressure of the valve orifice before and after the operation.

Through the examination and evaluation of cardiac ultrasound, it is possible to preliminarily judge whether the operation is successful or not.

Tang Zhanwei picked up the surgical probe, applied the coupling agent, and began to perform the final cardiac ultrasound examination on the patient on the bed.

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

The images after the self-expanding valve was implanted showed that the valve was implanted too high, completely beyond the valve ring structure, causing the aortic blood to flow back to the heart cavity 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? It's...high?" Wang Qingfeng was confused. "No, I was just looking at it very neatly, it must not be high!"

"Xiao Wang, take a closer look. The interventional valve is not completely attached to the root of the native aorta!" Tang Zhanwei pointed to the image.

Wang Qingfeng looked at it intently.

Sure enough, he found an abnormality.

Because the valve is located too high, it is not tightly combined with the root of the aorta.

"Director, what should I do?" Wang Qingfeng said nervously, "Can it be remedied?"

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

Paravalvular leak means that the valve is not completely attached, resulting in blood reflux around it. A large amount of reflux will seriously affect the patient's prognosis.

"Valve... paravalvular leak?" Wang Qingfeng's face turned pale when he heard it.

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

This problem occurred in the first operation, so what will happen to him in the future...

"The patient's hemodynamics are relatively stable. We will temporarily perform an aortic root angiography to evaluate the reflux volume of the paravalvular leak." Tang Zhanwei immediately took remedial measures, "If it is only a small amount of reflux, it's okay, we can temporarily not deal with it. If it is moderate to large..."

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

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

...

Angiography of the aortic root 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 good, this is at least moderate reflux!" Tang Zhanwei said slowly.

The results of the angiography sentenced Wang Qingfeng to "death" at once.

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

Tang Zhanwei glanced at Wang Qingfeng, "If you are still immersed in self-blame and cannot complete the next operation, then step down and call Yang Shuang over to assist."

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

Because the valve position was not good, Tang Zhanwei chose to pull the valve with a grabber.

"Xiao Wang, if you can use a grabber to pull the valve position down, it is possible to save your operation." Tang Zhanwei said slowly on the side.

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

Tang Zhanwei took a deep breath.

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

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

...

Ten minutes passed in a flash.

Tang Zhanwei's forehead was already covered with sweat.

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

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

"This... what should I do?" Wang Qingfeng was extremely anxious, "Transfer to the surgery department for thoracotomy?"

"This patient came to do tavr surgery because he could not tolerate thoracotomy. You let him do thoracotomy now?" Tang Zhanwei frowned, very dissatisfied with Wang Qingfeng's opinion.

Wang Qingfeng lowered his head and said nothing.

"There is another way, do balloon dilation."

Tang Zhanwei said slowly.

However, he has no confidence at all now.

Balloon dilatation is mainly used for patients with incomplete valvular expansion.

But the patient on the stage now mainly has paravalvular leakage because the valve is too high.

But now there is no other way, so I can only try it.

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

...

Ten minutes passed again.

Tang Zhanwei tried the balloon dilatation method, but still did not solve the paravalvular leakage.

If the operation is stopped like this, it can only be regarded as a failed operation!

Once the patient's family members pursue it, Guanghai First Hospital will definitely have a great responsibility.

"Xiao Wang, UU reading books www.uukanshu.net you quickly invite Director Zuo of the first area of ​​​​cardiac surgery!" Tang Zhanwei said in a deep voice, "Let him come and think of a solution!"

"Okay!" Wang Qingfeng nodded, but he was complaining in his heart.

Zuo Yaoqun of the first area of ​​​​cardiac surgery has only been doing tavr surgery for a few months?

What's the point of inviting him here?

However, Wang Qingfeng could only silently carry out Tang Zhanwei's order.

He walked out of the catheterization room and called Director Zuo of the First Cardiology Department.

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

After hanging up the phone, Wang Qingfeng prepared to go back to the catheterization room.

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

Wang Qingfeng gritted his teeth, still plucked up the courage, and made this call. 　　16377/10556908