Chapter 866 Ablation of Scar Area
Outside the duct.
The top doctors from the Kyoto Affiliated Hospital all looked very nervous.
"Director Yang, do you want to cut off the live broadcast signal?" An attending doctor hurriedly ran to Yang Feng's side.
"Okay, cut it off first!"
Yang Feng nodded, his face solemn.
If a patient has any problems and they are broadcast live, this will not be good for the reputation of Kyoto First Affiliated Hospital.
Just as the chief doctor from China wanted to return and informed the Information Department to cut off the live broadcast signal source, Shen Wenguang on the side spoke up.
"Director Yang, wait a moment."
At this time, there was no trace of nervousness or worry on Shen Wenguang's face.
"Director Shen, this situation is not good. If we don't cut off the signal source, what if something happens..." Yang Feng gritted his teeth and looked serious. He put his hands behind his back and clenched his fists uncontrollably.
"Don't worry, Lu Chen can handle it well." Shen Wenguang still looked calm and calm, "After this kind of ventricular tachycardia ablation induces the patient's ventricular tachycardia, ventricular fibrillation is inevitable, even if it causes Even if I do it, there is no way to avoid this situation 100%.”
"That's okay."
Yang Feng saw that Mayo's director Shen Wenguang had said this and was so calm.
What else could he say?
I could only call the attending doctor back, "Wait a minute, don't cut off the signal source yet."
After thinking about it, he also gave a grand reason for coronary artery disease, "Let all the viewers take a look at the rescue. Don't think that the operation is all smooth sailing."
The attending doctor was a little confused.
Director Yang Feng’s transformation is so big!
However, as a low-level minion, he could only do what Director Yang Feng said.
…
The scene of the live broadcast of the rescue really shocked the audience.
However, after the brief surprise, they were even more amazed by Lu Chen's calm handling.
Everyone knows that ablation of ventricular tachycardia is very likely to induce ventricular fibrillation.
But how to deal with the emergence of ventricular fibrillation is another matter.
As a magician, Lu Chen's extreme calmness was displayed in front of everyone without reservation.
Cardiopulmonary resuscitation, defibrillation, and intravenous cardiac resuscitation drugs.
Everyone went from being suspicious at the beginning to remaining silent now.
Everyone was staring closely at the scene in the live broadcast room of the surgery, unwilling to move their eyes at all.
…
Finally, after the third defibrillation, the patient’s ventricular fibrillation finally recovered!
"Sinus rhythm has been restored!" Xiao Shikang took a deep breath and said to Lu Chen, "Do you want to continue the operation?"
Lu Chen nodded without hesitation: "Continue!"
Ventricular fibrillation is inevitable!
Even if the operation is stopped this time, who can guarantee that ventricular fibrillation will not occur during the next operation?
Without surgery, this young male patient would most likely continue to suffer from the pain of electric shocks!
This is a situation that no one wants to see.
"Okay!" Xiao Shikang didn't say much. He just looked at Lu Chen blankly, seeming to recall the time when Lu Chen had surgery in Kyoto.
Back then, Lu Chen was still quite young.
As soon as I saw him, he had already become calm.
After the patient's ventricular fibrillation recovered, Lu Chen immediately started mapping the ventricular tachycardia.
"The distance and direction between the bipolar mapping catheter and the contact tissue will have an impact on the qualitative and quantitative signals, which will in turn affect the results of matrix mapping based on voltage and abnormal potential."
Lu Chen said as he spoke.
What he said was naturally to Xiao Shikang beside him and the audience in the live broadcast room.
"In addition, the patient has dilated cardiomyopathy and myocardial remodeling, so there are many scars inside the heart. The degree of delay of the local electric potential in the scar depends largely on its anatomical location."
These tips are all knowledge points that cannot be accessed in textbooks or by ordinary practitioners.
Lu Chen explained it to everyone without reservation.
Many of the people in the live broadcast room are knowledgeable.
Many people immediately sat up straight and watched the live broadcast more seriously.
…
Twenty minutes later, Lu Chen stopped mapping in his hands. He turned and looked at Xiao Shikang aside, "The mapping is done."
Xiao Shikang was slightly startled, the mapping was so fast!
Normal mapping, even if it goes smoothly, will take at least half an hour.
Lu Chen's speed was entirely due to his familiarity with the anatomical location and electrophysiology of the heart.
This ability can be improved not just by simply increasing the number of surgeries.
Rather, it requires personal perception and understanding of the surgery.
However, Lu Chen's expression did not relax at all.
Because the mapping is over, the next step is the more important ablation!
The patient has dilated cardiomyopathy.
In dilated cardiomyopathy, the heart gradually enlarges to compensate for cardiac insufficiency.
In medicine, this enlargement of the heart is called "ventricular remodeling."
Myocardial remodeling means there are many scars on the heart muscle.
The existence of scar areas greatly affects the progress of ablation.
Xiao Shikang wanted to see how doctors at Mayo handled ablation of scar areas.
At this time, Lu Chen had prepared the ablation catheter and said in a deep voice: "The mechanism of ventricular tachycardia in the scar area is mostly related to the diseased tissue near the valve annulus and reentry mediated by scar tissue!"
Xiao Shikang thought for a while and asked, "How can it be accurately ablated?"
If the ablation is not done carefully enough, VT may recur.
If the scope of ablation is too large, it is likely to damage the heart muscle.
This is the most challenging part of ablation for the surgeon. How to grasp the degree is the key to the success of the operation!
Lu Chen put the ablation catheter in his hand into the patient's heart along the channel, and smiled: "This is to formulate different ablation methods according to the individual's differences."
"In general, we can divide each part into isthmus, outer ring, inner ring, and bystander according to the role of each part in the reentry loop. The isthmus can be subdivided into the entrance, exit and central isthmus area. During the operation, the scar area and the isthmus-related area are determined by the low voltage area, and the key isthmus is found by dragging mapping."
"For non-ischemic heart disease ventricular tachycardia, due to the complex pathogenesis, endocardial and epicardial combined ablation is often required."
The experience of these operations was not imagined by Lu Chen out of thin air.
Instead, it was extracted from the surgical cases of predecessors after hundreds of thousands of surgical experiences.
Lu Chen's biggest help is the system virtual space.
He has countless opportunities for trial and error!
Every failure is Lu Chen's most valuable experience.
The surgical experience he has accumulated so far is something that many surgeons cannot comprehend in their lifetime.
On the side, Xiao Shikang listened to Lu Chen's explanation, his eyes becoming brighter and brighter.
If the previous Lu Chen was only better at surgery, but now, both his surgical operation and knowledge reserve have completely surpassed his cognitive scope.
Live surgery room.
The audience also heard Lu Chen's explanation.
Those who have been watching the live broadcast are all serious and understand the electrophysiological interventional surgery in the Department of Cardiology.
Everyone has learned more or less experience from Lu Chen.
The number of viewers watching the live broadcast has increased, but the barrage has decreased.
Everyone is immersed in Lu Chen's electrophysiological surgery, which is like an art.
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