Chapter 938: The Logo of Chinese Cardiology Department

Remember [New] in one second!     In the operating room.

Gu Xinyue began to anesthetize and lay the drape for the patient before the operation.

For this operation, the patient was anesthetized by general anesthesia.

After Gu Xinyue established intravenous access, Jin Miao began to puncture the right femoral vein.

On the side, Lu Chen performed transesophageal cardiac ultrasound.

This will be the first difficulty of this operation!

That is how to determine the atrial septum puncture point.

The patient's heart and structural morphology have undergone serious changes.

The normal atrial septum puncture point is not so obvious.

"Director, I... I didn't find the puncture point!"

Jin Miao's face was extremely ugly.

According to the routine operation, he couldn't touch the patient's atrial septum at all.

After the patient's overall heart changed, he couldn't find the puncture point at all.

On the side, Lu Chen was also constantly checking the patient's cardiac ultrasound morphology.

And in the system virtual space in his mind, he kept deducing the correct operation method.

Simulate various heart morphologies and try to puncture the atrial septum.

In a moment.

Lu Chen had made a decision in his heart.

"Jin Miao, first determine the puncture point position on the bi-bicaval section and the sax-short-axis section!"

"Okay, Director, got it!"

Hearing Lu Chen's voice, Jin Miao followed his instructions and began to operate.

"Afterwards, determine the distance between the puncture point and the mitral valve ring on the four-chamber heart section. The general puncture height is 4-4.5cm."

Jin Miao was slightly stunned when he heard this.

Director Lu could actually tell all the specific data.

Where did this data come from?

In addition to being surprised, Jin Miao's hands did not slow down at all.

With the help of fluoroscopy and Lu Chen's reminder, he finally successfully punctured the atrial septum.

"Okay, send the superstiff guidewire to the left atrium immediately."

Lu Chen's expression remained unchanged, and he continued to direct Jin Miao to operate.

After using the vascular sheath to dilate the femoral vein, Jin Miao introduced the guidewire into the 24F guide sheath across the atrial septum to the left atrium.

Through the 24F guide sheath, the mitral valve Mitraclip valve clip system (CDS) was delivered.

Under the guidance of transesophageal ultrasound, Jin Miao successfully reached the target position of the mitral valve and captured the flail valve leaflets.

"Director, the patient's blood pressure has dropped!"

Suddenly, Gu Xinyue shouted at the side.

"Pause the operation, pump in dopamine and norepinephrine!"

Lu Chen was slightly startled and commanded in an orderly manner.

The most worried event finally happened!

"Increase the pump speed immediately!"

At the same time, he asked the nurse to push the iabp and ecmo machines over.

These two machines are ready, and if the blood pressure cannot be maintained, they are ready for further operation at any time.

The bedside ECG monitor is measuring the patient's blood pressure intermittently.

Lu Chen monitors his vital signs at all times.

"Do you need iabp and ecmo?"

Jin Miao asked nervously at the side.

"No hurry, suspend the operation first and observe it." Lu Chen shook his head slightly, "If the blood pressure can be stabilized, iabp and ecmo will not be needed."

"Okay!"

Inside and outside the catheter room.

Everyone stared at the changes in blood pressure.

The focus of this operation is not only the difficulty of the operation.

More importantly, it is to get the patient off the stage successfully.

If the patient cannot tolerate the operation, then all efforts will be in vain.

Five minutes later.

The patient's blood pressure finally stabilized at hg.

"Okay, the operation continues." Lu Chen said, "I will perform esophageal ultrasound first to check the position of the valve, and you will operate according to my instructions."

Jin Miao and Gu Xinyue nodded slightly.

Lu Chen began to perform esophageal ultrasound.

He kept adjusting the position and carefully observed the position and shape of the valve.

"Okay, the position is OK, Jin Miao, you can release the valve."

Jin Miao nodded, with a hint of surprise on his face, "Yeah!"

After repeated confirmation by esophageal ultrasound.

Jin Miao implanted a MitraClipXTR mitral valve clip in the mitral valve A2/P2 deviation 1 area.

"Wait a minute, let me take a look at the position of the valve leaflet."

At this time, it is the second difficulty of the operation, how to adjust the position of the valve clip.

Lu Chen adjusted the position of the valve clip on the x-section.

"Mainly locate the A2/P2 area where Pisia is most obvious!" He said to Jin Miao beside him.

"Got it!"

Jin Miao responded, and then began to slowly locate with the help of Lu Chen's operation.

Lu Chen continued: "Adjust the axial direction of the clip on the mitral junction joint section and the LVOT section, and observe the position and area of ​​the clip on the 3D section at the same time."

Under Lu Chen's guidance, Jin Miao's technique has become more and more proficient from being unfamiliar at the beginning.

An esophageal ultrasound was performed again, and the examination showed that the valve clip was in a good position and the valve leaflets were firmly captured.

However, Lu Chen did not relax at this moment.

He slowly said: "Capture the anterior and posterior leaflets at the A2/P2 bias 1 area, and gradually close the valve clip."

"Good!" Jin Miao replied while operating, "The valve clip is in a good position, and the axial direction and position are ideal!"

TEE showed that the mitral regurgitation was significantly reduced to a trace amount.

The 3D perspective showed that the tissue bridge was continuous and complete, and the valve leaflet capture was stable.

Lu Chen smiled and nodded, finally relieved, and said: "The average transvalvular pressure of the mitral valve is 2mmhg, and multiple sections confirm that the clamping tissue is sufficient. The Doppler waveform of the left upper pulmonary vein has returned to normal from the reverse direction."

Jin Miao also breathed a sigh of relief when she heard Lu Chen's feedback.

The delivery of the valve has been completed, which has already indicated that the operation has been successful for the most part.

The immediate ultrasound after the operation showed that the mitral valve regurgitation has decreased to a trace amount.

The color blood flow indicates a trace amount of valve regurgitation, and the average transvalvular pressure difference is 3mmhg.

The blood flow spectrum of the left upper pulmonary vein has returned to the positive direction after reexamination, and the surgical effect is ideal.

"Jin Miao, start to gradually release the valve clip system and withdraw it from the body!"

"Okay!"

Although this last step is simple, it is also very important.

Jin Miao is meticulous in every step, afraid of making the slightest mistake.

"Take your time, don't rush." ​​Lu Chen instructed, "The most important steps have been completed, don't fail here."

"Yeah."

Jin Miao nodded slightly.

With the help of Gu Xinyue, he slowly released the valve clip system and successfully withdrew it from the body.

At this point, the whole operation was over!

In the operating room of the catheter room.

Jin Miao and Gu Xinyue were both filled with joy. UU Reading ｗww.ｕukanshｕ.net

Lu Chen also had a smile on his face.

Although they could suppress their inner excitement, the people in the Department of Cardiology of the Fifth Hospital of Magic City outside the catheter room could not calm down.

Everyone began to applaud unconsciously.

The completion of this operation means that the Fifth Hospital of Magic City has entered the ranks of the top hospitals in China.

From TAVR, electrophysiology, to transcatheter tricuspid valve surgery and TEER.

In the Fifth Hospital of Magic City, every operation performed by Lu Chen is the top domestic and first-class foreign surgical procedure.

Many Mayo people who are of the same period as Lu Chen are watching Lu Chen's live broadcast at this time.

Even in the Mayo of the United States, Professor Debed was amazed.

"Lu is indeed worthy of his name!"

Debde sighed in his heart.

In his heart, the cardiology department of the Fifth Hospital of the Magic City in China has gradually become the symbol of cardiology in China.