Chapter 941 Severe Plaques
Remember [new] in one second! Time cannot withstand memories.
Many things have passed away in the long river of time.
Lu Chen spent a week "inspecting" Beijing.
During this period of time, it can be regarded as a long vacation.
Lu Chen was too busy before!
Clinical and scientific research matters are too complicated.
Take advantage of this time to take a proper rest.
In Jinghua, Lu Chen discussed with Li Yao the matter of outstanding young people and asked what precautions should be taken.
On the other hand, he helped the interventional room of Jinghua Second Hospital to explain the key points of new surgeries such as TAVR.
With Lu Chen's current ability, this is a big opportunity for the entire Jinghua Second Academy.
Many doctors at Jinghua Second Hospital, under the leadership of Lu Chen and Gu Xinyue, have made great progress in interventional surgery.
A week later.
Lu Chen, Ke Yue and Gu Xinyue successfully completed their mission and returned to the Fifth Academy of Magic City.
The trip to Beijing is officially over.
Back at the hospital, Lu Chen continued to work on matters related to the "Outstanding Youth" application.
He wants to work hard to win the "Outstanding Youth"!
Ke Yue continues to handle the work of the national key acting laboratory.
Gu Xinyue also returned to clinical practice and continued her surgical career.
At this time, it had been less than two months since Lu Chen applied for the final Outstanding Youth Award.
…
Based on Lu Chen's current conditions, he has actually passed the "Outstanding Youth" review.
But, just like Ke Yue said.
The assessment of outstanding youth is no longer just an academic issue.
It also involves the medical background and human resources behind each person.
This is no longer an academic endeavor!
It’s even more about the resources behind everyone!
When he was in Beijing, Li Yao also talked about these things with him.
But the stubbornness in Lu Chen's character made him not intend to go through a backdoor relationship.
On the other hand, Lu Chen started from scratch.
If you want to compete with those second-generation students for resources, you will definitely not be able to win!
Except this way.
Lu Chen decided to use his own abilities to fight against the "outstanding youth" selection system.
If your ability is one or two levels higher than your opponent, the result may be different!
“If one new type of project doesn’t work, then two!”
Lu Chen murmured to himself.
He currently has a project.
It is about transcatheter mitral valve replacement surgery in patients after acute myocardial infarction.
Beyond that, he's looking for another project!
…
After Lu Chen's search and thinking.
Hard work pays off!
He found another way and did not continue to look for projects in valve intervention.
After all, the valve project was almost finished by him.
Except for valve intervention.
Among all surgeries in the cardiology department, coronary intervention is still one of the most common.
The idea for Lu Chen's new project this time came from a patient's coronary intervention surgery.
…
No. 5 Hospital in Magic City, outpatient building.
Nowadays, Director Lu Chen’s consultation number is hard to find!
In the hands of some scalpers, Lu Chen's consultation and registration fee even exceeded 700 to 800 yuan!
It was close to a thousand yuan at one time!
For this reason, the Fifth Academy of Magic City is now severely cracking down on ticket scalpers.
Today, an old man came to Lu Chen's clinic to see the doctor.
The patient is a 66-year-old man.
Suffering from grade 2 hypertension (extremely high risk, ten-year history of hypertension) and type 2 diabetes.
Three months ago, I went to a local hospital for chest tightness. Coronary angiography showed severe coronary artery stenosis, and I underwent PCI treatment.
This time, because "it was more than 3 months after the PCI surgery", I came to the Fifth Hospital of Magic City again.
The old man's original words were: "I don't really believe in the small hospital down there. After the operation, I still have chest tightness. The technical level is so poor!"
Lu Chen could only explain while helping the uncle with his medical treatment.
"Uncle, I just read your interventional surgery information. The surgery was very successful!" Lu Chen said, "There is no such thing as a failed surgery or poor technique!"
It is said that scholars look down upon each other.
It is also easy for medical staff to feel at odds with one another.
But Lu Chen always stuck to his own point of view.
Don’t look down on each other among peers!
"Professor Lu Chen, tell me, I just finished the operation, why did my chest tightness come back again?" the old man asked doubtfully.
Lu Chen smiled, "This is caused by many reasons. PCI intervention cannot solve all problems, and everyone has individual differences."
The patient has a USB disk with surgical video data in his hand.
After Lu Chen got it, he opened it.
Coronary angiography was performed at the local hospital.
The patient had moderate to severe stenosis in the anterior descending branch, diagonal branch, and obtuse marginal branch, and the proximal and middle segments of the anterior descending branch mainly had stenosis and calcification.
After watching the video information, Lu Chen frowned, "This is not going to be easy, the blood vessels are too calcified!"
"No? You can't do surgery!" When the old man heard this, he panicked instantly.
Lu Chen smiled and said, "Don't worry, it can be done, but the blood vessels are severely calcified and the surgery is risky."
"Okay, I can trust you!"
The old man said seriously.
After coming to the hospital, he already understood the intervention level of the Fifth Hospital in Shanghai, which was No. 1 level.
And Lu Chen also found an opportunity at this time.
Perhaps from the perspective of coronary intervention, we can think of a new project!
…
Soon, under the leadership of Lu Chen.
Another big discussion took place within the department.
Because the angiography indicated that there were severe calcification shadows on both sides of the lesion vessel and the lesion was long.
So Lu Chen decided to use the -cx shock wave balloon technology.
The impact precisely impacted the calcification foci under the coronary intima and media to loosen them.
Subsequently, OCT was used to evaluate the calcification ring rupture and lumen condition after shock wave balloon treatment.
Finally, the stent was implanted, and the postoperative effect was evaluated again under OCT and ultrasound angiography.
…
After a brief discussion, the coronary intervention surgery began.
This surgery mainly treated the anterior descending branch lesion.
Preoperative examination indicated that the patient's anterior descending branch had 70% stenosis in the proximal and middle segments with severe calcification (lesion length was about 30mm, and the diameter of the heaviest calcification was 3.0mm).
The FFR pressure microcatheter was inserted into the anterior descending branch, indicating that the FFR was 0.73.
OCT examination showed diffuse annular calcified plaques in the proximal and middle segments of the anterior descending branch. ＵU Reading www.uukanshu.net
……
During the operation.
Lu Chen selected a 3.0mm*-cx coronary artery shock wave balloon.
At the proximal and middle calcified lesions, 70 shock waves were triggered for 7 cycles.
In each cycle, 10 pulse shock waves were stimulated at 4atm, and then pressurized to 8atm for expansion.
During the calcified plaque fragmentation operation, it can be seen under DSA that with the release of shock waves and after 8atm expansion, the balloon at the most serious calcification is fully expanded.
……
The entire operation was broadcast live globally again.
China, Europe, the United States, Japan and other countries broadcast the whole process live.
After sufficient shock wave balloon pretreatment, the calcified ring was loosened, the vascular compliance was improved, and the stent was successfully implanted at the lesion.
Re-examination of OCT and angiography showed that the stent was well attached to the wall, the expansion was satisfactory, and the stent expansion rate reached 86.24%, without dissection and residual stenosis.