I can see health

Chapter 416 The Strange Origin Point
"What's going on? The patient in operating room No. [-] seems to have recovered premature ventricular contractions?"

What happened to Lu Chen here was immediately known to the audience.

Rao, some students who don't know much about electrophysiological surgery can also see Lu Chen's ablation, which seems to have failed? !

At the same time, the operation speed of several other students in the operating room also caught up with Lu Chen.

After performing puncture and mapping, they are all ready to start the operation of electric discharge ablation.

Among them, Yu Hewei's operation progressed the fastest.

He has already completed one-third of the ablation procedure.

In the demonstration classroom, the whispers of the crowd sounded again.

"It seems that the fastest is not necessarily the best! Our competition is not about who takes the shortest time!"

"Hey, young man, you still don't have enough experience!"

"However, have you noticed that this patient's arrhythmia seems to be different!"

……

catheter room.

Lu Chen stared at the patient's ECG monitor closely, his hands moving non-stop.

"Continue to ablate and discharge!"

Since one discharge ablation was not enough, Lu Chen carried out continuous discharge operation.

But what Lu Chen didn't expect was that after several attempts, the patient's sinus rhythm could only be maintained for a short period of time.

After the ablation discharge was withdrawn, the patient's ventricular premature beats soon recovered!
At this moment, Lu Chen fell into an endless loop.

He looked through the patient's medical records again.

"That's right, it's the right ventricle!" Lu Chen frowned.

The patient's electrocardiogram clearly showed that the ventricular premature beat originated from the right ventricle.

Now he has ablated the right ventricular outflow tract, which has a certain therapeutic effect, but the ablation effect cannot be maintained!
"Why is this?" Lu Chen stopped his hands, his eyes flickered, and he began to recall countless simulation trainings in his mind, trying to find out the reason.

……

Demonstration classroom outside the venue.

"Yo, I didn't expect it, a difficult case came out!"

Director Wan Jingshui of the third ward in the heart, looked at the big screen with a smile, touched his chin, and was very interested in Lu Chen in the third operating room.

"Director, I think there is nothing wrong with Lu Chen's ablation operation!" Fang Ruzhang sat next to Wan Jingshui, with a puzzled look in his eyes, "But why did it fail in the end?"

Wan Jingshui grinned, "So, you young people are very proficient in surgical operations, but you still have too little clinical experience!"

"Director, have you seen the reason for the failure?" Fang Ruzhang was slightly startled.

Wan Jingshui nodded with a smile, "Lu Chen's melting position is right and wrong again."

"Right, wrong again?" Fang Ruzhang scratched the back of his head, looked at the big screen again, and said in doubt, "I also read the patient's electrocardiogram, and the premature ventricle originated from the right ventricle, that's right!"

Through the electrocardiogram, the origin of ventricular premature is better judged.

Originated from right ventricular premature beats, the chest leads conform to the pattern of left bundle branch block, the main wave direction of QRS waveform is upward in leads V5 and I, and the main wave in lead V1 is downward or presents an obvious RS pattern. Fat, the time limit is greater than 30ms.

Originating from left ventricular premature beats, just the opposite.

Hearing Fang Ruzhang's words, Wan Jingshui shook his head and smiled slightly, "You are right, premature ventricle originates from the outflow tract of the right ventricle, but have you overlooked that the heart is a three-dimensional structure? After ablation of the inner lining of the heart, the right ventricle Afterwards, Shizao still exists, should we consider other possibilities?"

"Three-dimensional structure?" Fang Ruzhang frowned, and murmured, "Director, you mean that the origin of ventricular premature is inside the heart? That is, the middle part between the inner and outer membranes?"

The heart is divided into endocardium and epicardium.

For most operations, the doctor puts the catheterization laboratory into the blood vessel, and what is ablated is the intima of the heart.

"Children can be taught." Wan Jingshui nodded with a smile, "This kind of early origin is relatively rare!"

However, upon hearing this, Fang Ruzhang frowned even deeper, "Director, how can the origin point inside the heart be dissolved?"

"Hehe, it's difficult! Lu Chen's case looks like it's probably going to fail, and the chief surgeon is ready to take over." Wan Jingshui turned his head to stare at the big screen, shaking his head slightly, "This can only be said to be bad luck. Alright, if you just switch to the other four cases, Lu Chen may have completed the operation."

Yao Jie, who was on the side, also heard the conversation between the two of them. She stared at the big screen, bit her lips lightly with her white teeth, clasped her hands together, and kept praying to Lu Chen in her heart.

"Brother, you can definitely do it!"

……

catheter room.

After calming down, Lu Chen gradually realized the problem.

After all, he had tried most of the surgical operations in the systematic surgical simulation room.

"First of all, I want to make it clear that if my ablation is effective, it proves that the ablation site is generally correct, at least there is not much deviation!"

"However, the effect of ablation cannot be maintained, which only shows that the origin point of the premature ventricle is deeper and farther away from the ablation point of the endocardium!"

Lu Chen looked down at the patient on the operating table, without the slightest joy in figuring out the crux of the problem.

Because he is aware of a problem, the origin point of premature ventricular is deep, so how can we "reach" this lesion?

The lesion is between the intima and the adventitia, or closer to the adventitia!
"Perhaps, only by performing ablation on the epicardium, is it possible to completely resolve this patient's premature ventricle!" Lu Chen thought to himself, "However, my catheter is inside the blood vessel, how can I reach the epicardium for epicardium ablation? Woolen cloth?"

Time passed by every minute and every second.

Lu Chen seemed to give up, just staring at the ECG monitor without any other actions.

In the other four operating rooms, everyone's operations are coming to an end.

"Student No. [-], is the assessment over?"

In operating room No. [-], the chief surgeon stood beside Lu Chen for the first time.

As long as he sees Lu Chen nodding, he will immediately take over the operation.

However, the chief surgeon was also sighing for Lu Chen.

This is really bad luck!

Two words, black face!

Whoever chooses this patient will end in "failure" in the end.

"Classmate, you don't have to worry about it." The chief surgeon reminded, "The difficulty of this operation has exceeded expectations. Even I have to report it to the director of the department now to decide the next treatment plan."

Lu Chen paused, then shook his head slightly, "I, I don't want to give up yet."

"Okay, then I will give you the last 5 minutes to think. If there is no further operation, it will be considered as the end of the assessment!" The chief surgeon sighed. Although it is a pity, the patient's treatment cannot be delayed.

……

Outside the catheterization room, all the students from the other four operating rooms came out.

When they saw that Lu Chen was still in the operating room, they couldn't help being surprised and puzzled, and some even felt a little gloating.

"Xiao Fang, it seems that Lu Chen has given up!" Seeing Lu Chen who had been in the catheterization room for a long time, Wan Jingshui shook his head regretfully.

"Oh, what a pity!" Fang Ruzhang regretted, "Lu Chen has always been ranked second, and if there is no such accident, he will definitely pass this assessment!"

On the big screen in the classroom, everyone saw that the chief surgeon of No. [-] operating room had come out.

"Okay, the assessment is over, let's go back too!"

Wan Jingshui stood up, ready to go back to the department.

But just when everyone was about to leave the demonstration classroom, someone yelled loudly: "Damn it, look at operating room No. [-], why did it start operating again?!"

　Try to write another chapter.

　　
　
(End of this chapter)