I can see health

Chapter 434 The Dean's Order

"Percutaneous hepatic vein implantation?" Everyone was shocked.

Compared with other paths, this should be the most partial implantation path.

On the podium, Xiao Shikang said: "Dr. Lu is the surgeon for this patient. The first operation was performed by the two of us together."

Everyone's eyes turned to Lu Chen.

Most of the doctors present knew him.

Although Lu Chen is just a foreign doctor, his performance in the cath lab during this period is obvious to all.

He not only successfully completed dry pericardiocentesis, but also went to Kyoto Central Hospital to assist in the operation as a hospital representative.

This is used as a topic of conversation after dinner, and is talked about by many people.

After listening to Lu Chen's speech, Qin Sifeng frowned.

"Percutaneous hepatic vein puncture is a route we rarely use." Qin Sifeng glanced at Lu Chen, "I remember that Western Sichuan Medical College used this puncture route, and they were the first in the world at that time."

"En." Lu Chen nodded, "After I went back, I looked through the literature and found a case report published by West Sichuan Hospital two years ago. They had used this percutaneous hepatic vein puncture implantation to treat a Patients with vena cava blockage."

"I know about the case you mentioned. At that time, West Sichuan had consulted with me remotely." Qin Sifeng frowned, "But Lu Chen, do you know that although the method you mentioned is theoretically feasible, it is difficult in practice. Extremely high!"

When everyone heard Qin Sifeng's words, they also started to discuss.

Fang Ruzhang frowned deeply: "Puncture of the subclavian and superior vena cava is a short path that only needs to go through one curved arc, but implantation through the hepatic vein not only takes a longer path, but also needs to go through three arcs in a row!"

Compared with an arc with three turns, the difficulty of this operation is multiplied!
Another doctor said: "I think it's better if there are more arcs. If you try a few more times, you should be able to pass. But the operation through the hepatic vein is the most difficult operation. The entire path needs to be operated with a backhand. This backhand operation Skills, everyone should have no experience, right?"

There are few opportunities for surgical training in normal times, and this kind of situation is almost never encountered. Who would specially train the backhand operation?

At this time, Qin Sifeng added fuel and vinegar, "Actually, there is another problem that you may not have noticed. This operation not only includes the implantation of a pacemaker, but also the implantation of an ICD. The implantation through the hepatic vein ICD? I haven't seen a case like this..."

Everyone was chattering, and Lu Chen's proposal of "implantation via hepatic vein puncture" was quickly rejected.

Theoretically feasible, but the difficulty of practical operation is extremely high!
Lu Chen moved his lips, wanting to say something, but gave up again.

He really wanted to shout, "I want to try transhepatic vein puncture."

But the doctors present, whether in terms of clinical diagnosis and treatment experience or interventional surgery experience, were much richer than him.

He yelled like this, but he was a bit overconfident.

……

Half an hour later, the general consultation of the Department of Cardiology ended.

The people didn't come to a good conclusion after discussing, so they could only temporarily postpone the operation and carry out conservative treatment with drugs.

Lu Chen didn't have any solution either. He browsed through the literature all night, and finally came up with a solution, but it was not recognized by everyone.

However, Lu Chen was not discouraged.

Since it is possible to use this "percutaneous hepatic vein puncture and implantation" skill, he can just train in the virtual space of the system.

In the virtual space of the system, Lu Chen set the surgical simulator to a situation similar to that in reality.

The superior vena cava was occluded, and the transhepatic vein was punctured instead.

……

In the blink of an eye, two days passed.

Three areas in the heart.

Fang Ruzhang looked at the patient in front of him, anxious.

Just now this old man suffered from heart failure again!
This is also his fourth acute heart failure attack within three days.

"Doctor, how is my father's condition?" The patient's family member was a middle-aged man. He came to the office and asked proactively.

Fang Ruzhang shook his head slightly: "The old man's condition is not very good, as you can see, he just came to the hospital for a few days, and he needs to be rescued at least once a day."

"How could this be?" The middle-aged man's face was full of worry and bewilderment.

"If the heartbeat slows down to less than 40 beats per minute, there is a risk of sudden death." Fang Ruzhang explained, "Your dad's heartbeat has been stopped for a long time because of pacing dependence. In a fast situation, the ejection function of a normal person’s heart is above 50%, but it’s already below 25%.”

The middle-aged man sighed deeply, then looked up at Fang Ruzhang, and said, "You are one of the top cardiology departments in the country. After discussing for so many days, can't you come up with a feasible plan?"

Fang Ruzhang felt bitter when he heard this: "Don't worry, we have a general consultation in the Department of Cardiology."

"What's the use of just a big consultation?" The middle-aged man frowned, "What we need is a treatment plan!"

"Don't worry, we will do it as soon as possible." Fang Ruzhang talked to the patient's family members, and finally calmed his emotions.

Fang Ruzhang also understood very well that any father lying sick on the bed would only be in a worse mood than him!

"Hey, the operation can't be delayed any longer!" Fang Ruzhang thought.

Thinking of this, he immediately started calling Qin Sifeng.

"Professor Qin, about the patient with blocked superior vena cava..."

Before Fang Ruzhang could finish his sentence, Qin Sifeng said, "I know, the dean called me just now. It should be the patient's family members who got in touch with him. The dean asked us to come up with a solution as soon as possible."

"Hey, the leaders above are really real." Fang Ruzhang was a little helpless, "If they move their lips, we will suffer. This plan is not so easy to come up with!"

On the other end of the phone, Qin Sifeng fell silent.

Fang Ruzhang thought he had hung up, and was about to hang up, when Qin Sifeng's voice came again: "Xiao Fang, go and apply for a remote joint consultation with Sichuan West Medical College, Zhongshan Medical College, and Modu Medical College for the patient."

Fang Ruzhang was taken aback, "Professor Qin, joint consultation? Are you preparing for surgery?"

Qin Sifeng sighed, "Whether the dean said it or not today, I have already thought about it. I can't just sit around and drag it on because of the risk. We must take the safety of patients' lives as the first principle! After the consultation, come up with a specific surgical plan, and we will start to execute it!"

"Good!" Fang Ruzhang said.

After hanging up the phone, he immediately contacted the hospital's medical department.

Let the medical department come forward, notify the other hospital, and conduct a remote joint consultation with multiple hospitals.

……

Because of the dean's order, the joint consultation ended soon.

In the afternoon of the same day, the joint diagnosis and treatment plan of major hospitals was released.
After intense discussions, major hospitals headed by Western Sichuan Medical College unanimously recommended the "transhepatic vein puncture and implantation" scheme!
This is exactly the plan proposed by Lu Chen, and it is also the most compromised surgical plan at present.

Because other routes cannot be used, only "hepatic vein puncture" is available.

The only disadvantage of this operation is that it is very difficult!

Then, Qin Sifeng came up with an idea.

Before the formal operation, a small-scale simulated operation evaluation will be held in the cath lab.

The person with the highest surgical proficiency will have the opportunity to become the first assistant of the operation and participate in this operation.

As soon as this notice came out, all electrophysiological interventional doctors in the Department of Cardiology began to gear up.

It may not be feasible for them to perform such a difficult operation.

But as an assistant, they can still do it.

If you can succeed, you can also get a name.

This may be the world's first implantation of ICD and pacemaker through the hepatic vein at the same time!

(End of this chapter)