I can see health

Chapter 459 He is the main surgeon!

Lu Chen got the patient's medical records, which was a 24-year-old female patient.

"Lu Chen, this patient is a nurse in the orthopedics department of our hospital." Fan Zhiping said.

Lu Chen nodded and continued to read.

In the past month, the patient has repeatedly experienced symptoms of palpitations.

Especially at night, it was the worst. After being admitted to the hospital, an electrocardiogram was performed, which showed frequent premature ventricular onset.

"We did a 24-hour ambulatory electrocardiogram for the patient." Fan Zhiping, "It showed that she had more than 24 ventricular premature beats in 3 hours! And it was a multi-source ventricular premature beat, occasionally with short bursts of ventricular tachycardia. attack."

Lu Chen frowned slightly, "So you performed radiofrequency ablation for the patient?"

"En." Fan Zhiping nodded, but then he sighed, "Our department performed radiofrequency ablation for her, but found during the operation that the origin of her early ventricle was very strange. I ablated for three hours, but still The origin of ventricular tachycardia was not found..."

Hearing Fan Zhiping's description, Lu Chen almost understood the patient's medical history.

Patients with a particularly high number of premature ventricular chambers like this have also affected their daily life, so they must undergo ablation surgery.

What's more, the patient is young, and if the ventricular tachycardia continues, it may lead to heart failure or even cardiomyopathy in the long run.

The difficulty of this patient's operation lies in being able to find the "origin point" of the ventricular tachycardia!
Lu Chen checked the patient's electrocardiogram.

After studying it carefully for a while, I found out that this electrocardiogram is different.

"Brother Fan, how did you diagnose this ECG?" Lu Chen asked.

Fan Zhiping was puzzled, "Isn't this the ventricular tachycardia originating from the left ventricular outflow tract?"

"Nothing else?"

Fan Zhiping frowned, "It's gone."

Upon hearing this, Lu Chen didn't say much.

This electrocardiogram is extremely complicated. On the surface, it is indeed just a multi-source frequent ventricular tachycardia, but as long as you look deeper, more origins are still behind!

……

At this moment, Li Yao spoke up.

"Director Yin, prepare for surgery!"

"Okay." Yin Chao's face was quite serious.

Their department did three or four hours of surgery, but they couldn't find the origin.

Although Professor Li Yao's electrophysiological techniques are superb, Yin Chao still thinks that at least two hours should be done.

Soon, the patient was pushed into the operating room.

Li Yao led Lu Chen into the operating room.

On the side, Yin Chao sighed slightly, Professor Li Yao really still let her students be assistants!
……

Step inside.

Washing hands, disinfection, anesthesia...

These routine operations are all done by Lu Chen.

Yin Chao couldn't help thinking, maybe Lu Chen just did these ordinary operations, and when it was time for puncture and ablation, he would leave the intervention room.

But as the operation continued, Yin Chao knew he was wrong.

After Lu Chen was anesthetized, he directly started the electrophysiological examination, including mapping and ablation.

"This... oh..." Yin Chao has completely given up now.

……

At this time, Lu Chen held the electrophysiological examination catheter in his hand and slowly entered the punctured catheter.

The 20-year-old young female patient had good blood vessels, so Lu Chen's puncture operation went very smoothly.

This stunned everyone who intervened outside.

This technique and speed should definitely not come from a student!

This technology, in Feng M County, absolutely can not find the second person!
"Fan Zhiping, haven't you been in the eighth district of the Cardiology Department of Jinghua Second Hospital?" Yin Chao asked subconsciously, "Does this Dr. Lu Chen have such a strong electrophysiological intervention ability?"

Unexpectedly, Fan Zhiping also had a look of surprise at this time, and he slowly shook his head: "Director, when I was in the eighth area of ​​the heart, Dr. Lu Chen hadn't started learning electrophysiology intervention..."

"Ah?" Yin Chao was taken aback for a moment, then turned to look at Fan Zhiping, "He, he didn't know anything before? In just this year, his surgical ability is so strong?"

"En." Fan Zhiping nodded slightly.

But Yin Chao still felt a little unbelievable. Fan Zhiping probably remembered it wrong. He didn't think that someone could improve the ability of interventional surgery to this level within a year!

……

At this moment, Li Yao came out from the intervention room.

"Li Yao, this is..." Yin Chao was startled, the operation is still going on, why did the chief surgeon come out?

"I'll make room for you!" Li Yao glanced at Yin Chao, "If you don't make room, how will the doctors in your department study?"

"This..." Yin Chao was taken aback for a moment, and then said, "Professor Li, aren't you the chief surgeon?"

"I never said I was!" Li Yao pointed to Lu Chen who stepped into the room, "He is."

"But..." Yin Chaochao looked into the intervention room, "Your student hasn't graduated yet... Isn't this a little inconsistent with the rules? The most important thing is that he doesn't have a certificate. Without a certificate of intervention, he can't be the chief surgeon!"

Hearing this, Li Yao smiled.

Perhaps, Lu Chen lacks other things, but the certificate is the most important thing he lacks!
"He has a certificate!" Li Yao smiled, "The intervention certificate issued by the Huaxia Electrophysiology Society."

"Ah?" Yin Chao swallowed, and glanced at Lu Chen who stepped into the room.

Does this student have a certificate?

And it was issued by the Huaxia Electrophysiology Society, which is the most valuable electrophysiology intervention certificate!
If the person in front of him is not Professor Li Yao, Yin Chao really suspects that others are entertaining him.

……

But now that this is the point, Yin Chao stopped talking and winked at Fan Zhiping.

Fan Zhiping understood, immediately changed into the surgical gown and lead suit, and walked into the intervention room.

Step inside.

Lu Chen is in the process of ECG mapping and ablation.

This is also the most difficult and most important part of the entire electrophysiological surgery!
Fan Zhiping came to Lu Chen's side.

Lu Chen also noticed him.

"Lu Chen, come here to be your assistant." Fan Zhiping said calmly, with disbelief still in his voice.

He watched Lu Chen's operations at close range, and he could see the skillful skills even more.

Now, though, skill comes second.

The most important thing is to be able to find the origin of VT!
Otherwise, no matter how skilled the operation is, it will be futile.

……

At this moment, Fan Zhiping noticed that there seemed to be something wrong with the place where Lu Chen melted!

"Lu Chen, why did you dissolve here?" Fan Zhiping said calmly.

Lu Chen glanced at Fan Zhiping, then looked away, and while talking, the movements of his hands did not stop at all.

"Brother Fan, look carefully at the patient's ECG. On the graph, the premature ventricular transition in the chest lead is above the sinus rhythm chest lead transition, indicating that the premature ventricular may come from the left ventricular outflow tract."

"In addition, the R wave duration/QRS wave duration of V1 is greater than 50%, and the R wave amplitude/S wave amplitude of V1 is greater than 30%. Coincidentally, it also suggests that it may come from the left ventricular outflow tract; lead I is a negative wave, It shows that the frontal plane vector starts from the left and ends with the right, and it may come from the left coronary sinus ostium."

"Of course, it is also possible that the junction of the left and right sinuses of the left ventricular outflow tract or the AMC or the epicardium of the great cardiac vein at the top of the ventricle is premature, and the lower wall is also high R, but the shape of the chest conduction does not match the transition."

……

Fan Zhiping was not aware of it.

Lu Chen can see so many things from an electrocardiogram!
Lu Chen's current state reminded Fan Zhiping of his previous ECG reading in the WeChat group.

Really worthy of being "Professor Lu"!

Lu Chen finally said: "In personal consideration, the origin of the ventricular tachycardia in this patient is left ventricular outflow tract (left coronary sinus ostium) premature ventricle > right ventricular outflow tract anterior compartment premature ventricle > pulmonary artery dry ventricle, left ventricular outflow Premature ventricle at the junction of the left and right sinus or the AMC or the great cardiac vein."

"I don't know if you covered these parts during the three hours of your operation?"

Fan Zhiping touched the back of his head in embarrassment, "It's really not..."

……

Step outside.

Lu Chen's words clearly reached everyone's ears.

A look of astonishment appeared on Yin Chao's face.

Lu Chen's analysis can be described as profound and simple, even beyond his comprehension.

This is the electrophysiological intervention ability that a student can have?
(End of this chapter)