I can see health

Chapter 643 Resistance of the Guide Wire

This is Lu Chen's second surgery in Shanghai.

He recalled all the steps of atrial premature ablation in his mind, puncture, mapping, ablation!
The difficulty of premature atrial ablation surgery lies in the mapping!
The operator needs to map all possible areas of the atrium, find out the origin of premature atrial prematurely as much as possible, and then perform ablation.

Traditional point-by-point mapping needs to sweep the ablation catheter all over the atrium, and it takes at least 200 hours to map 300-2 points, and requires high catheter operation by the surgeon.

Lu Chen decided to use the latest high-density electrophysiological anatomical mapping technology to complete the ablation of premature atrial fibrillation.

"let's start."

Lu Chen stood in front of the operating table, gloves and hat already changed.

Normally, the assistant needs to prepare the surgical area for spreading and disinfecting.

However, this time the assistant is the mentor Zhang Shuqing, Lu Chen really dare not let him operate.

Therefore, Lu Chen silently disinfected the patient's surgery area by himself.

……

This time, the puncture path Lu Chen chose was the right femoral vein.

Enter from the femoral vein, go through the inferior vena cava → right atrium → puncture the interatrial septum, and finally reach the left atrium.

Lu Chen's piercing technique was the same as before.

Fast, accurate!

In the blink of an eye, Lu Chen's femoral vein puncture was completed.

The guidewire went through!

Zhang Shuqing on the side felt Lu Chen's piercing speed most intuitively.

too fast!
He literally just blinked...

Lu Chen successfully punctured and implanted the guide wire.

All the doctors watching from the catheterization room had surprised expressions on their faces.

Judging from this puncture technique, Lu Chen's electrophysiological technique is absolutely top-notch.

Such proficiency is impossible without years of surgical experience.

However, everyone is very strange.

With Lu Chen's age, it could be said that the intervention certificate lasts at most one or two years, how did he achieve such a high level of proficiency?
Chief Director Liu Jun also saw Lu Chen's operation for the first time.

"This young man is really good." Liu Jun said to Zou Yi beside him, "vascular puncture is the starting point and the focus of our interventional heart surgery!"

"Lu Chen's puncture level is considered top-notch in any hospital in the country."

Zou Yi nodded slightly.

He is a layman, watching the excitement, he doesn't know the meaning of this piercing.

Although he heard Xiao Shikang praise Lu Chen so much, he had never seen such a young surgeon before, and he was still a little worried.

Now that Liu Jun praised Lu Chen so much, he felt a little relieved.

……

catheter room.

Lu Chen gently pinched the guide wire, allowing it to slowly move towards the left atrium along with the blood vessels.

Suddenly, Lu Chen frowned.

He felt a trace of resistance!

"Shouldn't it?!" Lu Chen murmured, "It's just reached the inferior vena cava, how could there be resistance?"

Zhang Shuqing also saw that Lu Chen's movements paused, and asked in confusion, "What's wrong?"

"There is resistance!" Lu Chen frowned softly.

"There is resistance now?" Zhang Shuqing also looked very surprised.

The guide wire has just entered the femoral vein, reaching the inferior vena cava at most!

At this time, there is no resistance.

Could it be that there is something wrong with Lu Chen's operation?
Zhang Shuqing glanced at Lu Chen.

Everyone was watching outside, it was impossible for him to just question Lu Chen like that.

Unexpectedly, Lu Chen said, "Teacher, why don't you try it?"

Zhang Shuqing didn't expect Lu Chen to be so calm.

Isn't he afraid that if he succeeds, everyone outside will see it?
Zhang Shuqing pondered slightly, then nodded.

Patient safety comes first!

Lu Chen turned slightly sideways and gave up his position.

……

catheter outside.

Everyone saw the abnormality on the operating table.

"What's going on? Why did Lu Chen give way to Director Zhang?"

"I saw Lu Chen paused just now, could it be that the guide wire is not going through?"

"Impossible! Where did this guide wire go? It's impossible to make it through!"

"Hey, do you think it's because this kid's level is not up to the mark, so let Director Zhang come forward temporarily?"

The actions of Lu Chen and Zhang Shuqing aroused everyone's suspicion.

Zou Yi frowned and looked at Liu Jun, "Director Liu, what's going on?"

Liu Jun also frowned deeply. When he saw the puncture guide wire for the first time, he needed to change another person.

In this case, there is only one possibility, and that is trouble!

Otherwise, it is impossible to easily replace people.

"Zou Ju, let's take another look, but I haven't understood yet." Liu Jun laughed.

He was thinking about the possibility of this happening.

Zou Yi could only calm down and silently watched the changes in the operating room.

……

Zhang Shuqing took Lu Chen's place and began to insert the guide wire.

As soon as he started, his face changed.

There is resistance!
And this resistance is not small.

how could be?

As soon as the guide wire reached the inferior vena cava, it encountered resistance!
The blood vessels of the human body are very fragile, and brute force cannot be used, otherwise the blood vessels may be damaged.

In case of blood vessel rupture or dissection, the loss outweighs the gain.

So Zhang Shuqing didn't dare to make any changes!

"Let me try on the left side." Zhang Shuqing said in a deep voice.

They just punctured the right femoral vein, and now that they've encountered resistance, they can only try the left side.

"Okay." Lu Chen nodded slightly.

However, what they didn't expect was that.

The left femoral vein path, despite repeated adjustments to the angle, the guide wire still cannot pass!

The blood vessels on both sides have encountered the same problem.

This kind of situation is extremely rare, at least Zhang Shuqing has never encountered it.

Sweat slowly broke out on his forehead.

This patient has a special status, and his current state of mind is a little restless.

If something goes wrong, it will be difficult for him to be promoted in the future!
Zhang Shuqing turned to look at Lu Chen, and found that he, a student, was still indifferent.

"Teacher, why don't you do a contrast radiography." Lu Chen suddenly said, "If the guide wire passes through resistance, it only means that the blood vessel may be narrowed or deformed!"

Through contrast imaging, the specific conditions of blood vessels can be seen clearly.

"Well, it makes sense." Zhang Shuqing thought for a while, "Okay, then you do the imaging."

The guidewire cannot pass, but the contrast agent can pass.

This is currently the only way!

Zhang Shuqing stepped aside.

Lu Chen immediately stepped forward, took over the teacher's position, and started angiography.

……

Seeing the actions of the two, the people outside also reacted.

"If I'm not mistaken, they just pierced the left side again?"

"I think it's probably because the guide wire is not passing smoothly and is blocked!"

"Their positions are back again..."

"What is Lu Chen doing? He decided to have an imaging first?"

As the contrast image appears on the screen in front of the operating table.

Everyone inside and outside the catheterization room was stunned.

The patient's azygos vein flows into the superior vena cava and then goes to the right atrium, that is to say, the liver segment of the patient's inferior vena cava entering the atrium is absent!
The inferior vena cava loops around the heart through the azygos vein and enters the right atrium.

The popular explanation is that some of the blood vessels in the normal path of the patient into the atrium do not exist!

(End of this chapter)