I can see health

Chapter 664 Snare Assist
Dai Wansong reacted immediately.

Lu Chen from the Heart Failure Conference?
He also participated in the Heart Failure Conference some time ago, and immediately recalled that amazing young man in his mind.

He looked at Lu Chen in front of him, with a hint of surprise in his eyes!
He remembered that Lu Chen was studying dapagliflozin?

How did they come to their TAVR study class?

(TAVR is used instead of valve intervention below)
……

After a brief episode, calm was restored in the cath lab.

Dai Wansong took a deep look at Lu Chen.

Is it possible that this kid wants to engage in TAVR across research fields?

"Let's continue..." Dai Wansong withdrew his thoughts and continued to explain.

Everyone in the catheterization room looked at Lu Chen from time to time.

Everyone was curious about this mysterious young man.

On the operating table, Dai Wansong continued: "After the valve is successfully crossed, a hardened guide wire needs to be sent through the pigtail catheter for the implantation of large sheaths for vascular access, the delivery of dilated balloons and valve systems, and the management of peripheral vascular complications. Deal with it. Does anyone know what kinds of TAVR-hardened guide wires are available in China?"

As soon as this problem came out, the entire catheterization room fell silent.

This is already a very professional question. All the people present are newcomers to TAVR, so they probably don’t know this question, right?
Everyone looked at each other, without any clue.

Dai Wansong looked at Bai Xin, and was a little disappointed when he found that the latter lowered his head and did not look at him.

So, he turned his head to look at Lu Chen who was standing aside.

Lu Chen saw Dai Wansong's gaze, paused, stood up, and said softly, "At present, the hardened guide wires suitable for TAVR available in China mainly include Lunderquist and Amplatz."

Lu Chen paused, and continued: "The Lunderquist guide wire is harder than the Amplatz guide wire, and has stronger support. It is suitable for almost all types of valves, but at the same time, the chances of complications such as guide wire perforation and cutting injuries are relatively increased... ..."

As soon as Lu Chen finished speaking, everyone in the catheterization room looked at him in unison.

Let me go, is this still a newcomer to TAVR?

Actually have such an understanding of the current domestic market guide wire.

This time, no one had any doubts about Lu Chen's answer.

To be able to answer so fluently, it must be Lu Chen's true understanding, that's right!
Sure enough, a smile appeared on Dai Wansong's face, "Well said!"

He went on to add: "The arc of the tip of the hardened guide wire should match the size and shape of the ventricular cavity, and there should be no sharp corners. Otherwise, fatal complications such as myocardial perforation may occur during the delivery and release of the valve. It takes time during the operation." Note the position and tension of the guidewire within the ventricle."

This is why there are currently only two types of hardened guide wires in China.

Because hardening the guide wire is too important, once the matching is unsuccessful, it will directly affect the success rate of subsequent operations.

"Come to try track building and balloon pre-dilation?"

Dai Wansong's words were addressed to Lu Chen alone.

All the students in the catheterization room looked at Lu Chen enviously.

Opportunities like this are rare!
Falsification in the simulated operation room is very expensive, and the equipment required for each simulated operation has a lot of consumption.

"Okay." Lu Chen nodded with a smile.

He practiced in the virtual space of the system for a long time last night, but it was also the first time he operated in reality.

Slowly walked onto the stage and took Dai Wansong's place.

……

The operation in the virtual space of the system is somewhat different from that in reality.

The real touch made Lu Chen's heart beat slightly faster.

This is not an actual operation yet.

If it was a real human surgery, the string in Lu Chen's mind might be even tighter.

Lu Chen didn't get started quickly.

Instead, first select the appropriate size dilatation balloon based on ultrasound and CT measurements.

Then adjust the angle through the balloon marker and calcification position, place the middle part of the balloon in the calcified narrow area, and choose a suitable position according to the CT angle so that the target calcification area does not overlap with the balloon position, so as to observe the effect of balloon expansion.

Seeing Lu Chen's movements so mature and sophisticated, Dai Wansong couldn't help but nodded slightly.

In his mind, this kind of proficiency is absolutely impossible to do TAVR surgery for the first time!
After Lu Chen successfully completed the pre-expansion of the balloon, Dai Wansong did not stop, but said with some expectation: "Lu Chen, don't stop, you continue!"

Lu Chen nodded.

This time the opportunity to operate in reality was rare, and he concentrated his attention even more.

The next step is valve delivery and release.

This is the top priority of the entire operation!
Lu Chen needs to deliver the artificial valve to the location of the diseased valve, and then release it successfully.

This is also the step that most tests the skill of the practitioner.

Dai Wansong looked at Lu Chen without blinking.

The reason why he let Lu Chen continue was because he wanted to see where the limit of his ability was.

If this last step can be completed, it will prove that Lu Chen can already become a teacher.

……

in the catheterization room.

All the students didn't dare to show their anger, they all stared at Lu Chen's movements closely.

Every step he took touched everyone's nerves.

After the balloon is pre-dilated, if the valve is severely damaged, there is a large amount of regurgitation, and the patient's hemodynamics is unstable, an artificial valve needs to be implanted quickly.

However, it is only a simulated operation now, without such worries, Lu Chen can do it steadily without worrying.

In the case of full fluoroscopy, the artificial valve is slowly delivered.

The early delivery of the valve was very smooth.

When he came to the position of the aortic arch, Lu Chen paused for a moment.

"Be careful in this place!" Dai Wansong reminded appropriately.

At this time, if the stiff guide wire cannot be pulled in, it is easy to prolapse from the ventricle.

Lu Chen didn't act in a hurry, but recalled the training steps in the system space last night in his mind.

He first adjusted his body position to the left anterior oblique position, then pushed the valve, and at the same time tightened the ultra-hard guide wire to avoid damage to the aorta during valve delivery.

However, no matter how Lu Chen adjusted the position, the valve still couldn't be pushed in.

……

Other students also noticed the abnormality of Lu Chen's operation.

"its stuck!"

"The valve can't go in... I guess the angle of the valve is too big, it can't get through at all!"

"Hehe, let me just say that Lu Chen probably won't be able to get in. Theoretical knowledge is the first aspect, and ultimately operational skills are the first aspect."

"We are still in the study class now, and it is quite good to be able to achieve this level!"

Some people lamented, some gloated.

However, Lu Chen was completely unaffected.

"If it doesn't work, you can end the operation." Dean Dai Wansong said softly.

Regarding Lu Chen's performance, Dai Wansong was already very satisfied even if he failed to complete all the steps.

At this moment, Lu Chen raised his head slowly, without any nervous expression on his face, he put down the guide wire in his hand, and said to Dai Wansong beside him: "Dean Dai, the simulated patient's aortic valve angle is relatively large, and the artificial valve Difficult to pass through the aortic valve, I need snare to assist the valve and correct the misalignment of the prosthetic valve."

"This..." Dai Wansong was taken aback when he heard Lu Chen's words, "You want snare assistance? Why don't you use the dual wire guide technology?"

(End of this chapter)