I can see health

Chapter 669 The Floating Valve

Director Liu sat on the office chair with question marks in his mind.

Lu Chen, why did he go to the Central Hospital of Shanghai?
Moreover, the Shanghai Central Hospital even asked Lu Chen to go to the hospital for a consultation!

You must know that for general out-of-hospital consultation doctors, the minimum professional title must be a deputy chief physician, and no matter how bad it is, it must be a senior attending doctor.

And Lu Chen is just a doctoral candidate now, and has not yet obtained the qualification certificate of attending doctor!
(ps: After two years of master's degree, you can take the attending examination)
"Director Fang, is this in compliance with the rules?" Liu Jun asked doubtfully.

Fang Yu, director of the medical department, said: "How should I put it? If we were to send out by ourselves, it would definitely not be Lu Chen, but this is what the Shanghai Central Hospital asked for by name, and it is still about TAVR surgery. There are special policies for special circumstances."

"Well, there is nothing on my side, as long as the medical department agrees."

Liu Jun hung up the phone, and after thinking about it, he still called Zhang Shuqing.

"Shuqing, what is your doctor named Lu Chen doing recently?"

Zhang Shuqing was startled, and immediately replied: "Director, I told you last time, there is a TAVR class in Shanghai recently, and I asked Lu Chen to go."

"Oh, I remember." Liu Jun nodded.

"Dean, did something happen to Lu Chen?"

"No, it's like this." Liu Jun told the story of the Shanghai Central Hospital, "Lu Chen's TAVR surgery skills are very good?"

"This... probably not." Zhang Shuqing shook his head, "I remember Lu Chen said once that he is still just getting into TAVR techniques, so he should be... a novice."

"Should... be considered a novice? Are you sure?" Liu Jun asked back, "You mean that Dean Dai of the Shanghai Central Hospital is an idiot, please ask a novice for consultation?"

Zhang Shuqing was really not confident when asked this question.

"When Lu Chen comes back, I'll ask him again."

Liu Jun sighed, "Shuqing, you student, you are too evil, can we grasp it?"

Zhang Shuqing was stunned for a long while before slowly saying: "No matter what, Lu Chen is my student. The better he does, the brighter our hospital will be, isn't it?"

"Okay, you student, I'm just asking, you can cultivate it well." Liu Jun smiled.

"Okay, thank you Director!"

Hearing this, Zhang Shuqing breathed a sigh of relief for no reason.

No matter how powerful a person is, if the leader wears small shoes, he will be stunned!
However, Lu Chen's TAVR surgery skills are really doubtful, so I have to ask him what's going on later.

……

Modu Central Hospital.

in the catheterization room.

Standing beside Dai Wansong, Lu Chen began to perform the first real-world TAVR surgery in his life.

He took a deep breath to calm his heartbeat a little.

Even if he is a surgical assistant, not the chief surgeon, Lu Chen will give [-]% concentration.

Disinfection, draping, and puncture all in one go.

Dai Wansong looked straight and nodded.

"I'm here to insert the guide wire."

According to Lu Chen's analysis just now, the condition of the patient's entire blood vessels is very poor.

There are multiple calcified plaques at the origin and bifurcation of the femoral artery.

Calcified plaque is like garbage attached to the walls of blood vessels.

Too much garbage may affect the entry of the guide wire.

……

Even an experienced TAVR operator like Dean Dai Wansong carefully pushed in the guide wire at this time.

"There is resistance!"

As Lu Chen guessed, the plaque and stenosis of blood vessels seriously affected the entry of the guide wire.

Dai Wansong didn't dare to push too hard.

In case of blood vessel rupture and blood vessel dissection, it will be too much loss!

catheter outside.

Everyone was sweating for Dean Dai Wansong.

The insertion of the guide wire is the cornerstone of the entire operation.

If the guide wire cannot be fed in, forget about the subsequent operations.

At this time, Lu Chen, who had been fighting by his side, whispered, "Dean Dai, why don't you try wearing the superficial femoral artery?"

"Shaqian?" Dai Wansong put down the guide wire in his hand, "I... I haven't tried it."

"I can." Lu Chen said immediately.

"Okay, you come." Dai Wansong didn't hesitate, and quickly stepped aside.

Lu Chen immediately stepped forward, and with one injection, the puncture entered the femur.

"Dean Dai, I'm done."

"Huh? That's it?" Dai Wansong's eyes widened.

"Yes." Lu Chen nodded.

It's just a puncture of an artery, as long as you have practiced hundreds of times in the virtual space of the system, any difficult blood vessel puncture will be fine.

Surprise turned into surprise, after Gu Qian successfully punctured, the two switched positions.

Everyone outside the catheter room had no time to react.

Lu Chen has already become an assistant again.

……

Dai Wansong pushed the guide wire and fed it in bit by bit.

The guide wire quickly reached the position of the valve.

Next, is the most important guide wire transmembrane.

If the guide wire passes through the valve smoothly, it will affect the delivery and fixation of the subsequent artificial valve.

Dai Wansong was not in a hurry to insert the guide wire, but watched the patient's CT and ultrasound results again.

The patient's CT analysis results showed:

TYPE1 bicuspid valve, left and right fusion, leaflet thickening, severe calcification, calcification can be seen in the plane of the valve ring.

The height of the left coronary opening is about 11mm, the height of the right coronary opening is about 13.4mm, the French sinus structure is acceptable, the STJ height is about 16.9mm, the diameter is about 28.4mm, the ascending aorta is widened, the widest part is about 42.2mm, and the heart angle is about 53°.

Dai Wansong has rich experience in TAVR.

He immediately chose the appropriate transmembrane position based on the CT analysis results, and successfully passed the guide wire across the valve.

"Dean Dai has rich experience. Except for the initial guide wire entry, it went very smoothly."

"This assistant's position, I think I can do it..."

"Don't BB, didn't you see that Dean Dai asked Lu Chen to do the shallow puncture just now?"

Lu Chen didn't know what the people present thought.

At this moment, he was fully concentrated, staring closely at Dean Dai's operation.

"I started balloon pre-expansion." Dai Wansong also raised his spirits.

Before sending the artificial valve, the vascular access needs to be pre-dilated, which can create a better vascular pain, otherwise the artificial valve may not be sent to the correct position.

Dai Wansong completed this step perfectly.

From Lu Chen's point of view, even if he did it, he might not be as good as Dean Dai.

"Huh..." After finishing the above operations, fine sweat dripped from Dai Wansong's forehead, and he had exhausted a lot of energy.

However, the surgery is not over yet!
The last step remains, the delivery and release of the prosthetic valve!

The delivery of the valve is carried out under full fluoroscopy, so it is not difficult.

The rare thing is, the release of the valve.

The valve generates a "drill down" or "jump up" force during release, causing the valve to dislodge.

In addition, during the release process of the valve, especially the anterior 1/3-2/3, the valve has not been fully anchored in the valve annulus, and is easily displaced by the impact of regurgitated blood and respiratory movement.

Once the valve is displaced, it is not released at the predetermined position, which means the failure of the operation!
……

Sure enough, at this last step, Dai Wansong ran into trouble again.

"No, the valve is too imaged by the patient's breathing motion."

"The displacement is too obvious, and the valve can't be released at all!"

Lu Chen also noticed this problem immediately.

Floating valves, impossible to release!
He frowned deeply, and kept thinking about the training process in the system's virtual space in his mind.

Is there any way to stabilize the floating valve?
(End of this chapter)