I can see health

Chapter 858 Joint Surgery (Second Change, Thanks to Setsuna Wuyan for the reward)

"Lu, can you perform this operation?" Lambert asked nervously.

After a while, Lu Chen nodded slowly.

"You can try it, but I need to check the echocardiogram again and re-evaluate the patient's condition."

Lambert breathed a sigh of relief, "It's easy to talk about the inspection, as long as you have this sentence."

"Then let's start."

Lu Chen began to put on the surgical gown.

For the four-leaflet valve deformity, he has done it in the virtual space of the system.

However, he has never tried PCI combined with TAVR.

"It's okay to let Kenji Yamada be my assistant?" Lu Chen looked at Lambert.

"No problem at all!"

Lambert now only wants to solve the patient's condition.

Yamada Kenji looked happy.

It is a good opportunity for him to be able to perform several more operations.

However, Casas, who was on the operating table, didn't look very good.

But the attending doctor, Lambert, had agreed to Lu Chen, and there was nothing he could do.

……

Lu Chen has already changed into the surgical gown.

At this time, Kenji Yamada pushed the ultrasound machine.

The pair restarted the patient's echocardiogram.

Ultrasound showed that the peak flow velocity of the aorta was 470cm/s, and the peak pressure difference was 88mmHg.

Four leaflet deformity, valve ring circumference 70.3mm, average diameter 21.9mm, LVOT circumference 70.7mm, average diameter 22.5mm.Lu Chen frowned. The patient's aortic stenosis was more serious than imagined!
Lambert watched from the sidelines.

"Lu, what type of valve are you going to use?"

Lu Chen thought for a while and said: "The patient's aortic valve root is severely stenotic, the leaflets are thickened significantly, and the risk of coronary artery obstruction is high. First, use a minimally invasive 18mm balloon for pre-dilation. If there is no obvious regurgitation, then implant a TAV21mm valve. "

He said this to Lambert and also to Kenji Yamada.

When Kenji Yamada heard Lu Chen's words, he immediately started preparing artificial valves and balloons.

The two of them cooperated with many operations, and now they have a very tacit understanding.

"Lu Chen-jun, which side do you choose for the vascular access?" Kenji Yamada continued to ask.

Lu Chen rechecked the patient's vascular access.

The vessels in the bilateral approach are tortuous, the walls of the vessels are smooth, and the height of the bifurcation is stable.

The average smallest inner diameter of the left blood vessel was 7.6mm, and the average smallest inner diameter of the right blood vessel was 7.8mm.

"Choose the right femoral artery!" Lu Chen said in a deep voice.

"it is good!"

Kenji Yamada nodded and began to pierce at the same time.

His technique is very subtle, even Lu Chen can't beat him [-]%.

This islander really has some skills.

The puncture of the blood vessel was very smooth.

Kenji Yamada immediately sent the pre-expanded balloon.

It was almost the same as Lu Chen's prediction. The bilateral coronary arteries were visualized, and the 18mm balloon almost blocked the valve opening, and there was no obvious regurgitation!

"This 18mm balloon is really well chosen!" Lambert exclaimed from the side, "Lu, your eyes are vernier calipers, right?"

Lu Chen smiled, "Lambert, you can do the same if you do too much. There is an old saying in Huaxia that practice makes perfect."

Surgery continues.

"Lu Chenjun, the position of the valve is set, shall I release the valve directly?" Yamada Kenji's confidence increased greatly at this time.

Under Lu Chen's guidance, the operation is going well so far.

But Lu Chen immediately poured cold water on him.

"Not yet!"

"Not released?" Yamada Kenji said in surprise, "After a long time, the patient is prone to heart failure."

Lu Chen pointed to the patient's image, "The left and right coronary openings are low, especially the right coronary opening. In this case, releasing the valve will easily block the coronary artery!"

"So you need to protect the coronary arteries in advance?" Yamada Kenji understood.

"That's right!" Lu Chen nodded, "There is no need to consider this point in conventional TAVR, but the patient's coronary vessels are not good, and a little carelessness may cause cardiogenic myocardial infarction!"

Under the measures of coronary artery protection in advance, Kenji Yamada successfully released the artificial valve!
"Don't leave yet, take a look, maybe you need to adjust your position!"

Lu Chen is now staring at the image during the operation.

Because of the special four-leaflet structure, the positioning and stability of the release valve must be ensured to be foolproof.

After releasing the valve, Lu Chen observed in real time and made corresponding adjustments.

"Yamada, push it to the upper right to prevent paravalvular leakage!"

"receive."

Under Lu Chen's guidance, Kenji Yamada completed the delivery and positioning of the entire valve without any risk.

Ultrasound was re-examined after the operation, and the transvalvular pressure difference of the aortic valve was 0 mmHg.

The position of the artificial valve was fixed, there was no paravalvular leakage, and the shape of the valve was good.

Beside Lu Chen, Lambert and Casas have been observing.

Every delicate operation is like an art performance.

Lu Chen's greatest masterpiece is not to complete TAVR, but to escort the rest of the PCI operation while completing TAVR, to protect the patient's coronary artery as much as possible!

"Lambert, I'll leave the rest to you." Lu Chen took off his gloves.

"Don't worry, Lu, you have done such a good TAVR operation, he will not let you down."

Lambert took over the remaining PCI procedures.

His level of coronary intervention is a level higher than that of Lu Chen.

No way, who made Lu Chen's current coronary intervention skill card only advanced.

Instead of leaving, he, like Lambert, stood by the operating table, watching the rest of the PCI procedure.

……

"Recently, Mayo Clinic Department of Cardiology PCI and TAVR team combined surgery for a high-risk patient: four-leaf aortic valve, severe aortic valve stenosis with moderate regurgitation, low coronary ostium, small cavity, and severe calcification of the valve leaflets , with acute exacerbation of heart failure, the combined treatment of PCI+TAVR was successfully performed.”

It is considered a top-level difficult operation in Mayo, and it naturally caused a sensation on a global scale.

Lu Chen didn't pay too much attention.

He focuses more on himself.

After this operation, he also understood his shortcomings.

In addition to TAVR surgery, in the fields of coronary intervention, electrophysiology, and congenital heart disease, there is still a big gap between him and the top doctors at Mayo Clinic.

However, Lu Chen's outstanding performance aroused the idea of ​​the director of Mayo's cardiology department.

"Mr. Kebed, are you saying that the director wants me to go to his office?"

Lu Chen was a little confused.

"Yes, he called me today." Kebed nodded, "His office is on the fifth floor."

"Okay, I'll go find him right away."

Lu Chen didn't know much about the chief of the Department of Cardiology at the Mayo Clinic.

This is not like in China, where the director usually does not interfere with everyone's medical behavior.

Lu Chen has been in Mayo for so long, and he has never met the director of Mayo's cardiology department.

……

Come to the fifth floor.

After Lu Chen asked about the exact location of the office, he knocked on the door of the director's office.

"Please come in!"

A mid-spirited voice came out, and Lu Chen gently pushed open the door.

To Lu Chen's surprise, the director of the cardiology department in front of him had an Asian face.

　There are also updates

　　
　
(End of this chapter)