I can see health

Chapter 940 A rare technique

Demonstration classroom of the Cardiology Department of the Fifth Hospital of Shanghai.

Lu Chen stood on the podium.

On the projection screen at the front desk of the demonstration classroom, this paper from an American scholar is projected.

Everyone looked intently.

Lu Chen began to explain in detail what this article said about "Patients with Acute Myocardial Infarction Complicated with Severe Mitral Regurgitation".

"Compared three surgical approaches—surgical mitral valve replacement, transcatheter mitral valve edge-to-edge repair, and conservative medical management—in patients with acute myocardial infarction and severe mitral regurgitation."

"The research on the difference in prognosis shows that early active mitral valve edge-to-edge repair (Transcatheter edge-to-edge repair, TEER) can significantly improve the long-term prognosis of patients and reduce the mortality rate during hospitalization."

He showed everyone in the classroom, and began to discuss in a hurry.

Modern medicine emphasizes evidence-based medicine.

It means that any treatment method must be proved by experiments, and specific data on the effectiveness of the treatment must be produced.

Individual differences cannot be used to explain the effectiveness of a certain drug treatment.

Although the paper Lu Chen produced was not domestically produced in China, it is the most advanced research in the world.

"Director, I think you are right. This patient is definitely not going to be able to undergo surgery." Jin Miao immediately stood up and looked around, "There is only one way to completely solve the severe mitral valve regurgitation, and that is to go through surgery." Catheter intervention!"

Lu Chen smiled and nodded.

What Jin Miao said was what he thought in his heart.

If there is still a glimmer of hope for this patient, then this glimmer of hope lies in catheter intervention!
Afterwards, other people in the classroom also nodded in agreement.

A mature surgical team can put forward different opinions, but can also quickly get a unified solution.

However, the surgical plan was determined.

But the difficulty and risk of this operation are in front of everyone.

"Director Jin, are you sure about this operation?"

An attending doctor in the department asked Jin Miao.

Today, Jin Miao has also been successfully promoted to deputy chief physician.

Jin Miao paused, then shook his head slowly: "I have done ordinary transcatheter mitral valve replacement surgery, but after this kind of acute myocardial infarction, patients with mechanical complications of mitral valve prolapse, I really don't care about it." did."

In other words, he didn't have much confidence.

When the others heard the words, they all turned their attention to Lu Chen.

In the Fifth Hospital of Shanghai, Jin Miao's interventional surgery ability can be said to be one in a million.

Even in the field of cardiology intervention in China, any cardiologist would give a thumbs up when they heard Jin Miao's name.

If there is anyone who can stabilize Jin Miao's head, then only Lu Chen!

However, Director Lu Chen has not performed surgery himself for a long time.

At this time, Lu Chen on the podium spoke.

"This kind of mitral valve intervention after acute myocardial infarction is still blank in our country."

"Even in the world, it is considered a rare technique."

If there is only a single severe mitral regurgitation, many doctors can independently perform this type of operation.

However, in patients with severe mitral regurgitation in the acute myocardial infarction stage, this operation is required.

In comparison, this risk is not a little bit high!

Acute myocardial infarction, in simple terms, is the death of myocardial cells and necrosis of cardiac muscle tissue.

In this case, the contractile capacity of the heart function decreases, and heart failure is easily complicated.

Second, cardiomyocyte necrosis can lead to damage to the heart structure.

This time, the patient had severe mitral regurgitation caused by rupture of the chordae.

A serious complication that can lead to a ruptured heart!
This is better understood.

The beating amplitude of the necrotic heart tissue is smaller, but the beating amplitude of the normal myocardial tissue is the same as before.

In this way, a shear force will be generated between the necrotic normal myocardial tissue.

Under the action of shear force, the heart is extremely easy to rupture!

Once the heart is broken, the mortality rate is almost 100%!

It can be seen that the difficulty of this operation is dancing on the tip of the needle!

……

In the classroom, there was a brief silence.

Lu Chen raised his head this time and looked at Jin Miao.

"You are the patient's bed doctor, what is the opinion of the patient's family?"

In the face of such critically ill patients, in addition to the opinions of doctors, the opinions of family members are more important.

Active treatment, or give up and go home.

This is the choice that ultimately determines the fate of the patient.

If this kind of patient chooses to go home for conservative treatment, Lu Chen is sure that he will not survive for a week!

"The patient is an ordinary working family." Jin Miao said, "In order to treat the disease, he has already sold his house, went to many hospitals, and finally came to us."

Lu Chen looked solemn.

This patient is even more difficult.

It is a situation that no one wants to see.

"Jin Miao, call the patient's family to the doctor-patient communication room, let me communicate with him."

"Okay." Jin Miao nodded slightly, stood up and left the classroom.

This case discussion is just over.

There is a final solution, but the specific operation is still in doubt.

……

Jin Miao quickly called the patient's family to the doctor-patient communication room.

in the communication room.

Sitting in front of Lu Chen was a man in his 30s.

His hair was fluffy, his eyes were bloodshot, and he looked like he hadn't rested for a long time.

"Doctor, how is my mother?"

As soon as we met, the man hurriedly asked.

Lu Chen shook his head slightly: "The situation is not very good. You should also know the diagnosis of the doctor in another hospital. It is currently acute myocardial infarction combined with severe mitral valve regurgitation..."

Before Lu Chen could finish speaking, he was interrupted by the man.

"Doctor, don't talk to me about these technical terms, I just want to know what to do next!"

The man shook his head helplessly.

In fact, in his heart, he seemed to already know the final outcome of his mother.

He is not a native of Modu.

This time, in order to treat the disease, he traveled across mountains and rivers, and went to many hospitals in Shanghai.

More than half of the family's money was spent, but in the end there was still no hope of finding a cure.

Lu Chen held back his temper, and slowly said to the man in front of him: "Don't worry, I'm the director of the Cardiology Department of the Fifth Hospital of Shanghai, and I will explain the condition to you now. As for the next step of treatment, I will explain it to you .”

Hearing Lu Chen's words, the man quickly looked down at his badge, "You...you are Director Lu, right?! I know you. I came to the Fifth Hospital this time because a patient told me..."

The man's expression suddenly became excited.

Lu Chen hurriedly said: "I told you, don't get excited, the treatment needs to be done step by step."

"Okay." The man nodded immediately, without continuing to speak.

Seeing this, Lu Chen continued: "Your mother's current illness is caused by a broken heart valve due to myocardial infarction. Simply put, it is a broken window in a room."

The window is broken, what should I do?
One is to repair, and the other is to replace the entire broken window with a new one.

(End of this chapter)