I can see health

Chapter 942 Logo of Huaxia Cardiology Department
operating room.

Gu Xinyue began to anesthetize and drape the patient before the operation.

For this operation, the patient is under general anesthesia.

After Gu Xinyue established venous access, Jin Miao began to puncture the right femoral vein.

On the side, Lu Chen performed transesophageal echocardiography.

This will be the first difficulty of this operation!
That's how to determine the septal puncture point.

The patient's heart and structural shape have undergone serious changes.

The normal atrial septal puncture point is not so obvious.

"Director, I...I didn't find the puncture point!"

Jin Miao's face was extremely ugly.

According to the routine operation, he could not touch the patient's interatrial septum at all.

After the patient's overall heart changed, he couldn't find the puncture point at all.

On the side, Lu Chen kept checking the patient's echocardiogram.

And in the virtual space of the system in his mind, the correct operation method is constantly deduced.

Simulate various heart shapes and try to puncture the atrial septum.

In a moment.

Lu Chen already had a decision in his heart.

"Jin Miao, first determine the position of the puncture point on the Bi-bicaval section and the SAX-short-axis section!"

"Okay director, received!"

Hearing Lu Chen's voice, Jin Miao followed his prompts and began to operate.

"Afterwards, the distance between the puncture point and the mitral annulus is determined on the four-chamber view, and the general puncture height is 4-4.5cm."

Hearing this, Jin Miao was slightly taken aback.

Director Lu was able to tell all the specific data.

Where did this data come from?

In addition to being astonished, Jin Miao's movements were not slow at all.

With the help of fluoroscopy and Lu Chen's reminder, he finally succeeded in puncturing the interatrial septum.

"Okay, send the Super stiff guide wire to the left atrium immediately."

Lu Chen's expression remained unchanged, and he continued to direct Jin Miao to operate.

After using the vascular sheath to dilate the femoral vein, Jinmiao introduced the guide wire into the 24F guiding sheath across the interatrial septum to the left atrium.

Through the 24F guide sheath, the mitral valve MitraClip valve clip system (CDS) was sent.

Under the guidance of esophageal ultrasound, Jinmiao successfully reached the target position of the mitral valve and captured the flail leaflet.

"Director, the patient's blood pressure has dropped!"

Suddenly, Gu Xinyue shouted from the side.

"Pause the operation, pump in dopamine and norepinephrine!"

Lu Chen was slightly taken aback, and ordered in an orderly manner.

The most feared event finally happened!

"Increase pump speed now!"

At the same time, he had the nurses push the IABP and ECMO machines over.

These two machines are ready for further operations if the blood pressure cannot be maintained.

The bedside ECG monitor was intermittently measuring the patient's blood pressure.

Lu Chen monitored his vital signs all the time.

"Are IABP and ECMO used?"

Jin Miao asked nervously from the side.

"No rush, just suspend the operation for observation." Lu Chen shook his head slightly, "If the blood pressure can be stabilized, IABP and ECMO are unnecessary."

"it is good!"

Catheter indoor and outdoor.

Everyone stared at the changes in blood pressure.

In this operation, the key point is not only the difficulty of the operation.

More importantly, it is to let the patient successfully step down.

If the patient cannot tolerate the operation, then all the work is in vain.

5 minute later.

The patient's blood pressure finally stabilized at 90/60mmHg.

"Okay, the operation continues." Lu Chen said, "I will perform an esophageal ultrasound first to check the position of the valve, and you will operate according to my prompts."

Jin Miao and Gu Xinyue nodded slightly.

Lu Chen began to perform esophageal ultrasound.

He kept adjusting the position, carefully observing the position and shape of the valve.

"Okay, the position is okay, Jin Miao, you can release the valve."

Jin Miao nodded, with a hint of surprise on his face, "Hmm!"

After repeated confirmation by esophageal ultrasound.

Jinmiao implanted a MitraClip XTR mitral valve clip at the A2/P2 area of ​​the mitral valve.

"Wait a minute, I'll take a look at the position of the leaflets."

At this time, it is the second difficulty of the operation, how to adjust the position of the valve clip.

Lu Chen adjusted the position of the valve clip on the X-plane cut plane.

"Mainly locate the most obvious A2/P2 area of ​​PISIA!" He said to Jin Miao who was on the side.

"Roger that!"

Jin Miao responded, and then with the help of Lu Chen's operation, began to slowly position.

Lu Chen continued: "Adjust the axial direction of the clip on the joint view of the mitral valve junction and the LVOT view respectively, and at the same time observe the position and area of ​​the clip on the 3D view."

Under Lu Chen's guidance, Jin Miao's technique has become more and more proficient from being unfamiliar at the beginning.

An esophageal ultrasound was performed again, and it was found that the position of the valve clip was good, and the valve leaflets were firmly grasped.

However, at this moment, Lu Chen did not relax.

He said slowly: "Catch the anterior and posterior valve leaflets at A2/P2 deviation 1, and gradually close the valve clip."

"Okay!" Jin Miao replied while operating, "The position of the valve clamp is good, and the axial direction and orientation are ideal!"

TEE showed that the mitral regurgitation was significantly reduced to a small amount.

The 3D perspective shows that the tissue bridge is continuous and complete, and the valve leaflets are captured stably.

Lu Chen nodded with a smile, finally relieved, and said: "The average mitral valve transvalvular pressure is 2mmHg, multiple sections have confirmed that the clamping tissue is sufficient, and the Doppler waveform of the left upper pulmonary vein has returned to normal from the reverse."

Jin Miao also heaved a sigh of relief when he heard Lu Chen's feedback.

The delivery of the valve has been completed, which indicates that the operation is more than half successful.

Immediately after the operation, ultrasound suggested that the mitral valve regurgitation decreased to a small amount.

Colored blood flow indicates a small amount of valvular regurgitation, and the measured average transvalvular pressure difference is 3mmHg.

The blood flow spectrum of the left upper pulmonary vein was re-examined and returned to positive, and the surgical effect was satisfactory.

"Jin Miao, start to gradually release the valve clip system and withdraw it from the body!"

"it is good!"

This last step, although simple, is also very important.

Every step of Jin Miao is meticulous, afraid of the slightest mistake.

"Take your time, don't rush." ​​Lu Chen instructed, "The most important steps have been completed, don't let the halberd fall into the sand here."

"Ah."

Jin Miao nodded slightly.

With the assistance of Gu Xinyue, he slowly released the valve clip system, and then successfully withdrew from the body.

At this point, the whole operation is over!

In the operating room of the cath lab.

Both Jin Miao and Gu Xinyue's faces were filled with joy.

There was also a smile on the corner of Lu Chen's mouth.

Although they were able to suppress the excitement in their hearts, the people in the Cardiology Department of the Fifth Hospital of Shanghai outside the catheterization room couldn't calm down.

The crowd began to applaud unconsciously.

The completion of this operation means that the Shanghai Fifth Hospital has entered the ranks of the top hospitals in China.

From TAVR, electrophysiology, to transcatheter tricuspid valve surgery, TEER surgery.

In the Fifth Hospital of Shanghai, every operation performed by Lu Chen is a top-notch surgery in China and a first-class technique in foreign countries.

Many Mayo people who were at the same time as Lu Chen were watching Lu Chen's live broadcast at this time.

Even in Mayo in the United States, Professor Debed was amazed.

"As expected of Lu!"

Debde sighed in his heart.

In his mind, Huaxia's Department of Cardiology, the Fifth Hospital of Shanghai, has gradually become the symbol of Huaxia's Department of Cardiology.

(End of this chapter)