Auto chess in the operating room

Chapter 394 Second Heart Transplantation Completed

Professor Liu is the main surgeon, and Tang Lou is the first assistant.

The entire procedure of the operation has been deduced several times before the operation.

The recipient was pushed into the operating room 2 hours before the donor heart arrived, and the medical staff quickly established extracorporeal circulation.

"Yizhu, cooperate with me in the collection of heart offerings."

Professor Liu gave the order seriously, and at the same time as the operation began in the operating room, the multi-camera cameras had already started to record. After all, this is a highly difficult second heart transplant operation of great academic value.

The second assistant assisted in adjusting the patient to the supine position, and performed routine iodine tincture disinfection of the chest and abdomen skin.

"Systemic heparinization at 3mg/kg prevents thrombosis in the small blood vessels of the donor heart."

Professor Liu gave instructions from the side, and Tang Lou also participated in the formulation of this plan.

"One assistant starts the chest cut."

Professor Liu continued to control the rhythm of the operation, while Tang Lou on the side quickly took the scalpel and began to make an incision in the center of the patient's chest.

"Intraoperative inspection of the donor heart without trauma, deformity, and heart disease."

Tang Lou quickly completed the incision, cut open the pericardium at the same time, and completed the preliminary examination.

In the observation room, the rest of the expert team were nervously watching the operations in the operating room.

"Doctor Tang, you are really amazing. This is a free hand movement that ordinary doctors cannot learn in ten years or so."

"Yeah, especially when you watch him ligate the superior vena cava 4cm above the junction of the superior vena cava and the right atrium. It's too detailed. I'll have to watch this video several times afterward."

"Isolation of the aortic and pulmonary arteries with cold perfusion needle vascular clamps"

With talent and focus, Tang Lou has fully entered the rhythm.

Professor Liu on the side finally felt the ease of Director Dong before, this help is really considerate.

Tanglou soon completed the infusion of cardioplegia solution, and 3 minutes later the right superior pulmonary vein and superior vena cava were incised.

"Ice saline for local cooling."

Tang Lou gave the order directly, and the equipment nurse saw Professor Liu's tacit reaction, and immediately cooperated.

After the heart was cooled for 2 minutes, Tang Lou controlled the scalpel and quickly cut off the superior and inferior vena cava distal to the ligation, cut off the ascending aorta under the aortic blocking forceps, and cut off the pulmonary artery from the bifurcation of the left and right pulmonary arteries.

"Excellent operation."

"This level of concentration is astonishing. Dr. Tang is simply a surgical machine."

"How does it feel, this second heart transplant operation has become very common under Dr. Tang's operation."

"Yeah, I have the same feeling, floating, floating."

All the doctors watched Tang Lou's operations with pleasing eyes, and couldn't help expressing emotion.

"Under normal circumstances, there is a process of myocardial ischemia in donor heart collection. The time from brain death to donor blockage of the ascending aorta and the start of cold perfusion is warm ischemia time. The shorter the time, the better, and it can generally reach 5 minutes It was already very powerful. But this time, under Dr. Tang's operation, it was completed in less than 3 minutes. It's terrible!"

Not to mention the members of the expert group in the observation room, even Professor Liu was unexpected. What Tang Lou did was better than he could imagine.

"Professor Liu, I will trim the donor heart next."

After Tang Lou said something, he began to operate.

Professor Liu raised his eyebrows. Generally speaking, the pruning of a donor heart is very difficult, and the experience requirements for the surgeon are very strict.

Professor Liu originally wanted to operate it himself, but now that Tanglou has taken over it directly, Professor Liu hesitated and agreed to Tanglou's request.

In the observation room, the members of the expert group all stared wide-eyed, watching Tang Lou begin to trim the offering heart, in amazement.

"This is the job of the chief surgeon. Professor Liu is so relieved to entrust such an important step to Dr. Tang."

"Look, Dr. Tang has already cut the right atrium from the ostium of the inferior vena cava to the right atrial appendage to the root of the right atrial appendage."

"Quickly, this completes the trimming of the stumps of the aorta and pulmonary artery."

Amid everyone's admiration, Tang Lou checked the mitral and tricuspid valves and sutured the patent foramen ovale.

In the final step, Tang Lou made X-shaped cross-cut incisions along the four pulmonary vein entrances and cut the posterior wall of the left atrium to make a separate opening.

"Doctor Tang Niu Pi, the heart is ready so soon."

"Yes, Dr. Tang's basic skills are too solid. In particular, the operation of this step is all performed in 4 ℃ saline, and the donor heart is performed under the horizontal plane without colliding with the container. This operation is difficult for The stability of the hand and the fineness of the operation are too demanding."

As the second assistant, Chen Minjie had to accept it. Dr. Tang not only did the job of the chief surgeon, but also took care of his affairs as the second assistant.

"The next step is to perform resection of the recipient's diseased heart."

After completing the processing of the donor heart in Tanglou, Professor Liu on the side gave the second step of instructions with ease and excitement.

Since Ye Jian's heart was transplanted for the second time, it was several times more difficult than the first one, and the requirements for the operation were also several times higher.

Watching Tang Lou begin to cut open his chest, the expert group in the observation room also held their breath.

"Extracorporeal circulation blood cooling to 30 ℃."

As the second assistant, Director Chen reported the observation results from the sidelines.

"OK, tighten the superior and inferior vena cava bands. Block the ascending aorta"

After receiving the report, Tang Lou began to carry out the next operation.

Twenty minutes later, Tang Lou severed the interatrial septum, and the recipient's heart was completely removed.

The final step is to reimplant the donor heart.

Donor heart implantation includes left atrial anastomosis, right atrial anastomosis, aortic anastomosis and pulmonary artery anastomosis.

It can be seen that at this stage, the requirements for anastomotic skills are so high, which is also one of the biggest difficulties of this operation.

"Cold Saline Gauze Pad. 4-0 Polypropylene Suture."

Regarding this, Tanglou remained calm as usual, and the movements of his hands did not change at all with the passage of time.

Tang Lou put the donor heart into the recipient's pericardial cavity, lined the donor heart with cold saline gauze pads, and anastomosed the left atrium with 4-0 polypropylene sutures. The left atrium at the opening of the left superior pulmonary vein corresponds to the left atrium, and the suture is continuously sutured clockwise to the middle of the atrial septum, and then the other end of the suture is continuously sutured counterclockwise along the top of the atrium to the middle of the atrial septum, and tied with the first end.

"It's clean and tidy, the needle distance at each anastomosis point is even, the tension is consistent, and there is no blood leakage at the anastomosis site. This completes the left atrial anastomosis. It is really a pleasure to see Dr. Tang's anastomosis skills."

In the observation room, these doctors, even though they had seen Tang Lou's anastomosis technique several times, were once again impressed by Tang Lou's anastomosis technique.

"Beautiful!"

Next, Tang Lou quickly and neatly completed the anastomosis of the right atrium, aorta and pulmonary artery.

"Exhaust the left heart and ascending aorta, and open the aortic clamp. Thorough hemostasis"

Soon, Ye Jian's third heart started beating vigorously, synchronously, and the extracorporeal circulation was stopped.

A second heart transplantation that has gone down in the history of heart transplantation medicine was successfully completed under Tanglou's strong operation.

Professor Liu also announced in amazement: "The operation is complete!"

(End of this chapter)