Back in 2002 as a doctor

This is basic common sense.

But Zhou Congwen asked that the guide wire not touch the blood vessel wall!

Director Li stared blankly at the screen, he understood what Zhou Congwen just said - to prevent outflow tract spasm or ventricular arrhythmia from stimulating the ventricular wall.

But that's not human operation at all.

However, when everything appeared in front of his eyes, Director Li was not allowed to have any doubts.

The 0.035" guide wire is almost invisible, and it is thin like an artifact. And this shadow is floating in the pulmonary artery and right ventricle, without contact with blood vessels and the heart.

Even the 0.035" guidewire did not touch the stenotic pulmonary valve!

This is also... this is also...

Director Li looked at the screen and the micro-guide wire as if he was still dreaming.

Then the heart catheter was put in and angiography was started.

Cardiac catheterization showed severe stenosis of the pulmonary valve, the maximum open valve diameter was only 1.7mm, and the pressure gradient between the right ventricle and the pulmonary artery was 134mmHg, which was almost consistent with the previously measured 137mmHg.

"Here, the ratio of balloon diameter to pulmonary valve annulus diameter was chosen to be 1.2 to 1.4."

Zhou Congwen's voice floated out again.

"We used a 10mm×20mm balloon to expand the pulmonary valve of the child."

"The balloon catheter is sent along the track so that the center of the balloon just straddles the valve, and the pulmonary valve is expanded 3 to 4 times with a diluted contrast agent at a pressure of 2 to 3 atm."

"Pay attention here, you must not rush to expand the balloon first, but dilate the pulmonary valve 3 or 4 times with a diluted contrast agent at a pressure of 2 to 3 atm."

"The principle has been explained before, so it's good for everyone to remember it. If you have done a lot of operations, you can understand it with a little memory."

Director Li was startled, he had never heard what Zhou Congwen said.

In Director Li's cognition, the most powerful operation is balloon dilation, and I hope there will be no complications.

As for flushing the valve with diluted contrast agent, this incredible way...

"Director Zhang?" Director Li called out in a low voice.

But Zhang You didn't speak. He stared at the screen intently and didn't hear Director Li's words at all.

Zhang You knows when to pretend and when to study.

How wonderful the operation is, it doesn't mean anything to Zhang You.

Watch it every day, every day, you can't be shocked every day.After reading too much, no matter how awesome the surgery is, I think it should be like this.

Besides, if you don't know anything, just ask Zhou Congwen directly. He never hides his secrets in technology.

It's just that Zhang You can't do it by himself.

Not only Zhang You, but also Teng Fei felt that she would never be able to reach Zhou Congwen's level in her whole life.

After flushing with diluted contrast medium, the balloon is continuously inflated to propel the narrowed pulmonary valve.

Director Li was stunned.

Shouldn't this step be cautious and expand the pulmonary valve a little bit like walking on eggshells?If there is any stimulation, it is better to give medication.

Unknowingly, greasy sweat began to appear on his face.

Half of it was caused by excitement, and the other half was caused by Director Li's fright.

Director Li didn't even understand half of the operation.

"That's about it." Zhou Congwen's voice came from the intercom, "Now measure the transvalvular pressure, if it is less than 25, the operation is successful. I estimate that the transvalvular pressure of the child is between 18-20."

After Director Li heard Zhou Congwen's confident words, his heart seemed to be pinched by a pair of invisible hands, and he couldn't even supply enough blood for the most basic systemic circulation.

Is this the end?

What did Zhou Congwen do, and why did the operation end?

If the patient insists on undergoing surgery in the first year of the medical university, Director Li can be sure that he will not be able to come down for 5-6 hours, if the patient's life is really serious.

But in Zhou Congwen's hands, it was over as soon as it started...

Director Li bent down, wanting to get closer to the screen to take a closer look.

After all, Zhou Congwen chose too thin a microwire, and Director Li doesn't have presbyopia, but it's difficult for him to see the microguide easily with his eyesight.

Leaning over, the glasses slipped down the sweat on his face before Director Li got closer to the screen.

Director Li was engrossed in looking at the screen, but he didn't expect his glasses to fall off.

He didn't even have time to save him, when he heard a "snap", the glasses fell innocently to the ground.

Crouching down to pick up the glasses in a panic, Director Li was at a loss.

The operation was completed, and it seemed that it took less than 15 minutes, which was shorter than the 30 minutes that Zhou Congwen said before.

Even if you add the time to measure the transvalvular pressure and the finishing work, it is estimated to be about 25 minutes.

How could it be done so fast.

His mind was very disturbed, like a mess.

Surgery... Director Li didn't know how to describe it, and there was always a voice deep in his heart telling him that something seemed wrong.

The voice became louder and louder, but Director Li was at a loss.He thought that the operation must have been done well, and his glasses fell to the ground because of his fright.

When Director Li squatted on the ground to pick up the glasses, he suddenly remembered the scene just now - Zhou Congwen continued to inflate the balloon, but the vital signs of the child displayed on the screen in the operating room did not change at all!

Not even the heart rate changed!

This is impossible, absolutely impossible!

Even if there is no arrhythmia such as ventricular fibrillation, it is reasonable for the heart rate to change, at least it should be faster.

However, the value is there, and it has not changed at all...

Director Li squatted on the ground, pinching the legs of his glasses with his hands, holding his head up and motionless.

"The transvalvular pressure is 20 mm Hg, and it's done!" Zhang You clenched his fist with his right hand and smashed it on his left palm, saying loudly.

Then he took half a step back, but was tripped by Director Li who was squatting on the ground behind him.

In the operating room, chickens are flying like dogs jumping.

Chapter 1060 Completely Incomprehensible Surgery

"The luck of this operation was relatively good, and there was no convulsion." Zhou Congwen explained while pulling out the catheter, "Generally, if there is right ventricular outflow tract spasm at this time, you don't need to pay too much attention. Just give some propranolol after you step off the stage. It will recover soon."

As he spoke, Zhou Congwen heard a thump, thump sound from the intercom, and he frowned and looked sideways.

"What are you doing?" Zhou Congwen asked.

"..." Teng Fei looked at the two directors lying on the ground, and wanted to explain, but didn't know what to say.

Zhou Congwen's operation was simple but full of details.

If the same surgery was done by me, let alone the time of the surgery, it may not be possible to go smoothly.

No, it’s not impossible, it’s definitely not going well, and it’s the luckiest thing for the child to step down alive.

"Congwen, the operation looks okay, and it doesn't seem to be too difficult." Shen Lang didn't know what Teng Fei and the others were thinking outside, so he said to Zhou Congwen very attentively.

"Of course, I'll take you to do 30 similar operations, and you and Director Teng will do it in the future."

"I can do it myself, and I am very proficient at crossing my left and right hands!" Shen Lang said.

"Are you stupid? Don't you know what your professional title is?" Zhou Congwen scolded in a low voice, "It takes director Teng to come on stage, and he needs to have enough respect for the old director. How many times have I told you, why didn't you A memory."

Listening to the faint voice coming from the intercom, Teng Fei cried in a mess.

Who is Shen Lang? He is a junior doctor in the second and third grades from the Third Hospital of Jianghai City, and he has not even been promoted as an attending physician!

But Teng Fei knew that Shen Lang had Zhou Congwen's hands-on teaching, and his level improved extremely quickly in a short period of time.

Being young has its advantages. Shen Lang wore a full set of lead clothes for surgery, and his hands were still steady.What about yourself?

Moreover, when Shen Lang started, he was led by a master of Zhou Congwen's level, and his foundation was much stronger than his own.

He was still struggling with the countless minor ailments that he had developed when he was groping for surgery before, but Shen Lang didn't have any troubles in this area, and he was brave and diligent, which made Teng Fei envious.

It can be said that Shen Lang has a professional background, which is no worse than that of Xiehe, Fuwai, and Anzhen.

Teng Fei herself is Ye Luzi.

Thinking of this, Teng Fei was even more depressed.

Zhou Congwen pulled out the catheter, turned around and stepped off the stage.Kicking open the lead door, I was a little surprised to see Zhang You and Director Li lying on the ground twisted and twisted.

"The two of you are..."

"Director Li's glasses fell on the floor, really..." Zhang You was also thrown, but with Director Li on his back, he had nothing to do.

"Director Li, slow down, I'll help you." Zhou Congwen supported Director Li, worried that his old arm and leg would break if he fell.

After a brief inspection, fortunately there were only two soft tissue contusions, and there were no complications such as fractures.

Zhou Congwen was very speechless. It was fine to perform the operation by himself, and there was a lot of noise outside.

"Professor Zhou, you... your operation..." Director Li really didn't know what to say.

His admiration for Zhou Congwen was like a surging river, endless.

No matter what you say, it seems that you can't express your inner admiration.

5 and a half months old baby, weighing a little more than ten catties, blood oxygen 85%, transvalvular pressure difference... Zhou Congwen took 25 minutes to complete the operation, the postoperative transvalvular pressure difference was less than 20, and blood oxygen saturation has increased to 98 %.

The effect of the surgery can be described as immediate.

Moreover, the trauma suffered by the child is extremely small, compared with the previous operation of heart-chest splitting the sternum, it is simply an existence in another space and another dimension.

"My operation is okay." Zhou Congwen smiled, neither humble nor complacent.

It was just a balloon dilatation operation for pulmonary valve stenosis, which was not difficult, and Zhou Congwen couldn't be complacent even if he wanted to.

"Professor Zhou, what is the prognosis of the child after surgery?" Zhang You asked proudly.

"It should be no problem. You can leave the hospital in 3 days, and you can gain weight after 1 month." Zhou Congwen said with a smile, "More than 95% of the patients are cured, and the rest can survive until they are 7-8 years old before receiving surgical treatment. .”

The data given by Zhou Congwen was accurate, and Director Li had nothing to say.

"If you're okay, go back and have a rest, and take a film if you feel uncomfortable." Zhou Congwen urged, "Look at what's going on, but there must be no fractures, otherwise I don't know how to explain it. "

"It's all right." Director Li continued to say distressedly, "I just dropped my glasses, accidentally, accidentally."

"Go to my office and lie down for a while." Zhou Congwen said, "Don't go back in a hurry."

"No." Director Li felt that he had lost all face, and he felt confused in his heart.

Dean Lin asked himself to pick faults. At that time, he also felt that even if Zhou Congwen performed the operation well, there would definitely be faults.

It may not be possible to do surgery, but no one will pick faults.

However, Zhou Congwen taught himself a lesson today.Some people's faults can't be picked out.

Not to mention picking faults, after Zhou Congwen performed an operation, he didn't understand many details.

How did the guide wire at point [-] achieve successful presetting without touching the vessel wall, right ventricle, or narrow pulmonary valve?

Why is the pulmonary valve flushed with diluted contrast medium before balloon inflation?

When the balloon is inflated, it is not expanded once, and then observed, but continuously expanded.

It doesn't matter if you continue to expand, why the child's heart rate and other vital signs have not changed.

A series of problems made Director Li confused.

Because Zhou Congwen's operation was too...unbelievable, Director Li had the idea of ​​escaping.

"Don't mind." Zhou Congwen warmly persuaded him to stay, "Director Li was accidentally injured, so let's take a break first. I said something unlucky. If there is any problem, it is good to find out early. We dare not be careless. You are ours." Senior cardiothoracic surgeons in the province, you are welcome."

Director Li finally went to Zhou Congwen's office to rest.

After Zhou Congwen answered Director Li's question, he made a request "by the way"—if Director Li has local doctors he is familiar with, tell them that poor children with congenital heart disease in the local area can be sent to the Second Hospital of Medical University for free surgery.

Director Li really doesn't know what to say about the free surgery.

The Second Hospital of Medical University is really costly. An interventional operation costs tens of thousands, so it's free? !

He doesn't think it's really charity. Doctors are human beings, and they also have to support their families.