godfather of surgery

Chapter 803 Fontan Surgery
In the room of Sanbo Hotel, Xia Shu found his mentor and master, and everyone gathered to prepare to return to the imperial capital.

"Xia Shu, we are going to send you to Sanbo Hospital for a few months to learn heart surgery with Professor Yang. Are you willing?" Professor Xin asked Xia Shu for his opinion.

Xia Shu is Professor Xin’s Ph.D. It is difficult to stay in Fuwai after graduation because there are too few places, so he continues to engage in postdoctoral research in Fuwai, waiting for opportunities to find a job, or looking for opportunities to stay in Fuwai.

The instructor asked him if he was willing to come to Sanbo Hospital for further study. Of course he was not willing. Now he decided to stay and work in Sanbo Hospital. He had just gone to the Sanbo Human Resources Department to find out that he met the current recruitment conditions.

As a cardiac surgeon, An Zhen Fuwai, a doctor from Union Medical College and Shougang Medical University, is very popular because they represent the highest technology.

"Teacher Xin, I want to stay and work here!" Xia Shu said his thoughts directly.

"Work? Do you want to stay here and work? The postdoctoral research has not been completed yet, and we are going to send you to the United States as a visiting scholar."

Director Xin was very surprised by Xia Shu's thoughts.

"Can you tell me what you think?" Academician Wang's reaction was not that great. He wanted to hear what this unique student thought.

Xia Shu was very honest: "I have read Professor Yang's papers and now I have seen his surgery. I am sure that he is the best cardiac surgeon in the world. I don't need to go anywhere. I just want to stay and work here." , after studying with Professor Yang for five or eight years, I can become the world's top cardiac surgeon."

I have never seen such an honest student. He actually said in front of his tutor and master that an outsider is the best cardiac surgeon in the world, and that he can become the world's top cardiac surgeon.

Professor Xin felt a little worried, this guy's words were a bit offensive to the master.

Academician Wang didn't look unhappy at all. Yang Ping was originally the best in the world, and Academician Wang admired this student's confidence very much.

"You won't go to the United States either?" Academician Wang said deliberately.

Xia Shu shook his head: "I'm not going anywhere."

"You don't want to stay in Fuwai?" Academician Wang said again.

Xia Shu said categorically: "No more Fuwai."

"You have to think clearly. After you come back from the United States, you have a great chance of staying in Fuwai. The cardiac surgery department of Sanbo Hospital is not yet independent. There is only one thoracic surgery department, which is basically blank." Academician Wang half-squinted his eyes.

Xia Shu said calmly: "That's just now. In a few years, the cardiac surgery here will become world-class. It's precisely because their cardiac surgery is still in its infancy, so I have a place to use it. There are too many talents in Fuwai." But Sanbo is different. They are in short supply of cardiac surgery talents. I am an eight-year Ph.D. student at Union Medical College, and I am in line with their recruitment priority. I have made up my mind and will stay and work here."

"A blank piece of paper is the best for drawing!" Xia Shu added.

"You have great ideas. I support your idea. Let's do it this way. Weicong, this is a good thing. You guys go back and prepare. Lao Cao, can you please recommend it to Sanbo Hospital?"

Academician Wang said happily.

In terms of seniority, Xia Shu is already the disciple of Academician Wang. It is rare for a young person to have such an idea. Besides, it is a good thing to have a student under his disciple who can join Professor Yang to learn cardiac technology. Since Professor Yang cannot be introduced, then Just learn his techniques.

"It's definitely no problem for me to help with the recommendation. Xia Shu is an eight-year Ph.D. student at Xiehe University. In our hospital, eight-year Ph.D. students have no special problems and are directly admitted with priority. No other operations are required." Professor Cao is still relatively familiar with Sanbo's recruitment. People process.

Academician Wang thought for a while and said, "Weicong, I have an idea. Don't we have many PhDs? There are also many eight-year programs. Let's see if there are any who are willing to come to Sanbo Hospital. If there are people like Xia Shu , send a few more here, which not only solves the employment problem, but also allows young people to learn top technologies. Even those who do not have an eight-year doctorate are encouraged to come here to participate in recruitment."

"What do you mean?" Professor Xin was a little puzzled by Academician Wang's sudden suggestion.

Academician Wang took a deep breath and said: "This kid Xia Shu has a vision. In the future, the cardiac surgery department of Sanbo Hospital will definitely be world-class. If he can stay with Professor Yang for five or eight years, he will soon grow into the world's top cardiac surgeon." Doctor, if I weren't old, maybe I would be willing to study for a few years. The world belongs to you young people, study hard and study boldly."

"I'm a little selfish. It would be better if we could have a few more students. I hope my students can learn the best technology. I hope this group of people in the future will come from Fuwai."

Professor Xin finally understood Academician Wang's painstaking efforts: "I'll take care of this, Xia Shu. We'll start working on it this time when we get back. You prepare your resume."

"I have already submitted my resume." Xia Shu moved quickly.

Professor Xin did not expect the student to be so anxious: "Then please recommend Professor Cao."

Professor Cao agreed wholeheartedly and said there was no problem.

Academician Wang looked at the time and asked Professor Chen to buy a ticket to go back. Professor Cao said: "Professor Yang is still undergoing surgery. He said hello to me and asked you to have dinner with me tonight. He will take you to the airport tomorrow."

"Why is it so complicated? Professor Yang is so busy. Let's just be casual and don't have to go through any red tape. Let's take a rest. We'll have something to eat at the bakery and then go back. Yue Liang, book your flight tickets."

"I'm about to book it." Director Chen was searching for air tickets on his phone.

Academician Wang is very satisfied with this trip and has gained a lot.

At this time, Xia Shu took out a heart model from his bag and placed it on the coffee table, and began to study the heart. He looked at the model and pondered the surgery he had seen today, and did not waste even this time.

"You brought a model?" Academician Wang was very curious.

Xia Shu said: "I carry this model with me wherever I go."

"Let me take a look at your model. It's quite exquisite."

Academician Wang picked up the model and started playing with it. When he saw the heart model, he was filled with emotion.

Heart - as the pump of human life power, Academician Wang has been working in this field for more than [-] years and is still working hard on research.

A heart has four chambers and five blood vessels connected to it.

The left atrium is connected to the pulmonary veins, the left ventricle is connected to the aorta; the right atrium is connected to the superior and inferior vena cava, and the right ventricle is connected to the pulmonary artery.

This system of pumps and pipes pumps blood throughout the body and then recycles it, over and over again, until the moment of death.

The pulmonary artery carries blood to the lungs, the pulmonary veins returns pulmonary blood to the heart, the aorta pumps heart blood to the body, the superior vena cava returns body blood above the heart to the heart, and the inferior vena cava returns body blood below the level of the heart to the heart .

The left and right sides of the heart are isolated, and the middle is completely separated by the ventricular septum and the atrial septum.The left atrium and left ventricle are sometimes isolated and sometimes connected. This relies on the mitral valve, a one-way opening valve, to achieve this one-way flow function, allowing blood to flow from the atrium into the ventricle in one direction without Backflow occurs.

Similarly, the valves in the right atrium and right ventricle - the tricuspid valve - are similar, and there are similar valves in the roots of the aorta and pulmonary artery, which perform the same one-way valve function.

The entire heart constitutes the systemic circulation and pulmonary circulation.

The oxygen-rich blood in the left ventricle is transported out through the aorta as the heart beats, reaches all parts of the body, then passes through various capillaries, enters various veins, and is finally collected by the superior and inferior vena cava and returns to the right atrium.

Due to the consumption of oxygen by cells and tissues throughout the body, the blood returning to the right atrium already contains very little oxygen.

what to do?Add oxygen to it again, this work is completed by the pulmonary circulation.

The blood with low oxygen content is in the right atrium, and the one-way open tricuspid valve opens. The blood from the right atrium enters the right ventricle, and is pumped into the pulmonary artery as the heart beats. Then it undergoes gas exchange in the lungs, obtains oxygen, and becomes rich again. The oxygenated blood returns to the left atrium through the pulmonary veins.

Blood passes from the left atrium through a single open door into the left ventricle, where the next cycle begins.

Of course, when the heart is beating, all the work is done simultaneously.

Academician Wang held the heart and looked at it for a long time, recalling the most basic knowledge. He spent all his life on this, studying the heart model, and then closed his eyes to rest, as if thinking about something, worried. look.

The master took away the heart model, and it was hard for Xia Shu to ask for it.

Professor Cao, Professor Xin, and Professor Chen saw Academician Wang's expression and didn't know what Academician Wang meant, so they had no choice but to stay with them.

Study the model, frown, study the model again, sigh a few times, repeat this for half an hour.

"Yue Liang!"

Academician Wang called Professor Chen Yueliang over. Judging from his expression, he seemed to have something important to say.

"Sit here! Sit here, all of you."

Academician Wang asked Professor Cao and Professor Xin to sit over as well.

"Let me say a few words." Academician Wang said.

Everyone kept quiet and did not speak. Academician Wang began to sigh and said: "I was very touched when I just saw this model, because when I first started working, I also carried a heart model in my bag. Seeing this model, I recalled 40 years of I have been practicing medicine for more than 40 years and have saved countless lives, but it is inevitable that I will leave some regrets. Not to mention the early surgeries, even the later surgeries will inevitably leave regrets."

Director Xin didn't know what Academician Wang meant by mentioning this matter at this time. Surgeons have no regrets, especially those who deal with congenital heart disease. It is impossible for everything to come true.

"Teacher, our Fontan surgery now has the highest post-operative survival rate or survival time in Asia. This is all due to your hard work."

Academician Wang waved his hand: "It's insignificant. What I want to say is, Weicong, do you remember that I had a patient named Song Hanhui?"

"Remember, teacher, you performed an operation on him. He is now 11 years old." Director Xin remembered this patient.

Academician Wang's deep voice said: "I came for a review not long ago and found out that this child is in trouble again. I'm afraid he won't be able to hold on anymore. At that time, I planned to do orthopedics to solve the problem once and for all, but the child's heart malformation was too serious, with eight deformities. , and it was a congenital malformation that was not found in textbooks and literature, so I had no choice but to do palliative surgery. Now, after so many years, there is a way in theory, but it is too difficult to operate in practice. "

"Technology is always improving slowly. Besides, Fontan surgery is originally a palliative surgery. It is not your fault. If you hadn't performed the surgery on him at that time, he would not have lived to be nine years old."

Academician Wang waved his hand again: "The lack of ability back then meant lack of ability. We who study medicine must seek truth from facts."

Everyone still didn't understand what Academician Wang meant, so they waited quietly for him to continue.

"I mean, I've been thinking about it. Fontan surgery is a palliative surgery. After the three-stage surgery, the patient's symptoms are relieved and the patient's symptoms are improved and the goal is to improve the quality of life and extend the life span. But it is just a palliative surgery, not a radical surgery. , I have been wondering whether after the palliative surgery, these patients can undergo another surgery, which is the fourth surgery, to remove the whole heart + reconstruction when they become adults!"

This is an extremely bold idea. Academician Wang has always thought about it, but has never put it into practice because it is too difficult for surgery and cannot be done manually.

Academician Wang spent most of his medical career studying congenital heart disease and accumulated a lot of experience in this area. He was also the first person in the country to perform Fontan surgery, with countless survivors.

"I have always had this idea myself, but my ability is limited. When I saw Professor Yang's surgery today, I suddenly had the idea to refer this patient to Sanbo Hospital, or ask Professor Yang to come to our Fuwai to study this case together. , see if we can return the whole heart + rebuild!”

This is an extremely difficult operation. If it were to be done, it would be several times more difficult than Mai Zijing's operation. It can be called the most difficult heart operation in the world today.

"There is no other good way. I think we can give it a try." Professor Xin agreed.

Professor Chen then agreed.

"Yue Liang, not long ago you had a baby who needed Fontan surgery. However, because the large blood vessels are underdeveloped and the blood vessels are too brittle, it increases the difficulty of the surgery. You are going to let me do the surgery. I think you should let Professor Yang do this surgery. , we also take the opportunity to learn and learn.”

The two cases mentioned by Academician Wang are both regrets in his medical career. One is that when the operation was performed, the academic skills were not good and the quality of the operation was not high. Now the patient is in a desperate situation.

In another case, because Fontan for this kind of angiodysplasia was done before, the operation failed, and now there is the same case.

"I'll contact the patient and family members." Director Chen wrote it down.

Academician Wang thought for a while and said: "You should contact the family of this baby. I should contact Song Hanhui personally."

After this matter was settled, Academician Wang felt much more relaxed. They rested for a while at the Sanbo Hotel and rushed to the airport.

When Yang Ping was undergoing surgery, he learned from Professor Cao that Academician Wang, Professor Xin and Director Chen had left. They had many things to do at work and could not stay long.

Professor Cao told Yang Ping about Xia Shu, hoping to keep Xia Shu in the Department of General Surgery and study with Yang Ping for a few years.

An eight-year doctorate from Peking Union Medical College would be the best. Yang Ping likes doctors who take the initiative in learning the most.

Yang Ping immediately agreed and asked Xia Shu to come over for an interview. If there were no problems, he would be admitted directly.

(End of this chapter)