It's not that hard to open a hospital in another world, right?

Chapter 36 Patent Ductus Arteriosus
"tube?"

Aunt Erin wondered.Gretel reached out and gestured for the length of his forearm, then circled his left thumb and index finger together to measure the thickness:
"So thick, so long...to be hollow..."

"Just listen to it!" Aunt Erin waved her hand proudly: "Avril is so young. Besides, you also watched her grow up!"

This... Great Khan.He will never listen to his heart against his chest again!If possible, never again!
Seeing him persevering, Aunt Erin searched under the kitchen, took out a pitch-black hollow tube, washed it and handed it over.Grete took it in his hand and looked at it. It was longer than his entire arm. The end was covered with carbon black, and there were many burn marks. It was clearly a torch.

……All right.

Use it first, and then have the opportunity to build a stethoscope...

Gretel calmed his mind, pointed the torch to his ear, and put the blower on Avril.Said to listen to breath sounds, but the end of the torch is slowly moving until the apex of the heart beats the strongest point.Hold it firmly, listen with a breath, and move from time to time, the more you listen, the more serious your face becomes.

There is a murmur in the apex.

Moving to the left border of the sternum, in the area of ​​the pulmonary valve in the second intercostal space, the diastolic murmur was clearer, and it was clearly a continuous mechanical murmur.

Moving to the aortic valve area, the murmur gradually weakened.The murmur in the tricuspid valve area is also almost inaudible. After listening around the heart, moving to the left under the collarbone, the clear mechanical murmur sounded again...

In the second intercostal space on the left sternal border and below the left clavicle, a continuous mechanical murmur could be heard during diastole.Wide range of conduction.

Combined with previous dissociative cyanosis, frailty, fatigue, seasonal cough, high suspicion...

Patent ductus arteriosus.

One of the types of congenital heart disease.Mild cases have no symptoms for life, and severe cases can cause pulmonary hypertension, heart failure, and even death.

Gretel closed his eyes sharply.He listened to his lungs patiently, made sure that the breath sounds were normal, and put down the torch.After thinking for a while, holding a glimmer of hope, he turned and asked Aunt Erin:

"Auntie, Sister Avril's body... Have you seen the pastor? What did the pastor say?"

His serious look clearly frightened others.Under the oil lamp, Aunt Erin was stunned, forced Avril to go to sleep with a smile, and then sighed:
"Master Bishop said that Avril is also weak, so she needs to rest more often, and be careful not to catch a cold... If you have to treat the same as ordinary people, you need a very high level of magic, and he can't use it..."

Do they just feel weak?
Gretel was a little sad, but also a little relieved.It’s good to only know these words. Sometimes, ignorance is also a kind of happiness… Knowing that it is a congenital heart disease, what can I do?

Heart disease has been a terminal illness for a long time.Cardiac surgery, also long after surgery began to develop, was a restricted area of ​​medicine.The Austrian doctor Theodor Birroth, who was later regarded as the "father of surgery", had such a "curse" on heart surgery:
"Operating on the heart is a desecration of the art of surgery. Anyone who attempts to perform heart surgery will be disgraced." (Note 1)

There is no means of life support, no extracorporeal circulation device, or even the most basic hemostasis, disinfection and anesthesia.Under the current conditions, rashly performing heart surgery is tantamount to murdering the patient.

Rather than that, it's better to let Uncle Karen, Aunt Erin and the others just go on like this, ignorant.

Gretel reluctantly persuaded himself, and turned his eyes to Avril again.After the coughing stopped, the little girl's face eased a lot.On the toes, the faint purple has also faded, turning pink again.

This light powder, in Grete's eyes, is simply the most beautiful color in the world.

- Thank goodness!Cyanosis occurs only when there is severe coughing and hypoxia, but there is no cyanosis usually!
This level of patent ductus arteriosus develops to pulmonary hypertension, severe heart failure and even death. Fortunately, there is still more than ten years!
Gretel breathed a sigh of relief.He tried his best to hold back his unease, comforted little Avril with a smile, chatted a few words with Uncle Karen and Aunt Erin, and left.The door was closed behind him, and the moment he disappeared into the darkness, Gretel closed his eyes and clenched his fists tightly.

Patent ductus arteriosus is treatable.

In his previous life, he had seen countless such patients with his own eyes, and he had also referred such patients to his colleagues in the Cardiology Department.

This disease is not a terminal illness, and even the treatment does not need to go bankrupt.

A child like Little Avril, in a previous life, only needs an interventional operation.The catheter between the aorta and the pulmonary artery is blocked with an occluder, and the entire operation takes only an hour and a half.I can hear my heart sounds back to normal that day, and in a few days, I can be alive and kicking.

But that surgery is easier said than done—

It is necessary to have an electrocardiogram to determine whether the heart is defective, X-ray examination to exclude other diseases, echocardiography to identify diseases, cardiac catheterization to understand pulmonary vascular resistance and shunt conditions, to exclude other malformations, and to confirm whether they meet the conditions for surgery;
A guide wire with the largest diameter of 0.88 mm and the smallest diameter of 0.45 mm should be guided along the patient's femoral artery along the patient's femoral artery under the guidance of X-rays until it is inserted into the heart;

There must be an occluder made of superelastic nickel-titanium alloy, with a polymer biofilm attached inside, which is sent to the defect of the arterial duct by a guide wire, and then the occluder is controlled to open to block the gap;
Of course, there must also be a contrast agent with a high enough purity that will not cause thrombosis when injected into the blood vessel, injected into the blood vessel, and the blood flow will be displayed under the X-ray to confirm whether the operation is successful...

One by one, one by one, they are the crystallization of modern medicine, modern industry, and top high-tech.From the industrial revolution to the electrical age and the Internet age, countless years of technological, industrial and medical development have forcibly filled the gaps in life and turned the once terminal illness into an ordinary one.

But now, he, Gretel Nordmark, has nothing.

Here is another world.

No catheter guidewire occluder, no echocardiogram, no anesthesia, no blood transfusion, no angiography…

How can I take back Little Avril's life from the god of death?

The magic is unreliable.The bishop said that there is no cure, obviously lower-level magic can't deal with congenital diseases.magic, magic...

Can magic emit ultrasound?Can magic make an electrocardiogram?Can magic summon a guide wire thin enough to enter the human heart and heal the defect?
Magic...can he see the mysteries inside the human body?
Gretel doesn't know.But he knows that from tomorrow, he will open the door of magic, as long as he works hard enough, as long as he has enough imagination, everything is possible!

Ten years, he wants to do all this within ten years!
Uncle Karen, Aunt Erin, Sister Avril—

wait for me!

******
Note 1:

Quoted from "Legend Beyond the Heart"

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(End of this chapter)