Doctor Peerless

Chapter 650 One surgery is better than three

The operation is in progress.

After Zhou Sheng opened the mediastinum, both he and Director Tian found that the patient's right coronary artery was dissected like a cuff.

At the same time, Zhou Yisheng also found that there was a tumor at the root of the patient's aorta.

Typical aortic root aneurysm.

It turned out that the patient's aortic dissection was caused by an aortic root aneurysm.

Director Tian frowned when he saw the result.

The patient's condition is very complicated.

A surgical treatment is quite the solution for all conditions.

According to Director Tian's decades of experience outside the heart, the current situation requires at least three surgeries.

One surgery is done to fix the problem of aortic dissection.

One deals with coronary artery occlusion.

Another one is of course to treat the root aortic aneurysm.

These three operations all need to stop the heartbeat first, then lower the patient's body temperature, put him in a state of suspended animation, and perform it with the support of extracorporeal circulation.

Each operation performed individually is a top-notch operation with extreme difficulty.

Even Director Tian, ​​who is well-known in Qin Zhong, is so distracted that he still has lingering fears when he sees the situation in front of him.

One of the three operations is performed, which is a major operation among major operations.

Director Tian began to worry about Zhou Sheng.

Can he do these operations?

Although he had just opened his chest, Zhou Sheng showed some strength.

But thoracotomy is compared with these three operations.

That was nothing at all.

At the same time, Director Tian also began to feel that Dean Cheng had a foresight.

He thought that if Zhou Yisheng couldn't stand it anymore, he could go up and help out.

Of course Zhou Sheng was very clear about the current situation.

Before opening the mediastinum, the system has given a specific surgical treatment plan.

Bentall surgery, total arch replacement surgery, and right coronary artery bypass surgery are the only options for treating patients.

Bentall operation, also known as "ascending aortic replacement with aortic valve artificial vascular".It is a surgical procedure for the treatment of ascending aortic aneurysms.The operation requires pause of the heart to stop beating.

Total arch replacement surgery is one of the most difficult heart surgeries. It relies on the surgeon's superb technology and high-tech materials. The whole body is "quick-frozen" to 20 degrees Celsius, and the upper end of the damaged heart is quickly cut off. The largest body in the human body. Blood vessels are implanted with a substitute made of polymer polyester material.The goal is to manage the dissected aortic arch.

Right coronary artery bypass surgery, just listen to the name.This operation is to build a bridge for blood vessels.The specific method is to use one's own lower extremity veins as a bridge material, and also stop the heart under extracorporeal circulation, and bridge between the aorta and the distal end of the coronary artery disease.

These three surgeries are all four-level extracardiac surgeries.

Zhou Sheng performed all these operations in the director's copy last night.

But in the dungeon, he didn't perform three such operations at the same time in one operation.

Zhou Sheng murmured in his heart, good guy, this is enough rhythm!
Doing this one operation is worth the three major operations in the dungeon.

Zhou Sheng estimated that the three surgeries would not be completed within 7 or 8 hours.

Roll up your sleeves and just say "do it"!
Start with the Bentall procedure.

The right femoral artery inserts into the supply vessel...

The right atrium is inserted into the draining vessel...

Connect to an artificial heart-lung machine for bypass, clamp the ascending aorta distal to the lesion when the body temperature drops to 26°C, and perfuse cardioplegia.

Free the ascending aorta, resect the diseased segment of the ascending aorta, retain its rear and left and right coronary artery openings, resect the aortic valve, transplant artificial blood vessels with valves, and then transplant the left and right coronary arteries on the artificial blood vessels, artificial blood vessels Anastomose with the distal end of the ascending aorta.

……

Zhou Sheng put his head down and fought hard.

As the first assistant, Bai Mingming couldn't intervene at all.

He had never undergone cardiac surgery, so he was no better than Su Quan and Cao Xin.

Only watching life on Monday.

Occasional chores.

Surgery is very stressful.

Director Tian was originally watching from a relatively biased position. The operation was too tense, so in the end he couldn't help but moved to the second assistant Su Quan's side.

Su Quan's second assistant is basically the same as Cao Xin, a spectator.In this operation, there is no effect at all.

So when he found Director Tian approaching, he took the initiative to give up his position to Director Tian.

Director Tian nodded to him and said, "Thank you."

With a good position, Director Tian paid more attention to Zhou Sheng's every move.

Bentall surgery has many small details to pay attention to.

Zhou Sheng handled it very meticulously.

Director Tian is a master of surreptitiousness. One can tell from Zhou Sheng's operation that Zhou Sheng is experienced and has been instructed by experts.

That's right, what Lao He taught in the system was meticulous, and if Zhou Sheng made a mistake, she would deduct points and start over again.

So Zhou Sheng's technique is very solid.

Four hours later, Bentall's surgery was complete.

But this is only the first step in the operation.

Next, a total arch replacement is performed.

Zhou Sheng raised his spirits and continued to fight.

After four hours of surgery, even Su Quan, Cao Xin and others who watched from the side felt a little tired.

Zhou Sheng was also a little tired, but he didn't have time to rest.

In front of him, the aortic arch, which was originally only 3 cm in diameter, has been stretched to 7 cm thick by the dissection blood, and the blood vessel wall is so thin and transparent that it will rupture at any time.

Surgery must be carried out against the clock.

Under the doctor's order on Monday.

The extracorporeal circulation equipment is controlled, and the blood temperature drops.

The blood temperature slowly began to drop, and finally stabilized at 20 degrees Celsius, which was a full 37 degrees lower than the normal body temperature of 17 degrees Celsius.

CPB was stopped and aortic arch replacement started.

In a low temperature state, the human body can be "quick-frozen" for about 40 minutes, and no matter how long the time is, it will not work.

Zhou Sheng has half an hour to do replacement work.

Therefore, one of the most difficult operations outside the heart is not only a test of skill, but also a test of proficiency.

Zhou Sheng first cut off the damaged aortic arch.

Over there, Bai Mingming immediately handed over a 10 cm long "elephant trunk" bracket.

Zhou Sheng began to insert it, and then connected an artificial blood vessel.

This artificial blood vessel is called the artificial aortic arch.

When it comes to blood vessels, don't think that they are like water pipes, with only two simple ports.

This guy has 8 ports up, down, left, and right.

Each port must communicate with the great blood vessels and arteries, and all of them are lifelines.

Zhou Zhou, a novice, sewed up one port in an average of 2 minutes, and sewed 8 ports in one go.

All the vascular connections were sutured, and there was not much bleeding.

The 3000 milliliters of blood prepared aside to deal with the hemorrhage were of no use at all.

Director Tian praised in his heart.

Warm up and restore blood circulation.

The operating room was quiet, only the sound of Zhou Sheng's operation.

No one chats.

Not only because Director Tian was there, but also because the operation was very dangerous.Everyone was afraid of disturbing Zhou Sheng.

Before I knew it, the operation time had reached 6 hours.

The second operation is over.

There is one last operation left.

……

(End of this chapter)