Doctor Peerless

Chapter 666 Rejuvenation Under High Potassium
The equipment nurse handed over the valve forceps and the No. 15 round knife.

Holding valve forceps in his left hand and a circular knife in his right, Zhou Sheng began to remove the calcified aortic valve.

The valve clamp is fixed, and the circular knife cuts a circle along the edge of the calcified valve.

The diseased valve was successfully removed.

The next step is to measure the size of the valve and choose the appropriate valve replacement.

Stitched.

This process is the most difficult.

Small artificial valves need to be stitched precisely in place of the valve.

The distance of each stitch is precisely controlled between 2 and 3 mm.

The whole process can be said to require suturing at the vascular level.

Zhou Sheng is proficient in his movements.

In half an hour, the aortic valve replacement was completed.

Holding a pair of tweezers with a rubber sheath at the front, Zhou Yisheng tested the "door" that had just been replaced to see if the door opened and closed flexibly.

Although it is a man-made thing, it is small and exquisite, and there is no problem at all.

Changing the "door" worked successfully.

This is but the first of four "doors".

Next, there are three "doors" waiting for Zhou Sheng to deal with.

Before that, however, a second injection of cardioplegia was required.

The effectiveness of cardioplegia is only about half an hour.

The second time the high potassium solution was injected into the heart, Zhou Sheng had another half an hour for the operation.

Although cardioplegia can be added multiple times, it does not mean that Zhou Sheng's operation time is unlimited.

As an auxiliary means, extracorporeal circulation should generally be used within 3 hours.

And the time of cardiac arrest should not be too long.

Especially the patient is very old and the heart tolerance is limited.

If you stop for a long time, recovery is also very dangerous.

If it is not done well, it will become a permanent stop.

Zhou Sheng must race against time to perform the operation.

Zhou Sheng began to replace the mitral valve without stopping.

……

Two hours later, cardioplegia was administered four times.

All four valves were replaced successfully.

The extracorporeal circulation equipment is also operating normally, and the patient's various physiological indicators are also in a normal state.

All the people present breathed a sigh of relief.

At this point in the operation, it can almost be declared a success.

The next step is to wean off extracorporeal circulation.

Originally, this was an uncomplicated process.

After handling several intubations, restore aortic blood flow, and wait quietly for the patient to recover his heartbeat.

But never thought of it.

After the arterial clamp was released, blood entered the heart, and the heartbeat resumed for more than a minute, and the heart rate slowed down immediately.

Fang Jianzhang was the first to get nervous, he didn't care whether to disturb Zhou Sheng, and shouted directly: "Xiao Zhou, your heart rate has dropped!"

Of course Zhou Sheng also noticed.

This is CPR in trouble!
After the heart rate is too slow, there is a high probability of cardiac arrest, which can be said to be very dangerous.

As for why recovery is difficult, there are many reasons.

Many possibilities immediately appeared in Cao Xiangwen's mind.

Coronary air intake, poor oxygenation, low arterial pressure, high potassium, and even a reversed aortic valve can all occur.

Aortic valve installed backwards?This possibility can be ruled out immediately.

Zhou Sheng's technology is obvious to all.

Moreover, Cao Xiangwen also "surveilled" without stopping for a moment.

Finally, Zhou Yisheng also checked the flexibility of the installation of the valve. If it is installed backwards, it can be found immediately.

There are too many possibilities left.

For a while, Cao Xiangwen didn't know what the problem was, and only checked one by one to rule it out.

But for an elderly patient, his heart can't stand much time.

Failure to resuscitate may mean that he cannot get off the operating table.

But at this moment, Zhou Sheng was still very calm.

Because, with the auxiliary system, he can save a lot of investigation time.

In an instant, the system has given the exact reason.

High Potassium!

At this moment, the patient's blood potassium level has reached 7.0 units.The normal level is below 5.5.

Zhou Sheng immediately said to everyone: "I guess it's high potassium, and there are towering T waves in the electrocardiogram."

Director Tian and Cao Xiangwen looked at the electrocardiogram.

Indeed, as Zhou Sheng said, the possibility of high potassium is very high.

Zhou Sheng continued: "It may be because of the four infusions, and the potassium was absorbed too much. Diuretic, calcium and insulin therapy must be given immediately."

At this point in the operation, Zhou Sheng has already taken control of the audience.

He gave medical advice.

The itinerant nurses sprang into action immediately.

……

Some intravenous drug therapy.

The patient's serum potassium decreased significantly.

boom……

boom……

boom……

The heart revived again.

Fang Jianzhang's heart, which was hanging in his throat, fell down again, and he let out a long sigh of relief.He secretly rejoiced that it was really wise to choose Zhou Sheng for the operation. This kid is not only proficient in surgery, but he also does not panic in the slightest when dealing with emergencies.The judgment is more accurate.

Wait for the heartbeat to stabilize.

It is a chest closure operation such as suturing the pericardium, fixing the sternum, and so on.

Compared with the previous ones, this is considered a job without technical content.

It is hard work and tiring work.

Generally speaking, the chief surgeon will not do such chores after a lengthy operation.

This should be a matter of first aid and second aid.

If Bai Mingming and Su Quan were on the operating table at this moment, Zhou Sheng would let them take over, so that he could relax a bit and let them practice.

But today is a special case.

The first assistant is Director Tian, ​​and the second assistant is Cao Xiangwen.

These are all people with a big heart, and others usually do chores for them. Once upon a time, it was their turn to wipe other people's buttocks.

Although Zhou Sheng was the chief surgeon, he had the same scenery.But at the moment he is still clear-headed, "respecting the elderly" is still a traditional virtue.At this time, he did not mention letting the first and second assistants take over.

After the pericardium was sewn up, he had to deal with the sternum.

The operation was thrilling, Director Tian and Cao Xiangwen put all their energy on the operation.

Now that they were relaxed, the two suddenly became embarrassed again.

The two of them nominally worked together as the chief surgeon, and up to now, they haven't even touched a scalpel.

It's a bit embarrassing indeed.

After all, Cao Xiangwen was younger and his rank was lower. At this time, he also understood that he couldn't let the director who is dignified and unconcerned to suture his chest.

At this time, only he lowered his face and said, "Doctor Zhou, take a rest and deal with it for me next."

Of course, Zhou Sheng would not let Cao Xiangwen be "wronged".

Snatching out the operation outside the heart is enough to make the two big men outside the heart look ugly.

It would be a bit too much to let them be his subordinates again.

I don't have many opportunities to use my cardiothoracic surgery skills in the emergency department.Maybe he will have to deal with the two of them more in the future, so of course Zhou Sheng has to give them face.

Zhou Sheng immediately said: "Director Cao, you can rest at the same time. For such a small matter, you and Director Tian can guide and guide at the same time."

Of course, Cao Xiangwen has nothing to guide Zhou Sheng.

But at least part of the face is preserved.

His affection for Zhou Sheng suddenly increased...

(End of this chapter)