I run a clinic in the United States

Chapter 225
Because it was broadcast live on the entire Internet, a panel of eighteen academicians from the National Academy of Medicine commented online and asked questions online, so Ava did not play a song this time.

Not even the most soothing music was playing.

I didn’t think much of it when watching the game. It was their turn to compete, and Ava and Elena still felt a little nervous.

"I hope my brother can perform well this time and win the championship in one fell swoop."

"Brother, come on! If you behave well during the day, my sister will reward you in the evening!" Elena and Ava glanced at Zhou Qiao, encouraging him in their hearts.

Zhou Qiao's procedure this time was "transcatheter aortic valve replacement under local anesthesia and non-intubation under combined sedation."

Before entering the operating room, Zhou Qiao had already introduced the patient's condition and the next operation to the live broadcast camera to the national audience and academician judges with great energy, clear enunciation, calmness and clarity. name.

Although it is unscripted, it has actually been rehearsed many times in private.Including every expression, every gesture, every cadence of language.

The same goes for Murphy and Stephanie, who know it by heart.

There were three participating patients hospitalized in the clinic before, waiting for live broadcast surgery. Two were contributed by Luo Ya, a Mexican woman, an East African woman, and a Chinese patient introduced by Zhang Jianjun.

This Chinese patient is Zhou Qiao’s current surgical target.

The patient was actually quite old and not in good health. He was 93 years old. He had been hospitalized in the clinic for recuperation. Not only was he waiting for the surgery, but he was also being helped to recuperate his body so that he could withstand the intensity of the surgery.

When Zhou Qiao introduced the patient's information, the eighteen academicians immediately became energetic, while the other competitors watching the competition also took a deep breath.

There were five live broadcasts before, and the oldest patient was 61 years old. Although the older the patient, the more difficult the surgery, and the higher the score may be.However, older age also means greater risk.

93 years old, my God, if this one doesn't go well, he will die on the operating table.

The patients are all dead, so why fight for ranking?Definitely the last one!It is even possible to be kicked out of the game directly.

"Zhou Qiao is taking a risk!" The competitors exclaimed, but they did not dare to choose this mode by themselves.

Once there is a mistake in which a patient dies on the operating table, or it is broadcast live on the entire network, it will seriously affect their future careers.

Not only their personal reputation, but also the reputation of the hospital is seriously affected, and the hospital will not let them go.

Of course, their hospital would not approve such medical records to be used in the competition.

However, what they don't know is that "the soldiers march with danger" is their standard, not Zhou Qiao's standard.

Using their level to perform this operation would naturally be extremely risky, but in Zhou Qiao's eyes, with his perfect medical skills, he was 99% sure of winning.

What's more, he can secretly redeem the healing properties to ensure that the patient is safe.

Even Murphy and Stephanie were feeling a little nervous.

At the age of 93, even ordinary surgery is extremely risky, let alone heart surgery.

At this moment, the patient lying on the operating table is a "bombshell" that can explode at any time.

However, seeing that Zhou Qiao was calm and confident, they could only try their best to cooperate.In terms of professional skills, Zhou Qiao never needed their opinions.

This old man, whose surname is Gao, has a long life. He was diagnosed with chronic bronchitis 20 years ago. He suffers from cough and chest tightness every winter, spring and autumn, and often needs to be hospitalized for recuperation.

A month and a half ago, although the weather was okay, it was already the beginning of autumn, and there was another rain, one autumn rain and one cold. Maybe the sea breeze in San Francisco was cooler, and the old man's old problem relapsed.

His cough worsened, chest tightness, palpitation, and shortness of breath.Then when I go to bed at night, I can't lie down flat. As soon as I lie down, my chest tightness and palpitation will worsen.

The old man spent the whole night leaning on the bedside, so his rest was naturally very poor.

The old man has three sons and a little daughter.The eldest son and the second son have passed away in the past few years. The third son is 62 years old, and the youngest daughter is 59 years old. Usually the third son is the supporter of the old man.

After his son found out, he thought it was another attack of chronic bronchitis, so he stayed in a community hospital for more than a month. However, his condition not only did not improve, but became more serious.

Later, the respiratory physician recommended that he be transferred to the cardiology department for treatment. As a result, he was transferred for examination and found that it was not an "old disease" at all, but a heart disease.

A cardiac ultrasound examination revealed that Mr. Gao had congenital bicuspid aortic valve malformation, accompanied by severe calcific stenosis of the aortic valve.

Generally speaking, the human aortic valve has three valves, but this old man was a little special. He was born with only two valves.

Due to the abnormal structure of the valve leaflets, they are constantly impacted by blood flow for a long time, which can easily lead to valve thickening, calcification, stiffness, fibrosis, and eventually valve stenosis.

Everyone was surprised that the old man, who was born with two valves, could live for such a long time, even longer than his two sons.

The cardiology department recommended that the patient be transferred to cardiac surgery for treatment. However, after the transfer, experts evaluated that surgery was not recommended because the risk was too high, and conservative treatment was recommended.

This means that it can be delayed as long as it takes. He is 93 years old. Why should he be treated at such an old age?

Of course, the doctor wouldn't say it explicitly like this, but that's what he meant.

After discussion, Mr. Gao's son and daughter also decided not to undergo treatment, but later, they saw Zhang Jianjun's circle of friends.

After understanding the situation, I came to Iris Clinic with the mentality of giving it a try.

Originally, they were a little worried, but Zhou Qiao easily won the championship twice in a row (the California Division and the first two rounds of the National Finals), which gave them great confidence.

"If after the operation, the old man lives for a few more years, not too much, it will be good for him to live for three to five years. If he can live over a hundred years old, that will be really auspicious."

An old house where a treasure.What's more, the old man has both ears and eyesight and does not have Alzheimer's disease. As long as the disease is cured and the old man can eat by himself and walk slowly, it is not that troublesome to take care of him.

The other thing is that the old man himself wants to cure it.

The ants are still living an ignoble existence, who doesn't want to live?Wouldn't it be nice to live a few more years and see the world?
Of course, the most important thing is that treatment with Zhou Qiao not only costs no money, but also provides a subsidy as a reward for participating in the competition. Why not?

Arriving at the Iris Clinic, Zhou Qiao arranged a more detailed examination for the old man to improve the data.

The evaluation found that Mr. Gao's cardiac ejection fraction was only 30%, less than half of normal people.Heart failure, lung infection, and basic diseases such as hypertension and diabetes, the surgical mortality rate STS assessment is as high as 42% (generally more than 8% is considered high risk).

Regarding Mr. Gao's condition, Zhou Qiao believes that the only way to cure it is to "replace a door" in his heart through valve replacement surgery.Other conservative medical treatments can only relieve symptoms, but will relapse soon, and the effects will become worse and worse.

Thoracotomy carries a huge risk of death, and if there is no surgery, there is a high probability that he will not survive this winter.

However, if minimally invasive surgery is used, although the risk is still very high, Zhou Qiao's perfect surgery is already controllable.

While performing the surgery, Zhou Qiao introduced to the jury in clear, standard and fluent English: "Transcatheter aortic valve replacement under combined sedation and local anesthesia without intubation is the reason why I chose the method of local anesthesia without intubation. , is based on the following advantages: first, it can reduce the cardiovascular stress and irritation response of endotracheal intubation, and second, it can reduce the risk of postoperative pulmonary infection..."

His daily hard work on English has paid off, and he can speak professional vocabulary fluently than many native Americans.

This surgery is minimally invasive and requires only a few needle holes. It does not require extracorporeal circulation or cardiac arrest. The operation time is short and the trauma is minimal. It is especially suitable for aortic valve disease in elderly and high-risk patients.

It sounds simple, but anyone who knows the business knows that the risks of this surgery are still extremely high.

The eighteen academician judges were focused as never before, because even if they were to perform this surgery, they could not say they were absolutely sure.

93-year-old patient, heart surgery, hypertension, diabetes, chronic bronchitis... super bombshell!

Without that absolutely proud confidence and strength, no one would dare to do this job of bomb disposal.

In addition to the judging panel, competitors, some doctors in the field of cardiac surgery, some doctors who know Zhou Qiao, there are also many audience friends outside the circle who are interested in this, all downloading APP online or on their mobile phones. Go watch.

For example, Loya, Thalia, Jenna, Ling Qingqing, Veronica, Governor Hulk, and even Loya's uncle and aunt, the former mayor of Ellot Town Kevin Nix and his wife Tracy McKenna.

Cathy, Mr. and Mrs. Westin, Mr. and Mrs. Clark and their daughters Jessica, Taylor and Felipe...

Zhang Jianjun and others in Chinatown.

Chen Zhining and others from the East Africa base.

Rachel, Vivica, Park Soo-joo, Kim Hee-jin who stayed at the Iris Clinic, Ariel from the laundry next door, Murphy's grandparents, etc.

Many people are paying attention.

Most of the patient's family members, including the third son's family, the youngest daughter's family, and the descendants of the eldest son and second son, came to the San Francisco University Medical Center and waited outside the operating room while watching the live broadcast.

In the rest area outside the operating room, the staff performed high-definition projection on the 55-inch large TV screen.

For the patients’ families, it is actually a good thing and can be considered a welfare.

After all, when you have an operation, especially a major operation that goes into the operating room, will the doctor let you see it?You can't see it at all.

But now, being able to sit outside and watch the live broadcast on the big screen while praying for the old man together is a very meaningful thing.

In addition, it has been a long time since so many people in the family have gathered together.There are more people than during the Chinese New Year.

It is a pity that Zhou Qiao is too low-key and did not inform his teachers and classmates in China. If those people knew the level of competition he is currently participating in, they would probably be shocked.

In fact, Talia is usually timid. When taking blood for physical examination, she always turns her head in other directions and does not dare to look directly at the needle inserted. However, watching the live broadcast, she actually suppressed the timidity and discomfort in her heart and forced Staring at the screen is even a bit relishing and interesting.

My best friend Jenna wanted to laugh a little, thinking that Talia was hopeless and that she was probably in trouble. She wanted to be treated like Dr. Zhou.If her fans knew about it, they would probably be heartbroken.

She has known Talia for so long, and this is the first time she has seen Talia be so proactive and show obvious interest in a man.

On the live broadcast screen, Zhou Qiao's smooth and smooth operations are pleasing to the eye.

He punctured from the root of the patient's thigh and transported a catheter with a thickness of less than 6 millimeters, carrying the artificial valve and device, from the blood vessel to the patient's heart valve with great care and safety.

Then, the catheter is slowly rotated, and the artificial valve is gradually released. Through extremely subtle control, the implanted artificial valve blooms perfectly on the patient's heart like petals...

Zhou Qiao's surgery was a breeze. It was a highly difficult, precise and sophisticated surgery, but it made him feel that it was very simple!

It's like that. Everyone who sees it has a reaction: wow~, this is so simple, it should be possible if I do it!

In fact, this is just what they have learned with their eyes. If they really do it, they will lose their knowledge.

The surgery live broadcast room was not always silent. Eighteen academicians asked questions from time to time.

Moreover, there are a few academicians who are always asking questions suddenly when Zhou Qiao is reaching a critical step.

It's like that kind of money counting contest, with hundreds of banknotes, counting and memorizing the data at the same time, and then there are people deliberately making trouble and interrupting the money. The contestants have to answer questions, but they can't stop their hands, and they can't forget the numbers.Otherwise, you have to count again.

Zhou Qiao's current situation is much more difficult than counting money.If his operation is suspended, it may not affect the final quality of the operation, but it will definitely affect the final score.

"Dr. Zhou, please answer immediately, which patients are suitable for TAVR surgery?" an academician asked when Zhou Qiao's catheter tip was about to reach the heart valve.

How can we stop at this critical moment?Stopped and couldn't show your level!
Therefore, Zhou Qiao was divided into two tasks: one was carefully controlling the conduit, and the other was talking fluently.

"Generally speaking, there are four situations."

"First, elderly patients with severe aortic valve stenosis or insufficiency have been evaluated by the cardiac surgery team and the risk of conventional surgical thoracotomy is too high."

"The second is elderly patients whose aortic valves have failed after surgical bioprosthetic valve replacement and require valve replacement again."

"The third is patients with severe aortic valve disease who have contraindications for surgery, such as severe bleeding tendency, changes in the porcelain aorta, anticoagulation contraindications, history of chest radiotherapy, sternal infection, etc."

"Fourth, patients with severe aortic valve disease combined with malignant tumors have a life expectancy of more than one year."

After answering, the valve also bloomed smoothly!

perfect!

The academicians all nodded, and some even gave a thumbs up.

This is not over yet. Another academician asked: "Dr. Zhou, why did you choose the technique of local anesthesia under compound sedation without intubation? What is your understanding of this technique?"

"Contestants, please make a brief discussion on which is more important, small incision or fast operation speed."

These questions were timed very well. It has to be said that the academicians are quite tricky. They often get stuck during Zhou Qiao's key operations and ask him to answer them immediately.

But naturally it didn't affect Zhou Qiao at all. He kept his hands on his hands and opened his mouth to speak, showing the style of a master.

"This is my understanding of this technique..."

"As for the small incision and the speed of the operation, I think that both the patient and the surgeon want the incision to be small and the quality of the operation to be fast and good. However, it is difficult to have both in the world. Everything must be done on the basis of ensuring the quality of the operation. , on the basis of ensuring the safety of patients' lives. Excessive pursuit of speed and minimal trauma, while ignoring the quality of medical care itself, is to abandon the trunk of the tree and grasp the branches and leaves..."

(End of this chapter)