Start From Emergency Doctor

Chapter 201

The director of cardiac surgery hesitated, saying: “Although sequential anastomosis is good, once the bridge of sequential anastomosis is blocked, it will affect the blood supply of the myocardium extensively, even involving the entire ventricular wall. And the single anastomosis bridge will be blocked. It only affects the blood supply of the myocardium in one part…”

Zhou Yuan knows this naturally.

However, a large part of the blockage is because few doctors can do a sequential anastomosis.

In itself, the difficulty of a single-root anastomosis is very great, and a few more branches of the anastomosis, without certain technical and physical support, may leave various sequelae during the anastomosis.

“What I think is that sequential anastomosis can shorten the operation time and the time of cardiac arrest. The shorter the cardiac arrest, the better the postoperative recovery of the patient, and the lower the possibility of postoperative recurrence.”

“Moreover, the sequential anastomosis can save the bypass material, maximize the use of the vascular bridge, and reduce the operation cost. Postoperative angiography also shows that the patency rate of the sequential anastomosis is much better than that of a single-root anastomosis.”

“Another point is that according to Neeter’s 10-year follow-up report, the sudden death rate of patients with sequential anastomosis is lower than that of patients with single-root anastomosis, and the survival rate is better than the latter.”

The last point is an important reason why Zhou Yuan chose sequential coincidence.

Moreover, Zhou Yuan’s master-level heart bypass surgery can avoid the shortcomings of sequential anastomosis to the greatest extent.

“The coronary artery anastomosis is complete.”

“Open the ascending aorta vascular clamp.”

The director of cardiac surgery immediately removed the clip and began to induce the heart to resume beating.

In heart bypass surgery, the vascular bridge needs to be anastomosed separately on the coronary arteries and the aorta.

Next is the anastomosis of the vascular bridge at the aortic end.

This step is relatively easy, and the aortic punch will be used to make incisions and assist sutures. Zhou Yuan’s workload is also reduced a lot.

Finally, the incision between the vascular bridge and the aorta is sutured continuously with 5-0 sutures.

With the last stitch out, Zhou Yuan exhausted the air in the aortic isolation cavity, and finally tightened the suture and ligated to complete the final anastomosis.

“Release the vascular clamp.” Zhou Yuan said.

He Jianyi slowly loosened the vascular clamp that blocked the blood flow, for fear that the excessive blood flow would tear the anastomosis.

However, He Jianyi’s worries were unnecessary. Zhou Yuan did a good job of suturing. There was no leakage of blood flow and no signs of damage to the anastomosis.

“The blood circulation is okay, the blood vessel bridge is unblocked…” Zhou Yuan announced one by one.

Finally, Zhou Yuan showed a smile on his face: “Heart bypass surgery was successful.”

“Needle holder.”

Zhou Yuan began to suture the tissue outside the heart layer by layer.

Absorbable sutures are used subcutaneously, which will dissolve by themselves after a meal, so there is no need for suture removal.

As for the outer skin, non-absorbable sutures are used, which need to be removed after the wound has healed.

Because it was a heart bypass operation, the big scars were unavoidable. Zhou Yuan could only sew the scars as beautifully as possible.

Zhou Yuan was very careful about the suture of the heart.

It took a full half an hour before the last stitch was made under the skin and the knot was tied again.

“finished.”(Read more @ wuxiax.com)

Zhou Yuan breathed a sigh of relief and glanced at the time.

“The operation is complete.”

“call.”

He Jianyi and the director of cardiac surgery breathed a sigh of relief at the same time.

This operation is too unconventional…

Some of Zhou Yuan’s operations are not ordinary heart bypass surgery at all.

Take the most typical sequential coincidence.

The coronary arteries themselves are very small. Anastomosis of the coronary arteries is a delicate task and is prone to accidents. However, Zhou Yuan chose to build multiple branches on the coronary arteries…

Although sequential anastomosis does have many benefits, it has to be done well!

For others, I would rather choose a single-root anastomosis than take the risk. After all, not everyone has master-level heart bypass surgery.

It can be expected that after ten years, Qian Wei’s vascular bridge patency rate will still be maintained at more than 90%, and the probability of recurrence of acute myocardial infarction after surgery will be very low-this is all due to sequential anastomosis.

The equipment nurse cleaned the equipment, and Zhou Yuan, He Jianyi and others walked out of the operating room.

Squeak.

The door of the operating room was pushed open, and he had noticed that Qian Wei’s wife, whose sign had gone out during the operation, had already been waiting anxiously at the door.

“Doctor Zhou, how is my husband? Did he wake up?”

Zhou Yuan took off his mask and said, “Don’t worry, the operation was a success.”

Qian Wei’s wife covered her mouth and tried to suppress her crying.

“Great…Thank you! Thank you Doctor Zhou!”

Zhou Yuan smiled and said, “This is what we should do.”

Soon, Zhang Ling and Lin Wen ran over, preparing to push Qian Wei to the ward.

“Zhang Ling, take a bedside photo immediately after waving the ward to observe the depth of the tracheal intubation.”

Before the end of the operation, Zhou Yuan gave Qian Wei a tracheal intubation.

This is to prevent the occurrence of lung failure.

Although the risk of heart bypass surgery is not high, postoperative complications are almost always fatal, such as lung failure, which is an important cause of early postoperative death.

“Assisted breathing for twelve hours after the operation to reduce the burden on the heart and increase the oxygen supply. After that, the tracheal intubation can be pulled out.” Zhou Yuan asked.

Qian Wei’s wife felt distressed when he watched Qian Wei being pushed away while X was holding the tube.

“Doctor Zhou, when can my husband wake up?”

“It depends on the individual’s physique. General anesthesia usually wakes up four to six hours after surgery, and the resistance to anesthetics is longer.”

Qian Wei’s wife nodded, and stopped talking a little.

“Then…when can I visit him?” Qian Wei’s wife said hesitantly.

Zhou Yuan smiled: “The operation has been completed, you can actually visit him now. But don’t let him have intense emotional swings.”

Qian Wei’s wife was taken aback, “Thank you doctor!”

Then, quickly ran to the direction of Qian Wei’s hospital bed.

Zhou Yuan and He Jian were preparing to return to the office, while the director of cardiac surgery reluctantly left the emergency department.

After returning to his office, Zhou Yuan fell asleep directly on the table.

Stitching blood vessels is not so easy. I have been staring at the microscope and being shaken by the shadowless lamp, my eyes can’t stand it.

Not long after he lay down, Zhou Yuan’s breathing became soothing and regular.

At this time, the emergency department hall.

Zhang Ling’s phone rang suddenly, and after pressing it off, she called again.

Zhang Ling glanced, it was his mother.