Start From Emergency Doctor

Chapter 395

Everyone felt in a trance. Everyone here is more like watching the performance, occasionally helping to pass the instrument or something, and at other times, they just need to be responsible for shouting 666 next to them.

“Prepare surgical instruments.” Zhou Yuan said while pressing.

Lu Chenxi was taken aback for a moment: “Is the operation performed right here?!”

Zhou Yuan nodded: “There is no other way, only on-site surgery.”

Zhang Ling had almost regarded Zhou Yuan’s words as an imperial decree, and immediately ran out to prepare equipment.

Outside the ward, Li Li and others rushed to receive the news. They were waiting anxiously at the moment. As soon as they saw Zhang Ling coming out, they immediately surrounded her.

“Nurse, how is it!”

“What happened to my son!”

Zhang Ling didn’t have time to answer, “I need to prepare surgical equipment immediately, Zhao Qiang must perform the operation immediately!”

Li Li and the others immediately gave way when they heard the words. No matter how curious they were, they couldn’t block Zhao Qiang’s way of life-saving!

When returning, Zhang Ling found that Li Li and the others were still waiting outside the operating room with a worried expression on their faces, a little unbearable, and said softly before entering the door: “Don’t worry, the best doctor in our hospital is the one who performed the operation on Zhao Qiang, Zhou Yuan. Does the doctor know… he will definitely be able to save people back!”

I don’t know why, Zhang Ling has such confidence!

After saying this, Zhang Ling stopped staying, and went straight into the ward, closing the door again.

The shadowless lamp that was sent temporarily has been set up, and Zhang Ling put all the necessary surgical instruments on the surgical tray. She also participated in the discussion of the previous surgical plan, so she was also very clear about what equipment was needed.

Everything is ready, Zhou Yuan continues to press, the value on the monitor is already much better, Zhao Qiang’s heart has gradually recovered, although it is still mild, but at least it can barely maintain the patient’s life.

Can only perform surgery in this case.

He Jianyi and the Deputy Director of Cardiac Surgery were shocked. Both of them had undergone cardiopulmonary resuscitation to the patient’s heart deformity. Therefore, they knew that Zhao Qiang’s current situation was particularly bad, and it was extremely difficult to rescue him, but Zhou Yuan actually did it, and he was back to the point where he could undergo surgery!

In the eyes of the two, this is almost impossible!(Read more @ wuxiax.com)

“Intratracheal intubation and intravenous combined anesthesia.”

Zhou Yuan continued to press the patient’s chest.

Now you need to pay special attention, because the lungs are nearby, you must be careful not to damage the lungs, otherwise the anesthetic may escape through the lung bubbles, and the damage to the lungs will endanger Zhao Qiang’s life.

After the anesthesia was completed, He Jianyi and others assisted Zhou Yuan to adjust Zhao Qiang’s posture, and finally took the supine position, with the chest and back elevated. This posture is conducive to the exposure of the surgical field.

“Get ready to start the operation.” Zhou Yuan marked again with a marker on both sides of the patient’s incision.

The previous chest incision was for intra-chest compression. It only needed to accommodate two hands, so the incision was relatively small, but now the surgeon is required to perform instrument operations in the chest cavity. A large incision is definitely needed.

The position of the opening is still the breast. Zhou Yuan used a scalpel to expand the incision along the marker.

Cardiac surgeon and Lu Chenxi prepared the device for extracorporeal circulation. Both of them did a lot of this step. They were familiar with it. Once Zhou Yuan completed the anatomy of the chest incision, they immediately installed the extracorporeal circulation device.

In this operation, the aortic cannula was used. The extracorporeal circulation tube passed through the right atrial appendage and the right atrium, and some parts of the superior and inferior vena cava were intubated respectively. The whole process of the cardiopulmonary bypass maintained severe hypothermia and local deep myocardium. Low temperature.

This is to reduce energy loss as much as possible while ensuring the normal life activities of the patient.

“Extracorporeal circulation is complete.”

“Ready.”

Lu Chenxi and the deputy director of cardiac surgery said one after another.

Zhou Yuan nodded, “Start myocardial protection.”

This step is very important in surgery.

Due to the sudden onset of the patient’s condition, neither the patient’s family nor the doctor has enough time to prepare, let alone the small details before the operation. Even the current operation is driven out, and only as much as possible during the operation Protect Zhao Qiang’s myocardium and reduce surgical damage.

The first dose of cardioplegia was injected into Zhao Qiang’s body from the root of the aorta by Lu Chenxi. The total amount is 1,000 ml, which is almost comparable to a large bottle of Coke…

After completing myocardial protection, Zhou Yuan did not stay any longer and directly took the scalpel to make an incision in the aorta.

There are generally three types of aortic incisions: transverse incision, hockey stick incision and spiral incision.

The transverse incision is more conventional, which is to cut the anterior wall and side wall of the ascending aorta at a distance of 1.5 to 2.0 cm above the opening of the right coronary artery. This is mainly for cases with thick aorta. In this case, the patient’s incision is better. The hockey stick-shaped oblique incision is made from the left anterior side about 2 cm from the aortic root to the lower right to 1.0 to 1.2 cm above the midpoint of the non-coronal valve leaflet. It is suitable for patients with thin aortic roots.

The last type of spiral incision, the upper end of the opening is close to the main pulmonary artery, and the lower end is inside the non-coronal valve, and the root of the mitral valve is cut between the non-coronal valve and the left coronary valve. This incision is suitable for patients with too small aortic annulus.

Zhao Qiang’s aortic valve insufficiency is not very specific, but because of heart disease since childhood, his aortic root is relatively weak, so he can only choose a hockey stick incision.

Eight minutes later, Zhou Yuan completed the incision of the aorta, and the next step was to cut the valve and the suture ring.

Zhou Yuan carefully enlarged the aortic incision to reveal the aortic valve.

Zhao Qiang no longer has a heart at this moment, and has lost the effect of blood pressure. The entire blood vessel has collapsed. It took a lot of effort to open the incision and find the aortic valve.

Zhou Yuan carefully pulled open the blood vessels around the valve and explored the diseased condition of the aortic valve.

“There is no fibrosis or hardening.” Zhou Yuan breathed a sigh of relief.

This is probably the only good news.

Of course, this is good news that is meaningless. Even if fibrosis and sclerosis occur, Zhao Qiang still has to replace the valve. Now the condition of the aortic valve is not so important.

“Middle bending pliers.” Zhou Yuan said.

He took the middle-curved forceps, clamped the middle of the valve leaflets, pulled the aortic lumen on both sides like this, and then removed the left coronary valve. After the resection, Zhou Yuan took the needle holder and started suturing along the junction to the middle of the sinus. The span of each needle was precisely controlled at three millimeters, and the stitch length was controlled between two millimeters. .