When doctors have a simulated operating room

The doctor said that the operation was not successful.

In the office, everyone started a discussion.

For this kind of difficult surgical disease, everyone can only come up with a plan after discussion.

At this moment, Jin Zhenglun looked at the picture, his eyes narrowed slightly, and his expression was very cold.

7.5 cm in diameter!

Although this is not the largest ascending aortic aneurysm patient in Jin Zhenglun's career.

But it is definitely a diameter that can be ranked in the top five!

In addition, the patient's age is here, and the difficulty of this operation makes Jin Zhenglun unable to relax.

He looked at Zhang Yi who was sitting next to him:

"Zhang Yi, if it was you who had this surgery, what would you choose? Ascending aortic transplantation or Bentall surgery? Or Wheat surgery?"

Zhang Yi didn't say anything after hearing this. Although he thought that any of them would be fine, he had tried them all and got full marks.

But...

After thinking about it, Zhang Yi decided to play it safe:

"I just came to see the case, and I don't know what the patient's condition is. I'll go see the old lady after the consultation."

Jin Zhenglun nodded.

Yes, the patient was 85 years old, and had a huge ascending aortic aneurysm and type A aortic dissection. It was impossible to complete the surgery without stopping the heart like Zhang Yi did before.

Aortic dissection is divided into type A and type B.

Type A is more serious than type B.

The best surgical method for type A is to open the chest and reconstruct the artificial pipeline after establishing extracorporeal circulation.

This treatment has the best effect, but the operation time is long and the risk is high.

If the symptoms of type B are mild, interventional treatment can be used to puncture a needle from other aortas and insert a catheter to complete the operation.

The risks of these two operations are completely different.

If it is type B, then the operation can be a little easier.

But this old lady happened to be unlucky, and she encountered all the difficult ones.

Huge ascending aortic aneurysm, type A aortic dissection, and tortuosity of the aorta.

It is even more difficult!

This is not like coronary artery bypass grafting, where the heart keeps beating around the ventricle and the operation can be completed.

In the office, the meeting continued.

The cardiac surgeon talked for a long time in front of the projector.

Even the video of the CT scan was played.

The conclusion is nothing more than one.

How to do this operation.

Jin Zhenglun thought for a while and made a suggestion:

"Considering the patient's serious condition, this huge ascending aortic aneurysm and type A aortic dissection, my suggestion is to open the chest and establish extracorporeal circulation before surgery.

I know that this plan has a very high surgical risk, but if the chest is not opened, the aortic aneurysm cannot be solved.

This 7.5 diameter can only be removed manually, and interventional surgery cannot achieve this effect.

There is also dissection. The aortic dissection of this old lady has caused cardiac tamponade. Only correction of the aortic valve can solve the heart blood flow situation.

At present, the blood gas analysis of the old lady is not too serious.

Such a large tumor grows in her chest cavity, and the oxygen partial pressure can still be 35mmHg.

It is not particularly low, so I judge that the old lady's physical fitness may not be as fragile as we think.

You can try open-chest surgery."

Jin Zhenglun stood and finished his opinion.

There are only two options for surgery.

One is open-chest surgery, and the other is interventional surgery.

But it was obvious that the old lady's condition was so serious that all the doctors present knew that intervention alone could not solve all the problems.

They could only rely on thoracotomy.

But the problem with thoracotomy is that the patient is old and the risk is high.

Are the family members willing to undergo this high-risk thoracotomy?

In the office, a group of doctors discussed it seriously.

Although the family members didn't understand it very well, they could feel the tense atmosphere in the entire office.

At this moment, an idea popped up in Zhang Yi's mind.

An idea that was completely different from others!

——

Everyone in the office still had doubts.

What were the doubts?

It was nothing more than the surgical method.

Either thoracotomy or intervention.

But the pros and cons of these two surgeries were already on the surface.

Everyone could only choose the one with more advantages and fewer disadvantages.

And what was Zhang Yi's idea?

Zhang Yi turned his head and looked at the middle-aged couple sitting in the corner.

They were Guan Hua's daughter and son-in-law.

The old couple looked at the doctors around them nervously.

The doctors were discussing something, and they could only watch.

, I didn't even know how to get in the conversation.

Zhang Yi thought for a moment, turned around and walked to the family members and asked:

"Family members, can I ask you a question?"

The family members nodded quickly: "Ask, ask, ask! As long as we know, we will definitely tell you!"

"You really don't know about this time bomb in your mother's chest? She has never had a physical examination before?"

The old couple shook their heads in regret:

"No... It's our negligence! It's all my fault. He said he would check my mother before..."

The old lady said while pointing to her husband sitting next to her.

There was also some self-blame in her tone.

"But...but my mother has always been very frugal.

When she heard about going to the hospital for a checkup, wouldn't it cost money?

She said she wouldn't go, no matter how I persuaded her...

So...so...I didn't force her later.

And my brother also wanted to take my mother to the hospital for a checkup, but my mother didn't even listen to my brother.

She just didn't want to go to the hospital no matter what I said...

It's all my fault! If...if I had persuaded my mother to go to the hospital for a checkup earlier, my mother wouldn't have discovered the tumor on her heart until it grew so big...

Oh...it's all my fault..."

The family member became more and more emotional as she spoke.

It seemed like tears were about to fall in the next second.

Zhang Yi took out a pack of paper from his bag and handed it to her and asked:

"You said your mother never wanted to get checked before?"

"Well..." The family member nodded.

Zhang Yi narrowed his eyes slightly and thought for a while before asking a question that shocked and surprised all the doctors and family members present:

"Is it possible... I'm just saying it's possible, your mother knew she had this disease a long time ago?

She knew she had a tumor on her heart a long time ago, this time bomb.

But at that time, maybe for some reason, she didn't go to get treatment, so later, no matter how you asked her to go to the hospital to check her body, she didn't go??"

As soon as Zhang Yi said this.

The doctors who were discussing around him fell silent instantly!

Everyone stared at Zhang Yi in a daze...

What? ? ?

The old lady... knew it herself? ?

No way!

Impossible? ? !

She didn't get treatment for such a time bomb in her heart? ? ?

She just waited for the bomb she secretly created to explode, and then she died? ?

How is this possible?

It doesn't make sense.

Who doesn't cherish life!

The family members were also confused, and looked up at Zhang Yi in a daze.

His eyes were filled with disbelief and panic.

He was also muttering:

"No...my mother...if she really knew it a long time ago...

Then...why didn't she tell me and my brother? Why did she hide it from us?"

As everyone was puzzled, Zhang Yi raised his head and looked at Jin Zhenglun and asked a question.

"Dean Jin, the diameter of the aneurysm in that CT scan is 7.5 cm.

So under what circumstances can an aneurysm grow so large?"

Everyone looked at Jin Zhenglun in unison.

Jin Zhenglun lowered his eyes and thought for a few seconds, then raised his eyes and looked at Zhang Yi and said:

"Avoiding the severity of the aneurysm, only time can make it grow so big!"

"Time? Yes, it's time!"

"That's right, a 7.5 cm ascending aortic aneurysm can't grow so big in a few years.

The diameter of a normal artery is only about 2.7-3.5 cm, and her diameter is more than doubled!

It's impossible to grow so big in a few years!

It must be more than five years!"

People in the office began to discuss.

It's true that such a large tumor can't grow to this size overnight!

It must be more than five years!

After getting the answer, Zhang Yi turned around and asked the family members:

"So now I want to ask, when did you and your eldest brother want your mother to go for a checkup, but your mother said firmly that she didn't want to go to the hospital?"

The family member pursed his lips nervously and swallowed his saliva before saying:

"It seems to be... seven years ago... At first, I asked my mother to go to the hospital for a checkup.

After all, my mother was over 70 years old at that time. I thought that although my mother didn't have any serious illness at such an old age, we, as children, would feel at ease if she went for a checkup.

But...but my mother didn't agree at that time.

No matter what I said, my mother didn't want to go. I thought that it might be because my father passed away in the hospital, and my mother would be sad when she saw the hospital, so she didn't want to go.

Even this time when we came to the hospital for a checkup, it took two weeks, and my mother is now a little bit demented, so we can

Come to the hospital.

If she were younger, she would never come to the hospital. "

"Seven years ago? Seven years ago, your mother was already very reluctant to come to the hospital?"

"Yes, I have a good memory, I won't be wrong. A few years ago, my eldest brother told my mother about the physical examination, but my mother still didn't want to go."

After getting the answer, Zhang Yi turned around and looked at Jin Zhenglun.

At this moment, Jin Zhenglun must have the answer in his eyes!

"More than five years, this aneurysm may... may have been "peacefully coexisting" with this old lady for more than seven years, or even... ten years!"

As soon as Jin Zhenglun finished speaking, there were surprises in the office!

"Ten years? !"

"Damn! The ascending aortic aneurysm has been growing on the heart for ten years and it hasn't exploded? !"

"Oh my god! Zhang Yi saw something new today!"

"Quiet! "

Jin Zhenglun suddenly slammed the table and yelled.

The office suddenly became quiet.

Jin Zhenglun also looked at the family member's face:

"Why didn't you tell our doctor about the dementia this morning?"

The family member spread his hands: "No...you didn't ask? And my mother's dementia is not serious...

No, no...it's not dementia, just a bad memory occasionally, always forgetting things.

But she can remember the names of family members, grandchildren and so on. She remembers the names. "

"It may be a precursor to dementia, memory loss."

"Oh...I see."

Jin Zhenglun stood up, looked around the doctors in the office and said:

"Let's do this, the surgical plan is tentatively set to open the chest, but the time of the operation needs to be determined.

Let's go and see the patient's specific situation first, and then determine the surgical steps and time after confirmation. "

Kim Jong-lun has spoken, what else can they say?

Just follow Kim Jong-lun and it's done.

Kim Jong-lun glanced at Zhang Yi before leaving: "Zhang Yi, you come too."

"Okay."

Zhang Yi followed Kim Jong-lun's footsteps and came to the ward with his family.

Most of the inpatients in the cardiac surgery department are older patients.

A small number are middle-aged people.

Because of Guan Hua's special condition, she was arranged in the ICU of the cardiac surgery department.

The room in the ICU is relatively large, and the general ward can accommodate three people.

This ICU can accommodate ten critically ill patients at the same time.

A group of doctors followed Kim Jong-lun to the old lady's bed.

At this time, the old lady was breathing oxygen, and the head of the bed was shaken up for her to sit.

She couldn't hear the sound of the TV, but it didn't stop her from watching.

"Old lady, can you hear me?"

Kim Jong-lun bent down and spoke to her.

The old lady pricked up her ears and opened her mouth: "Ah? What? ”

“Oh, Mom, Director Jin, oh no… Director Jin has questions for you, you have to answer truthfully.”

Her daughter quickly leaned over to her other ear to explain, and then the old lady nodded: “Okay.”

“Old lady, do you know that you have a tumor in your heart? ? ”

Everyone was staring at the old lady’s reaction.

Sure enough!

The old lady was stunned for a moment, then opened her mouth and said: “Ah?”

“Mom! The doctor asked you if you knew that you had a tumor in your heart? ? ”

The old lady looked up at the doctors around her, not knowing what she was thinking.

After hesitating for a while, she slowly sighed and said:

"Hey... It's okay, the tumor is not particularly big, I'm fine..."

Wow!!

Oh my god!!

This old lady really knows that she is sick!!

Oh no...

This is too ridiculous!!

She knows that there is a time bomb in her heart, how can she live so calmly??

She didn't tell her son and daughter??

She was asked to go to the hospital for a check-up but she didn't want to go??

Oh my god, this old lady is so stubborn!

The family members next to her started crying, covering their mouths and shouting:

"Mom, why don't you tell me... Do you know how big the tumor on your heart is now? ? The doctor said you can only survive if you have surgery!

"Wuwuwu... Mom... What should I do, Mom..."

The family members cried very hard.

The crying was filled with self-blame and guilt.

Perhaps, as children, they also regretted not forcing the old lady to the hospital.

In this case, if the operation was done earlier, it might not be as difficult as it is now.

The tumor on the heart must not be as big as it is now.

And the old lady was not as old as she is now.

The success rate of the operation might be higher.

The old lady looked up and saw her daughter crying, and a trace of heartache appeared on her face.

"Don't cry, Pingping, Mom is not uncomfortable... In fact

It seems like I've had this tumor for almost 21 years now, and look at your mom, isn't she doing fine too?"