When doctors have a simulated operating room

The patient was diagnosed with angina, but the disease was not cured.

Wang Xueqin is over 50 years old.

He has been working in cardiovascular medicine and interventional surgery for most of his life.

He believes that he has seen many rare cases, either deformed or typical.

He even handles the most difficult fortresses of cardiovascular interventional treatment, such as CTO of the anterior descending branch and right coronary artery.

But today's patient really refreshed his cognition.

At first, the patient only had symptoms of angina pectoris, which would soon be relieved on its own, so he himself did not pay too much attention to this problem.

The consequences of not paying attention to the disease are often very heavy.

Coronary artery sclerosis, which could have been solved in advance, was finally delayed into acute myocardial infarction.

Coronary heart disease, like the hepatitis B trilogy, has a gradual development process.

At the beginning, it is just coronary atherosclerosis, which can be treated with drugs to dissolve the thrombus and relieve the symptoms.

In the middle stage, coronary artery blockage will occur, and severe cases will have precursors to infarction. This kind of situation must rely on surgery to dissolve the thrombus.

If it is not treated in the later stage, the result will be the same as the male patient in his 50s on the operating table now, acute myocardial infarction.

It is unclear when the disease will occur, but once it occurs, it will be fierce and the mortality rate is also very high.

This patient is really, dragging to a point that even Wang Xueqin feels very difficult.

The person was sent to the hospital by the emergency department an hour ago.

As soon as he was admitted to the hospital, blood tests, electrocardiograms, ultrasound dynamics, and CT were performed.

All kinds of tests related to myocardial infarction were done.

The electrocardiogram showed that the angle of ST segment elevation was very exaggerated.

The ST segment elevation angle of general acute myocardial infarction is not like this person. This person has both the inferior wall and the anterior wall elevated. Not only is the range large and the amplitude exaggerated, but there is also a giant R wave.

The appearance of a giant R wave means that the area of ​​myocardial infarction is very large!

There are also CT and angiography, and the results of these two made Wang Xueqin feel a lot of pressure.

The aorta is twisted, the distal end of the descending aorta can be seen to be obviously bent and twisted twice...

The aortic valve is stenotic and slightly calcified, the middle segment of the right coronary artery is stenotic, and multiple twists and blockages can be seen in the right coronary artery...

The coronary artery is a blood vessel attached to the surface of the heart. It wraps the heart tightly like a net and provides continuous nutrition to the myocardium.

The coronary artery has three branches, namely the left anterior descending branch, the left circumflex branch and the right coronary artery.

Compared with the left side, Asians have the right coronary artery as the main dominant type.

Judging from Wang Xueqin's many years of experience, this patient is definitely not a simple single coronary artery blockage.

It is more like one of the ceilings of surgical difficulty in the Department of Cardiology Intervention, and it is also a disease that few people have been able to conquer for many years...

That disease is very rare, and so far, Wang Xueqin has only seven cases.

Four of them failed, and only three were successful.

And the conditions of the three patients who were successfully treated were far less serious than the current patient.

However, time was tight, and Wang Xueqin could only take the patient to the operating room directly after reading the examination list.

He thought that he would deal with it as soon as possible.

Even if it was that disease, he could solve it with his rich experience in intervention.

But he didn't expect...

The setback came so quickly.

In the operating room, the dynamic angiography images on the display screen made him and all the doctors present look solemn.

A large tangled network of blood vessels trembled again and again with the rhythm of the heartbeat.

It looked like an earthworm covered with tentacles, with its crooked body and tentacles coiled in front of everyone.

Every time the heart beats, the color of the tentacles will change from dark to light, and then from light to dark.

It is simply an unpredictable monster, waiting for the doctors to show their fists and feet in front of him to see if they can knock it down.

Wang Xueqin frowned, looking unhappy.

The difficulty of interventional surgery is not only because the blood vessels themselves are too narrow.

It is also because the surgery is performed in a dynamic situation.

For example, when the guidewire passes through a curved section of a blood vessel, the doctor's hand must not only be steady, but also follow the rhythm of the heartbeat. If you are not careful, the guidewire will pierce the blood vessel wall and destroy an interventional pathway.

The patient in front of him has more than one blocked section, and the winding blood vessel pathways are densely packed. The guidewire is like entering a maze, which is very difficult to walk.

Wang Xueqin was silent.

The guidewire in his hand is stuck in the calcified part of the aortic valve and cannot enter.

What to do?

If you can't get in here, try another route? ?

But if the aorta can't get in, the right coronary artery can't get in either.

Change the guidewire?

But it's already been changed.

The SAL1.0 guidewire was changed to 2.0, but the 2.0 one is obviously worse, and the balloon is bigger than the 1.0 one, so it can't get through.

Just as Wang Xueqin was thinking hard, a quick prompt sound suddenly came from the monitor!

Beep beep beep!

The nurse panicked and said, "No! Ventricular fibrillation!"

The wrinkles between Wang Xueqin's eyebrows deepened unconsciously, and he ordered with a sullen face, "First rescue, remove the guidewire, and push 5 ml of lidocaine intravenously!"

"Okay!"

In the operating room, a tense and depressing atmosphere was quietly spreading.

At this time, Zhang Yi had just arrived home.

He was surrounded by those reporters for a long time at the door of the emergency room just now.

If Kang Yanming hadn't come forward to help him out, he probably wouldn't have been able to get home by now.

After washing up, Zhang Yi lay on the bed and watched today's real-time news.

The cause of the explosion in the firecracker factory was found. The surveillance showed that a few children went to the warehouse to play with firecrackers because they were playful, and somehow ignited all the firecrackers around.

This led to such a tragedy.

Oh!

What a sin!

Why did they go to steal firecrackers?

How pitiful those workers who died.

In addition to the netizens' condemnation of those children, Zhang Yi found that he was also on the hot search.

'Zhang Yi performed surgery on injured firefighters'

'The surgery on injured firefighters was successful'

'Zhang Yi is really amazing'

Several entries were listed on the hot search, and the private messages on Zhang Yi's several platform accounts also increased.

However, Zhang Yi will never be able to read all these private messages.

Because every time he opens the message, there are 999+.

He really doesn't have the time to read them.

He actually doesn't like the feeling of being frequently followed.

He just wanted to be an ordinary doctor in a low profile.

As he thought about it, he felt sleepy and gradually closed his eyelids.

…

In the operating room of the Department of Cardiology Intervention of Union Hospital.

The patient not only had ventricular fibrillation, but also had ventricular fibrillation twice in thirteen minutes!

Although he was supported by drugs, everyone present knew that the patient didn't have much time left.

If he dragged it on, he would die on the operating table.

For a moment, everyone looked at Wang Xueqin.

Wang Xueqin's eyes were deep and his face was expressionless, and everyone couldn't see what he was thinking.

Only he knew how much pressure he was under. The success rate of this operation in his hands was not high.

But he was the director of a department after all.

He had to withstand the pressure!

Then, he quickly picked up the guidewire, but this time he changed it to a 1.2 guidewire.

He chose to believe in himself again.

Just as he was holding the guidewire and inserting it through the sheath again, Liang Ming, the deputy director, suddenly said:

"Director Wang, actually... I thought of someone."