I Can See Health

   Chapter 416 Weird Origin Point

   "What's the matter? The patient in operating room No. 3 seems to have recovered from premature ventricular contractions?"

   Lu Chen's accident here was immediately known to the audience.

  Rao is a student who doesn't know much about electrophysiological surgery. He also saw Lu Chen's ablation. It seems that he failed? !

   At the same time, the operation speed of the other students in the operating room also caught up with Lu Chen.

   After performing puncture and mapping, they are all ready to start discharge ablation.

   Among them, Yu Hewei's operation progressed the fastest.

   He has already completed a third of the ablation procedure.

   In the classroom, the whispers of everyone resounded again.

   "It seems that the fastest is not necessarily the best! In this competition, we are not using the shortest time!"

   "Hey, young man, you still don't have enough experience!"

   "However, have you noticed that this patient's arrhythmia doesn't seem to be the same!"

  …

   Catheter room.

  Lu Chen stared at the patient's ECG monitor, his hands were constantly moving.

   "Continue the ablation discharge!"

  Since one discharge ablation failed, Lu Chen performed a continuous discharge operation again.

   But what Lu Chen didn't expect was that after several attempts, the patient's sinus rhythm could only be maintained for a short time.

  After the ablation discharge was withdrawn, the patient's premature ventricular contractions quickly recovered!

   At this point, Lu Chen fell into an endless loop.

   He flipped through the patient's case data.

   "That's right, it's the right ventricle!" Lu Chen frowned.

   The patient's electrocardiogram clearly showed that the premature ventricular contractions originated in the right ventricle.

   He is now ablating the right ventricular outflow tract, which has a certain therapeutic effect, but the effect of the ablation cannot be maintained!

   "Why the **** is this?" Lu Chen stopped the movements in his hands, his eyes flickered, and he began to recall countless simulation trainings in his mind, trying to find out the reason.

  …

   The classroom outside the venue.

   "Yo, I didn't expect it, there's a tricky case!"

   Director Wan Jingshui of the third ward in his heart smiled and looked at the big screen. He touched his chin and was extremely interested in Lu Chen in the third operating room.

   "Director, you see Lu Chen's ablation operation, I don't think there is any problem!" Fang Ruzhang sat beside Wanjingshui with a puzzled look in his eyes, "But why did it fail in the end?"

  Wan Jingshui grinned, "So, you young people, you are very skilled in surgical operation, but you still have too little clinical experience!"

   "Director, do you see the reason for the failure?" Fang Ruzhang was slightly startled.

  Wan Jingshui smiled and nodded, "Lu Chen's melting position is right and wrong again."

   "Right, wrong again?" Fang Ruzhang scratched the back of his head, looked at the big screen again, and said suspiciously, "I also looked at the patient's electrocardiogram, and the ventricle originated from the right ventricle, that's right!"

  The origin of premature ventricular early can be easily judged by electrocardiogram.

Originated from right ventricular premature beat, the chest leads are consistent with the left bundle branch block pattern, the main wave direction of the QRS waveform is upward in leads V5 and I, and the main wave in lead V1 is downward or has an obvious RS pattern. Fat, the time limit is greater than 30ms.

   originates from left ventricular premature beats, just the opposite.

Hearing Fang Ruzhang's words, Wanjingshui shook his head slightly and smiled, "You are right, the ventricle originates from the right ventricular outflow tract, but have you forgotten that the heart is a three-dimensional structure? In the ablation of the right ventricle of the endocardium After that, Shizao still exists, should we consider other possibilities?"

   "Three-dimensional structure?" Fang Ruzhang frowned and muttered, "Director, do you mean that the origin of premature ventricular arrhythmia is inside the heart? That is, the middle part of the intima and the adventitia?"

  The heart is divided into the endocardium and the epicardium.

  In the vast majority of surgeries, doctors put the catheterization lab into the blood vessel and ablate the intima of the heart.

   "Ruzi can be taught." Wan Jingshui nodded with a smile, "This kind of early origin is relatively rare!"

   However, hearing this, Fang Ruzhang's brows furrowed even deeper, "Director, how can the origin of this heart be melted away?"

"Hehe, difficult! This case of Lu Chen seems to be about to fail. The chief surgeon is ready to take over." Wan Jingshui turned his head to stare at the big screen and shook his head slightly, "This can only be said to be bad luck. Now, just change to the other four cases, and Lu Chen may have completed the operation."

Yao Jie on the side also heard the conversation between the two. She stared at the big screen, bit her lip with her teeth, and folded her hands together, praying to Lu Chen constantly in her heart.

   "Senior brother, you can definitely do it!"

  …

   Catheter room.

   After calming down, Lu Chen gradually realized the problem.

   After all, he has tried most surgical operations in the system's surgical simulation room.

   "First of all, I want to make it clear that my ablation is effective, which proves that the ablation part is generally correct, at least there is not much deviation!"

   "However, the effect of ablation could not be maintained, which can only mean that the origin of ventricular angioplasty is deeper and farther from the ablation point of the endocardium!"

  Lu Chen looked down at the patient on the operating table, without the slightest joy in thinking about the crux of the problem.

   Because he realized a problem, the origin of Shizao is deep, so how can he "reach" this lesion?

   The lesion is between the intima and the adventitia, or closer to the adventitia!

"Perhaps, only by ablation of the epicardium, it is possible to completely solve this patient's premature ablation!" Lu Chen thought to himself, "However, my catheter is in the blood vessel, how can I reach the epicardium and perform epicardial ablation? Woolen cloth?"

   Time passes in a minute and a second.

  Lu Chen seemed to give up, just stared at the ECG monitor, without any other action.

   In the other four operating rooms, everyone's operation is coming to an end.

   "Student No. 3, do you end the assessment?"

   In operating room No. 3, the chief surgeon stood beside Lu Chen for the first time.

   As long as he sees Lu Chen nodding, he will immediately take over the operation.

   However, the chief surgeon was also sighing for Lu Chen.

   This is really bad luck!

   Two words, face black!

  Whoever chooses this patient will end up with a "failure".

   "Classmate, you don't have to worry about it." The chief surgeon reminded, "This operation is more difficult than expected. Even me, I have to report it to the director of the department now to decide the next treatment plan."

  Lu Chen paused, then shook his head slightly, "I, I don't want to give up yet."

   "Okay, then I'll give you the last five minutes to think about it. If there is no next step, the assessment will be considered over!" The chief surgeon sighed. Although it was a pity, he could not delay the patient's treatment.

  …

   In the catheter room, all the students from the other four operating rooms came out.

   When they saw that Lu Chen was still in the operating room, they couldn't help being surprised and puzzled, and some people even gloated.

   "Xiao Fang, it looks like that kid Lu Chen gave up!" Looking at Lu Chen who had not acted in the catheterization room for a long time, Wan Jingshui shook his head regretfully.

   "Oh, what a pity!" Fang Ruzhang said regretfully, "Lu Chen has always been ranked second. Without this accident, he will definitely pass this assessment!"

   On the big screen in the classroom, everyone saw that the chief surgeon in the No. 3 operating room had come out.

   "Okay, the assessment is over, let's go back too!"

  Wan Jingshui stood up and prepared to return to the department.

   But just when everyone was about to leave the classroom, someone shouted loudly, "Fuck, look at the operating room No. 3, why is it operating again?!"

   Try to write another chapter.

   (end of this chapter)