I Can See Health

   Chapter 558 Disappointed? !

   "Go!" Qin Sifeng waved his hand and walked towards the No. 3 catheterization room.

The female doctor and Lu Chen next to    saw this and followed closely behind.

   On the way, the young female doctor kept silently observing Lu Chen.

   Didn't Professor Qin pick up a big man just now, why did a young man suddenly appear?

  …

   No. 3 conduit outdoor.

   Qin Sifeng did not rush in, but wanted to know the patient's condition first.

"what's the situation?"

  The young doctor outside the catheter room immediately said: "The operation went well at first, but when the puncture was just performed, there seemed to be some problems."

After   , the young doctor handed the patient's medical record to Qin Sifeng.

   Qin Sifeng opened the medical record, the first page was the patient's echocardiography report.

   "This ultrasound...the patient's atrial septal puncture is indeed a bit tricky." Qin Sifeng said with a frown.

  Compared with coronary intervention, the talent pool of electrophysiology is relatively small, and Xiao Shikang is already a leader among the younger generation.

   The surgical problem that even he can't solve is not a routine small problem.

  Lu Chen also saw the patient's echocardiogram and said solemnly, "Blend fossa ovalis?"

   Qin Sifeng nodded, his face quite serious. .

  Atrial septal puncture is the most basic step in atrial fibrillation ablation, and it is also the most dangerous step!

   Generally, the puncture point of the interatrial septum is in the fossa ovalis.

  At the time of puncture, make sure that the puncture is only on the fossa ovalis.

   If it goes beyond the fossa ovalis, it may cause cardiac tamponade!

   In addition, the location of the puncture point is also related to the patient's body shape, heart shape and structure, etc.

  Some people are slender and slender, the heart is vertical, and the puncture is generally a little higher.

  If it is too low, the duct will pass under the fossa ovalis to the bottom of the atrium. In some people, the left atrium is very small, and the top of the left atrium goes to the opposite side of the left atrium and causes cardiac tamponade!

  If it is a transverse heart, the puncture should be a little lower, and if it is too high, it may pass through the roof, or even into the pulmonary artery, and the aorta in the front.

   Also, don't pierce too fast, if you pierce too deeply, it may go to the opposite side.

   "Mr. Qin, shall I get you a lead coat?" said the young female doctor on the side.

   Usually, Qin Sifeng would come to power in person at times like this.

   But today...

   Qin Sifeng looked at Lu Chen beside him, he didn't need to take action himself!

   "No." Qin Sifeng shook his head slightly and pointed to Lu Chen beside him, "Find him a suit that fits him."

   Hearing Qin Sifeng's words, everyone around looked at Lu Chen with surprised expressions on their faces.

   There is a lot of mobility in the catheterization room. A small number of people think Lu Chen is a little familiar, but they didn't meet the number for a while. They just regarded Lu Chen as a doctor in the general ward upstairs.

  Lu Chen smiled lightly, he had expected this situation long ago.

   Mr. Qin brought him to the catheterization room, but he didn't plan to let him "watch the play" by the side!

   "Find it for him?" The young female doctor had never seen Lu Chen at all, her expression was a little hesitant. Teacher Xiao couldn't solve the problem, should such a young doctor do it?

   "Don't waste time!" Qin Sifeng urged.

  The young female doctor didn't dare to neglect her, and she even threw away her thoughts, and hurriedly prepared to find a lead coat for Lu Chen.

   "Don't bother you, I'll find it myself." Lu Chen smiled.

   In the catheterization laboratory of the First Affiliated Hospital of Kyoto University, he once stayed for a month.

   I am relatively familiar with the environment here.

  He found a set of lead suits with ease, put them on, and walked into the catheterization room.

  …

   No. 3 catheter room.

  Xiao Shikang was staring at the angiography image in front of him.

   This is a case of radiofrequency ablation of atrial fibrillation, but he ran into trouble while performing a transseptal puncture.

  Because in the contrast image, he saw a bulging tumor in the fossa ovalis of the patient’s atrium.

   A fossa ovalis tumor is soft, elastic, and not easy to pass through.

   And the left atrium is small, so special care should be taken in puncturing. Once the puncture needle passes through the bulging tumor and reaches the free wall side of the left atrium, it will cause the risk of cardiac perforation.

   Even under the guidance of the cardiac ultrasound, Xiao Shikang flinched.

   Because once there is any mistake, the patient's heart is at risk of perforation!

   "Have you told Professor Qin?" Xiao Shikang asked the graduate student who was following the stage.

   "Said, Professor Qin will come right away." The graduate student said.

  Xiao Shikang nodded slightly, now he can only wait for Qin Sifeng's arrival to see if he has any better way to pierce.

   Just as Xiao Shikang was dazed by the contrast image, a familiar and somewhat unfamiliar voice suddenly sounded in his ear.

   "Mr. Xiao, here I come."

  Xiao Shikang looked back immediately, and at some point, a doctor wearing a surgical gown appeared beside him.

   He was wearing a mask and hat, and Xiao Shikang could not see his appearance.

   But listening to his voice and looking at his piercing eyes, Xiao Shikang felt very familiar.

"You are……"

  Lu Chen squinted his eyes and smiled, "Mr. Xiao, I'm Lu Chen, I haven't seen you for a year, you don't remember me?"

   At the beginning, Lu Chen came to the Kyoto Institute of Electrophysiology for the second round of assessment, that is, to study under Xiao Shikang.

   "Lu Chen?" Xiao Shikang was stunned, the figure in his mind slowly overlapped with the person in front of him, and a surprised look appeared on his face, "You, why are you here?!"

   "Mr. Xiao, wait until the operation is over to catch up. Let's take a look at this patient first." Lu Chen smiled.

   "Okay!" Xiao Shikang nodded slightly and began to tell Lu Chen about the patient's situation.

The patient    is a female patient in her 60s with a diagnosis of paroxysmal atrial fibrillation.

   In recent years, her frequent episodes of atrial fibrillation and angina pectoris have caused the patient to suffer a lot.

  After much deliberation, I finally made up my mind to do atrial fibrillation ablation!

   When the operation started today, everything went smoothly.

   But when it was time for atrial septal puncture, Xiao Shikang felt something was wrong.

  …

   "Lu Chen, have you seen the patient's preoperative cardiac ultrasound?" Xiao Shikang asked.

"I have seen it." Lu Chen nodded, "The patient has a fossa ovalis bulge tumor, which is soft and large, and is not easy to puncture through. Once it touches the free wall of the left atrium, the heart is easily perforated. ."

   "Yes, I'm considering this possibility now, so I haven't dared to start." Xiao Shikang sighed.

   He turned his head slightly, glanced at Lu Chen beside him, and found that he was staring at the patient's angiography image.

   "Lu Chen, is there any safe way?"

  Lu Chen didn't answer directly, but instead asked, "Have you done an intraoperative ultrasound?"

   "I just asked the ultrasound teacher to do it." Xiao Shikang said, "Do you need to do it again?"

  Lu Chen looked at the angiography image and nodded, "Push the ultrasound machine over, and I'll take a look at the specific location of the fossa ovalis tumor."

   "Okay." Xiao Shikang immediately instructed the graduate student beside him to push in the ultrasound machine outside the catheter room.

   Qin Sifeng, Xiao Shikang and others were not surprised by Lu Chen's superb and skilled ultrasound technology.

   It was outside the catheter room. When other young doctors saw Lu Chen showing off his ultrasound skills, they knew that this young man was unusual!

  Lu Chen didn't waste too much time, he mainly wanted to use ultrasound to determine the approximate location of the bulging tumor in order to facilitate the puncture direction.

   "Now, even with ultrasound-guided puncture, the risk is not small!" Xiao Shikang frowned deeply.

   Anyway, he didn't dare to pierce like this!

  Because the risk is extremely high, once you fail, you will be ruined!

   Does Lu Chen want to take such a risk?

   (end of this chapter)