I Can See Health

  Chapter 643 Guide Wire Resistance

   This is Lu Chen's second surgery in the magic capital.

   He recalled all the steps of ablation in his mind, puncture, mapping, and ablation!

  The difficulty of premature atrial ablation surgery lies in mapping!

  The operator needs to map all possible areas of the atrium, find out the origin of the atrial anomaly as much as possible, and then perform ablation.

  Traditional point-by-point mapping requires sweeping the ablation catheter all over the atrium. It takes at least 2 hours to map 200-300 points, and requires high catheter operation for the surgeon.

  Lu Chen decided to use the latest high-density electrophysiological anatomical mapping technology to complete the ablation of this premature atrial.

"let's start."

  Lu Chen stood in front of the operating table, his gloves and hats already changed.

   Normally, the assistant needs to prepare the surgical area for draping and disinfection.

   However, this time the assistant was the mentor Zhang Shuqing, and Lu Chen really didn't dare to let him operate.

   Therefore, Lu Chen silently disinfected the patient's surgery area.

  …

   This time, Lu Chen chose the right femoral vein as the puncture route.

   Enters from the femoral vein, passes through the inferior vena cava → right atrium → puncture the interatrial septum, and finally reaches the left atrium.

   Lu Chen's puncture technique was the same as before.

   Fast and accurate!

   In the blink of an eye, Lu Chen's femoral vein puncture was completed.

  The guide wire passed smoothly!

   Zhang Shuqing next to him felt Lu Chen's piercing speed most intuitively.

too fast!

   He really just blinked...

  Lu Chen succeeded in the puncture, and the guide wire was implanted.

   All the doctors watching outside the catheter room had surprised expressions on their faces.

   Judging from this puncture technique, Lu Chen's electrophysiological technique must be considered top-notch.

   This level of proficiency is impossible without years of surgical experience.

   However, everyone is very strange.

   With Lu Chen's age, how could he have achieved such a high level of proficiency in an intervention certificate for at most one or two years?

   Director Liu Jun also saw Lu Chen's operation for the first time.

   "This young man is really good." Liu Jun said to Zou Yi, "Vascular puncture is the starting point and key point of our cardiac interventional surgery!"

   "Lu Chen's puncture level is top-notch in any hospital in the country."

  Zou Yi nodded slightly.

   He is a layman, looking at the excitement, he doesn't know the meaning of this piercing.

   Although he heard that Xiao Shikang admired Lu Chen so much, he had never seen such a young chief surgeon before, and he was still a little worried.

   Hearing Liu Jun complimenting Lu Chen so much, he felt a little relieved.

  …

   Catheter room.

  Lu Chen gently squeezed the guide wire and let it follow the blood vessel, slowly heading towards the left atrium.

   Suddenly, Lu Chen frowned.

   He felt a little bit of resistance!

   "Shouldn't it be?!" Lu Chen murmured, "I just arrived at the inferior vena cava, how could there be resistance?"

   Zhang Shuqing also saw that Lu Chen's movements paused for a while, and asked in confusion, "What's wrong?"

   "There is resistance!" Lu Chen frowned softly.

   "Is there resistance now?" Zhang Shuqing's expression was also very surprised.

  The guide wire has just entered the femoral vein, at most the inferior vena cava!

   At this time, it is impossible to have resistance.

   Could it be that there is something wrong with Lu Chen's operation?

   Zhang Shuqing glanced at Lu Chen.

  Everyone was watching from the outside, he couldn't just question Lu Chen like that.

   Unexpectedly, Lu Chen said, "Teacher, why don't you try it?"

   Zhang Shuqing did not expect Lu Chen to be so light.

   He is not afraid that if he succeeds, everyone outside will see it?

   Zhang Shuqing pondered slightly, then nodded.

   Patient safety comes first!

  Lu Chen turned slightly to his side and gave up his position.

  …

  Conduit outdoor.

   Everyone saw the abnormality on the operating table.

   "What's going on? Why did Lu Chen give way to Director Zhang?"

   "I saw Lu Chen paused just now. Could it be that the guide wire can't get through?"

   "Impossible! Where did this guide wire go? It's impossible!"

   "Hey, do you think it's because this kid's level is not enough, so let Director Zhang come forward temporarily?"

   Lu Chen and Zhang Shuqing's behavior aroused everyone's suspicion.

  Zou Yi frowned and looked at Liu Jun, "Director Liu, what's going on?"

   Liu Jun also frowned deeply. It was the first time he saw the puncture guide wire, and he still needed to be replaced.

   In this case, there is only one possibility, and that is trouble!

  Otherwise, it is impossible to easily substitute.

   "Juju Zou, let's take a look. I don't understand it yet." Liu Jun snorted.

   He was thinking about the possibility of this happening.

  Zou Yi could only sink his heart and silently watch the changes in the operating room.

  …

  Zhang Shuqing took over Lu Chen's place and started feeding the guide wire.

   As soon as he got started, his expression changed.

  There is resistance!

   And this resistance is not small.

how could be?

  As soon as the guide wire reached the inferior vena cava, it encountered resistance!

  The blood vessels of the human body are very fragile, and brute force cannot be used, otherwise the blood vessels may be damaged.

   In case of rupture or dissection of blood vessels, it will not be worth the loss.

   So Zhang Shuqing didn't dare to make any changes!

   "Let me try to wear the left side." Zhang Shuqing said solemnly.

   They just punctured the right femoral vein, and now they encounter resistance and can only try the left side.

   "Okay." Lu Chen nodded slightly.

   But what they didn't expect was.

  The left femoral vein path, despite repeated adjustment of the angle, the guide wire still cannot pass!

The blood vessels on both sides of the    have encountered the same problem.

   This situation is extremely rare, at least Zhang Shuqing has never encountered it before.

   A fine sweat slowly appeared on his forehead.

  This patient has a special status, and his current state of mind is a little unstable.

   If something goes wrong, his future promotion will be difficult!

   Zhang Shuqing turned to look at Lu Chen, and found that he, the student, was still indifferent.

   "Teacher, why don't you do an angiogram?" Lu Chen suddenly said, "There is resistance to the passage of the guide wire, which only means that the blood vessel may be stenotic or deformed!"

  Through angiography, you can see the specific conditions of the blood vessels.

   "Well, it makes sense." Zhang Shuqing thought for a while, "Okay, then you come to the imaging."

   The guide wire cannot pass, but the contrast agent can pass.

   This is also the only way at present!

   Zhang Shuqing gave way.

  Lu Chen stepped forward immediately, took over the teacher's position, and started angiography.

  …

   Seeing the movements of the two, the people outside also reacted.

   "If I read that right, they just pierced the left side again?"

   "I think it's probably because the guide wire is not passing smoothly and is blocked!"

   "Their positions have changed again..."

   "What is Lu Chen doing? Did he decide to do an imaging first?"

   As the contrast image is displayed on the screen in front of the operating table.

Everyone inside and outside the catheter room was stunned.

  The patient's azygos vein joins the superior cavity and then reaches the right atrium, which means that the hepatic segment where the inferior vena cava enters the atrium is absent!

  The inferior vena cava goes around the heart in a large circle through the azygos vein and finally enters the right atrium.

   The popular explanation is that some blood vessels do not exist in the normal path of the patient into the atrium!

   (end of this chapter)