I Can See Health

   Chapter 664 Snare Assistant

   Dai Wansong reacted immediately.

   Lu Chen at the Heart Failure Conference?

   He also participated in the heart failure conference some time ago, and he immediately recalled the young man who surprised everyone in his mind.

   He looked at Lu Chen in front of him with a hint of surprise in his eyes!

   He remembered that Lu Chen was studying dapagliflozin?

  Why did you come to their TAVR class?

   (The following uses TAVR instead of valve intervention)

  …

   After a brief interlude, calm was restored in the catheterization lab.

  Dai Wansong took a deep look at Lu Chen.

   Could this kid want to engage in TAVR across research fields?

   "Let's continue next..." Dai Wansong retracted his thoughts and began to explain.

Everyone in the catheterization room looked at Lu Chen from time to time.

   For this mysterious young man, everyone has a trace of curiosity in their hearts.

On the operating table, Dai Wansong continued: "After the successful transvalvular valve, a stiffened guide wire needs to be sent through the pigtail catheter for the implantation of large sheaths for vascular access, the delivery of dilatation balloons and valve systems, and the prevention of peripheral vascular complications. Deal with it. Who do you know of the types of guide wires that are hardened by TAVR in China?"

   As soon as this question came out, the entire catheterization room was silent.

   This is already a very professional question. Everyone present is new to TAVR. Shouldn’t they be familiar with this question?

   Everyone looked at each other in dismay, without any clue.

  Dai Wansong looked at Bo Xin and found that the latter lowered his head and didn't look at himself, so he was a little disappointed.

   So, he turned to look at Lu Chen who was standing beside him.

  Lu Chen saw Dai Wansong's gaze, paused, stood up, and said softly, "Currently, there are mainly two types of hardened guide wires suitable for TAVR available in China, Lunderquist and Amplatz."

Lu Chen paused and continued: "The Lunderquist guide wire is harder and stronger than the Amplatz guide wire. It is suitable for almost all types of valves, but at the same time, the risk of complications such as guide wire perforation and incision is also relatively increased... …”

   As soon as Lu Chen finished speaking, everyone in the catheterization room looked at him.

  Let me go, is this a newcomer to TAVR?

   Actually know so much about the current domestic market guide wire.

   This time, everyone had no doubts about Lu Chen's answer.

   Being able to answer so fluently must be Lu Chen's real understanding, that's right!

   Sure enough, a smile appeared on Dai Wansong's face, "Well said!"

He went on to add: "The shaping curvature of the tip of the stiffened guide wire should match the size and shape of the ventricular cavity, and there should be no edges and corners, otherwise fatal complications such as myocardial perforation may occur during valve delivery and release, and it takes time during the operation. Note the position and tension of the guidewire within the ventricle."

   This is why there are currently only two types of hardened guide wires in China.

  Because it is too important to harden the guide wire, once the matching is unsuccessful, it will directly affect the success rate of subsequent surgery.

   "Come and try orbital establishment and balloon pre-dilation?"

   Dai Wansong said this to Lu Chen alone.

All the students in the catheterization lab looked at Lu Chen enviously.

   There are not many opportunities for this kind of practice!

  The fraud in the simulated operating room is very expensive, and the equipment required for each simulated operation has a lot of consumption.

   "Okay." Lu Chen smiled and nodded.

   He practiced in the virtual space of the system for a long time last night, but it was the first time to operate in real life.

   walked slowly to the stage and took over from Dai Wansong.

  …

  The virtual space of the system and the operation in reality are still somewhat different.

   The real touch made Lu Chen's heart beat slightly faster.

   This is not real surgery yet.

   If it was a real human surgery, the string in Lu Chen's mind might be even tighter.

  Lu Chen didn't get started quickly.

   Instead, choose an appropriately sized dilation balloon based on ultrasound and CT measurements.

   Then adjust the angle through the balloon marker and calcification position, place the middle of the balloon in the calcified stenosis area, and select an appropriate body position according to the CT angle so that the target calcification area does not overlap with the balloon position, so as to observe the balloon expansion effect.

   Seeing Lu Chen's actions, so mature and sophisticated, Dai Wansong couldn't help but nodded slightly.

   In his heart, this kind of proficiency is definitely not the first time to do TAVR surgery!

   After Lu Chen successfully completed the balloon pre-dilation, Dai Wansong did not call to stop, but said expectantly: "Lu Chen, don't stop, you continue!"

  Lu Chen nodded.

   This opportunity to operate in reality was rare, and he concentrated his attention even more.

  The next step is valve delivery and release.

   This is the top priority of the whole operation!

  Lu Chen needs to deliver the artificial valve to the location of the diseased valve, and then release it successfully.

   This is also a step that tests the skill of the practitioner the most.

  Dai Wansong looked at Lu Chen without blinking.

   The reason why he let Lu Chen continue is to see where his abilities are.

   If this last step can be completed, it will prove that Lu Chen is ready to go to school.

  …

   Catheter lab.

   All the students didn't dare to let out the air, they all stared at Lu Chen's movements.

   His every step touched everyone's nerves.

  After balloon pre-expansion, if the valve is severely damaged, there is a lot of regurgitation, and the patient's hemodynamics are unstable, a prosthetic valve needs to be implanted quickly.

   However, it is only a simulated operation now, without such concerns, Lu Chen can take it easy and play steadily.

   In the case of full fluoroscopy, the artificial valve is slowly delivered.

The early delivery of the    valve was smooth.

   Lu Chen paused for a while until he reached the position of the aortic arch.

   "Be careful here!" Dai Wansong reminded appropriately.

   At this time, if the hardened guide wire cannot be pulled in, it is easy to get out of the ventricle.

  Lu Chen did not act in a hurry, but recalled the training steps in the system space last night in his mind.

  He first adjusted the body position to the left anterior oblique position, and then pushed the valve, while tightening the super-hard guide wire to avoid damage to the aorta during valve delivery.

   However, no matter how Lu Chen adjusted the position, the valve could not be delivered.

  …

  Other students also noticed the abnormality of Lu Chen's operation.

"its stuck!"

   "The valve can't get in... I guess it's because the valve's angle is too big, and it's impossible to get through!"

   "Hehe, let me just say it, Lu Chen probably won't be able to get in. Theoretical knowledge is one aspect, and final operational skills are the first aspect."

   "We're still in a class, and it's pretty good to be able to do this!"

   Some people sigh, others gloat.

   However, Lu Chen was completely unaffected.

   "If it doesn't work, you can end the operation." Dean Dai Wansong said softly.

   For Lu Chen's performance, even if he failed to complete all the steps, Dai Wansong was very satisfied.

At this moment, Lu Chen slowly raised his head, without any nervousness on his face, he put down the guide wire in his hand, and said to Dai Wansong, "President Dai, the aortic valve of this simulated patient has a large angle, and the artificial valve is very large. It was difficult to pass through the aortic valve, and I needed a snare to assist the valve and correct the misalignment of the prosthetic valve."

   "This..." Dai Wansong was stunned when he heard Lu Chen's words, "You want snare assistance? Why not use double guide wire technology?"

   (end of this chapter)