I Can See Health

   Chapter 669 Floating Valve

   Director Liu sat on the office chair with question marks in his mind.

   Lu Chen, why did he go to the Magic Capital Central Hospital?

   Moreover, the Magic Capital Central Hospital even asked Lu Chen to go to the consultation!

  You should know that for general out-of-hospital consulting doctors, the minimum professional title should be a deputy chief physician, and no matter how bad it is, a senior attending doctor should be.

   And Lu Chen is only a doctoral student, and he has not yet obtained the qualification certificate of the attending doctor!

   (ps: Master's degree can be taken in two years after graduation)

   "Director Fang, is this in line with the rules?" Liu Jun wondered.

   Director Fang Yu of the Medical Department said: "How should we put it, if we are sent abroad, it must not be Lu Chen, but this is what the Magic City Central Hospital asked for, and it is also about TAVR surgery. There are special policies for special circumstances."

   "Okay, I have nothing to do here, as long as the medical department agrees."

   Liu Jun hung up the phone, and after thinking about it, he still called Zhang Shuqing.

   "Shuqing, what is your doctor named Lu Chen doing recently?"

  Zhang Shuqing was stunned, and immediately replied: "Director, I didn't tell you last time, there is a TAVR class in Modu recently, and I asked Lu Chen to go."

   "Oh, I remember." Liu Jun nodded.

   "Dean, what happened to Lu Chen?"

   "No, it's like this." Liu Jun told the story of the Modu Central Hospital, "Lu Chen's TAVR surgery technique is good?"

   "This... it shouldn't be." Zhang Shuqing shook his head, "I remember Lu Chen said once that he was just getting started with the TAVR technique, so he should be... a novice."

   "Should... be considered a novice? Are you sure?" Liu Jun asked in return, "You mean that Director Dai of the Modu Central Hospital is a fool and asked a novice for consultation?"

   Zhang Shuqing felt a little unconfident after being asked this.

   "When Lu Chen comes back, I'll ask him again."

   Liu Jun sighed, "Shuqing, you student, you are too evil, can we grasp it?"

  Zhang Shuqing was stunned for a while before slowly saying: "No matter what, Lu Chen is my student. The better he does, the better our hospital's face is, isn't it?"

   "Okay, you student, I don't need to ask, you can cultivate." Liu Jun smiled.

   "Okay, thank you Director!"

   Zhang Shuqing was relieved for no reason when he heard this.

   No matter how powerful people are, if they are led to wear small shoes, they will not be able to stand up!

   However, Lu Chen's TAVR surgery skills are really doubtful, and he has to ask him what's going on when he looks back.

  …

  Modu Central Hospital.

   Catheter lab.

  Lu Chen stood beside Dai Wansong and started the first real-world TAVR operation in his life.

   He took a deep breath and calmed his heart a little.

   Even when he was a surgical assistant, not the chief surgeon, Lu Chen would still devote 100% of his concentration.

  Disinfection, drape, puncture, all in one go.

   Dai Wansong looked straight and nodded.

   "I've come to insert the guide wire."

   According to Lu Chen's analysis just now, the patient's entire blood vessel condition is very poor.

   There are multiple calcified plaques at the origin and bifurcation of the femoral artery.

   Calcified plaques are like garbage attached to the walls of blood vessels.

   There is too much garbage, which is likely to affect the entry of the guide wire.

  …

   Even an experienced TAVR surgeon like Dean Dai Wansong carefully pushed in the guide wire at this time.

   "There is resistance!"

   and Lu Chen guessed the same, the plaque and stenosis of the blood vessels seriously affected the entry of the guide wire.

   Dai Wansong didn't dare to push too hard.

   In case of rupture of blood vessels or dissection of blood vessels, it would be a huge loss!

  Conduit outdoor.

   Everyone sweated for Dean Dai Wansong.

  The feeding of the guide wire is the cornerstone of the entire operation.

  If the guide wire cannot be fed in, forget about the subsequent operations.

   At this time, Lu Chen, who had been playing beside him, whispered, "Dean Dai, why don't you try wearing the superficial femoral artery?"

   "Shallow strands?" Dai Wansong put down the guide wire in his hand, "I...I haven't tried it."

   "I can." Lu Chen said immediately.

   "Okay, you come." Dai Wansong didn't hesitate, and quickly stepped aside.

  Lu Chen stepped forward immediately, and as soon as the needle went down, the puncture entered the shallow part of the thigh.

   "Dean Dai, I'm done."

   "Huh? That's it?" Dai Wansong's eyes widened.

   "Yes." Lu Chen nodded.

   puncture an artery only, as long as you have exercised hundreds of thousands of times in the virtual space of the system, it is not a problem to puncture any difficult blood vessels.

   Amazed but surprised, after Gu Qian successfully punctured, the two changed their positions.

   Everyone in the conduit room didn't have time to react.

  Lu Chen had already become an assistant again.

  …

  Dai Wansong pushed the guide wire into it bit by bit.

  The guide wire quickly reached the valve position.

   Next, is the most important guide wire transmembrane.

  If the guide wire is successfully passed through the valve, it will affect the delivery and fixation of the subsequent prosthetic valve.

  Dai Wansong did not rush into the guide wire, but watched the patient's CT and ultrasound results again.

   CT analysis of the patient showed:

  TYPE1 bicuspid valve, with fusion of left and right, thickened valve leaflets, severe calcification, and calcification can be seen in the plane of the valve annulus.

  The left coronary opening height is about 11mm, the right coronary opening height is about 13.4mm, the French sinus structure is acceptable, the STJ height is about 16.9mm, the diameter is about 28.4mm, the ascending aorta is widened, the widest point is about 42.2mm, and the heart angle is about 53°.

  Dai Wansong has rich experience in TAVR.

   He immediately selected an appropriate transmembrane position based on the CT analysis results, and successfully passed the guide wire across the valve.

   "It's still Dean Dai's experience. Except for the first guide wire entry, it was too smooth."

   "The position of this assistant, I think I can do it too..."

   "Don't BB, didn't you see that Dean Dai asked Lu Chen to do the shallow puncture just now?"

   Lu Chen didn't know the thoughts of those present.

   He was engrossed at the moment, staring closely at Dean Dai's operations.

   "I started the balloon pre-dilation." Dai Wansong also raised some spirits.

  Before the prosthetic valve is delivered, the vascular access needs to be pre-dilated, which can create a better vascular pain, otherwise the prosthetic valve may not be delivered to the correct position.

   In this step, Dai Wansong still completed it perfectly.

   In Lu Chen's view, even if he did it, he might not have done well as Dean Dai.

   "Phew..." After finishing the above operations, Dai Wansong's forehead oozes fine sweat, and he has spent a lot of energy.

   However, the operation is not over yet!

   The last step left, the delivery and release of the prosthetic valve!

The delivery of the    valve is performed under full fluoroscopy, so it is not difficult.

   Rare is the release of the valve.

   The valve creates a force that "drills down" or "jumps up" during release, causing the valve to displace.

   In addition, during the valve release process, especially the anterior 1/3-2/3, the valve has not been fully anchored in the valve annulus, and is easily displaced by the impact of the regurgitation blood and the respiratory movement.

  Once the valve is displaced, it is not released at the predetermined position, which means the failure of the operation!

  …

   Sure enough, at this last step, Dai Wansong ran into trouble again.

   "No, the image of the valve being affected by the patient's breathing motion is too large."

   "The displacement is too obvious, and the valve can't be released at all!"

  Lu Chen also noticed this problem right away.

  The floating valve is impossible to release!

   His brows were furrowed, and he kept thinking about the training process in the virtual space of the system in his mind.

   Is there any way to stabilize the floating valve?

   (end of this chapter)