I Can See Health

   Chapter 762 I asked an expert

  Guanghai Central Hospital.

   Cardiology CCU ward.

   At this time, nurse Xiao Rong didn't dare to be stunned, but stared at the patient on the hospital bed.

   If there is another problem, the patient will not be able to be saved!

   Now, when she recalls what she said just now, she really regrets it too much!

doctor's office.

  Shi Langqin, Dai Wansong and other bigwigs gathered.

   The reason is the patient with "severe aortic stenosis" who just developed heart failure.

"Fortunately, the nurse found out in time. The first time the patient had heart failure, she immediately called for help." The doctor on duty introduced the condition, "But when I arrived, the patient was already sitting up breathing, and his blood oxygen saturation and blood pressure were not good. already."

  Dai Wansong listened silently without speaking, and kept flipping through the patient's hospitalization in his hands.

   for a long time.

   "Dean Dai, can...can you do it?" Shi Langqin looked at Shi Langqin beside him with hopeful eyes.

   This time, he decided to perform TAVR surgery before the conference for the sake of building momentum.

   If he fails, it may damage his subsequent deployment, and even affect the selection of his chairman.

   "Yes." Dai Wansong nodded slightly and paused for a while, "However, the risk of surgery is extremely high, and the patient may not be able to get off the operating table. You must discuss this with the patient's family. The family will take the risk, and we will start preparing for the surgery!"

   "That's great, with your words, then I'm relieved."

  Shi Langqin's heart was determined.

   "As for the family members, I'll go talk to them in person!"

   He immediately took the doctor on duty to the doctor-patient communication room, ready to explain the risks of the operation to the patient's family.

  …

   On Dai Wansong's side, he was not idle either.

  The reason why he dared to agree to Shi Langqin was of course because there had been similar cases before.

  Emergency TAVR surgery, although there are few cases, he has cooperated with Lu Chen for a few.

   What impressed Dai Wansong the most was the "pause ventilator" operation that made the valve input to the designated position.

   At that time, it was amazing!

   Lu Chen's hand is even close to the level of the world's top practitioners.

   In that operation, Lu Chen was the chief surgeon and Dai Wansong was the assistant.

After   , Dai Wansong also encountered several similar emergency TAVR surgeries.

  At the beginning, he would invite Lu Chen to perform the operation together.

   Later, Dai Wansong simply asked Lu Chen's opinion online.

   After a comprehensive evaluation, a reasonable surgical plan is assigned to the patient according to the patient's opinion.

   Don't look at it as just a surgical plan, but there are many things in it!

   Taking the surgical approach as an example, the shape of the valve leaflets, the degree of calcification, the presence of fusion, and the diameter of the valve annulus should be evaluated preoperatively based on ultrasound.

  After tracheal intubation, the anatomy of the aortic root needs to be determined through the esophagus, and the course of the carotid artery, femoral artery, abdominal aorta, and ascending aorta should be evaluated to further exclude relevant contraindications and select an appropriate approach.

  Generally, inexperienced surgeons are prone to detours and even choose the wrong path, which delays the best time for surgery.

The risk of    patients is so high, Dai Wansong still habitually asks Lu Chen's opinion.

   He collected the patient's medical records, took a photo and sent it to Lu Chen.

  …

  Lu Chen was checking the paper when he suddenly received a message from Dai Wansong.

   However, he is used to it now.

   Dean Dai usually refers to his opinions when encountering interesting or difficult operations.

   As the dean, it is extremely rare for him to pull down his face and ask his own opinion.

   In the same way, Lu Chen is also happy to answer, not only can he earn a wave of gratitude, but also have a good relationship with Dean Dai.

   After receiving the surgical information from Dean Dai, Lu Chen began to study it.

   "Severe aortic stenosis, rapid atrial fibrillation, acute exacerbation of heart failure!"

   "The patient has intractable heart failure, and the medication is not well controlled. The patient is at risk of cardiogenic shock and sudden cardiac death at any time, and there is an indication for emergency TAVR surgery!"

   Dai Wansong nodded when he received Lu Chen's reply.

   As expected of Lu Chen, he immediately judged the patient's condition.

   "Lu Chen, we also decided to do emergency TAVR surgery here." Dai Wansong said immediately, "I made a plan myself, you can see if there is anything that needs to be modified..."

  Lu Chen quickly evaluated Dai Wansong's surgical plan again, and really found a lot of problems.

   "President Dai, I just checked the patient's left ventricular outflow tract internal strength, circumference and area, as well as the calcification of the outflow tract. You may need to pay attention to the risk of postoperative conduction block in the patient."

   Dai Wansong frowned slightly: "Well, I will prepare a temporary pacemaker and put it on the stage for use."

   "In addition, I measured the angle between the left ventricle of the patient's aorta and it was over 70 degrees. Considering the transverse heart, we must pay attention to the angle of valve delivery during the operation."

   "Okay." Dai Wansong recorded every point of General Lu Chen.

   "The last point, Director Dai, you should also know that for this kind of patient who uses a ventilator, when the valve is finally stepped in, the ventilator may affect the operation, so it may have to be paused for a few seconds."

  Dai Wansong couldn't help but smile: "Don't worry, I still remember this very clearly!"

   "Well, that's about it." Lu Chen said, "The plan you made, Dean Dai, is generally correct."

  Dai Wansong smiled, Lu Chen, this slick little guy, can really take care of his emotions.

   There are quite a few loopholes in his plan. Although it is not a big problem, after Lu Chen's modification, it can greatly reduce the occurrence of complications.

   "Lu Chen, thank you." Dai Wansong said, "If you have time, let's get together. You helped me a lot!"

   "Okay." Lu Chen smiled, "But I've left the magic capital now. When I go back, I'll find you as soon as possible."

   "Lu Chen left the magic capital?" Dai Wansong was taken aback.

   He knew that Dr. Lu Chen had graduated, and thought that Zhang Shuqing would keep him if he said anything.

   But, Lu Chen actually left? !

   If he knew earlier, he would dig a corner and bring Lu Chen to the Magic Capital Central Hospital.

   Then their hospital will take off!

   Just when Dai Wansong was about to continue questioning Lu Chen, Shi Langqin came back.

   "Old Dai, the family agrees, let's start the operation!"

   Dai Wansong took back his phone when he saw this.

   "Okay, I just sent the patient information to a TAVR expert and asked him for his opinion." Dai Wansong smiled, "The success rate of the operation has improved a lot!"

   "Old Dai, someone you even call an expert?" Shi Langqin said in surprise.

   "Yeah, TAVR surgery has developed rapidly in our magic capital in recent years, and his credit is not small!" Dai Wansong continued.

   "I really want to get to know each other." Shi Langqin became interested.

   "Don't worry, there is a chance." Dai Wansong said, "Let's settle this patient's operation first today."

   "Okay." Shi Langqin's expression was solemn, and then he ordered everyone to start preparing for the operation.

   In this operation, Dai Wansong was the main surgeon, and Shi Langqin was the assistant.

   (end of this chapter)