I Can See Health

   Chapter 807 Peripheral leak!

  Guanghai First Hospital, Cardiology Catheterization Laboratory.

  Wang Qingfeng's first TAVR surgery in his life is in progress.

  Puncture, catheter entry, and valve push, Wang Qingfeng has done it well.

   Of course, all of this is due to Wang Qingfeng's several sessions in the TAVR class.

   Let him grow rapidly from a TAVR novice to where he is now.

   When the artificial valve was stably implanted in the patient, Wang Qingfeng breathed a sigh of relief and was overjoyed.

   The successful completion of this operation marks that he will officially become a TAVR surgeon from now on.

   Next, papers, scientific research, and funds came in one after another.

  Wang Qingfeng even thought of the picture after he became famous.

  …

   aside, Tang Zhanwei nodded in satisfaction.

   In front of the attending doctor named Wang Qingfeng, all the techniques and operations are quite good.

   If it can be cultivated well, it will definitely be an important member of the surgical team in the future.

   "Xiao Wang, it's well done!" Tang Zhanwei nodded to Wang Qingfeng with a smile, "After the valve is delivered, I will do a post-operative ultrasound. If there is no problem, you can step down."

"OK."

  Wang Qingfeng immediately rushed to push the cardiac ultrasound machine.

   In a successful TAVR operation, the flow rate, size, and pressure of the valve opening will change significantly before and after the operation.

   Through the examination and evaluation of cardiac ultrasound, we can preliminarily judge whether the operation is successful or not.

  Tang Zhanwei picked up the surgical probe, put on the couplant, and began to perform the final cardiac ultrasound examination on the patient on the hospital bed.

   However, when the ultrasound probe was placed on the patient's heart, Tang Zhanwei felt something was wrong just after a few glances.

  The images after self-expanding valve implantation show that due to the high implantation position of the valve, it completely exceeds the valve annulus structure, causing the aortic blood to flow back into the heart chamber through the lower edge of the valve!

   "The position of the valve is a little too high!"

  Tang Zhanwei said solemnly.

   "Ah? Tall... Tall?" Wang Qingfeng looked confused, "No, I was very neat just now, definitely not tall!"

   "Xiao Wang, take a closer look yourself, the interventional valve does not fit the native aortic root completely!" Tang Zhanwei pointed to the image.

  Wang Qingfeng watched intently.

   Sure enough, an anomaly was found.

  Because of the high position of the valve, it is not tightly combined with the aortic root.

   "Director, what can I do about this..." Wang Qingfeng asked nervously, "Can it be repaired?"

  Tang Zhanwei had a serious expression and said solemnly, "I just checked it with an ultrasound, it should be a paravalvular leak!"

   Paravalvular leakage, that is, the valve is not fully attached, resulting in blood regurgitation around, and a large amount of regurgitation will seriously affect the prognosis of the patient.

   "The flap...the flap around the flap?" Wang Qingfeng heard the words, his face was bloodless.

   Paravalvular leak, one of the most serious complications of TAVR surgery.

   This kind of problem occurred in the first operation, then his future operation path...

"The patient's hemodynamics are relatively stable, and an aortic root angiography is temporarily performed to assess the regurgitation flow of paravalvular leakage." Tang Zhanwei immediately took remedial measures, "If it is only a small amount of regurgitation, that's fine, we can temporarily not deal with it. ...if it's medium to large..."

  Tang Zhanwei didn't say anything, but Wang Qingfeng already understood.

   If there is a moderate to large amount of regurgitation, the next troubles are inevitable!

  …

   Active root angiography is a relatively simple operation.

  Tang Zhanwei completed the angiography immediately, and the angiographic image projection visualized the proximal aorta and the entire left ventricle.

   "Not very good, this is at least moderate reflux!" Tang Zhanwei said slowly.

The result of    angiography immediately sentenced Wang Qingfeng to "death penalty".

  Wang Qingfeng stared blankly at the result in front of him, in a trance and self-blame.

  Tang Zhanwei glanced at Wang Qingfeng, "If you are still immersed in self-blame and unable to complete the next operation, then step down, call Yang Shuang over and ask him to assist the stage."

  Wang Qingfeng recovered this time and immediately stood beside Tang Zhanwei.

   Because of the poor valve position, Tang Zhanwei chose to use the trap to pull the valve.

   "Xiao Wang, if you can use the catcher to lower the valve position, it is possible to save your operation." Tang Zhanwei said slowly beside him.

   "Director, thank you, I'll trouble you next." Wang Qingfeng stood beside Tang Zhanwei, staring nervously at his operation.

  Tang Zhanwei took a deep breath.

  When he was studying in Kyoto, he also encountered this situation at that time. In the end, the surgeon successfully saved the operation with a trap.

   Recalling the operation in his memory, Tang Zhanwei slowly pushed the catcher and began to try to adjust the position of the valve.

  …

  Ten minutes passed in a flash.

  Tang Zhanwei's forehead was already sweating.

   This kind of delicate work is difficult to grasp. Once something goes wrong, it is likely to affect the blood vessels.

   "No way!" Tang Zhanwei finally stopped his movements, "It is difficult for the catcher to adjust the patient's valve position."

   "This... how can I do this?" Wang Qingfeng was extremely anxious, "Will you be transferred to surgery to open the chest?"

   "This patient came for TAVR surgery because he couldn't tolerate thoracotomy. Now let him have his chest opened?" Tang Zhanwei frowned and was very dissatisfied with Wang Qingfeng's opinion.

   Wang Qingfeng lowered his head and remained silent.

   "There is another way, after balloon expansion."

  Tang Zhanwei said slowly.

   However, he has no confidence at all now.

   Post-balloon expansion is mainly used for patients with valve insufficiency.

   But for the patients on stage, paravalvular leakage is mainly caused by the position of the valve being too high.

   But now there is no other way, I can only try it.

  Tang Zhanwei pushed in the balloon and slowly expanded the balloon, trying to see if the valve could be adjusted to the correct position.

  …

   Ten minutes passed.

  Tang Zhanwei tried balloon dilation, but the paravalvular leakage was still not resolved.

   If you stop the operation like this, it can only be regarded as a failed operation!

   Once the family members of the patients are held accountable, Guanghai First Hospital will definitely have a great responsibility.

   "Little Wang, hurry up and invite the Director Zuo of the first district in your heart!" Tang Zhanwei said solemnly, "Let him come and think of a way!"

   "Okay!" Wang Qingfeng nodded, but he was full of slander in his heart.

   Zuo Yaoqun in the first area of ​​his heart has only had TAVR surgery for a few months?

   invite him over for wool?

   However, Tang Zhanwei's order, Wang Qingfeng could only execute silently.

   He walked out of the catheterization room and called the left director of the first district of the heart.

   On the phone, Wang Qingfeng briefly explained the situation and invited Zuo Yaoqun to come to the consultation.

   hung up the phone, and Wang Qingfeng was going back to the catheterization room.

   As soon as he reached the door, he stopped, took out his mobile phone, opened the address book, and stopped on a strange yet familiar phone.

   Wang Qingfeng gritted his teeth, but summoned up his courage and made the call.

   (end of this chapter)