I run a clinic in the United States

Chapter 214 Live 20 more years!
UCSF Medical Center, Cardiac Catheterization Laboratory.

In fact, in the past, traditional transcatheter aortic valve replacement was performed in a hybrid operating room, using general anesthesia and with the presence of cardiac surgeons and extracorporeal circulation equipment.

Later, with the accumulation of experience and the development of technology, someone proposed the concept of minimalist TAVR.

The minimalist TAVR surgery can be performed in an ordinary catheterization laboratory, using enhanced local anesthesia, transthoracic echocardiography, femoral artery approach, subcutaneous puncture, and vascular stapler suturing, which greatly simplifies the TAVR surgery.

Because she was participating in the competition, Ava carefully selected a dozen songs and played them on a loop as background music this time.Of course, if you feel that the background music is not good, you can process it later and replace it with other audio.

In order to highlight Zhou Qiao's style, the first song is still a Chinese song.

"I just sigh that the autumn water she looked back at has been hidden, and I just remember that she revealed how miserable the days were..."

In the very nice melody of "Yan Wu Xie", Zhou Qiao started the operation.

It goes without saying that the dangers of aortic stenosis are serious. Once patients with severe aortic stenosis develop angina, fainting and other discomforts, if they do not receive timely and effective treatment, the 2-year survival rate is only about 50%.

Some patients with severe aortic stenosis may not have very serious symptoms at first. They are lucky and want to wait. However, once this disease attacks, it is so dangerous and abnormal that it may be too late to rescue them. On the way to the hospital, no, I died before I even left the house.

At present, the medical treatment methods for aortic valve disease mainly include drug therapy, traditional surgery and minimally invasive surgery.If it is an early stage patient without obvious symptoms, it can also be treated conservatively with drugs.But as symptoms worsen, the valve can only be replaced surgically.

Traditional surgical methods require general anesthesia, extracorporeal circulation, and opening of the chest. The surgery is invasive and risky. It is really a last resort for the elderly.

Many elderly people may not be able to beat back at all when their heart starts to beat again.That is, as we often hear, he died on the operating table.

Because extracorporeal circulation requires cardiac arrest, the extracorporeal circulation machine (artificial heart-lung machine) is used to replace the human body's heart and lung function, allowing the patient's heart to pause before surgery, and then resume beating after the operation.

Then, the doctor was shocked to discover that there was no way to jump back, and there was no future.

Transcatheter aortic valve replacement and repair is suitable for patients with aortic stenosis with complications. It can reduce mortality and has the advantages of small incisions, fewer complications, and quick recovery.Most importantly, no extracorporeal circulation is required.

This surgery only requires opening a small hole in the root of the thigh, using a catheter no thicker than a ballpoint pen refill to carry the artificial valve (mechanical valve or biological valve), entering from the blood vessel at the root of the thigh, and delivering the artificial valve to the heart through the femoral artery. At the diseased site, the artificial valve will replace the original damaged valve after opening.

This kind of surgery does not require an incision. The surgery that originally required a "thoracotomy" has been "slightly invasive", and the concept must be said to be ingenious.

Of course, it sounds simple, but it is actually very difficult to do.Doctors who are not experienced enough can easily cause medical accidents when performing this kind of interventional surgery.

Zhou Qiao's perfect surgical skills are naturally as if they were assisted by a god, and every move he makes is natural...

……

In the monitoring room, the doctors from the cardiac and vascular surgery department who came to watch were filled with admiration.

"God, why is Dr. Zhou so powerful!"

"Is this really the first time he's had this kind of surgery?"

"Oh my god, this, this... is so good, isn't it?"

"Excellent! Beautiful!"

"No, is this really the first time for him to do it? It's impossible, right?" Some doctors were suspicious.

Another doctor curled his lips and said, "It's impossible. That's the surgical genius Zhou Qiao! It is said that he received medical education in China."

"Lord, is China's medical level so good? How can a 24-year-old young doctor be so good? I feel like I can't win the championship without him!"

"Haha, even without Dr. Zhou, you wouldn't be able to win the championship! Whether you can enter the National Finals or not is a question!"

"Can you speak? Give you another chance to reorganize your language!" The female doctor became angry and snorted coldly.

"You guys, don't think too much. People like Dr. Zhou, even if you look at the world, are top geniuses. Do you think there are really that many in China? If there were really that many, the United States would have been ruthlessly crushed by them!"

"That's right. I was wrong."

The female doctor thought to herself, this is the first time I saw Dr. Zhou perform surgery, so I was just shocked.Although she had heard of Zhou Qiao before and knew he was powerful, she didn't expect him to be so powerful.

It feels a bit beyond expectations.

Someone posted a photo of Zhou Qiao undergoing surgery on Twitter, along with a text praising Zhou Qiao and expressing his shock.

Then, doctors from other departments in the medical center saw it, and the news spread like wildfire, and soon it reached the neurosurgery department.

The neurosurgery doctors shrugged, their expressions very indifferent.

For example, Dr. Alonna McLoughlin snorted lightly when she saw the news. After thinking about it, she casually commented below: "Dr. Zhou can even perform operations as complex as our neurosurgery. Now let's do your heart surgery." Is minimally invasive surgery in major vascular surgery difficult? Is it difficult to understand? "

The words are full of arrogance.

Then, it triggered a "battle of words" between the two departments.

Of course, they are all cultural people and basically do not use curse words.But it's full of gunpowder.

The neurosurgery doctors believed that Zhou Qiao was an expert in their field of neurosurgery, but now he was "downgraded" to perform minimally invasive cardiac surgery, which should have been easy for him.

But the doctors at the cardiac and vascular surgery department were naturally dissatisfied.

That's right, even within the medical center, there is a chain of contempt between departments, and they secretly look down upon other departments.Neurosurgery, for example, mainly performs cranial and brain surgeries. They believe that the human brain is the most complex organ, so naturally they look down upon other surgeries and orthopedics.

Because the human brain is really complex, with different areas in charge of different functions of the human body, such as speech, movement, memory, emotions...

Human memory, breathing, first love, heartbeat... are all located in different neurons in the brain.

Neurosurgeons can be said to be the most difficult to grow among all surgeons. This may be one of the reasons why neurosurgeons are arrogant and arrogant.

……

outside the operating room.

Grandma Huang's son and grandson all came to the scene and stood stupidly in the corridor.

The father and son stared at each other, and the atmosphere was extremely dull.

A nurse came over and suggested that they wait in the rest area, saying that there was free coffee and donuts there, but neither of them was moved.

Why don't you think about drinking coffee and eating donuts?

"Brother, how is Mom?"

A trembling voice came over, and the father and son turned to look.

"younger sister!"

"aunt!"

The father and son hurriedly greeted him, and then greeted his brother-in-law (uncle) and nephews (cousins).

"How is mom?" Grandma Huang's daughter's eyes were red, and she had obviously been wiping tears all the way here.

Grandma Huang's son said: "Still in the operating room, not out yet. Doctor Zhou... should be fine."

"Alas~, it's useless to say anything now." Grandma Huang's daughter choked, and then couldn't help coughing.

"Sister, you..."

"Uncle, my mother has not recovered yet and was discharged from the hospital early." The nephew said quickly.

Grandma Huang's son nodded.

Grandma Huang's daughter rubbed her temples, forced herself to cheer up, and said, "I hope my mother will be lucky enough to turn misfortune into good luck, and everything will be fine this time!"

She secretly said in her heart: "A while ago, I went to church to pray for my mother, but I don't know if it was of any use."

"Grandma, come on!"

"Come on grandma!"

Now that there are more people, the atmosphere is a little more "lively". The juniors clenched their fists and waved to call for the grandma in the operating room.

The door to the cardiac catheterization laboratory opened, and Zhou Qiao walked out with Murphy, Stephanie and others.

"Dr. Zhou, how is my mother?" Grandma Huang's son took the lead and asked in a very urgent tone.

When Grandma Huang's daughter saw Zhou Qiao, she immediately felt something bad in her heart, because after Zhou Qiao took off his mask, I said, "Isn't this too young?"High school student?

It's too childish for the eldest brother to ask a high school student to perform surgery on his mother?

Zhou Qiao smiled slightly and said, "Congratulations, the operation went well! The old man's life is not in danger for the time being!"

"what?"

Grandma Huang's daughter thought she heard wrongly and rubbed her ears hard. Then, she heard her brother shouting: "That's great! That's great! Doctor Zhou, thank you!"

Grandma Huang's daughter couldn't believe it.

However, Grandma Huang was soon pushed out of the operating room, and the doctor said she would be temporarily transferred to the intensive care unit.

The whole family followed him and ran around the hospital bed, asking questions as they ran.

"Mom, are you okay?"

"Mom, how are you?"

"grandmother……"

"grandmother……"

Grandma Huang was very weak. Because the operation was only under local anesthesia, not general anesthesia, she remained conscious.When she saw her daughter's family coming over, she couldn't help but feel very happy. She wanted to raise her hand to say hello, but she didn't have the strength to do so, so she couldn't help but grin slightly and smiled reluctantly.

Although the smile was very small, this scene made Grandma Huang's son excitedly shout: "Mom laughed, Mom laughed! Haha, Mom should be fine!"

By this time, they had arrived at the entrance of the intensive care unit, and the nurse stopped them outside and signaled them to stop.Only then did Grandma Huang's relatives stop.

"Sister, do you know? Mom has been in a blur since last night until she entered the operating room. She felt like she was about to die. Unexpectedly, the effect was immediate right after the operation. She actually smiled softly. His eyes are still clear, and it looks like he wants to say hello to you!" Grandma Huang's son shook his sister's shoulders excitedly.

"Brother, please stop shaking me. If you shake me again, I will fall apart. Ahem..."

Only then did Grandma Huang's son realize that his sister was still ill. He couldn't help but stop and said: "Sister, why don't you stay in the hospital here, recuperate your health, and spend some time with your mother, haha!"

"Brother, it's really good, it's really good..." Grandma Huang's daughter murmured, not knowing how to express her inner excitement.

……

The intensive care unit of the University of California Medical Center is not a single room, nor the common two- or three-person rooms, but a huge hall with many beds densely packed in a row.

There are advanced monitoring equipment and rescue equipment above each bed and on both sides of the bedside, and the environment is naturally of a very high level of cleanliness.

Opposite the hospital bed is the nurse's station, which is very close. Medical staff are always stationed there. If there is a problem, someone will come over immediately to rescue.

What makes Grandma Huang's children happy is that Grandma Huang only stayed in the intensive care unit for one day before being transferred to the general ward.

Three days later, his complexion improved, and the family was filled with gratitude to Zhou Qiao.

Grandma Huang's son made an unkind request, hoping that the whole family could take a photo with Zhou Qiao.

Naturally, Zhou Qiao would not refuse such a small request.

So, Grandma Huang sat in a wheelchair and stood in position C with Zhou Qiao.

Next to Zhou Qiao were other staff involved in the operation, Murphy, Stephanie, Elena and Ava.

On the other side of Grandma Huang are her sons, daughters, their spouses, and children.

This is a super clear photo.

Aunt Huang's son washed it out and hung it at home as the most precious memory in his life.

Grandma Huang lived for more than 20 years because of Zhou Qiao's perfect surgery, which resulted in great results, and she did not die until she was 98 years old.Of course, during this period, I also came to the Iris Clinic regularly for follow-up visits and treatment for some other illnesses.This time it’s free, and the rest will never be free again.

But, that’s all for later.

This surgery is still very valuable. First, the surgery video for Zhou Qiao's competition was completed.Second, Murphy and Stephanie have a deeper understanding of this technique, and both have reached the peak of expertise.It is only one step away from the master level.

But there are several other techniques in the competition, so Zhou Qiao still needs more patients to practice.

Fortunately, there was news from Luo Ya that the family members of eight employees were willing to come to Iris Clinic for treatment.

There are some employees who are actually quite rich, but they are willing to come here just because they are the men of the "Queen of Violence".It doesn’t matter if it’s free or not, it’s just to show your loyalty and support!

For example, there is an employee at the East African base named Hrashwayo, who is from the local area. Because of Zhou Qiao’s actions at the East African base, he admires Zhou Qiao very much. It happens that an old man in his family has heart disease, and over there in East Africa The medical conditions were too poor, and this opportunity happened to be available, so after applying, I took the old man with me and rushed all the way from East Africa.

In view of his excellent performance, Luo Ya reimbursed them for the round trip expenses.

This old man is Hrashwayo's grandfather, but he is very young, only 55 years old.

Because Hlashwayo's grandfather gave birth to his father when he was 15 years old, and his father was even more powerful, giving birth to him when he was 14 years old.

Although Hlashwayo's grandfather is only in his 50s, his health is already failing.If I had not had this opportunity and stayed in Africa, I would not have lived to be 60 years old.

The average life span of Africans is actually only 40 to 50 years old. Living to more than [-] years is considered a long life!
Of course, it also depends on the country.Like Mozambique, because of the epidemic of AIDS, many people will die before they are thirty.Some countries, such as South Africa, are considered "big" in Africa, with average life expectancy reaching 60 years.

After Hrashwayo's grandfather arrived at the Iris Clinic, although the other party was voluntary, the required agreement still had to be signed.Although, it’s no trouble even if you don’t sign.

After Zhou Qiao admitted him to the hospital, he did many examinations.Naturally, this also includes AIDS and so on.

Fortunately, except for heart disease, Hrashwayo's grandfather had no other messy problems, nor did he carry any serious viruses.

Detailed preoperative examination showed that the patient's heart function was very poor, he suffered from rheumatic heart disease, and his mitral valve stenosis was severe. He was out of breath with the slightest movement and could not walk 500 meters.

In this situation, people in Africa are basically waiting to die.Fortunately, his son joined the East African base, and the family's economic conditions improved.And with this "relationship" and channels, he could be brought to the United States for treatment.

It can also be said to be the welfare of employees at the East African base.

Zhou Qiao took Murphy and Stephanie to discuss the condition and design a surgical plan. Finally, Murphy was the surgeon, Stephanie was the first assistant, and Zhou Qiao was the second assistant to perform the operation on Hrashwayo's grandfather. .

The surgery they chose was minimally invasive thoracoscopic mitral valve replacement.

As before, it was performed in the operating room of the University of California, San Francisco Medical Center.Then Ava did the video recording as well.

Regardless of whether it is useful or not, record it first and then talk about it.

This is what they think: record a few more and then pick the one with the best performance and the most competitiveness and take it out to compete!

Come once or twice, there will always be a suitable one.Anyway, there are quite a lot of heart disease patients coming to Luo Ya now.

Stephanie was slightly jealous and wondered why Zhou Qiao didn't let her come first.I have dreamed about him hundreds of times.

But then she thought about it, this was just her dream, and Zhou Qiao didn't know about it at all.Suddenly I felt like I had unrequited love.

However, what she didn't know was that Zhou Qiao also participated in the dream in his "real body", and the feeling was infinitely close to reality.

Zhou Qiao comforted her and told her that she would be the surgeon next time. Stephanie became excited and looked at Zhou Qiao with eyes full of tenderness and sweetness.

For this surgery, a small incision on the right chest was chosen.

An incision of about 5 cm was made from the breast edge of the fourth rib on the right chest. Due to the detailed preoperative report and various data, Murphy's virtual 3D visualization modeling was very successful.

The display screen in the operating room is only 2D, not three-dimensional enough. The model she visualized is a holographic 3D virtual projection that can be rotated 360 degrees, can be seen through, and has various annotation boxes, which can be fine-tuned at any time, which is much better than the existing monitoring system. I don’t know how advanced the equipment is.

So the operation went very smoothly.After this battle, Murphy's technique has reached the beginning of the master level!

Afterwards, when she logged into the e-sports simulation training server again, her performance caused her ranking to skyrocket, from over 40 to No. 18.

The main reason is that this is just one of the techniques. If all six techniques are advanced to the primary master level, there is absolutely no problem in entering the top ten.

After the operation, Hlashwayo's grandfather stayed in the intensive care unit of the medical center for two days, and then was transferred to the general ward. He was discharged from the hospital on the sixth day and followed Hrashwayo back to Africa.

In the future, the review will not come to the United States, but will be conducted directly at the base in East Africa.Chen Zhining is now in charge there. He can't treat serious illnesses, but he can still treat common minor illnesses and conduct post-operative reviews.

This kind of surgery, if it is a traditional surgery, requires an incision in the middle of the patient's sternum. The incision is at least 25 centimeters long, and there is a lot of bleeding. The patient will have to stay in the ICU for at least five days after the operation, and then stay in the ICU for another week or two before being discharged.

In addition to the physical suffering, the cost is much more expensive!Apart from anything else, the average family really cannot bear to stay in the ICU for that long.

The first minimally invasive cardiac surgery Zhou Qiao arranged for Stephanie was left atrial appendage combined with PFO (prevented foramen ovale) closure.

The patient is from Mexico.The medical conditions there are also very poor. It is a 15-year-old girl whose mother works as a logistics clerk in Loya's organization.

About a year ago, the girl always found herself having headaches, which often occurred during class, causing delays in her studies.

After the girl's mother found out, she took her daughter to the neurology department of a large hospital in Mexico for a checkup, but no problems were found.I had a headache, so I thought there was some disease in my head.

Later, I visited many departments, including pain department and orthopedics, but found nothing.

I took a lot of medicines, including painkillers, which only treated the symptoms but not the root cause.

Later, a doctor suggested they get their hearts checked.

Then, the problem was found. There was something wrong with the left atrial appendage and the foramen ovale.

Just then, the organization issued a notice that the man behind the famous Queen, Dr. Zhou, who solved the unknown disease in the East African base, was recruiting patients with heart disease.

The organization is also responsible for reimbursing medical expenses and performing surgeries in the United States, so the girl’s mother brought her daughter over.

Coming from Mexico, it's quite close.

Zhou Qiao led Murphy and Stephanie to arrange an examination for the girl. After discussing the condition, the diagnosis was given as patent foramen ovale with atrial fibrillation, which required combined left atrial appendage and patent foramen ovale closure surgery.

The last operation was performed by Murphy, so this time, the opportunity was given to Stephanie.

This kind of interventional closure requires local anesthesia, and the patient can undergo the surgery while awake.

So while doing it, Stephanie chatted with the girl while performing very precise operations.It can be described as doing two things at once.

She is a very accomplished psychiatrist and is very good at communicating with patients.A small mouth can talk a lot, which is much better than Murphy's doctor-patient communication skills!
The two blocking procedures took more than 30 minutes in total. The girl and her mother were shocked!The girl feels that she is not even having fun chatting with her elder sister!
It is worth mentioning that the girl got out of bed and moved around on the second day after the operation.How can you tell that you just had heart surgery yesterday?
I was discharged from the hospital that evening.

The girl's mother decided to send her daughter to the United States to study. Not to mention educational resources and job opportunities, she would enjoy better medical resources alone.

Mexico is really far behind.

Of course, after all, it was a "major surgery" on the heart, and he still needed to be followed up regularly afterwards.

There were also some patients from Zhang Jianjun's side, and new patients from Luo Ya's side were sent over. In just one month, Murphy and Stephanie each performed more than [-] minimally invasive heart surgeries. .

The six techniques of the two people have finally been upgraded to the primary or intermediate master level in reality.

Relatively speaking, Murphy is more talented in surgery. Of these six techniques, Murphy has reached the intermediate master level in 4, while Stephanie only has 1.

This is because Murphy has 3D modeling skills in his head, which are not comparable to ordinary people. He has a natural advantage.

However, Stephanie also has the expertise of a psychiatrist and can hypnotize.Therefore, in terms of overall strength, the two are on par.

After their surgical skills improved greatly, they started to play simulation games and gradually caught up.Already ranked fifth and seventh.

If you push forward, you won't be able to make it any further.

There are really experts among those players. They may be older and come from unknown hospitals. With their current level, they may not be able to defeat each other.

(End of this chapter)