The Godfather of Surgery

Yang Ping hurriedly ran to the operating room of the interventional department, changed into a hand sanitizer, put on a sterile cap and mask, and rushed into the operating room.

The operation was in progress, and the two major directors, Director Ji and Director Guan of the Interventional Department, had already appeared on stage, which showed how difficult this operation was.

Director Guan is the surgeon, Director Ji is the assistant, and several young doctors are surrounded by the operating table, unable to help, they can only watch helplessly.

Defibrillation!

The director stopped immediately, the patient suffered a cardiac arrest, and the monitoring screen showed dense ventricular fibrillation.

Anesthesiologists and nurses immediately defibrillated the patient.

After several defibrillations, the patient's heartbeat resumed under strong electrical stimulation, and the patient screamed after recovery, possibly due to the impact of the electrical stimulation.

Outside the operating room, someone was knocking and kicking the door frantically. It could be heard that several people were punching and kicking the door at the same time.

Xiao Yu, please explain to the patient's family. Director Guan ordered his doctor, Dr. Yu.

Director Ji added: Don't open the door, you go out from the locker room.

These directors have experience. Once the door is opened, family members who don't know where to go rush in, making noise and quarrels, and the patient will definitely not be saved.

They didn't know the danger of the operation, and when they heard the patient's cry, they thought the doctor was abusing the patient.

The heartbeat recovered, Director Guan and Director Ji continued the operation.

Professor Yang came to the stage! Director Ji felt at ease when he saw that Yang Ping had arrived.

Chronic total occlusion of the coronary artery, the left main coronary artery is completely blocked, the two bifurcations of the anterior descending and circumflex branches are completely occluded + severe calcification, and the right main coronary artery is 90% blocked. The calcification of the blocked mouth is as hard as a rock, and the condition is too dangerous and complicated, so please come and take a look. Director Ji quickly and briefly introduced the condition.

Director Guan focuses on interventional treatment of the cardiovascular system, while Director Ji is an all-rounder, proficient in almost all interventional treatments, including intracranial and tumor.

Relatively speaking, Director Guan has deeper attainments in cardiovascular intervention, after all, he only focuses on this aspect.

Therefore, this operation was performed by Director Guan.

Obviously, Director Guan's back was already soaked. This severe coronary artery occlusion still had rock-hard calcification. Multiple complex occlusions are simply devil-level cases.

Coronary arteries are the blood vessels that supply the heart. They run on the surface of the heart and spread out like a tree crown. They have a trunk and branches. They are like oil pipelines that provide gasoline to a car engine. Once blocked, the heart will lose power.

The coronary artery, which is used as an oil pipeline, is divided into two branches, left and right. When atherosclerosis or vasospasm occurs in these two arteries and their branches, it will lead to narrowing or occlusion of the lumen.

When the stenosis of the coronary artery lumen exceeds 50%-70%, coronary artery circulation disorder will occur, resulting in insufficient blood supply to the myocardium, resulting in an imbalance of myocardial oxygen supply and demand, and obvious clinical symptoms such as angina pectoris. When the coronary artery lumen is completely blocked, the myocardial Ischemia, hypoxia, necrosis, causing myocardial infarction.

At this time, interventional therapy is often required, and a stent is implanted to open the blood vessel.

This patient has severe blockage and severe calcification. The blockage is as hard as a rock. Ordinary instruments cannot open the blood vessels at all. Instead, special rotary atherectomy instruments are used to grind away these rocks bit by bit to open the coronary arteries, and then insert Stent expansion.

As for bifurcation lesions, one is the main branch and the other is the branch, both of which are blocked, and the blocked parts are close to each other, concentrated at the bifurcation.

Since the lesion affects the fork in the road of the heart and blood vessels, the surgical technique is particularly complicated, and the rate of postoperative restenosis is particularly high. Stenosis and thrombosis.

In this case, if the stent is simply implanted in the main branch, the plaque will be displaced under the extrusion of the stent, and sometimes it will be squeezed into the branch blood vessel to form a new blockage, making the situation worse.

If both the main branch and the branch are implanted with stents, due to the close distance between the blocked parts, the two stents will fight and interfere with each other. With the current medical technology, it is impossible to cut the stent in advance to adapt to the bifurcation. cause a fight.

Therefore, for bifurcation lesions, it is necessary to implant stents to open up the blood vessels, but also to ensure that the implanted stents perform their duties without fighting or forming new blockages. This is where the difficulty of treatment lies.

It not only solves the current problems, but also does not bring new problems. The interventional treatment of coronary bifurcation lesions is extremely difficult.

Rock-like hardness, coupled with complex forks, doubles the difficulty.

CCTV technology must be used! Director Guan added.

This is a double-stent procedure, which can be summarized as CCTV: C extrusion series stents: classic crush, DK-crush, mini-crush, step-crush; C hakama series stents: classic and modified hakama Stenting; T series stenting: classic and modified T stenting, V series stenting: classic and SKS stenting.

This kind of patient has a complete blockage. In this situation, the blood vessels must be opened as soon as possible to allow the ischemic myocardium to obtain blood supply, so as to have a glimmer of hope. Otherwise, if the time is too long, the myocardium will develop extensive necrosis, and even if it is opened, it will not help.

Yang Ping quickly brushed his hands, put on the lead coat, and then, with the help of the itinerant nurse, put on the surgical gown and sterile gloves.

Professor Yang, Director Ji said that you are very skillful, are you sure to get through these blockages quickly? Director Guan was also unambiguous.

Yang Ping just glanced at it. Although he usually doesn't pay much attention to intervention, the training in the system space is a basic technique.

When he was in the United States, Yang Ping used interventional technology to rescue astronauts, which was not a problem for him.

After the operation reaches a certain level, it will be easy to understand.

It's not a big problem! Yang Ping replied decisively.

In Professor Yang's mouth, the problem is not big, that is, there is no problem.

The patient's heartbeat stopped again! .

Defibrillation! Defibrillation! Defibrillation!

Director Guan has no idea whether this patient can come back today. This is the most difficult and dangerous patient he has ever encountered. He dare not go too far into the rotary grinding instrument for fear of breaking the blood vessel.

bang bang bang!

The sound of punching, kicking, and door smashing outside the operating room kept coming and going.

However, since Director Xia implemented the hospital's safety plan, the doors of these operating rooms have been replaced with explosion-proof doors, and they can be kicked and beaten as they please.

The anesthesiologist and nurse started to defibrillate the patient again, and Director Guan yelled, Xiao Yu! What's going on?

Dr. Yu went out and was still explaining to the family, but obviously it didn't work.

Don't open the door! Rescue first, then talk! Director Ji was afraid that the doctors in the audience would be careless and ran to open the door. The family members rushed in, and everything was over.

After several defibrillations, the patient's electrocardiogram showed normal QRS complexes again. The director immediately stepped aside and Yang Ping stepped forward.

Asking Yang Ping to come just wanted to be quick.

Do you want to use intravascular ultrasound again? Director Guan reminded Yang Ping.

No need! Yang Ping felt that watching it was a waste of time.

He took the instrument, and the miniature diamond drill began to grind on the hard calcification. Compared with Director Guan, he was obviously bolder and more exaggerated. Director Guan's heart jumped when he saw Yang Ping's exaggerated operation.

It's okay, he's sure! Director Ji held onto Director Guan.

The atherectomy head is always aimed at the calcification and will not come into contact with the blood vessel wall. Under the bold and aggressive operation, the first blockage site is slowly opened through the radical atherectomy.

Immediately afterwards, Yang Ping began to overcome a blockage.

This kind of operation is undoubtedly drag racing in the downtown area, which is Yang Ping's consistent style.

Director Guan's throat was dry, and he kept swallowing saliva. He was afraid that Yang Ping would damage the blood vessel wall. Director Ji looked very calm and said, You are brave, don't worry!