I Can See Health

Remember [new] in one second!​ In the operating room.

Gu Xinyue began to give the patient preoperative anesthesia and draping.

For this operation, the patient's anesthesia was general anesthesia.

After Gu Xinyue established intravenous access, Jin Miao began to puncture the right femoral vein.

On the side, Lu Chen performed a transesophageal heart ultrasound.

This will be the first difficulty of this operation!

That's how to determine the septal puncture point.

The patient's heart and structural morphology have undergone serious changes.

The normal atrial septal puncture point is not that obvious.

"Director, I...I didn't find the puncture point!"

Jin Miao's face was extremely ugly.

According to conventional operations, he could not touch the patient's interatrial septum at all.

After the patient's overall heart changed, he couldn't find the puncture site at all.

On the side, Lu Chen was also constantly checking the patient's heart ultrasound pattern.

In the system virtual space in his mind, he was constantly deducing the correct operation method.

Simulate various heart shapes and try to puncture the interatrial septum.

within a moment.

Lu Chen already made a decision in his heart.

"Jin Miao, you first determine the location of the puncture point on the bi-bicaval section and the sax-short-axis section!"

"Okay Director, received!"

Hearing Lu Chen's voice, Jin Miao followed his prompts and started operating.

"After that, the distance between the puncture point and the mitral annulus is determined in the four-chamber cardiac view. The general puncture height is 4-4.5cm."

Jin Miao was slightly startled when he heard this.

Director Lu was actually able to tell all the specific data.

Where does this data come from?

In addition to being surprised, Jin Miao's hand movements were not slow at all.

With fluoroscopy assistance and Lu Chen's reminder, he finally succeeded in puncturing the interatrial septum.

"Okay, send the superstiff guidewire to the left atrium immediately."

Lu Chen's expression remained unchanged and he continued to direct Jin Miao to operate.

After using the vascular sheath to dilate the femoral vein, Jin Miao introduced the guidewire into the 24f guide sheath across the interatrial septum to the left atrium.

The mitral valve mitraclip valve clamp system (cds) is introduced through the 24f guiding sheath.

Under the guidance of esophageal ultrasound, Jin Miao successfully reached the target position of the mitral valve and captured the flail leaflets.

"Director, the patient's blood pressure has dropped!"

Suddenly, Gu Xinyue said loudly from the side.

"Pause the operation and pump dopamine and norepinephrine in!"

Lu Chen was slightly startled and then commanded in an orderly manner.

The event that I was most worried about finally happened!

"Increase pump speed now!"

At the same time, he asked the nurse to push the iabp and ecmo machines over.

These two machines are on standby, ready for further operations if the blood pressure cannot be maintained.

The bedside ECG monitor is continuously measuring the patient's blood pressure.

Lu Chen monitored his vital signs at all times.

"Do I need iabp and ecmo?"

Jin Miao asked nervously from the side.

"There's no rush. Let's pause the surgery for observation first." Lu Chen shook his head slightly, "If the blood pressure can be stabilized, there will be no need for iabp and ecmo."

"good!"

Inside and outside the cath room.

Everyone stared at the changes in blood pressure.

The most important thing about this operation is not only the difficulty of the operation.

More importantly, it is to allow the patient to step down successfully.

If the patient cannot tolerate the surgery, then all the effort is in vain.

five minutes later.

The patient's blood pressure finally stabilized at hg.

"Okay, the operation continues." Lu Chen said, "I will perform an esophageal ultrasound first to check the position of the valve. You can operate according to my instructions."

Jin Miao and Gu Xinyue nodded slightly.

Lu Chen began to perform esophageal ultrasound.

He kept adjusting the position and carefully observed the position and shape of the valve.

"Okay, the position is okay. Jin Miao, you can release the valve."

Jin Miao nodded, with a hint of surprise on his face, "Yeah!"

After repeated confirmation via esophageal ultrasound.

Jinmiao implanted a mitral valve clip, mitraclipxtr, in the 1 area of ​​the mitral valve a2/p2.

"Wait a minute, I'll check the position of the valve leaves again."

At this point, the second difficulty of the surgery is how to adjust the position of the valve clamp.

Lu Chen adjusted the position of the valve clamp on the X-section.

"Mainly locate the most obvious a2/p2 area of ​​pisia!" He said to Jin Miao aside.

"receive!"

Jin Miao responded, and then with the help of Lu Chen's operation, he began to slowly position himself.

Lu Chen continued: "Adjust the axial direction of the clip on the mitral valve junction joint section and LVOT section, and at the same time observe the clip position and area on the 3D section."

Under Lu Chen's guidance, Jin Miao's techniques went from being unfamiliar at the beginning to becoming more and more proficient now.

An esophageal ultrasound was performed again, and the examination showed that the valve clamp was in good position and the valve leaflets were firmly grasped.

However, Lu Chen did not relax at this moment.

He said slowly: "Capture the front and back leaflets in the a2/p2 area 1, and gradually close the valve clamp."

"Okay!" Jin Miao replied while operating, "The valve clamp is in good position, with ideal axial direction and orientation!"

tee showed that mitral regurgitation was significantly reduced to a trace amount.

The 3D perspective shows that the tissue bridge is continuous and complete, and the valve leaflets are captured stably.

Lu Chen smiled and nodded, finally relieved and said: "The average transvalvular pressure of the mitral valve is 2 mmhg. Multiple sections have confirmed that the clamping tissue is sufficient, and the Doppler waveform of the left upper pulmonary vein has returned to normal from the reverse direction."

Jin Miao was relieved after hearing Lu Chen's feedback.

The completion of the valve delivery indicates that the operation is mostly successful.

Immediate postoperative ultrasound showed that the mitral regurgitation dropped to a trace amount.

The colored blood flow indicates a trace amount of valve regurgitation, and the average transvalvular pressure difference measured is 3mmhg.

The reexamination of the left upper pulmonary vein blood flow spectrum returned to the positive direction, and the surgical effect was ideal.

"Jin Miao, start gradually releasing the valve clamp system and withdrawing from the body!"

"good!"

This last step, although simple, is also very important.

Jin Miao was meticulous in every step she took, fearing the slightest mistake.

"Take your time, don't rush." ​​Lu Chen urged, "The most important steps have been completed, don't let it sink into the sand."

"Um."

Jin Miao nodded slightly.

With Gu Xinyue's assistance, he slowly released the valve clamp system and then successfully withdrew from the body.

With that, the entire operation is over!

In the operating room of the cath lab.

Jin Miao and Gu Xinyue's faces were filled with joy. UU reading www.uukanshu.net

Lu Chen also had a smile on his lips.

Although they were able to suppress their inner excitement, the people in the Department of Cardiology of the Fifth Hospital of Magic City outside the catheter room could not calm down.

Everyone began to applaud unconsciously.

The completion of this operation means that the Fifth Hospital of Magic City has entered the ranks of the top hospitals in China.

From TAVR, electrophysiology, to transcatheter tricuspid valve surgery and TEER surgery.

Every operation performed by Lu Chen in the five hospitals in Shanghai was top-notch in China and top-notch in foreign countries.

Many Mayo people who were at the same time as Lu Chen were watching Lu Chen's live broadcast.

Even for Mayo in the United States, Professor Debed was astonished.

"As expected of Lu!"

Debde sighed in his heart.

In his heart, the Cardiology Department of the Fifth Hospital of China's Magic City has gradually become the symbol of China's Cardiology Department.