I Can See Health

I can see that the bold method innovation in Chapter 851 of the main volume of Life Value will always be an eternal topic in medical technology.

Every time a new surgical procedure appears, it means that a clinical problem is solved.

As the world's number one Mayo Clinic, it has many innovations and discoveries.

For example, the current ecmo machine and the division of various internal medicine departments all originated from the Mayo Clinic.

And today, in Mayo's cardiovascular interventional department, can everyone witness the birth of a new surgical procedure?

Facing a brand new technique, Lu Chen felt a very unfamiliar feeling.

All surgeries he has performed before can be simulated and trained in the system simulation space.

But now this "secondary surgery for valve failure" cannot be simulated in the system virtual space.

However, the more difficult the operation, the more it inspired Lu Chen's fighting spirit!

…

In the operating room.

Kebed, Lu Chen, and Yamada Kenji have already made preparations for the operation.

"Prepare for vascular puncture!"

Kenji Yamada performed the puncture work consciously.

This is also the basis of tavr surgery.

Kenji Yamada is extremely skilled in puncture surgery, and he is worthy of being a doctor at Mayo Clinic.

After puncturing the femoral artery, the catheter and guidewire were successfully implanted.

The three of them don't cooperate much, but they have a tacit understanding.

As the chief surgeon, Lu Chen and Yamada Kenji would immediately execute every order given by Kebed.

The blood vessel was punctured and the catheter was inserted, everything went smoothly.

Among the celebrities watching on the sidelines, everyone was very impressed with the cooperation of the three people.

Although Lu Chen and Yamada Kenji are both newcomers, they are definitely the best among their peers.

"Everyone, cheer up!"

When it came time to expand the balloon, Kebed looked serious and whispered to the two people beside him.

Balloon dilation of the aortic valve is one of the important steps during the operation.

Only after balloon expansion can the artificial valve be successfully delivered to the designated position.

…

The three immediately divided the work and cooperated.

"start!"

Kebed gave the order and the balloon expansion officially started.

Kenji Yamada quickly adjusted the temporary pacemaker frequency to 180 beats/min.

The ECG monitor next to the operating table showed an ultra-rapid heart rate.

At this time, the patient's blood pressure dropped to 50~60mmhg.

Lu Chen immediately performed aortic valve balloon catheter inflation and dilation, and DSA exposure.

"Stop!" Kebed shouted again, and Lu Chen stopped what he was doing.

Kenji Yamada adjusted the temporary pacemaker frequency back to 60 beats/min.

Balloon dilatation is completed.

The three people closely observed the patient's blood pressure recovery, electrocardiogram waveform, and DSA images.

"Everything is normal!" Lu Chen said slowly.

The three of them breathed a sigh of relief this time.

In patients without effective cardiac reserve, the dilation process can completely occlude the left ventricular outflow tract.

Some patients cannot tolerate it and may develop serious complications such as ventricular fibrillation and cardiac arrest.

"Go on." Kebed's eyes were blazing.

After balloon dilation of the aortic valve, he re-evaluated the average diameter of the aortic valve annulus to determine the type of aortic valve to be implanted.

Lu Chen compressed the cleaned self-expanding valve to the minimum diameter using a holder and a transfer tool, loaded the diameter T ear into the T-shaped slot, pushed the capsule cavity, so that all the outflow ends of the stent were loaded into the capsule cavity, and controlled the rotation at a uniform speed The handle completes the loading.

"The stent valve is ready!" Lu Chen said slowly.

"Got it." Kebed nodded to Lu Chen, "Get ready to deliver the valve!"

…

The delivery and release of the valve are the key points for the success of the entire TAVR surgery.

The kebed began to slowly transport the valve.

Lu Chen stared at the position of the valve intently.

In addition, invasive pressure such as left ventricular and aortic pressure will affect the final surgical effect.

Kenji Yamada adjusted the transducer to "0" before and after the valve was released to ensure the accuracy of invasive pressure measurement.

As time passed by, Kebed could not find the final position for valve release.

"I think it should be closer." Yamada Kenji suddenly said, "The status of the valve is a bit low."

"No!" Kebed shook his head, "Any closer and it may hit the blood vessels. If the blood vessels tear, the consequences will be too serious."

On the side, Lu Chen has been observing the position of the old valve.

He found that no matter how much the valve was released, it would never be perfect.

The positions of the old and new valves overlapped in some places.

"I think this position is fine." Lu Chen said solemnly.

"This won't work. I feel that paravalvular leakage may occur!" Kenji Yamada looked at Lu Chen doubtfully, "Once paravalvular leakage occurs, the patient's heart function will become worse."

Kebed glanced at Lu Chen, "What did you think about it?"

Lu Chen said slowly: "There can be no perfect position. The current position can only be said to satisfy the conditions of all parties."

"After the valve is released, we can use cardiac ultrasound to evaluate the aortic valve regurgitation, and based on the results, consider whether to redevelop the balloon or implant a valve-in-valve, and be ready for valve-in-valve implantation!"

"This..." Yamada Kenji was a little surprised. Lu Chen's thoughts were wild and unconstrained.

Others were trying to find the best position, but Lu Chen directly considered the remedy.

Kebed hesitated for a while.

He recalled Lu Chen's performance in the fellow review.

The operation of that operation amazed everyone.

"Okay, listen to Lu Chen!"

…

After the valve was released, the expressions of the professors watching around him varied.

"Isn't this location not good? The surrounding locations don't seem to match up, right?"

"But I feel there is no better position. The second operation is different from the first operation. It is difficult to have a perfect valve release position."

"These young people are really brave! If it were another person, it would be impossible to release the valve in this position, right?"

On the operating table.

The kebed has released the valve.

"Pay attention to your blood pressure and heart rate!"

"Received." Kenji Yamada re-measured all the patient's vital signs, "Everything is normal!"

At this time, Lu Chen pushed the cardiac ultrasound machine over.

After valve implantation, ultrasound positioning needs to be re-evaluated.

Sure enough, the valve did not fit tightly, and paravalvular leakage occurred!

But kebed, Lu Chen, UU reading www.uukaｎshu． NET also had Yamada Hyatsu, and he was not panicked, and immediately began to prepare the implantation of "petals in the petals".

But just when Kenji Yamada inserted the second artificial valve, the alarm on the monitor on the operating table rang.

"Oops, the patient's blood pressure has collapsed!" Kebed reacted immediately, "Quick! Add balance fluid and pump another norepinephrine!"

The nurse who arranged the table acted very quickly and quickly connected the patient with the medicine.

Everyone is wondering, why did their blood pressure suddenly drop?

"Look at the monitor quickly."

Lu Chen suddenly pointed at the monitor on the operating table.

The electrocardiogram on the patient monitor showed significant depression of the st segment!

－－－－－－Digression－－－－－

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