I Can See Health

"Lu, can you do this surgery?" Lambert asked nervously.

After a long while, Lu Chen nodded slowly.

"You can try it, but I need to check the heart ultrasound again and re-evaluate the patient's condition."

Lambert breathed a sigh of relief, "It's easy to say anything about checking, as long as you say this."

"Then let's get started."

Lu Chen began to put on surgical clothes.

For this four-leaf valve deformity, he had done it in the system virtual space.

But he has never tried the PCI combined with TAVR surgery.

"Is it okay to let Kenci Yamada be my assistant?" Lu Chen looked at Lambert.

"No problem at all!"

Lambert was now focused on solving the patient's condition.

Yamada Kenji looked happy.

Being able to undergo a few more surgeries is a good opportunity for him.

However, Casas, who was on the operating table, didn't look very good.

But the attending doctor, Lambert, had already promised Lu Chen, and there was nothing he could do.

…

Lu Chen had already changed into surgical clothes.

At this time, Yamada Kenji brought in the ultrasound machine.

The two began to review the patient's cardiac ultrasound again.

Ultrasound showed that the peak flow velocity of the aorta was 470cm/s and the peak pressure difference was 88mmhg.

The four-leaf valve is deformed, the annular circumference is 70.3mm, the average diameter is 21t, the circumference is 70.7mm, and the average diameter is 22.5mm. Lu Chen frowned. The patient's aortic stenosis was more serious than imagined!

Lambert looked on.

"Lu, what type of valve are you going to use?"

Lu Chen thought for a moment and then said: "The patient's aortic valve root has severe stenosis, the valve leaflets are significantly thickened, and the risk of coronary artery obstruction is high. First, use a minimally invasive 18mm balloon to pre-dilate. If there is no obvious regurgitation, then implant the tav21mm valve. "

He said this to Lambert and also to Yamada Kenji.

After hearing what Lu Chen said, Yamada Kenji immediately started preparing the artificial valve and balloon.

The two of them have cooperated in many surgeries and now have a tacit understanding.

"Lu Chen-kun, which side should we choose for the vascular access?" Kenji Yamada continued to ask.

Lu Chen rechecked the patient's vascular access.

The blood vessels of the bilateral approach are tortuous, the walls are smooth, and the bifurcation height is high.

The average minimum inner diameter of the left blood vessels was 7.6mm, and the average minimum inner diameter of the right blood vessels was 7.8mm.

"Choose the right femoral artery!" Lu Chen said solemnly.

"good!"

Yamada Kenji nodded and started piercing at the same time.

His techniques are very subtle, even Lu Chen can't beat him 100%.

This island countryman is really quite capable.

The blood vessel puncture went smoothly.

Kenji Yamada immediately sent in the pre-dilation balloon.

It was almost the same as Lu Chen predicted. Bilateral coronary arteries were visualized, and the 18mm balloon almost blocked the valve orifice, with no obvious regurgitation!

"This 18mm balloon is so well chosen!" Lambert admired from the side, "Lu, your eyes are vernier calipers, right?"

Lu Chen smiled and said, "Lambert, you can do this if you do it too much. There is an old Chinese saying that practice makes perfect."

The surgery continues.

"Lu Chenjun, the position of the valve has been determined, should I release the valve directly?" Kenji Yamada's confidence was greatly increased at this time.

Under Lu Chen's leadership, the operation is going well.

But Lu Chen immediately poured cold water on him.

"Not yet!"

"No release?" Yamada Kenji said in surprise, "Over time, the patient will easily suffer from heart failure."

Lu Chen pointed to the patient's image, "The height of the left and right coronary openings is low, especially the right coronary opening. In this case, releasing the valve can easily block the coronary arteries!"

"So we need to protect the coronary arteries in advance?" Kenji Yamada understood somewhat.

"That's right!" Lu Chen nodded, "Conventional TAVR does not need to take this into consideration, but the patient's coronary blood vessels are not good to begin with. If you are not careful, it may cause cardiogenic myocardial infarction!"

With prior coronary protection measures, Kenji Yamada successfully released the artificial valve!

"Don't leave yet, keep an eye on it, you may need to adjust your position!"

Lu Chen was now staring closely at the images during the operation.

Because of the special four-leaf valve structure, the positioning and stability of the release valve must be guaranteed to be foolproof.

After releasing the valve, Lu Chen observed in real time and made corresponding adjustments.

"Yamada, push it to the upper right to prevent paravalvular leakage!"

"receive."

Under the guidance of Lu Chen, Kenji Yamada completed the delivery and positioning of the entire valve without any danger.

The ultrasound was reviewed again after the operation, and the postoperative aortic valve transvalvular pressure difference was 0mmhg.

The position of the artificial valve is fixed, there is no paravalvular leakage, and the valve shape is good.

Beside Lu Chen, Lambert and Casas have been watching.

Every delicate operation is like an art performance.

Lu Chen's greatest stroke was not to complete the TAVR, but to complete the TAVR while escorting the remaining PCI surgeries to protect the patient's coronary arteries as much as possible!

"Lambert, I'll leave the rest to you." Lu Chen took off his gloves.

"Don't worry, Lu, you did such a good job in TAVR surgery, he won't let you down."

Lambert took over the rest of the PCI surgeries.

His level of coronary intervention is a level higher than Lu Chen's.

There was no way, why Lu Chen's current coronary intervention skill card was only advanced.

He did not leave. Instead, like Lambert, he stood next to the operating table and observed the rest of the PCI surgery.

…

"Recently, the PCI and TAVR groups of the Department of Cardiology at the Mayo Clinic performed a joint operation on a high-risk patient: a four-leaf aortic valve, severe aortic valve stenosis combined with moderate regurgitation, low coronary artery opening, small cavities, and severe calcification of the valve leaflets. , heart failure was acutely exacerbated and successfully underwent combined PCI+TAVR surgery.”

It was considered a top-notch operation at Mayo, and it naturally caused a sensation around the world.

Lu Chen didn't pay too much attention.

He focuses more on himself.

After this operation, he also understood his shortcomings.

In addition to TAVR surgery, in the fields of coronary intervention, electrophysiology, congenital heart disease and other fields, there is still a big gap between him and the top doctors at the Mayo Clinic.

However, Lu Chen's outstanding performance attracted the attention of the director of Mayo's Department of Cardiology.

"Mr. Kebed, are you saying that the director wants me to go to the office to find him?"

Lu Chen was a little confused.

"Yes, he called me today." Kebed nodded, "His office is on the fifth floor."

"Okay, I'll go find him right away."

UU Reading www.uukanshu.net Lu Chen didn't know much about the director of cardiology at the Mayo Clinic.

This is unlike in China, where the director usually does not interfere with everyone's medical behavior.

Lu Chen has been at Mayo for so long, but he has never met the director of Mayo's Department of Cardiology.

…

Come to the fifth floor.

After Lu Chen asked about the specific office location, he knocked on the door of the director's office.

"Please come in!"

An energetic voice came out, and Lu Chen gently opened the door.

What surprised Lu Chen was that the director of the Department of Cardiology in front of him had an Asian face.

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