I Can See Health

After dinner in the evening.

Lu Chen entered the system virtual space.

"Use the valve intervention skill card!"

With a thought, a simulated operating table immediately appeared in the virtual space of the system.

Various equipment and surgical instruments are all matched with "valve intervention" surgery.

After studying last week.

Lu Chen already knew something about valve intervention surgery.

If the heart is compared to a house, then the valves of the heart are the doors and windows of the house.

Once the valve is broken, that is, the doors and windows of the room are broken, in the long run, the heart function will be damaged, which is heart failure.

The conventional treatment methods are surgical thoracotomy, repair of the valve, or replacement of the entire valve, which is often referred to as valve replacement surgery.

This kind of major surgery is very traumatic to the human body and requires surgical thoracotomy, that is, extracorporeal circulation surgery.

Valvular intervention (TAVR), like coronary intervention, is a minimally invasive treatment through peripheral blood vessels.

It causes little harm to the human body and is especially suitable for middle-aged and elderly patients who cannot tolerate surgery.

…

Now it’s time to test your results and improve your skill proficiency!

With the foundation of electrophysiological surgery, Lu Chen could get started faster.

From the initial awkwardness and unfamiliarity, Lu Chen began to gradually master the essentials of "valve intervention".

After staying in the system virtual space for about four hours, Lu Chen felt a little tired, so he quit and started to sleep.

A night of silence.

The next day.

Lu Chen had breakfast and came to the cath lab of Shanghai Central Hospital early.

Under the leadership of Dai Wansong, director of the Central Hospital, everyone began to observe the operation.

"The peripheral approaches of TAVR include femoral artery, carotid artery, axillary artery, etc. The specific approach chosen depends on the patient's condition and vascular conditions."

Dean Dai Wansong explained and performed simulated operations for everyone.

"Which of you knows the most commonly used blood vessel routes?" Dai Wansong continued.

At this time, a middle-aged doctor said: "Dean, clinically about 90% of TAVR is completed through the femoral artery approach."

"That's right." Dai Wansong nodded slightly, "Take femoral artery puncture as an example. Before puncture, we need to read the CTA images of peripheral blood vessels in detail to identify the bifurcation positions of the deep femoral artery and superficial femoral artery. There is no obvious stenosis, plaque or Calcification and other conditions.”

Because it is a simulated surgery, everyone enters in batches and can clearly see the surgical area.

"Can anyone demonstrate the puncture process?" Dai Wansong looked around at the crowd.

"Me!" The middle-aged doctor who just answered the question stood up again.

"Okay, let Dr. Bai Xin demonstrate it."

Dean Dai Wansong gave up his position.

Bai Xin put on gloves, held the puncture needle, and began to puncture the femoral artery.

Lu Chen stood aside and observed carefully.

Bai Xin's operation is very professional, and there is no trace of unfamiliarity at all.

"The puncture point is usually within the femoral head, below the inguinal ligament, and at least 10mm above the femoral artery bifurcation. Puncture methods include micro puncture, contralateral contrast puncture, ultrasound-guided puncture, pigtail tube puncture..."

Bai Xin's explanation is also very clear.

However, Lu Chen knew very well that the puncture of these peripheral blood vessels was not the focus.

The most difficult techniques of "valvular intervention" are the guidewire crossing technique, orbit establishment and balloon pre-dilation technique.

Sure enough, after the femoral artery puncture, Dean Dai Wansong continued to ask: "Can anyone demonstrate the transmembrane operation of the guidewire?"

As soon as the words fell, no one responded.

Dr. Bai Xin, who was more active just now, also looked very hesitant at this time.

"Aren't you willing to give it a try?" Dai Wansong asked again.

When Lu Chen was about to step forward, Bai Xin moved.

He stepped forward and said, "Dean Dai, let me try again."

"Okay." Dai Wansong smiled and nodded, "Don't be afraid of making mistakes. This is your first try. Once you have started, you can slowly improve in the future."

Bai Xin took a deep breath and then walked onto the simulation console.

He held the guidewire in his hand and began to push it in.

"The guidewire should be operated gently when crossing the valve to prevent the guidewire from accidentally entering the coronary artery. Seize the opportunity of the aortic valve opening during systole to push the cross-valvular guidewire. For severely stenotic valve orifices or misaligned valve leaflets, super-slip guides can be used. Silk."

Bai Xin said while feeding the guide wire.

His movements were no longer as skillful as before, but despite the bumps and bumps, he successfully passed the guide wire through the valve.

If it was Bai Xin's first time to have a valve intervention, it would be very difficult if the guidewire could pass through the valve!

Everyone watching was amazed.

"I heard that Bai Xin is Dean Dai's student. It seems that he has received the true inheritance!"

"I'm sure Bai Xin has done this kind of surgery before, otherwise he wouldn't be so skilled."

"Should you come to the study class after doing it? Doesn't this count for a quota?"

"Continue to study. I've done it before, but I was just an assistant..."

While everyone was discussing, a student suddenly asked: "Dr. Bai, what if after using a super-slippery guide wire, it still cannot pass?"

"This..." Bai Xin suddenly froze.

He had indeed undergone valve intervention surgery, but he was only the first assistant and had never encountered such a situation.

Everyone else also stared at Bai Xin, expecting an answer from his mouth.

However, everyone was disappointed.

Bai Xin thought for a while, then shook his head, "I haven't encountered such a situation yet, so..."

Dai Wansong also had a hint of disappointment in his eyes, and he was about to remind everyone.

At this moment, a calm voice came from among the students.

"If the guidewire cannot pass through the stenotic valve forward through the above methods, you can consider puncturing the interatrial septum and crossing the aortic valve in a reverse direction to establish a track."

It was Lu Chen who said this, and he took a step forward.

All students followed the sound and watched.

In the eyes of everyone, why is this student so young?

Dai Wansong's face showed a look of surprise, "Have you encountered it before?"

Lu Chen shook his head, "No, I have read the corresponding operating information, and it seems to have been mentioned in it."

Lu Chen had never encountered it in reality, but he had seen it in the system virtual space.

Is what he said right?

Everyone was a little confused and looked at Dean Dai Wansong.

Dean Dai Wansong nodded slowly, "Yes, this student is right! At this time, we can consider puncturing the interatrial septum and establishing a track across the aortic valve in a reverse direction."

It's actually right!

Everyone was shocked and looked at Lu Chen in surprise.

Where did this person come from?

"What's your name? Which hospital are you from?"

Dai Wansong asked everyone's thoughts.

Lu Chen smiled slightly, looked at everyone, and said slowly: "Lu Chen, a Ph.D. candidate in the Department of Cardiology at the First Affiliated Hospital of Shanghai University, Lu Chen."

Lu Chen?

Everyone thinks this name sounds familiar!

Among the students, someone suddenly exclaimed.

"Is he the Lu Chen from the heart failure conference?!"

－－－－－－Digression－－－－－

Because a school where I was responsible for checking nucleic acid results was all negative, I ended the quarantine early this afternoon...

What a short period of isolation. (two days)

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