I Can See Health

Director Liu sat in his office chair with questions in his mind.

Why did this kid Lu Chen end up at the Shanghai Central Hospital?

Moreover, Lu Chen was asked to go to the Shanghai Central Hospital for consultation!

You know, for general out-of-hospital consultation doctors, the minimum professional title is deputy chief physician, and no matter how low the title is, it must be a senior attending physician.

And Lu Chen is just a Ph.D. student now and has not yet obtained the attending physician qualification certificate!

(ps: You can take the exam to treat medicine after two years after graduating with a master’s degree)

"Director Fang, is this in compliance with the rules?" Liu Jun asked doubtfully.

Director of the Medical Department Fang Yu said: "What? If we are sent out ourselves, it certainly cannot be Lu Chen, but this is what the Shanghai Central Hospital requested, and it is also about TAVR surgery. There are special policies for special circumstances."

"Okay, I have nothing to do here, as long as the medical department agrees."

Liu Jun hung up the phone, thought for a while and called Zhang Shuqing.

"Shu Qing, what is your doctor named Lu Chen doing recently?"

Zhang Shuqing was stunned and immediately replied: "Director, I didn't talk to you last time. There was a TAVR class in Magic City recently, and I asked Lu Chen to go there."

"Oh, I remember." Liu Jun nodded.

"Dean, what happened to Lu Chen?"

"No, that's it." Liu Jun told what happened at the Shanghai Central Hospital, "Lu Chen's TAVR surgery skills are very good?"

"This... probably doesn't happen." Zhang Shuqing shook his head, "I remember Lu Chen did it once. He had just started to come into contact with the tavr technique. He should... be considered a novice."

"Should...be considered a novice? Are you sure?" Liu Jun asked back, "Are you the director of Shanghai Modu Central Hospital? Are you a fool? Are you asking a novice for consultation?"

When Zhang Shuqing was asked this question, he really felt a little unconfident.

"I'll ask Lu Chen again when he comes back."

Liu Jun sighed, "Shuqing, you are too evil. Can we control it?"

Zhang Shuqing was stunned for a long time, and then said slowly: "No matter what, Lu Chen is my student. The better he does, the better our hospital's face will be, right?"

"Okay, you're a student, I won't bother you. You can cultivate yourself." Liu Jun smiled.

"Okay, thank you, director!"

Zhang Shuqing felt relieved for no reason when he heard this.

No matter how powerful a person is, if his boss puts him in small shoes, he won't be able to stand up!

However, Lu Chen's TAVR surgery skills are really doubtful, and I have to ask him what's going on later.

…

Shanghai Central Hospital.

In the cath lab.

Lu Chen stood next to Dai Wansong and began to perform the first real-world TAVR surgery in his life.

He took a deep breath to calm his heartbeat a little.

Even if he is a surgical assistant instead of the chief surgeon, Lu Chen will give 100% concentration.

Disinfection, draping, and puncture are all done in one go.

Dai Wansong looked at it and nodded.

"I'm here to insert the guide wire."

According to Lu Chen's analysis just now, the patient's overall vascular condition is very poor.

There are multiple calcified plaques at the origin and bifurcation of the femoral artery.

Calcified plaque is like debris attached to the walls of blood vessels.

Too much garbage may affect the entry of the guide wire.

…

Even experienced TAVR surgeons like Dean Dai Wansong carefully pushed in the guide wire at this time.

"There's resistance!"

As Lu Chen guessed, the plaque and stenosis of the blood vessels seriously affected the entry of the guide wire.

Dai Wansong didn't dare to exert too much effort.

If it causes blood vessel rupture or blood vessel dissection, you will lose too much!

Outside the duct.

Everyone was sweating for Dean Dai Wansong.

The introduction of the guidewire is the cornerstone of the entire operation.

If the guide wire cannot be fed in, forget about subsequent operations.

At this time, Lu Chen, who had been standing beside him, whispered: "Dean Dai, why don't you try to penetrate the superficial femoral artery?"

"Shallow thigh?" Dai Wansong put down the guide wire in his hand, "I...I haven't tried it before."

"I can." Lu Chen said immediately.

"Okay, come on." Dai Wansong quickly moved out of the way without hesitation.

Lu Chen immediately stepped forward and inserted the needle into the superficial thigh.

"Dean Dai, I'm done."

"Huh? That's it?" Dai Wansong's eyes widened.

"Yes." Lu Chen nodded.

It's just puncturing an artery. As long as you have practiced hundreds or thousands of times in the system's virtual space, any difficult blood vessel puncture is not a problem.

Surprised and surprised, after the superficial penetration was successful, the two of them changed positions.

Everyone outside the catheter room had no time to react.

Lu Chen had already become an assistant again.

…

Dai Wansong pushed the guide wire and inserted it bit by bit.

The guidewire quickly reached the position of the valve.

Next, the most important step is the transmembrane guidewire.

If the guide wire passes through the valve smoothly, it will affect the subsequent delivery and fixation of the artificial valve.

Dai Wansong did not rush to insert the guidewire, but looked at the patient's CT and ultrasound results again.

The patient’s CT analysis results show:

Type 1 bicuspid valve has left and right fusion, thickened leaflets, severe calcification, and calcification can be seen on the annular plane.

The left coronary opening height is about 11mm, the right coronary opening height is about 13.4mm, the French sinus structure is OK, the stj height is about 16.9, the ascending aorta is widened, the widest part is about 42.2mm, and the heart angle is about 53°.

Dai Wansong’s TAVR experience is very rich.

He immediately selected the appropriate transmembrane position based on the CT analysis results and successfully passed the guidewire across the valve.

"Dean Dai has a lot of experience. Except for the initial entry of the guide wire, it went very smoothly."

"As for the position of assistant, I think I can do it..."

"Don't be so stupid. Didn't you see that Dean Dai asked Lu Chen to do the shallow piercing just now?"

Lu Chen didn't know what the people present were thinking.

He was fully focused at the moment, staring closely at Dean Dai's operations.

"I started to pre-dilate the balloon." Dai Wansong also got a little more energetic.

Before the artificial valve is inserted, the vascular access needs to be pre-dilated to create a better vascular pain, otherwise the artificial valve may not be delivered to the correct position.

Dai Wansong still completed this step perfectly.

In Lu Chen's opinion, even if he were to do it, he might not be able to do it as well as Dean Dai.

"Huh..." After completing the above operation, sweat broke out on Dai Wansong's forehead. He had spent a lot of energy.

However, the operation is not over yet!

The final step remains, the delivery and release of the artificial valve!

The delivery of the valve is performed under full fluoroscopy, so it is not difficult.

What is rare is the release of the valve.

During the release process, the valve produces a "drilling down" or "jumping up" force, causing the valve to shift.

In addition, UU Reading www. uｕukanshu.netｔDuring the valve release process, especially the first 1/3-2/3, the valve has not yet been completely anchored in the annulus, and is easily displaced due to the impact of regurgitated blood and respiratory movement.

Once the valve is displaced and is not released at the intended position, this means that the operation has failed!

…

Sure enough, in this last step, Dai Wansong ran into trouble again.

"No, the image of the valve being affected by the patient's respiratory movement is too great."

"The displacement is too obvious and the valve cannot be released at all!"

Lu Chen also noticed this problem immediately.

It is impossible to release a floating valve!

He frowned deeply and kept thinking about the training process in the system's virtual space in his mind.

Is there any way to stabilize a floating valve? 16377/10373401