Start as an Emergency Physician

The director of cardiac surgery hesitated a little and said: "Although sequential anastomosis is good, once the bridge of sequential anastomosis is blocked, it will have a wide impact on the blood supply of myocardium, and even affect the entire ventricular wall. The blockage of a single anastomosed bridge only affects the blood supply to the myocardium in one part..."

Zhou Yuan naturally knew this.

However, a large part of the blockage occurs because few doctors can do a sequential anastomosis.

In itself, the difficulty of a single anastomosis is very great, and the anastomosis of several branches without certain technical and physical support may leave various sequelae when anastomosis.

"I like that sequential anastomosis can shorten the time of surgery and the time of cardiac arrest. The shorter the cardiac mooring, the better the patient's postoperative recovery and the lower the likelihood of recurrence. "

"Moreover, sequential anastomosis can save bypass materials, maximize the use of vascular bridges, and reduce surgical costs. Postoperative angiography also showed that the patency rate of sequential anastomosis was much better than that of single anastomosis. "

"Another point is that, according to Neeter's 10-year postoperative follow-up report, the sudden death rate of patients with sequential anastomosis is lower than that of patients with single anastomosis, and the survival rate is also better than that of the latter. "

The last point is an important reason why Zhou Yuan chose to coincide sequentially.

Moreover, Zhou Yuan's master-level heart bypass surgery can avoid the shortcomings of sequential anastomosis to the greatest extent.

"The coronary anastomosis is complete. "

"Open ascending aorta vascular clamp. "

The chief of cardiac surgery immediately removed the clip and began to induce the heart to return to beating.

In heart bypass surgery, vascular bridging requires anastomosis on the coronary artery and aorta, respectively.

This is followed by anastomosis of the vascular bridge at the aortic end.

This step is relatively much easier, and the aortic punch will be used to make an incision and assist in suturing, and Zhou Yuan's workload will be reduced a lot.

Finally, the vascular bridge is closed with a 5-0 suture sequence of 5-0 sutures to the incision of the aorta.

The last stitch was pierced, and Zhou Yuan drained the air in the aortic isolation cavity, and finally tightened the sutures and performed ligation to complete the final anastomosis.

"Loosen the vascular clamp. Zhou Yuandao.

He Jianyi slowly loosened the vascular clamp that blocked the blood flow, for fear that the excessive blood flow would tear the anastomosis.

However, He Jianyi's worries were unnecessary, Zhou Yuan's suturing work was done well, the blood flow did not show any leakage, and the anastomosis did not show signs of breakage.

"The blood circulation is fine, the vascular bridge is unblocked..."Zhou Yuan announced one by one.

Finally, a smile appeared on Zhou Yuan's face: "Heart bypass surgery was successful. "

"Needle forceps. "

Zhou Yuan began to suture the tissue outside the heart layer by layer.

Absorbable sutures are used under the skin, which will dissolve on their own after a meal and do not need to be removed.

As for the outer skin, non-absorbable sutures are used, which need to be removed after the wound has healed.

Because it was heart bypass surgery, big scars could not be avoided, and Zhou Yuan could only stitch up the scars as much as possible.

The sutures of the heart area, Zhou Yuan was extra careful.

After half an hour, the last stitch was placed under the skin, and the knot was tied again.

"It's done. "

Zhou Yuan breathed a sigh of relief and glanced at the time.

"The operation is complete. "

"Whew. "

He Jianyi and the director of cardiac surgery breathed a sigh of relief at the same time.

This surgery is so unconventional...

Some of Zhou Yuan's operations are not ordinary heart bypass surgery at all.

Take the most typical sequential coincidence.

The coronary arteries themselves are very small, and anastomosis of the coronary arteries is a delicate job, which is prone to accidents, but Zhou Yuan chose to establish multiple branches on the coronary arteries...

While there are many benefits to sequential matching, it also has to be done well!

If you are someone else, you would rather choose a single anastomosis than take this risk. After all, not everyone has a masterful heart bypass.

It can be expected that ten years later, Qian Wei's vascular bridge patency rate will still be maintained at more than 90%, and the chance of recurrence of acute myocardial infarction after surgery will be very low - this is all due to the sequential anastomosis.

The instrument nurse cleaned up the instruments, and Zhou Yuan, He Jianyi and others walked out of the operating room.

Squeak.

The door of the operating room was pushed open, and Qian Wei's wife, who had long noticed that the "operational" sign was extinguished, was already waiting anxiously at the door.

"Dr. Zhou, how is my husband? Has he woken up?"

Zhou Yuan took off his mask and said, "Don't worry, the operation was successful." "

Qian Wei's wife covered her mouth and tried her best to suppress her crying.

"Great... Thank you! Thank you, Dr. Chow!"

Zhou Yuan smiled and said, "This is what we should do." "

Soon, Zhang Ling and Lin Wen ran over, ready to push Qian Wei to the ward.

Zhang Ling, immediately after waving the ward, took a bedside camera to observe the depth of the tracheal intubation. "

Before the end of the operation, Zhou Yuan gave Qian Wei a tracheal intubation.

This is to prevent lung failure from occurring.

Although the risk of heart bypass surgery is not high, postoperative complications are almost always fatal, such as lung failure, which is an important cause of early postoperative death.

"After 12 hours of assisted breathing, the heart is relieved of the burden and the oxygen supply is increased, after which the endotracheal tube can be removed. Zhou Yuan instructed.

Qian Wei's wife watched Qian Wei, who was holding the pipe, being pushed away, and felt distressed.

"Doctor Zhou, when will my husband wake up?"

"It depends on the individual's physique. General anesthesia usually wakes up four to six hours after surgery, and the resistance to anesthetics is worse for a longer time. "

Qian Wei's wife nodded, and stopped talking a little.

"That's... When can I go to see him?" said Qian Wei's wife with some hesitation.

Zhou Yuan smiled: "The operation has been completed, you can actually go to see him now." But don't let him have violent mood swings. "

Qian Wei's wife was stunned, "Thank you, doctor!"

Then, he quickly ran in the direction of Qian Wei's hospital bed.

Zhou Yuan and He Jianyi were about to return to the office, and the director of cardiac surgery reluctantly left the emergency department.

After returning to his office, Zhou Yuan fell asleep directly on the table.

Suturing blood vessels is not such an easy thing, staring at the microscope all the time, and being shaken by a shadowless lamp, the eyes have long been unable to stand it.

Not long after lying down, Zhou Yuan's breathing became soothing and regular.

At this time, the emergency department lobby.

Zhang Ling's phone rang suddenly, and after pressing it, he called again.

Zhang Ling looked at it, it was his mother.

"Lin Wen, help me take a look, I'll be back soon!"

As he spoke, Zhang Ling went to the side and connected the phone.

"Mom, I'm at work now, what's the matter when I get off work!"

A somewhat stern voice came from the other side: "Are you still waiting for you to get off work?

"Mom, I don't call you every day!" Zhang Ling said coquettishly.

"I don't want you to call me, I want you to go on a blind date for me! Tomorrow happens to be Sunday, and I believe in the afternoon, I've arranged it!"

Zhang Ling was anxious: "I'm only twenty-five years old!"

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