Chapter 429: The Dean's Order

Remember [New] in one second!     "Percutaneous hepatic vein puncture implantation?" Everyone was shocked.

Compared with other routes, this should be the most unconventional implantation route.

On the podium, Xiao Shikang said: "Doctor Lu is the surgeon of this patient. The first operation was performed by the two of us together."

Everyone's eyes were all turned to Lu Chen.

Most of the doctors present knew him.

Although Lu Chen was just an outsider doctor, his performance in the catheterization room during this period was obvious to all.

Not only did he successfully complete the dry pericardial puncture, but he also went to Kyoto Central Hospital as a representative of the hospital to assist in the operation.

This was a topic of conversation after dinner, and many people talked about it with relish.

Qin Sifeng frowned after listening to Lu Chen's speech.

"Percutaneous hepatic vein puncture implantation, this route is rarely used by us." Qin Sifeng glanced at Lu Chen, "I remember that Sichuan West Medical College once used this puncture route, and they were the first in the world at that time."

"Yeah." Lu Chen nodded, "After I went back, I looked through the literature and found a case report published by Sichuan West Hospital two years ago. They used this percutaneous hepatic vein puncture implantation to treat a patient with superior vena cava obstruction."

"I know the case you mentioned. Sichuan West consulted with me remotely at that time." Qin Sifeng frowned and said, "But Lu Chen, do you know that the method you mentioned is theoretically feasible, but in practice, it is extremely difficult!"

When everyone heard what Qin Sifeng said, they also began to discuss.

Fang Ruzhang frowned: "Subclavian and superior vena cava puncture, this path is short, only one curved arc is needed, but implantation through the hepatic vein is not only a longer path, but also requires three consecutive arcs!"

Three turning arcs, the difficulty of this operation is multiple times that of one arc!

Another doctor said, "I think it's okay if there are more arcs. If you try a few more times, you should be able to pass it. But the most difficult part of the operation through the hepatic vein is that the entire path needs to be operated with the backhand. This kind of backhand operation skill, everyone should have no experience, right?"

There are few opportunities for surgical training in normal times, and almost no such situation is encountered. Who would deliberately train backhand operation?

At this time, Qin Sifeng added fuel to the fire, "In fact, there is another difficult problem. You may not have noticed that this operation not only involves the implantation of pacemakers, but also the implantation of ICDs. ICD implantation through the hepatic vein? I haven't seen such a case yet..."

Everyone talked about it, and Lu Chen's "implantation through hepatic vein puncture" was quickly rejected.

It is feasible in theory, but the actual operation is extremely difficult!

Lu Chen moved his lips and wanted to say something, but gave up.

He really wanted to shout, "I want to try hepatic vein puncture."

But the doctors present, whether in clinical diagnosis and treatment experience or interventional surgery experience, are much richer than him.

He shouted out like that, which was a bit overestimating his own abilities.

…

Half an hour later, the cardiology department's consultation ended.

The crowd did not come to a good conclusion, so they could only postpone the operation temporarily and conduct conservative drug treatment.

Lu Chen had no other solution. He read the literature all night and finally came up with a solution, but it was not recognized by everyone.

But Lu Chen was not discouraged.

Since it was possible to use this "percutaneous hepatic vein puncture implantation" skill, he could just train in the system virtual space.

In the system virtual space, Lu Chen set the surgical simulator to a similar situation to that in reality.

The superior vena cava was blocked, and the hepatic vein puncture was performed instead.

…

In the blink of an eye, two days passed.

Intracardiac zone three.

Fang Ruzhang looked at the patient in front of him, anxious.

Just now, this old man's heart failure recurred!

This was also his fourth acute heart failure attack in three days.

"Doctor, how is my dad's condition?" The patient's family member was a middle-aged man. He came to the office and asked proactively.

Fang Ruzhang shook his head slightly: "The old man is not in good condition. You can see that he has just been in the hospital for a few days and needs at least one minor rescue every day."

"How could this happen?" The middle-aged man's face was full of worry and confusion.

"When the heartbeat slows to less than 40 beats/minute, there is a risk of sudden death." Fang Ruzhang explained, "Your father's heartbeat has long-term pauses due to pacing dependence. At the same time, his heart also has potential tachycardia. The normal heart ejection function is more than 50%, and his is less than 25%."

The middle-aged man sighed deeply, then looked up at Fang Ruzhang and said, "You are one of the top cardiology departments in the country. After so many days of discussion, you still can't come up with a feasible plan?"

Fang Ruzhang heard this and felt bitter in his heart: "Don't worry, our cardiology department has held a large consultation."

"What's the use of just a large consultation?" The middle-aged man frowned and said, "What we need is a treatment plan!"

"Don't worry, we will do it as soon as possible." Fang Ruzhang talked to the patient's family and finally calmed him down.

Fang Ruzhang also understood that anyone whose father was sick lying in bed would be in a worse mood than him!

"Hey, the surgery can't be delayed any longer!" Fang Ruzhang thought to himself.

Thinking of this, he immediately started to contact Qin Sifeng by phone.

"Professor Qin, about the patient with superior vena cava obstruction..."

Before Fang Ruzhang finished speaking, Qin Sifeng said, "I know, the dean called me just now. The patient's family must have found a connection and told him about it. The dean asked us to come up with a solution as soon as possible."

"Oh, the leaders above are really something." Fang Ruzhang was a little helpless, "As soon as they talk, we are in trouble. This solution is not that easy to come up with!"

On the other end of the phone, Qin Sifeng was a little silent.

Fang Ruzhang thought he had hung up, and was about to hang up when Qin Sifeng's voice came again: "Xiao Fang, go apply for a remote joint consultation for the patient from Sichuan West Medical College, Zhongshan Medical College, and Shanghai Medical College."

Fang Ruzhang was stunned, "Professor Qin, joint consultation? Are you preparing for surgery?"

Qin Sifeng sighed, "Whether the dean talks about this today or not, I have actually thought about it. We can't just sit there and wait for death because of the risk issue and continue to drag it out. We must take the safety of patients' lives as the primary principle! After the joint consultation, come up with a specific surgical plan, and we will start to implement it!"

"Okay!" Fang Ruzhang said.

After hanging up the phone, he immediately began to contact the hospital's medical department.

Let the medical department come forward and notify the external hospital to conduct a remote joint consultation with multiple hospitals.

...

Because of the dean's order, this joint consultation ended quickly.

That afternoon, the joint diagnosis and treatment plan of major hospitals was released.

After intense discussions, major hospitals, led by Sichuan West Medical College, unanimously recommended the use of the "transhepatic vein puncture and implantation" plan!

This is exactly the plan proposed by Lu Chen, and it is also the most compromised surgical plan at present.

Because other paths cannot be used, only "hepatic vein puncture" can be used.

The only disadvantage of this operation is that it is difficult!

So, Qin Sifeng came up with an idea.

Before the formal operation, a small-scale simulated surgery evaluation will be held in the catheter room.

The person with the highest surgical proficiency will have the opportunity to become the first assistant of the operation and participate in this operation.

As soon as this notice came out, all electrophysiological interventional doctors in the cardiology department began to gear up.

For such a difficult operation, it may not be possible for them to be the main surgeon.

But if they are an assistant, then they can still do it.

If it succeeds, they can also get a reputation.

This may be the world's first case of simultaneous implantation of ICD and pacemaker through the hepatic vein!