Chapter 665: Floating Valve

Director Liu sat in his office chair, his mind full of question marks.

Why did Lu Chen go to the Magic City Central Hospital?

Moreover, the Magic City Central Hospital specifically requested Lu Chen for consultation!

You know, the general outpatient consultation doctor must be at least an associate chief physician, or at least a senior attending physician.

And Lu Chen is only a doctoral student and has not yet obtained the attending physician qualification certificate!

(ps: Masters can take the attending physician qualification certificate two years after graduation)

"Director Fang, is this in line with the rules?" Liu Jun asked in confusion.

Director Fang Yu of the Medical Department said: "Why? If we send it out ourselves, it must not be Lu Chen, but this is specifically requested by the Magic City Central Hospital, and it is about the tavr surgery. Special circumstances have special policies."

"Well, I don't have anything here, as long as the Medical Department agrees."

Liu Jun hung up the phone, thought about it and called Zhang Shuqing.

"Shuqing, what is your doctor Lu Chen doing recently?"

Zhang Shuqing was stunned for a moment, and immediately replied: "Director, didn't I tell you last time that there is a TAVR training class in Shanghai recently, and I asked Lu Chen to go."

"Oh, I remember." Liu Jun nodded.

"Dean, did something happen to Lu Chen?"

"No, it's like this." Liu Jun told the story of Shanghai Central Hospital, "Is Lu Chen's TAVR surgery technique very good?"

"This... shouldn't be." Zhang Shuqing shook his head, "I remember Lu Chen once, he just started to get in touch with TAVR procedures, he should... be considered a novice."

"Should... be considered a novice? Are you sure?" Liu Jun asked back, "You are Dean Dai of Shanghai Central Hospital. Are you a fool? Ask a novice for consultation?"

Zhang Shuqing was really a little unconfident when asked this question.

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

Liu Jun sighed, "Shuqing, your birth is too weird, can we handle it?"

Zhang Shuqing was stunned for a long time before slowly saying, "No matter what, Lu Chen is my birth. The better he does, the more honorable our hospital will have, right?"

"Okay, I won't ask about your birth, just cultivate him well." Liu Jun smiled.

"Okay, thank you, Director!"

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

No matter how powerful a person is, if he is bullied by his leader, he can't stand it!

However, Lu Chen's tavr surgery skills are really a questionable point, and I will ask him about the situation later.

...

Modu Central Hospital.

In the catheter room.

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

He took a deep breath to stabilize his heartbeat.

Even as an assistant in surgery, not the main surgeon, Lu Chen would give 100% of his attention.

Disinfection, laying towels, puncture, all done in one go.

Dai Wansong looked and nodded.

"I'll put in the guidewire."

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

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

Calcified plaques are like garbage attached to the blood vessel wall.

Too much garbage is likely to affect the entry of the guidewire.

...

Even an experienced TAVR operator like Dean Dai Wansong was cautious in pushing the guidewire in at this time.

"There is resistance!"

It was similar to what Lu Chen guessed. The plaques and stenosis of the blood vessels seriously affected the entry of the guidewire.

Dai Wansong did not dare to push too hard.

If the blood vessels ruptured or dissected, it would be a big loss!

Outside the catheter room.

Everyone was worried for Dean Dai Wansong.

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

If the guidewire cannot be inserted, forget about the following operations.

At this time, Lu Chen, who had been helping out beside him, whispered: "Dean Dai, how about puncturing the superficial femoral artery?"

"Superficial femoral artery?" Dai Wansong put down the guidewire in his hand, "I... I haven't tried it yet."

"I can do it." Lu Chen said immediately.

"Okay, you do it." Dai Wansong did not hesitate and quickly made way.

Lu Chen immediately took over and punctured the superficial femoral artery with one needle.

"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 no problem.

Although they were amazed, after the superficial femoral artery was successfully punctured, the two changed positions.

Everyone outside the catheter room had no time to react.

Lu Chen had already become an assistant again.

...

Dai Wansong pushed the guidewire and inserted it bit by bit.

The guidewire quickly reached the position of the valve.

Next, the most important thing is to pass the guidewire across the membrane.

If the guidewire 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 instead looked at the patient's CT and ultrasound results again.

The patient's CT analysis results showed:

Type 1 bicuspid valve, left and right fusion, thickened leaflets, severe calcification, and calcification visible on the annular plane.

The opening height of the left coronary artery is about 11mm, the opening height of the right coronary artery 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 has rich experience in TAVR.

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

"Dean Dai is still experienced. Except for the initial guidewire entry, it was too smooth."

"This assistant position, I think I can do it..."

"Don't talk, didn't you see that Dean Dai asked Lu Chen to do the superficial puncture just now?"

Lu Chen didn't know what the people on the scene thought.

He was concentrating at the moment, staring closely at Dean Dai's operation.

"I started the balloon pre-dilation." Dai Wansong also raised his spirits.

Before delivering the artificial valve, the vascular access needs to be pre-dilated, so that a better vascular pain can be created, 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 did it, he might not do it as well as Dean Dai.

"Huh..." After completing the above operations, Dai Wansong's forehead was sweating. He had already spent a lot of energy.

However, the operation is not over yet!

The last step is to deliver and release the artificial valve!

The delivery of the valve is carried out under full fluoroscopy, so it is not very difficult.

The difficulty is the release of the valve.

The valve generates a force of "drilling down" or "jumping up" during the release process, causing the valve to shift.

In addition, during the release process of the valve, especially the front 1/3-2/3, the valve has not been completely anchored in the valve ring, and it is easy to shift due to the impact of the reflux blood and the influence of respiratory movement.

Once the valve shifts and is not released at the predetermined position, it means the failure of the operation!

...

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

"No, the valve is too affected by the patient's breathing movement."

"The displacement is too obvious, the valve can't be released at all!"

Lu Chen also noticed this problem at the first time.

It is impossible to release a floating valve!

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

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