Chapter 851: Bold Methods

I can see the life value of the main volume Chapter 851 Bold innovation of techniques will always be the eternal topic of medical technology.

Every new procedure that appears means that a clinical problem has been solved.

As the world's number one clinic, Mayo Clinic has many innovations and discoveries.

For example, the current ECMO machine and the division of various internal medicine departments are all derived from Mayo Clinic.

And today, in Mayo's cardiovascular intervention, can everyone witness the birth of a new procedure?

Facing the new procedure, Lu Chen felt a very unfamiliar feeling.

All the operations he had done before could be simulated and trained in the system simulation space.

But now this "secondary operation for valve failure" cannot be simulated in the system virtual space.

However, the more difficult the operation, the more it inspires Lu Chen's fighting spirit!

...

In the operating room.

Kebed, Lu Chen, and Yamada Kenji have made preparations for the operation.

"Prepare for vascular puncture!"

Yamada Kenji consciously performed the puncture.

This is also the basis of TAVR surgery.

Kenji Yamada is very skilled in puncture surgery, and he is worthy of being a doctor who can come to Mayo.

After puncturing the femoral artery, the catheter and guidewire were successfully implanted.

The three people cooperated not many times, but they were very tacit.

As the chief surgeon, kebed would immediately execute every order issued by Lu Chen and Kenji Yamada.

The vascular puncture and catheter insertion were all very smooth.

Among the big names watching on the side, everyone was very appreciative of the cooperation of the three.

Although Lu Chen and Kenji Yamada are both newcomers, they are definitely the best among their peers.

"Everyone should cheer up!"

When it came to the balloon dilatation step, kebed had a serious expression and whispered to the two people beside him.

Aortic valve balloon dilatation is one of the important links in the operation.

Only after balloon dilatation can the artificial valve be successfully delivered to the designated position.

...

The three people immediately divided the work and cooperated.

"Start!"

Kebed gave an order and officially started balloon dilatation.

Kenji Yamada quickly adjusted the temporary pacemaker frequency to 180 beats/min.

The ECG monitor next to the operating table showed an overspeed pacing heart rate.

At this time, the patient's blood pressure dropped to 50~60mmHg.

Lu Chen immediately performed aortic valve balloon catheter filling and dilation, and DSA exposure.

"Stop!" Kebed shouted again, and Lu Chen stopped his hand.

Kenji Yamada adjusted the temporary pacemaker frequency back.

Balloon dilation was over.

The three closely observed the patient's blood pressure recovery, ECG waveform, and DSA image.

"Everything is normal!" Lu Chen said slowly.

The three slowly breathed a sigh of relief this time.

For patients without effective cardiac function reserve, the dilation process will completely block the left ventricular outflow tract.

Some patients cannot tolerate it and may have serious complications such as ventricular fibrillation and cardiac arrest.

"Go on." Kebed's eyes were sharp.

After the aortic valve balloon dilation, he once again evaluated the average diameter of the aortic valve ring and determined the type of aortic valve to be implanted.

Lu Chen compressed the cleaned self-expanding valve to the minimum diameter with a crimping gripper and a transfer tool, loaded the diameter T ear into the T-slot, pushed the capsule cavity, loaded the stent outflow end into the capsule cavity, and rotated the control handle at a constant speed to complete the loading.

"Stent valve is ready!" Lu Chen said slowly.

"Received." Kebed nodded to Lu Chen, "Prepare to deliver the valve!"

...

The delivery and release of the valve are the key points for the success of the entire TAVR operation.

Kebed began to deliver the valve slowly.

Lu Chen stared at the position of the valve intently.

In addition, invasive pressures such as left ventricular and aortic pressures will affect the final effect of the operation.

Yamada Kenji adjusted the transducer to "0" before and after the valve was released to ensure the accuracy of the invasive pressure measurement.

As time passed, Kebed could not find the final valve release position.

"I think it should be closer." Yamada Kenji suddenly said, "The position of the valve is a bit low."

"No!" Kebed shook his head, "If it's closer, it may hit the blood vessels. If the blood vessels are torn, the consequences will be too serious."

On the side, Lu Chen has been observing the position of the old valve.

He found that no matter how the valve is released, it is impossible to achieve perfection.

The position of the old valve and the new valve overlapped in some places.

"I think this position is fine now." Lu Chen said in a deep voice.

"This won't work. I feel like paravalvular leak may occur!" Yamada Kenji looked at Lu Chen in confusion. "Once paravalvular leak occurs, the patient's heart function will become worse."

kebed glanced at Lu Chen, "What do you think?"

Lu Chen said slowly, "There is no perfect position. At this point, we can only try to meet the conditions of all parties."

"After the valve is released, we can use cardiac ultrasound to evaluate the aortic valve regurgitation, and consider whether to perform balloon dilatation or valve-in-valve implantation again based on the results, and prepare for valve-in-valve implantation!"

"This..." Yamada Kenji was a little surprised. Lu Chen's ideas were so wild.

Others tried to find the best position, but Lu Chen directly considered the remedy.

Kebed hesitated for a long time.

He recalled Lu Chen's performance in the fellow review.

The operation of that operation amazed everyone.

"Okay, listen to Lu Chen!"

...

After the valve was released, the professors watching around had different expressions.

"Isn't this position good? The surrounding positions don't seem to match, right?"

"But I don't think there is a better position. The second operation is different from the first operation. It is difficult to have a perfect valve release position."

"These young people are really bold! If it were someone else, it would be impossible to release the valve in this position, right?"

On the operating table.

Kebed has released the valve.

"Pay attention to blood pressure and heart rate!"

"Received." Yamada Kenji remeasured all the patient's vital signs, "Everything is normal!"

At this time, Lu Chen pushed the cardiac ultrasound machine over.

After the valve is implanted, the ultrasound position needs to be re-evaluated.

Sure enough, the valve was not tightly closed, and paravalvular leakage occurred!

However, Kebed, Lu Chen, UU reading wｗw.uukaｎsｈｕ． ｎｅt and Yamada Kenji, did not panic, and immediately began to prepare for the implantation of the "valve-in-valve".

But when Yamada Kenji inserted the second artificial valve, the alarm of the monitor on the operating table sounded.

"Oh no, the patient's blood pressure has collapsed!" Kebed reacted immediately, "Quick! Add balancing fluid and pump another dose of norepinephrine!"

The nurse at the table acted quickly and quickly connected the patient to the drug.

Everyone was wondering why the blood pressure suddenly collapsed?

"Look at the monitor."

Lu Chen suddenly pointed to the monitor on the operating table.

The electrocardiogram on the patient's monitor showed a significant depression of the ST segment!

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