Chapter 936: Rare and Uncommon Spells

Remember [New] in one second! Demonstration room of the Department of Cardiology of the Fifth Hospital of Shanghai.

Lu Chen stood on the podium.

The projection screen at the front of the demonstration room showed this paper from American scholars.

Everyone looked at it intently.

Lu Chen began to explain in detail the content of "patients with acute myocardial infarction complicated by severe mitral regurgitation" in this article.

"Compared three surgical methods in patients with acute myocardial infarction complicated by severe mitral regurgitation - surgical mitral valve replacement, transcatheter mitral valve edge-to-edge repair and conservative drug treatment."

"The study on the difference in prognosis showed that early active transcatheter mitral valve edge-to-edge repair technology (transcatheter edge-to-edge repair, TEER) can significantly improve the long-term prognosis of patients and reduce the mortality rate during hospitalization."

Everyone in the demonstration room began to discuss.

Modern medicine emphasizes evidence-based medicine.

This means that any treatment method must be proven by experiments and provide specific data on the effectiveness of the treatment.

Instead of using individual differences to illustrate the effectiveness of a drug treatment.

The paper that Lu Chen took out was not from China, but it was the most advanced research in the world.

"Director, I think you are right. This patient will definitely not be able to undergo surgery." Jin Miao immediately stood up and looked around at everyone. "If you want to completely solve the severe mitral valve regurgitation, there is only one way to go, that is, catheter intervention!"

Lu Chen smiled and nodded.

What Jin Miao said was what he thought in his heart.

If there is still a glimmer of hope for this patient, then this glimmer of hope lies in catheter intervention!

Then, other people in the demonstration room also nodded in agreement.

A mature surgical team can put forward different opinions, but can also quickly get a unified solution.

However, the surgical plan has been determined.

But the difficulty and risk of this operation are in front of everyone.

"Director Jin, are you sure about this operation?"

A chief doctor in the department asked Jin Miao.

Now, Jin Miao has also been successfully promoted to deputy chief physician.

Jin Miao paused, then shook his head slowly: "I have done ordinary transcatheter mitral valve replacement surgery, but I have never done this kind of patients with mechanical complications of mitral valve prolapse after acute myocardial infarction."

The implication is that he is not very sure.

When the others heard this, they all cast their eyes on Lu Chen.

In the entire Magic City Fifth Hospital, Jin Miao's interventional surgery ability is one in a million.

Even in the field of interventional cardiology in the whole of China, any cardiologist who hears Jin Miao's name will give a thumbs up.

If there is anyone who can suppress Jin Miao, then it is only Lu Chen!

However, Director Lu Chen has not performed surgery himself for a long time.

At this time, Lu Chen on the podium spoke.

"This kind of mitral valve intervention surgery after acute myocardial infarction is still blank in our country."

"Even in the international arena, it is a rare procedure."

If it is just a single severe mitral valve regurgitation, there are many doctors who can independently perform this type of surgery.

However, patients with severe mitral valve regurgitation during acute myocardial infarction need to undergo this surgery.

In comparison, the risk is much higher!

Acute myocardial infarction, in simple terms, is the death of myocardial cells and necrosis of cardiac muscle tissue.

In this case, the contractile ability of the heart function decreases, and it is easy to have heart failure.

Secondly, myocardial cell necrosis will cause damage to the heart structure.

The patient this time had severe mitral valve regurgitation caused by ruptured chordae tendineae.

Severe complications can cause heart rupture!

This is easier to understand.

The necrotic heart tissue beats less, but the normal myocardial tissue beats the same as before.

In this way, a shear force will be generated between the necrotic and normal myocardial tissue.

Under the action of shear force, the heart is extremely easy to rupture!

Once the heart is broken, the mortality rate is almost 100%!

It can be seen from this that the difficulty of this operation is dancing on the tip of a needle!

...

There was a brief silence in the demonstration room.

This time, Lu Chen raised his head and looked at Jin Miao.

"You are the patient's attending physician. What do the patient's family members think?"

In the face of such critically ill patients, in addition to the doctor's opinion, the opinions of the family members are more important.

Is it active treatment or giving up and going home.

This is the decision that ultimately determines the patient's fate.

If this patient chooses to go home for conservative treatment, Lu Chen is sure that he will not survive a week!

"The patient is from an ordinary working-class family." Jin Miao said, "In order to treat the disease, he has sold his house, and has been to many hospitals, and finally came to us."

Lu Chen looked solemn.

This kind of patient is more difficult.

Losing both money and people is a situation that no one wants to see.

"Jin Miao, call the patient's family to the doctor-patient communication room, and I will communicate with him."

"Okay." Jin Miao nodded slightly, stood up and left the demonstration room.

This case discussion is over.

The final solution is available, but the specific operation is still in doubt.

...

Jin Miao quickly called the patient's family to the doctor-patient communication room.

In the communication room.

Sitting in front of Lu Chen was a man in his thirties.

His hair was fluffy and his eyes were bloodshot. It looked like he hadn't rested for a long time.

"Doctor, how is my mother?"

As soon as they met, the man asked hurriedly.

Lu Chen shook his head slightly: "The situation is not good. You should also know the diagnosis made by doctors from outside hospitals. It is acute myocardial infarction combined with severe mitral regurgitation..."

Before Lu Chen could finish speaking, he was interrupted by the man.

"Doctor, don't use these professional terms with me, I just want to know how to treat it next!"

The man shook his head helplessly.

In fact, in his heart, he seemed to already know his mother's final outcome.

He is not a native of Magic City.

This time, in order to seek medical treatment, UU read books www.uukanshu.net traveled across mountains and rivers and visited many hospitals in the magical city.

The family spent more than half of their money, but in the end there was no hope of treatment.

Lu Chen calmed down and slowly said to the man in front of him: "Don't worry, I am the director of the cardiology department of the Fifth Hospital of Shanghai. I will explain the condition to you now. As for the next treatment method, I will explain it to you clearly. ”

Hearing Lu Chen's words, the man quickly lowered his head and looked at his badge, "You... you are Director Lu, right?! I know you. I came to the Fifth Hospital this time because a patient told me..."

The man's expression suddenly became excited.

Lu Chen said quickly: "I told you, don't get excited yet. Treatment needs to be done step by step."

"Okay." The man nodded immediately and did not continue talking.

Seeing this, Lu Chen continued: "Your mother's current illness is caused by a broken heart valve due to myocardial infarction. To put it simply, the window in a room is broken."

The window is broken, what should I do?

One is to repair, and the other is to replace the entire broken window with a new one.