Professor Liu took Professor Yang and his doctoral student Wang Xiaoying to her office.

After an introduction to the other party, we directly talked about this time, the content of the academic exchange, and the discussion of ventricular correction surgery.

Professor Yang is very accomplished in this matter.

"Professor Yang, this time we have a very special case in our department. The patient transferred from Ninglang First Hospital is a double outlet right ventricle (DORV) combined with complete atrioventricular septal defect, a very rare congenital heart disease.

It happens that our department is still studying the surgical plan, and I would like to ask Professor Yang to give us some guidance."

Wang Xiaoying on the side had a pair of eyes shining brightly. This was the first time she had encountered this kind of disease.

Seeing the curiosity on his doctoral student's face, Yang Guoshu also became interested and explained to Wang Xiaoying: "DORV-AVSD is a complex and rare cardiac malformation, which includes a forward-extending unrestricted VSD, primary

ASD, common atrioventricular valve, aortic straddling or right ventricular outflow tract stenosis caused by anterior and superior infundibular septum displacement, etc."

"Internationally, in 1975, the idea that combined deformities could be corrected by enlarging the interventricular septal communication port was first proposed. The first corrective surgery was successfully performed in 1980, but the surgical mortality rate was high, especially when combined with pulmonary artery stenosis or ectopic pulmonary vein connection.

The surgical mortality rate of patients is higher. In the 1990s, there were reports in the literature that the surgical mortality rate was about 50%. "

Wang Xiaoying was obviously a little surprised when she heard the data given by Professor Yang. It was really a terrible disease.

"Professor Liu, why don't we waste time and go check on the patient first?"

Professor Yang is a very dedicated and experienced expert who is very dedicated to medicine, and he doesn't care about traveling and traveling.

"Okay, thank you for your hard work, Professor Yang. I'll ask Director Huang and Deputy Director Qian to participate in this joint consultation so that they can also learn."

Professor Liu's words are of course sincere. After all, Professor Yang's level is recognized in the country, especially in ventricular corrective surgery.

Soon, after receiving a call from Professor Liu, Director Huang and Deputy Director Qian rushed over.

When they saw the famous Professor Yang, Director Huang and Deputy Director Qian, they were naturally humble and respectful, and their postures were extremely low.

"Professor Yang, I have long admired your name. This time, I want to learn from you about your experience and skills in ventricular correction."

Director Huang said excitedly, and Deputy Director Qian on the side also boasted about business.

"Director Huang, Director Qian is too polite. We are just communicating and sharing with each other. Then let's take a look at the patient's condition first?"

"Okay, okay."

Deputy Director Qian had already prepared the patient's condition in advance.

"Professor Yang, these are the patient's echocardiogram and cardiovascular angiography data."

After Professor Yang took it, he looked at it carefully and saw that the patient's two major arteries completely originated from the right ventricle and there was pulmonary hypertension, which was a typical DORV-AVSD syndrome.

Professor Yang continued to look at the rest of the patient’s examination information:

The patient had moderate growth failure and mild heart failure. Grade 3/6 systolic murmurs could be heard in the third and fourth intercostal spaces on the left sternal border, and P2 hyperactivity; chest X-ray showed: whole heart enlargement, bilateral

The pulmonary blood increased significantly, the pulmonary artery segment protruded, and the cardiothoracic ratio was 0.62~0.85.

After reading it, even Professor Yang felt a little heavy: "Professor Liu, this patient's condition is a bit complicated and really tricky."

Professor Liu was not too surprised by Professor Yang's reaction, but he was still a little disappointed. Could it be that even the senior experts from the 301 People's Liberation Army Hospital couldn't come up with a perfect plan?

Everyone in the office was silent for a while, and only the sound of turning pages could be heard.

Director Huang looked at the prestigious Professor Yang and sighed.

Although Professor Yang lowered his head, looking at the information and thinking about the plan, in the quiet office, Director Huang's sigh was very obvious and hit Professor Yang's heart hard.

This Zijingang Hospital was the first to propose a consultation, but it couldn't come up with a solution, which was really embarrassing.

After all, Professor Yang was also an expert. He pondered for a while. Although he could not come up with a one-time solution, it did make him think of a transitional method: "Professor Liu, Director Huang, and Director Qian, although they are still

I can’t think of a one-time solution, but I do have an idea, we can use two-stage surgery to solve this problem.”

“In the first stage of surgery, we can use body-pulmonary shunt. Body-pulmonary shunt can increase pulmonary blood perfusion, increase oxygenated blood volume, promote the further development of pulmonary artery and left ventricle, and provide conditions for the second-stage radical surgery.

"

"Two installments?"

After hearing Professor Yang's thoughts, Professor Liu also pondered for a while: "Professor Yang's suggestion is also a solution. However, the systemic lung shunt, the maintenance of the operation center function, whether the shunt blood vessels are unobstructed and the size of the shunt volume will affect the operation.

The key factor for the effect. If the shunt is too large, it will lead to pulmonary edema and pulmonary perfusion, and you will not be able to wait for the second-stage radical surgery."

"Yes, so the choice of surgeon for this phase of systemic-pulmonary shunt surgery is very critical. It requires superb skills and keen judgment on artificial blood vessels. Moreover, the reaction and speed requirements during the operation are very high.

At the same time, it is best to have superb suturing and incision techniques.”

Professor Yang also sighed. Although he was able to formulate a two-stage overall surgical plan, he was not very confident about performing this surgery.

"Moreover, this patient has a patent ductus arteriosus. During the operation, we must try to avoid the opening of the ductus arteriosus to prevent hypooxygenation."

Professor Liu had the deepest understanding of this patient's condition, so he added some details that Professor Yang ignored, but they were also key points.

Hearing this, Professor Yang took the patient's detailed physical examination information directly from Professor Liu and took a closer look: "It's true that in the first phase of this operation, the difficulty and risk increased exponentially.

The surgeon must be required to complete these complicated operations within an hour and a half. Based on my current experience, my control over the entire operation is much better than when I was young. But after all, I am older now and my physical strength is better.

Some of them can’t keep up. If I were to do the surgery, I might not be able to do it so fast, it would be difficult.”

Professor Yang made another assessment. As a cautious expert, the success rate is less than 30%. Of course, he will not take risks. He said with great regret: "Professor Liu, I carefully evaluated the patient's physical condition and tolerance. This surgery

When the plan is implemented, the success rate is too low, so I don’t agree with trying it.”

After hearing what Professor Yang said, the glimmer of hope that Professor Liu, Director Huang and others had just raised was shattered again.

Professor Yang shrugged. He proposed a surgical plan, but the doctors at Zijingang Hospital couldn't do it, so they could only do nothing.

Of course, this does not mean that the doctors in Zijingang are not good. In fact, the patient’s physical condition is too poor and the surgery is too complicated:

"If I were ten years younger, I would be 90% sure."

Director Huang murmured: "Excellent skills, keen judgment on artificial blood vessels, speed of operation, and suturing and incision skills."

Suddenly, his eyes lit up, and Deputy Director Qian next to him obviously had a clear understanding. The two of them said in unison:
Chapter completed!