After Zhou Sheng opened the mediastinum, he and Director Tian both discovered that the patient's right coronary artery had been detached like a sleeve.
At the same time, Zhou Yisheng also discovered a tumor at the root of the patient's aorta.
Typical aortic root aneurysm.
It turned out that this patient's aortic dissection was caused by aortic root aneurysm.
Director Tian frowned when he saw this result.
This patient's condition is very complex.
One surgical treatment is ideal for all conditions.
According to Director Tian's decades of extracardiac experience, the current situation requires at least three surgeries.
One surgery was performed to solve the problem of aortic dissection.
One deals with coronary artery occlusion.
Another one is of course to treat the root cause of aortic aneurysm.
These three operations all require the heart to be stopped first, and then the patient's body temperature is lowered, placed in suspended animation, and performed with the support of extracorporeal circulation.
Taken individually, every operation is the most difficult extracardiac operation.
Even Director Tian, who was famous in Qinzhong for being attentive, was still frightened when he saw the situation in front of him.
Three operations are performed in one operation, which is a major operation among major operations.
Director Tian began to worry about Zhou Sheng.
Can he do these surgeries?
Although he had just opened his chest, Zhou Sheng showed some strength.
But compared with these three surgeries, thoracotomy.
That's nothing.
At the same time, Director Tian also began to feel that Dean Cheng was prescient.
He thought that if Zhou Yisheng couldn't bear it anymore, he could go up and help.
Zhou Sheng is of course very clear about the current situation.
Before opening the mediastinum, the system has already given a specific surgical treatment plan.
Bentall surgery, total arch replacement surgery, and right coronary artery bypass surgery are the only options for treating patients.
Bentall surgery, also known as "ascending aorta replacement with aortic valve artificial blood vessel", is a surgical method to treat ascending aortic aneurysm. The surgery requires stopping the heart.
Total arch replacement surgery is one of the most difficult heart surgeries. It relies on the surgeon's superb skills and high-tech materials. It is the largest human body to quickly cut off the upper end of the damaged heart when the whole body is "quickly frozen" at 20 degrees Celsius.
The blood vessel is implanted with a substitute made of polymer polyester material. The purpose is to treat the aortic arch with dissection.
Right coronary artery bypass surgery, as you can tell from the name. This operation is to bridge the blood vessels. The specific method is to use the veins of your own lower limbs as the bypass material. Also under extracorporeal circulation, the heart is stopped and the aorta is connected to the coronary artery.
Bypassing between distal arterial lesions.
These three surgeries are all Level 4 extracardiac surgeries.
In the director's copy last night, Monday was born and these surgeries were performed.
But in the copy, he did not perform three such operations at the same time in one operation.
Zhou Sheng murmured in his heart, good guy, this is enough rhythm once!
This one operation is worth three major surgeries in the dungeon.
Zhou Yisheng estimated that the three surgeries would take less than 7 or 8 hours to complete.
Roll up your sleeves and just say "do"!
Let’s start with bentall surgery.
The right femoral artery is inserted into the donor vessel...
A catheter is inserted into the right atrium...
The patient was connected to an artificial heart-lung machine for bypass. When the body temperature dropped to 26°C, the ascending aorta distal to the lesion was clamped and cardioplegic solution was perfused.
Free the ascending aorta, remove the diseased segment of the ascending aorta, preserve its rear and the openings of the left and right coronary arteries, remove the aortic valve, transplant a valved artificial blood vessel, and then transplant the left and right coronary arteries onto the artificial blood vessel. The artificial blood vessel
Anastomose with the distal end of the ascending aorta.
…
Zhou Sheng worked hard with his head down.
As the first assistant, Bai Mingming couldn't get involved at all.
He had never experienced any extracardiac surgery, so he was no better than Su Quan and Cao Xin.
I can only watch Monday's busy life.
Occasionally do odd jobs.
The surgery was very stressful.
Director Tian originally stood at a side position to watch, but the surgery was too stressful, so in the end he couldn't help but move closer to the second assistant Su Quan.
Su Quan, the second assistant, is basically the same as Cao Xin, just a spectator. In this operation, he has no effect at all.
So when he found Director Tian approaching, he took the initiative to give up his position to Director Tian.
Director Tian nodded towards him and said, "Thank you."
Now that Director Tian was in a good position, he paid more attention to Zhou Sheng's every move.
There are many small details to pay attention to in bentall surgery.
Zhou Sheng handled it very carefully.
Director Tian is an expert at heart and mind. One look at Zhou Shengsheng’s operations and you can tell that Zhou Shengsheng has rich experience and has received guidance from experts.
Yes, Lao He in the system taught me meticulously. If Zhou Yisheng made a mistake, she would deduct points and have to do it again.
So Zhou Yisheng's skills are very solid.
Four hours later, the bentall surgery was completed.
But this is only the first step of the operation.
Next, a full bow replacement is performed.
On Monday, I must cheer up and continue to fight.
After four hours of surgery, even Su Quan, Cao Xin and others who were watching from the side felt a little tired.
Zhou Sheng was also a little tired, but he didn't have time to rest.
In front of my eyes, the aortic arch, which was originally only 3 centimeters in diameter, was now 7 centimeters thick due to the dissection of blood. The blood vessel wall was so thin and transparent that it could rupture at any time.
The operation must be carried out against the clock.
Under doctor's advice on Monday.
Extracorporeal circulation equipment control, blood temperature drops.
The blood temperature slowly began to drop, and finally stabilized at 20 degrees Celsius, which was a full 17 degrees Celsius lower than the normal human body temperature of 37 degrees Celsius.
Extracorporeal circulation was stopped and replacement of the aortic arch was initiated.
In a low temperature state, the human body can be "quickly frozen" for about 40 minutes, but if the time is longer, it will not work.
I have half an hour on Monday to do the replacement work.
Therefore, this one of the most difficult extracardiac surgeries is not only a test of technical skills, but also a test of proficiency.
Zhou Sheng first cut off the damaged aortic arch.
Over there, Bai Mingming immediately handed over a 10cm long "elephant trunk" bracket.
The implantation started on Monday, and then an artificial blood vessel was connected.
This artificial blood vessel is called the artificial aortic arch.
When it is said to be a blood vessel, don't think it is like a water pipe with only two simple ports.
This guy has 8 ports top, bottom, left and right.
Every port must be connected to the major blood vessels and arteries, and all of them are lifelines.
On Monday, I sewed one port in an average of 2 minutes from start to finish, and 8 ports were sewn in one go.
All the vascular interfaces were sutured, but there was not much bleeding.
The 3,000 ml of blood prepared to deal with severe bleeding were not used at all.
Director Tian was filled with praise in his heart.
Increase the temperature and restore blood circulation.
The operating room was quiet except for the sound of Zhou Sheng's operation.
No one to chat with.
Not only because Director Tian was there, but also because the operation was very dangerous. Everyone was afraid of disturbing Zhou Sheng.