Chapter 706

Nearly 60 kilometers of expressway is a severe test for several people on the car!

The alarm sound of the monitor keeps ringing.

Chen Cang's clothes were soaked with sweat, and Kobayashi's hair was also wet. The whole person was sweating, trying to rescue!

In such a cold winter, the car is full of warmth!

The man didn't dare to say anything for fear of disturbing them.

However, fortunately, the rescue was effective after all. When getting off the highway, the old man's vital signs finally stabilized.

This time, everyone was relieved.

However, Chen Cang began to contact the emergency department of the second provincial hospital to open the green channel, improve relevant examinations and prepare for surgery as soon as possible!

The elderly have completed various physical and chemical tests in township health centers, which is good news. There is no need to delay too much time.

At eight o'clock in the evening, the car stopped at the door of the emergency department of the second provincial hospital, and the party hurried out to get ready.

After Chen Cang entered the door, he quickly began to organize the medical orders in an orderly manner!

"Lele, you take your family to go through the formalities first."

"Xiaoyan, prepare the condition notification."

"Brother Qian, go to the operating room with Wenfu and get ready..."

"Kobayashi, call the color Doppler ultrasound room, bedside cardiac ultrasound!"

……

After Chen Cang came, he first sent the patient to the emergency room.

At this time, Tao MI and Xia Gaofeng suddenly came down. Chen Cang was stunned: "director Tao? Director Xia, why are you here?"

Tao Mi frowned: "we just had an operation in the first hospital of Dongda. Director Li told us that you picked up a patient with ventricular septal rupture caused by acute myocardial infarction from the outside. Let's come and see if we need help. He's in the operation and doesn't care. We'll come and have a look."

Chen Cang nodded gratefully without delay and said directly, "please two directors. The situation is like this. The patient is 71 years old, an elderly woman, seven days ago..."

After Chen Cang explained the disease in detail.

Tao Mi said directly, "Xiao Chen, I suggest that it is better to observe the acute injury of ventricular septal rupture for a period of time and then choose an operation!"

Xia Gaofeng nodded: "well, that's why director Tao and I came here. We're afraid you're young and anxious for surgery."

"This is the acute stage. It is not only difficult to operate, but also will significantly increase the risk and mortality of operation. Moreover, the patient is an elderly woman, 71 years old, with a history of heart disease and acute myocardial infarction seven days ago."

"For such patients, it's too difficult for you to have an operation now. I suggest that you have an elective operation when the scar tissue at the edge of the breach is formed. Now go to the cardiology department and be hospitalized."

Chen Cang was silent. The two directors were right and reasonable.

At this time, Li Baoshan called Niu Tianfu, director of Cardiology.

Four directors went to the emergency room and began to discuss the patients.

This time is not a reckless time at all. Chen Cang is not stupid. It is the most important to formulate the most appropriate rescue plan, not impulsive surgery.

Surgical treatment is only a way, and before surgery, it is best for patients to have a preparation that can provide a safe environment for surgery.

Soon the color Doppler ultrasound results came out, and Chen Cang also finished the CT of the heart with him.

In the rescue room, after reading the patient's heart function, Tao Mi said directly: "the current heart function is OK, and the ejection fraction can meet daily consumption. I suggest stabilizing first, not surgery."

Niu Tianfu shook his head directly: "director Tao, you see, the risk of acute myocardial infarction is very high, whether it is interventional surgery or thrombolysis. At that time, if the ventricular septum ruptures, the cardiac function will only be worse and worse."

"According to the old lady's situation, it won't last for a few days. Where can I afford it!"

Tao Mi immediately argued with Niu Tianfu!

"Your cardiology department can't maintain this situation. Our cardiac surgery will only have risks!"

Niu Tianfu directly said: "the patient is a ruptured ventricular dilator caused by acute myocardial infarction! Once it occurs, it can lead to intractable heart failure, serious arrhythmia and peripheral arterial embolism. The prognosis is very poor. How do you treat it?"

Xia Gaofeng and Chen Cang are silent. They listen patiently and argue. Sometimes, the answer will appear in the quarrel!

Research shows that when humans argue, their brains react several times as much as usual!

Especially when boyfriend and girlfriend quarrel, women often play better!

Seeing the two people arguing for a long time, Xia Gaofeng concluded and suddenly said: "in fact, it is not impossible to operate. The patient has been treated with cardiotonic diuresis. At this time, the cardiac function is OK. If the preoperative intravenous infusion of dopamine positive inotropic drugs is used to maintain the blood pressure, so as to ensure coronary artery perfusion, it is not impossible."

"However, director Tao is right. The operation risk is really great."

"Now there are risks on both sides. I think we should fully respect the opinions of the patient's family members!"

At this time, Tao Mi calmed down, looked at Niu Tianfu, nodded, and said to Chen Cang, "Xiao Chen, go tell the patient and let him make a decision."

Chen Cang nodded.

These old directors are national treasures. With them, it's like a ship has a route!

All risks and countermeasures can be stated in advance, and the situation can be guaranteed even in case of problems.

This is to avoid and reduce the risk of surgery.

After some discussion, the old lady's son had already prepared for a desperate fight and signed for the operation!

Chen Cang gets up, while Tao MI and Xia Gaofeng look at each other: "I'll go too!"

Niu Tianfu obviously did the dishes at home. He didn't take off his apron. He took it off and put it in the nurse station: "I'll go too!"

Chen Cang couldn't help nodding gratefully.

Tao Mi told Chen Cang: "Xiao Chen, we can only remind you that you still have to do the operation. Now the patient has ventricular septal rupture and myocardial infarction. You must remember not to damage the coronary artery and the incision must be small! You must avoid affecting the left ventricular function!"

Tao Mi keeps telling me

Chen Cang nodded gratefully.

Because of the old lady's own reasons and the existence of complications, this operation increases the risk and complexity of the operation, so that the difficulty increases again and again, and the risk coefficient also increases in proportion.

Chen Cang has no bottom in his heart!

Maybe that's what surgery should be like?

This is full of risk and uncertainty!

No one can control life and death. All he can do is go all out.

Even Tao MI and Xia Gaofeng can't guarantee the success of the operation!

……

……

At the beginning of the operation, the hypothermic cardiopulmonary bypass machine operated and the heart officially stopped working.

After thoracotomy, looking at this aging heart, Chen cangmei's heart was tight!

Extensive anterior wall infarction, now you can see the color change of the heart!

Chen Cang had no choice but to carefully judge the opening and scope of the operation.

Try not to damage the ventricle.

The heart is old, bruised, ischemic and hypoxic, and the left ventricle is the heart muscle that pumps blood. If he is injured again, the old man will be gone!

Chen Cang knows the difficulty.

At this time, we must determine the scope and degree of myocardial injury and observe whether there are other injuries.

Chen Cang held his heart in his hand and explored the site of ventricular septal rupture from the left ventricular surface.

Try to find a suitable opening point for surgery!

The patient is a ruptured ventricular dilator caused by acute myocardial infarction. The effect of surgical treatment is better than that of conservative treatment, which is also the reason why Chen Cang made up his mind to operate.

Everyone around is staring at the heart. Now we need to find the most suitable opening point for surgery!

Chen Cang kept thinking in his mind and touched his heart for a long time. Finally!

He found a place where the right ventricular surface meets the atrium, where the coronary artery can be avoided, and most importantly, the damage to the left ventricular wall is minimal.

Chen Cang thought of this, took the scalpel directly and opened his mouth!

And Tao Mi suddenly frowned!

"Xiao Chen, is this position... Good for the needle?"

Xia Gaofeng also frowned: "yes... There is little damage and side effects here. Yes, but it's not easy to operate!"

Chen Cang nodded: "try it!"

Thinking of this, Chen Cang made an intermittent mattress suture with a double needle noninvasive suture with a small gasket through the edge tissue of the vital ventricular septal defect!

This process needs to be very careful not to damage the broken heart.

Chen Cang did not dare to shake his hands. His right hand was hard to start, so he had to pick up his left hand!

The directors who looked at me suddenly stared!

left hand???

The needle holder inserted the needle from the right ventricular surface, first sutured the ventricular septal defect and the posterior edge of the patch, and the patch was sutured and ligated on the left ventricular surface.

This process is all done under the left hand.

Although it seems clumsy, we can imagine the difficulties.

The left hand operation itself is unstable, and in this way, it will increase the risk of surgery. Once the operation is improper, the gain will outweigh the loss!

So Chen Cang himself is cautious.

The whole process, watching a few people thrilling!

Even the nurse Yuanyuan frowned a little. Is her left hand... So powerful?

Intermittent mattress suture with small gasket was used on the right side of the anterior descending coronary artery, then through the right ventricular wall and through the front edge of the ventricular septal defect patch, and then through the left edge of the left ventricular incision.

Because of the opening, it must be divided under the operation of the left hand.

Every drop of sweat on Chen Cang's head is not left. He is wet through his hat and mask, and the atmosphere dare not take a bite!

The right hand stands up in the air and dare not move any more for fear of damaging innocent myocardium!

Time goes by like this.

Chen Cang feels that today's consumption is more than two or three times that of the past!

Finally, when the suture was ligated, the ventricular septal defect and left ventricular incision were completely closed.

Everyone is relieved!

Chen Cang can't wait at this time.

Stop bleeding thoroughly, wash pericardial cavity, stop cardiopulmonary bypass after cardiac resuscitation, and observe the effect!

At this time, everyone stared at the data on the ECG monitor and waited for the successful signal.

Anesthesiologist Liu Jian said: "vital signs are completely normal!"

At this moment, everyone's tight heart was loosened.

it's too hard!

This moment is really too difficult.

Chen Cang himself felt that it was really not easy.

Liu Jian couldn't help but thumbs up to Chen Cang: "director Chen, the older and the better! He is more and more like a director!"

Several directors around also smiled and nodded happily.

They watched Chen Cang grow up.

It's just... This speed is a bit like fast forward X4! Not the normal growth rate.

But... Genius is different from ordinary people!

No one else can intervene in this operation, because once the left ventricular wall is damaged, the consequences are very serious, and if the coronary artery is damaged, it will be more troublesome!

Therefore, Chen Cang can only go alone for thousands of miles!

The moment the operation was successful.

Everyone laughed!

They found that the young man was more and more like a director.

However, they all have a problem in their mind now.

When washing his hands, Tao Mi couldn't help asking, "Xiao Chen... Is your left hand so powerful?"

Xia Gaofeng nodded: "yes! I think your left hand is very stable. Have you practiced it?"

Chen Cang thought for a moment, thought of his young foreign female teachers who trained his left and right hands, and nodded: "well, often."

After several directors heard it, they suddenly realized it.

Sure enough, success is no accident!

How much effort did they make?

The eyes of people looking at Chen Cang at this moment were full of appreciation.

This young man is too strict with himself!

……

……

PS: Thank you for the 10000 reward from "Mo Chen Sui" and "Xiao Lei 1028". Thank you.

It was half written and ready to upload, but I decided to finish the operation. It looked comfortable. I wrote nearly two chapters at once.

In addition, it's the middle of the month. Please ask for the monthly ticket. The great gods behind us are starting to work hard, and we have to increase the price.

So, ask for a monthly ticket! Ask for a monthly ticket! Ask for a monthly ticket!