Chapter 1201

Results after the scalpel.

Chen Cang held his breath and gently touched the blood vessel wall with his hand. He wanted to feel the gurgling and flowing of arterial blood pressure and the pressure of the blood vessel wall.

Vaguely, Chen Cang can feel some.

But it's too difficult!

Maybe the whole operation is very difficult.

"Sodium nitroprusside."

"Punerol!"

……

Before the operation, in order to ensure the patient's condition, Chen Cang can only give medicine again.

It is not so much the difficulty of the operation as the challenge of the patients themselves.

Multiple aortic dissection is not 1 + 1 + 1 = 3. Well, it's equivalent to three dissection operations.

The tension and elasticity of the blood vessel wall are limited. When the tension bearing capacity of the blood vessel wall fibers reaches a limit, if one of the operations is performed after blocking, the pressure of other blood vessels will increase a lot!

If you don't pay attention to it a little, it is very likely to cause interlayer rupture during operation and aggravate the condition!

Even let the patient die on the operating table.

Here, the blood transfusion department has completed blood matching and prepared one person's blood according to Chen Cang's requirements.

Nearly 5000 ml of blood has 1000 ml ready for preheating.

Everyone is nervous. This may be the most difficult operation they have ever experienced.

Looking at the thick and even deformed blood vessel walls section by section, although the bulging interlayer is not very obvious, there is an unspeakable strangeness.

From the aortic arch to the thoracic aorta and then to the abdominal aorta.

The first problem was encountered before the operation began!

That's how to start!?

Is the use of traditional, advanced iliac artery replacement? Then complete the abdominal aorta to ensure renal blood flow and will not induce damage to liver and kidney function?

But!

The most critical ascending aorta and thoracic aorta are the difficulties and key points.

Now, once the iliac artery and abdominal aorta are clamped off, the systemic blood reflux is limited, and the change of blood flow directly affects the patient's systemic blood pressure!

Just in case, Chen Cang said just in case!

In case of rupture of the thoracic aorta during replacement of the abdominal aorta and iliac artery.

Who can help you deal with it?

operation!

After all, it's not alone!

A qualified and excellent team can make Chen Cang have no worries.

But at this time, when Chen Cang doesn't have his own excellent team, he needs to consider more clearly, thoroughly and comprehensively!

Even think of any possibility!

So as to make countermeasures.

After thinking about it, Chen Cang decided to perform ascending aortic replacement first!

In this way, is it difficult?

It will certainly be bigger, but it will not cause a series of bangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbangbang!

Of course, it's OK to clamp the ascending aorta hard.

But

If the blood supply to the spinal cord and nervous system is insufficient due to hemostasis, it will lead to ischemia, hypoxia and necrosis of the nervous system.

The patient may indeed survive.

But what's the difference between living and dying?

Looking at Chen Cang, one hand gently touches the blood vessel, the other hand holds the scalpel, but his eyes are staring at the monitor.

Everyone thought Chen Cang was waiting for the effect.

I can't see that Chen Cang is actually anxious.

But Hou Liang and Zhang Peiyi were anxious and noisy, and they were really uneasy.

They really have no bottom in their hearts!

Don't know how to deal with the patient.

I don't even know how to start.

Hou Liang is much more professional than Zhang Peiyi. However, this is the first time Hou Liang has found what is called: the more he knows, the more afraid he is!

It is precisely because he understands the difficulty of this operation that he is more afraid. Even at the beginning of the operation, he has no confidence!

This situation is not unprecedented. He has seen it in many patients with very high mortality.

He looked up at Chen Cang, but it was the first time he saw such calm eyes.

In the face of such a patient, Chen Cang... Isn't he nervous?

At this time!

Chen Cang gave the operation plan!

"Hypothermic circulatory arrest, ascending aortic replacement!"

Anesthesiologist is the director of anesthesiology department. After hearing Chen Cang's words, he nodded and began to work.

This is his first cooperation with Chen Cang!

He hopes it will go better.

Young and promising director Liang Tai quickly began to deal with it in an orderly manner.

Liang Tai's fellow apprentice brother is Zhou He, the director of the emergency center.

Even though Liang Tai has achieved the director level in the provincial people's Hospital, he still respects Zhou he!

He often heard elder martial brother Zhou he say that Chen Cang is powerful.

He remembered a sentence very clearly!

"Professor Chen's operation, don't ask why! Just cooperate fully!"

In the past, he used to think this sentence was a little exaggerated.

But when he saw the operation today, he knew that it was no exaggeration.

Because he has no idea about the operation.

He seems to know how long it took his senior brother to become like this?

When the temperature drops to 30 ℃ of nasopharynx!

Chen Cang took a look at Hou Liang, Zhang Peiyi, anesthesiologist Liang Tai, and every nurse!

Although only one eye, but the eyes are very sharp!

Chen Cang said calmly, "I'm going to block the ascending aorta and have replacement surgery. The whole operation time, I don't want 20 minutes!"

"In these 20 minutes, I hope everyone will go all out and cooperate with me!"

These plain words stopped in everyone's ears, like thunder!

20 minutes?

Complete ascending aorta replacement?

This is crazy!

Moreover, Chen Cang is not only crazy, but also needs each of them to accompany Chen Cang crazy!

Nervous?

nervous!

Is there pressure?

yes!

But looking at the chief surgeon Chen Cang is so determined, we can't help being driven by this momentum!

"Are you ready?"

"Ready!" everyone nodded in unison!

As soon as the voice fell, Chen Cang directly took the hemostatic forceps and decisively blocked the ascending aorta 3.0cm away from the beginning of the innominate artery!

This distance is very important!

No more, no less, just played a key role in the operation!

Low temperature for 20 minutes!

Circulatory arrest injury will not be obvious.

Even many operations require hypothermic circulatory arrest for 40 minutes.

Chen Cang squeezed the time within 20 minutes to ensure the key of operation and the need of follow-up operation!

At this time, Chen Cang quickly said to Hou Liang: "cardiac arrest fluid! Prepare for injection!"

Hou Liang nodded quickly and began to prepare.

After Chen Cang said that, without any pause, he directly picked up the scalpel to cut the artery dissection through the left and right coronary arteries!

Operation time is limited!

Chen Cang can't waste his time on these jobs!

Because the next anastomosis is the top priority of the operation!

At this moment, the director of the imaging department and the director of the blood transfusion department... Everyone stood around and couldn't help getting excited when watching this scene!