Chapter 1447

Zheng Ren made a mattress suture on the anterior adventitia of the ascending aortic root and put it into the hemostat.

Then, the cold cardioplegia solution was perfused into the needle to exhaust the gas, and then inserted into the central part of the mattress suture and into the ascending aorta.

Tighten the hemostat and fix the intubation and hemostat together with thick thread. Connect the cannula to the perfusion device.

"Boss Zheng? What's next?" Lao he asked in advance.

"Left room."

"OK."

There are two options for the next step of surgery.

Left atrial drainage or left ventricular drainage.

There are no advantages and disadvantages, only suitability. For the cardiopulmonary bypass division, the left atrial and left ventricular drainage are slightly different. Lao he is showing off to boss Zheng with his professional details.

I must be more suitable than twin sisters! Boss Zheng, look at me, look at me!

Look here, look here!

Zheng Ren couldn't hear the cry in Lao he's heart. He just felt that the operation was too smooth for him to do alone in the system operating room.

He made a large mattress suture at the connection between the root of the right upper pulmonary vein and the left atrium and put a hemostatic device on it.

After cutting a small opening in the mattress suture ring, insert the left atrial drainage tube into the left atrium, tighten the hemostat, ligate with thick silk thread, fix the drainage tube and the hemostat together, and connect the drainage tube with the artificial cardiopulmonary machine.

After completing all operations, Zheng Ren checked all pipelines and their connections again, found no errors, confirmed that there were no obstacles in each channel, and began cardiopulmonary bypass.

At the moment of starting cardiopulmonary bypass, Lao he soared his hand speed.

Although he knew that he was the first, he wanted to leave a number that others could not surpass.

In the past, there were not many heart operations in 912, and the level of operators was average, so Lao he had no position in the group.

Although it is a group of chatting and farting, people with high level have a certain authority.

Technical people have similar common problems. Although it is only a group for chatting and communication, it is not free from vulgarity.

This time, we must fight for breath. Lao he glances at the timer from time to time.

Although it's meaningless to argue for this tone, it's completely different from the heart bypass surgery that used to stop beating.

However, even if cardiopulmonary bypass exits the historical stage in the future, he has left a record in the domestic surgical industry... And even the surgical industry in the world!

5′05″！

When he saw the number, he was in a trance.

In the past, the highest record was 9 ′ 22 ". Boss Zheng's operation greatly doubled the time for establishing cardiopulmonary bypass!

Really, is this a human thing?

When Lao he saw the time, he clenched his right hand and waved it fiercely.

Yes, it must be a world record!

Although no one recognizes it, in my heart, this is the world record!

Go to show off in the group after the operation. Now you'd better concentrate on matching the platform for boss Zheng. If you travel a hundred miles, you must leave a good impression on boss Zheng.

Don't be careless outside the front, all previous efforts will be wasted.

Twin sister flower, such a powerful opponent, is under great pressure. Lao he carefully observed the process of Zheng Ren's operation from the patient's head.

A few minutes after cardiopulmonary bypass, Zheng Ren blocked the superior and inferior vena cava and entered complete cardiopulmonary bypass.

At this time, the superior and inferior vena cava blood completely flows into the artificial heart lung machine through intubation, and does not flow into the right atrium.

At the same time, the blood is cooled.

Lao he kept reporting the blood temperature.

36℃……

35℃……

32℃……

When the whole body temperature dropped to 30 ℃, Zheng Ren lifted the ascending aorta cuff and blocked the ascending aorta with aortic blocking forceps.

Su Yun immediately perfused 4 ℃ cold cardiac arrest through the perfusion tube at the root of aorta. Zhao Yunlong cooled the heart surface with 4 ℃ ice saline or ice chips at the same time to make the heart stop beating quickly.

Zheng Ren was very satisfied.

It's really much faster than surgery in the system operating room.

There are two doctors who can perform type 1 aortic arch replacement as assistants. There are anesthesiologists like Lao he who can anesthetize and cardiopulmonary bypass. The key is that there are little Iraqis.

Not to mention anything else, the little Iraqi smiled with curved eyebrows and eyes. The fatigue of not sleeping last night and only making up for sleep on the plane was swept away.

In contrast, the experience in the operating room of the system is very poor.

After blocking the ascending aorta, Lao he began to report various values.

Cardiopulmonary bypass is very difficult. If you don't pay attention, the patient won't wake up.

"Arterial pressure, 70mmhg."

"Central venous pressure 9 cm water column."

"Body temperature, 27 degrees Celsius."

"Lao he, lower your temperature." Zheng Ren looked down at the operation area and communicated with Lao he.

Generally, the body temperature under cardiopulmonary bypass can be maintained at about 28 ℃.

However, if the operator judges that the operation is very difficult and the operation process is very long, he will let the cardiopulmonary bypass division lower his temperature again.

"How much?" Lao he asked.

"Deep low temperature, 15 degrees Celsius." Zheng Rendao.

Old he is awe inspiring.

Cardioplegia fluid promotes cardiac arrest, quickly stops all bioelectric and mechanical activities of the heart, and is conducive to preserving cardiac energy reserve.

Supplemented by local deep hypothermia of the heart, it can further reduce the consumption of myocardial energy and oxygen, and reduce the accumulation of harmful substances such as carbon dioxide, hydrogen ions and oxygen free radicals.

Deep hypothermia means that the operation takes more than 3 hours.

He immediately began to operate the instrument to reduce the temperature.

"Myocardial temperature, 15 degrees Celsius." Lao he said.

"Enough."

"Flow, 50 ~ 60ml / kg."

"Lao he, take a look at the blood gas value." Zheng Ren, holding a blunt scissors in his hand, began to free the pulmonary artery segment and communicated with Lao he in his mouth.

Speaking did not delay Zheng Ren's operation, and the operation was quite fine.

After cardiopulmonary bypass started, the patient's body temperature dropped below 25 ° C and the myocardial temperature also dropped to 15 ° C. Zheng Ren first observed the coronary artery.

When the coronary artery was ok, Zheng Ren began to free the pulmonary artery.

The pulmonary valve is located between the right ventricle and the pulmonary artery, which inhibits the blood flow injected into the pulmonary artery from flowing back to the right ventricle.

The heart has two atrioventricular valves and two large arterial valves.

The pulmonary valve belongs to one of the large artery valves, which is a 3-and-a-half-month valve. The leaflet and annulus are relatively weak. The annulus is connected with the right ventricular infundibulum muscle and has no direct fibrous continuity with the tricuspid valve.

When it came to the important play, Zheng Ren took a deep breath, held his breath and began to cut open the pulmonary artery. The position of the junction of the left and right valves.

Zheng Ren was very careful when he dropped the knife. He was more careful than ever before.

He knew that if the pulmonary artery wall was cut through, the aorta might be injured, and the location was very deep and difficult to stop bleeding.

A little bit with a lancet, and then separate layer by layer with hemostatic pliers.

It is still the smallest hemostatic forceps. Zheng Ren's fingers can't reach in, so he can only touch them.

Here, he still didn't use a microscope.

At this point, the assistant is more idle. Su Yun did not speak, but focused on watching Zheng Ren separate the pulmonary artery.