Chapter 1831

After opening the aorta, the intima of the aortic arch was torn in pieces.

The true and false lumen was formed by intimal dissection at the opening of three brachial vessels. The transverse tear of intimal in descending arch was more than 2 / 3, and the diameter of false lumen was 3.0 cm.

Most of the intima collapsed at the opening of the true cavity, with a diameter of about 2.0 cm.

"Rich son!" Zheng Ren shouted.

"Well." Professor Rudolph Wagner replied, "shall we start now?"

"Ready, wait a minute."

With that, Zheng Ren reached out and patted an artificial blood vessel with membrane stent in his hand.

Support: 28 mm × 100 mm, the length is appropriate.

Zheng Ren inserted and released the covered stent artificial blood vessel from the true cavity to fully expand the stent.

Then, the left subclavian artery was cut off from the beginning, and the descending aorta was transected at its opening. The proximal suture edge of some covered stent artificial blood vessels was cut off, and the adventitia and intima of the proximal aorta of the descending aorta were sutured and fixed intermittently with the suture edge of covered stent artificial blood vessels.

The artificial blood vessel with the diameter of 30mm of the four branches of datascope interconnected was connected with the proximal cutting edge of descending aorta and covered stent with 3-0 Prolene line

The suture edge of the tube was anastomosed end to end.

Connect the spare arterial perfusion tube with one branch of the four branch artificial blood vessel, slowly inject blood into the descending aorta, block the four branch artificial blood vessel at the proximal end of the side branch, and the descending aorta begins to supply blood.

The perfusion flow was 20ml / (kg · min).

The proximal end of the incision of the left subclavian artery, the left common carotid artery and the innominate artery was anastomosed end-to-end with the corresponding branches of the four artificial blood vessels with 5-0 Prolene line.

The operation began 1 hour and 22 minutes, and the anastomosis of aortic arch was carried out in an orderly manner.

……

……

At this time, in the observation room on the second floor, Dr. Charles sat in his chair and stared at the image on the big screen.

"Doctor, is the operation going well?" Rudy was a little flustered.

The operation went quite smoothly, but the more so, the more flustered he was.

Bentall operation, will it be so smooth?

The operation field is clean and clear, each step is orderly, and the operator's technique is sharp, unlike human beings.

Although things are moving in a good direction, Rudy is more and more frightened.

And it is said that the heart has stopped beating before operation, and there will be no brain death.

"Up to now, it is still a perfect operation. It is accurate like a machine." Dr. Charles said.

His English has an accent, but it doesn't hinder the communication between him and Rudy.

"Doctor, do you think the operation can..." Rudy asked carefully. Things had exceeded his expectations and walked farther and farther on the unpredictable road like a stiff wild dog.

When he picked up Dr. Charles, he knew that the operation had begun. Because of the aggravation of brachiocephalic artery tear and cardiac arrest, the condition can not be delayed.

Rudy almost fainted when he heard the news.

In fact, he didn't believe Zheng Ren, because of the arrival of Dr. Charles, Rudy put his trust on Zheng Ren's side.

"No, I'll go." Dr. Charles said: "I haven't had surgery for many years. The peak of surgery is just once. The picture you see now is the peak of surgery today."

"..." Rudy was stunned.

Dr. Lerner clenched his fists and stood behind Dr. Charles, somewhat angry.

But it's just anger. He can't pick out any problems in the operation process in the picture.

If you are on the operating table, you can only do this.

Of course, this is just Dr. Lerner's own idea. Deep in his heart, Dr. Lerner was sure that he could not reach the level of an operator.

From the initial dissociation to blocking, establishment of cardiopulmonary bypass and incision of aortic arch, each step is clean, simple and lively.

The operation was done quickly, but it was not a simple Biao hand speed. Although it's fast, it's not chaotic. Every step is methodical, like... Dr. Lena knows that it's like doing the operation with the most serious attitude, and the speed is fast forward.

Although he was unconvinced, he could not refute it.

Anastomosis is obviously microsurgical anastomosis with small needle eye, and there are no signs of tear or suspected tear in the endovascular and adventitia.

After each anastomosis, move the blocking forceps to the proximal end of the anastomotic branch of the four branch artificial blood vessels, so that each anastomotic blood vessel can supply blood in time.

Each moving position is very standard, as measured with a ruler.

Is this the peak? Lena was in a trance.

If the patient who has died is rescued, Lena knows that his self-confidence will suffer an unprecedented blow.

"Lena, vascular anastomosis has always been your weakness. I think you can learn a lot from this operation." Dr. Charles suddenly said.

Dr. Lerner was silent.

Although he knew this was the truth, he was still unwilling to admit that his operation was worse than that young man with yellow skin.

If he is facing his teacher, Dr. Charles, Lena can still think that the teacher has not had surgery. Even if his previous level is higher, what's the significance?

But even this nihilistic haze has brought almost unlimited pressure to Dr. Lerner.

That's why he accepted Cleveland's invitation to leave the Mayo Clinic.

This behavior also indirectly led to the Cleveland Clinic ranking higher than the Mayo Clinic in the field of cardiac surgery.

But the operation in front of us is another concept.

Practitioners are younger than themselves. In the era when they should have accumulated experience, practitioners have climbed to such a height. And after that? What kind of an artist he will become.

Lena was in a trance. He felt as if he had just graduated and watched Dr. Charles perform surgery.

Infinite admiration and admiration in my heart.

But he soon woke up and told himself that the operator was the younger operator.

The pressure of youth on Lena is far more than that of Dr. Charles.

Because the performer is younger, his limit is not just here. Because the surgeon is younger, he will rule the field of cardiothoracic surgery for many years.

At the thought of this, Lena felt that her heart had begun to hurt.

Before getting out of Dr. Charles's haze, have you been shrouded in another layer of heavier haze that you can never get rid of?

"Lena, do you remember what I told you that a good surgeon can perform interdisciplinary surgery?" Dr. Charles asked as he watched the operation.

"Teacher, I remember." Lena answered in a trance and clenched his fists. He didn't know when it had been released.

"That's why." Dr. Charles looked at the image on the screen and said: "the purpose of the operation is simple and clear. As long as we understand the anatomical structure, there are no operations that can not be done. But these are rooted in one point - hand feeling."