Chapter 2461

Entering the operating room, Zheng Ren sees Xie Yi and the itinerant nurse light the instruments. Although Xie Yi didn't look at himself, he still left a smiling face at Yi.

Wearing clothes and gloves on the stage, Hu Yanhui put on live glasses again, and the operation officially began.

Zheng Ren thought silently that he must have better luck. Then he stretched out his hand and patted the lancet in the palm of his hand.

Only the trunk of the tattooed plum tree is exposed in the operation field. Zheng Ren chooses to open his chest in the middle, slightly deviate from the scar left by the last operation, and cut it layer by layer.

Unscrew and remove the steel wire used to fix the sternum in an operation.

In the operating room, only the song of good luck was floating, and no one spoke. The medical team is like a machine. All communication depends on tacit understanding and eyes.

The electric saw buzzed, and white bone debris and blood droplets splashed on the sterile gauze in Su Yun's hand.

Be careful to protect the thymus. Su Yun suddenly asked, "boss, is the continuous valve disease from tattoos?"

"It's possible." Zheng Ren explored the pericardium and said, "Dr. D.K. satchithananda of papworth hospital in Cambridge, UK reported a 28 year old male patient with congenital bicuspid aortic valve in 2001. He received tattoo once a month for five years."

"There are many case reports. The child has nothing to do with tattooing such a big plum tree on his body." Lao he said.

Before cardiopulmonary bypass, he still had time to chat and relax his nervous nerves. Lao he also has some regrets that boss Zheng didn't get the Nobel Prize. But he was older and didn't participate in the whole process, so he didn't feel very frustrated.

"In order to be beautiful, an old man won't think about it. For a girl, think about how ugly such a big scar is on the chest. You can't wear a swimsuit." Su yundao.

Friends of women can look at this issue from a female perspective, and tattoos are quite necessary.

Zheng Ren opened the pericardium and found no adhesion in the pericardial cavity. He left part of the pericardium to Xie Yi.

"Glutaraldehyde." The Shay whispered.

The instrument nurse poured glutaraldehyde into an empty basin on the sterile table and soaked the pericardial tablets just cut by Zheng Ren.

Zheng Ren looked down at the "familiar" operation area and looked forward to it. He hoped that the luck of the operation would be better!

"Prepare for cardiopulmonary bypass!" Zheng Rendao.

Lao he didn't ask his assistant to write the anesthesia record. He went all out about all the operations of boss Zheng.

Pethidine 75 mg and scopolamine 0.3 mg were injected intramuscularly 30 min before operation.

After entering the room, the mask was given for oxygen inhalation, the ECG and pulse oxygen saturation were routinely monitored, and the radial artery puncture and catheterization were completed to monitor the arterial blood pressure. The entering blood pressure was 143 / 74mmhg. Anesthesia induction was given midazolam 3mg, etomidate 20mg, atracurium CIS benzenesulfonate 10mg and sufentanil 150 μ g。

After intravenous injection, endotracheal intubation, mechanical ventilation, set tidal volume of 500ml and respiratory rate of 12 times / min.

Looking at the records on the anesthesia record sheet, Lao he felt impeccable.

He just glanced and ruled out any problems, and his vision returned to the operation area again.

Boss Zheng seldom goes on stage now, especially rarely calls himself. But whenever he shouted himself on stage, the operation was very difficult.

This is his trust. It's not enough to go all out. How dare Lao he be distracted.

"Prepare heparinization." Zheng Ren said in a deep voice.

As soon as the voice fell, Lao he began to take action. Systemic heparinization followed by cardiopulmonary bypass.

Cardiopulmonary bypass was established by intubation through the ascending aorta and superior and inferior vena cava, blocking the ascending aorta and attracting through the right upper pulmonary vein.

After the establishment of cardiopulmonary bypass, the most important part of the operation is to free the aortic valve and peel off the abscess invading the heart and aortic wall.

Through the oblique incision of aortic root and the opening of left and right coronary arteries, cardioplegia was satisfactory.

Zheng Ren was absorbed. Zheng Ren stretched out his hand and clapped the hemostatic forceps in the palm of his hand.

There are three valve lobes in the explored aorta. A 15x10mm vegetation can be seen in the left coronal valve. Under the left coronal valve and non coronal valve, an abscess is formed at the fiber junction of aortic valve and mitral valve. There is no vegetation in the mitral valve.

After 16 ′ 23 ″, Zheng Ren asked an outside technician to tune out the dynamic images of the patient's coronary angiography.

Looking up at the image, as shown in the system operating room, he recalled that he had just done dozens of hours of surgical training, and all operations were in his body's memory.

According to the normal procedure, the diseased aortic valve should be removed first. Because it is a secondary operation, the local tissue has abnormal hyperplasia, coupled with a huge abscess, the anatomical structure between square inches is extremely complex.

Zheng Ren lowered his head, stretched out his hand and clapped the lancet in the palm of his hand.

Cut it all at once, 0.62cm away from the aortic valve, then pat the lancet on the patient's leg, and Xie Ren patted the smallest pliers under the microscope in Zheng Ren's hand.

Zheng Ren began to free carefully. Starting from the root of the aortic mechanical valve, he skillfully dissected the visceral tissue, and "picked out" the terminals and slightly thicker capillaries.

Su Yun didn't understand what Zheng Rengang was going to do coronary angiography until this time.

This method does not exist in previous operations.

When making a gross specimen, the antiseptic solution is poured from the artery, and then a hole is left in the vein to allow the excess antiseptic solution to flow out.

In this way, the teacher's blood vessels will harden. Then a skilled anatomy teacher dissected the arteries and veins, and even the capillaries.

Of course, it is not easy to make such a gross specimen, mainly because it is difficult to find skilled anatomy teachers.

I didn't expect my boss to show his anatomy and skills in front of me.

Su Yun is speechless. Can normal human blood vessels be compared with those filled with antiseptic liquid!

This anatomical level and surgical technique are as high as the sky! This is not all. Su Yun knows that the most difficult thing is to use the fleeting contrast medium image of coronary angiography to find the capillaries in the actual anatomical position.

The level of watching the film is the same as that of surgery. Du is not human. Su Yun said something in his heart.

"Electric fire, don't be distracted." Zheng Ren lowered his head and separated a capillary with pliers under the microscope. After pausing for a second, he said in a deep voice when he saw that the electric burn had not come yet.

Su Yun frowned, and his mood was still a little stunned.

I just saw the coronary angiography image myself. The black contrast medium flashed away, especially the capillaries at the end. There was only a trace of black that was very difficult to see, and then disappeared.

The boss knows at a glance? This is incredible.

But thinking about it, Su Yun didn't delay the operation. He threw away his thoughts and surprise and gently touched Zheng Ren's hemostatic forceps with an electric fire.

A tiny sound came, and a capillary was coagulated.