v3 Chapter 2221： The Birth of a King

Cardiac Treatment Center, Sao Paulo Hospital, Brazil.

Dr. Domingo Paul personally retrieved various data for preoperative evaluation.

Just like doing a math problem, left ventricular volume reduction must first calculate the amount of myocardium to be cut through various clinical values.

According to the law: T = 2P × r, that is, the larger the volume and the inner diameter, the higher the liquid tension (P) and the larger the container tension (T).

Batista observed a large number of animal heart specimens and human dilated cardiomyopathy heart specimens and concluded similar conclusions: M = 4.18 × R3, where M is the left ventricular wall tension and R is the left ventricular diameter.

Enlargement of the left ventricle results in a disproportionate increase in left ventricular tension and an increase in oxygen consumption, reducing the efficacy of the left ventricle. He hypothesized that the function of all enlarged hearts was improved after the inner diameter was reduced.

The purpose of left ventricular volume reduction is to reduce the diameter of the left ventricle in order to re-establish a new relationship of left ventricular volume, tension, and diameter.

With the deepening of research, recent research on Frank-Starling mechanism cannot be used to explain end-stage heart failure.

Left ventricular enlargement in advanced cardiomyopathy may be a malignant compensation for myocardial damage, and left ventricular volume reduction may affect the process of this vicious cycle.

Simple mitral valve reconstruction in end-stage cardiomyopathy can also improve cardiac function in some patients. Other concurrent operations such as coronary bypass surgery can also help the recovery of the left heart.

The non-spherical shape after remodeling of the left ventricle makes the left ventricular contraction more coordinated and reduces the distortion of the heart. Other possible factors include changes in blood volume and peripheral vascular tone, and drug adjuvant therapy.

Theoretical research is just theoretical research, and math problems should be done.

Because of the small number of cardiac donors, the study of left ventricular volume reduction in the Cardiac Therapy Center of São Paulo Hospital in Brazil is second to none in the world.

The number of operations per year is also far ahead of other hospitals. Dr. Domingo Paul is one of the best. Since dasBatista initiated left ventricular volume reduction surgery in 1996, he is now a doctor who has performed more such operations.

After huge and complicated calculations and surgical simulations, Dr. Domingo Paul was shocked to find that this patient's surgery was far more complicated than imagined.

Left ventricular volume reduction surgery needs to remove a lot of myocardium. In a sense, the amount of myocardial tissue removed can prove the difficulty of the operation.

Until now, one of the most resected operations had removed 302 g of myocardium.

However, according to his own calculations, the patient in front of him must remove at least 330g of myocardium before the operation can be considered successful.

After careful research by Dr. Domingo Paul, the first idea was to abandon the operation.

But the patient who contacted him on the vaguely expressed that he would change his mind after donating to the heart treatment center if the operation was successful.

Especially after seeing the patient's son and getting a check, Dr. Domingo Paul decided to give it a try.

The patient's condition was very poor, because he flew half an earth and had severe heart failure symptoms. Even with the use of the left ventricular assist system, continued deterioration is inevitable.

On the third day, Johns Hopkins' intensive care team was invited to St. Paul, where Dr. Domingo Paul performed the operation.

The whole operation was extremely difficult. After 11 hours and 22 minutes, the operation was barely ended.

Although the operation was successful, Dr. Domingo Paul finally took a measurement of the left ventricle that was cut-there was 343g!

I have improved the previous record by 41g!

You know, every 10g of resection is a bump, and the difficulty of the operation will increase geometrically.

Because it means that the left ventricular hypertrophy is more severe; the patient's own body is worse; the risk of surgery and perioperative risk is huge.

but!

Anyway, I successfully completed the operation myself.

Dr. Domingo Paul is proud of it.

The patient was sent to the intensive care unit for postoperative treatment and care, and was looked after by a professional team at Johns Hopkins Hospital.

On the third day after the operation, Dr. Domingo Paul was standing outside the transparent isolation room and watching the values ​​displayed on the monitor, and he was satisfied with it.

This is the highest level of integration in the world, whether it is surgery or perioperative management. The best surgeons, the best intensive teams, and the patient's mortality rate has dropped dramatically.

"It looks like the patient will soon recover," Dr. Domingo Paul's assistant said happily.

"Ok."

"Doctor, left ventricular volume reduction surgery, your surgery is fully mature, it is indeed the first person in the world." The assistant said happily.

Dr. Domingo Paul believes his assistant is telling the truth.

Regarding the data and medical records of the surgery, he is compiling the paper and publishing it. This paper was a bomb that shocked the medical community, Domingo thought.

"Doctor, it is estimated that within 20 years, you will keep a record of myocardial tissue removal by left ventricle volume reduction." His assistant continued, "This is your field, no one else can get involved!"

"Hahaha ~" Dr. Domingo Paul smiled happily.

The previous record was maintained by rival Ney Amaral. Surgery time and the like don't explain anything. Surgery is not a race. It can't explain the problem quickly. Www.novelhall.com ~ And the successful cases completed by the two each year are similar. Nye has been pressing Dr. Domingo Paul. One end is because he had a surgery to remove the left ventricle's 302g myocardium.

This is a sound of nature that separates Dr. Ney Amaral from other doctors who perform the same type of surgery.

And this time, Dr. Domingo Paul crossed over and raised this record by 41g!

Domingo believes that this record can be maintained for 20 years, which is still a conservative estimate. It is no exaggeration to say that this record may be sealed on the altar forever.

And Ney ... is no longer the king of left ventricular volume reduction, the crown of the king has fallen on his head.

Do you know how great you are this time, Domingo smiled happily. Leaving the intensive care unit, he happened to meet Ney Amaral.

Domingo Paul walked up with his head up, completely ignoring Ney's presence.

In the past, Ney treated herself this way, and finally she can look down on him! Domingo was extremely happy.

"Doctor, I started collating the materials. The paper was sent to the Lancet or ..." Dr. Domingo Paul's assistant asked for his opinion.

"It's the Lancet." Domingo was in a particularly good mood, and smiled. "Then I'm more interested in the new breakthrough in surgery."

"This paper will definitely change the opinion of the stubborn Yankees on volume reduction." Dr. Domingo Paul's assistant added: "343g! This is an appalling number. It is estimated that the Yankees should Question the authenticity of our surgery. "

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