Entering the operating theater, Zheng Ren saw Xie Yiren and the circulating nurse touching the instruments. Although Xie Yiren did not look at him, he still smiled at her.
He put on his clothes and gloves and went on stage. Hu Yanhui put on his livestream glasses again and the surgery officially began.
Zheng Ren thought to himself that his luck must be better. Then, he reached out and slapped the lancet in his palm.
Only the trunk of the plum tree that had been tattooed was exposed in the surgical field. Zheng Ren chose to open the chest in the middle, slightly deviating from the scar left by the previous surgery, and cut it layer by layer.
He unscrewed the steel wire that had been fixed to the sternum during the previous surgery and removed it.
In the operating theater, only the song of good luck was drifting. No one said anything. The medical team was like a machine. All communication was based on tacit understanding and eye contact.
The buzzing of the electric saw sounded. Bone fragments and blood splattered on the sterile gauze in Su Yun's hand.
Carefully protecting the thymus, Su Yun suddenly asked, "Boss, did the continuous valve disease come from the tattoo?"
"Possibly." "Dr. Satchithananda from Papworth Hospital in Cambridge, England, reported a 28-year-old male patient with congenital bicuspid lobar aortic valve in 2001. He received a tattoo once a month for a total of five years."
"There are many case reports. Why did this child tattoo such a big plum tree on his body?" Lao He asked.
Before the cardiopulmonary bypass started, he still had time to chat a little to relax his nervous nerves. Lao He also felt a little regretful that Boss Zheng did not win the Nobel Prize. However, he was older and did not participate in the whole process, so his sense of frustration was not very strong.
"For the sake of beauty, you don't know how to think about it. If it were a girl, think about how ugly such a big scar on her chest would be. She wouldn't even be able to wear a swimsuit," Su Yun said.
The Friend of Women could look at this problem from a woman's point of view. The tattoo was quite necessary.
Zheng Ren opened the pericardium and checked that there was no adhesion in the pericardial cavity. He left a part of the pericardium for Xie Yiren.
"Glutaraldehyde," Xie Yiren said softly.
The scrub nurse poured glutaraldehyde into the empty basin on the sterile table and soaked the pericardial slice that Zheng Ren had just cut.
Zheng Ren lowered his head and looked at the 'familiar' operating area. He was a little expectant. He hoped that his luck would be better during the surgery!
"Prepare for cardiopulmonary bypass!" Zheng Ren said.
Lao He did not ask his assistant to write the anesthesia record. He would do his best for all of Boss Zheng's surgeries.
Intramuscular injection of pethidine 75mg and scopolamine 0.3mg 30 minutes before surgery.
After entering the ER, the patient was given a mask to inhale oxygen, and the electrocardiogram and pulse oxygen saturation were routinely monitored. Radial artery catheterization was performed to monitor arterial blood pressure. The blood pressure at the ER was 143/74 mmHg. Anesthesia induction included midazolam 3mg, etomidate 20mg, atracurium cis-benzenesulfonate 10mg, sufentanil 150μg.
After intravenous infusion, the trachea was intubated and mechanical ventilation was performed. The tidal volume was set at 500ml and the breathing rate was set at 12 breaths per minute.
Looking at the records on the anesthesia record sheet, Lao He felt that it was impeccable.
He just glanced at it and ruled out any problems. His vision returned to the operating area.
Boss Zheng rarely went on stage now, especially when he rarely called him. But every time he was called to go on stage, the surgery was extremely difficult.
This was his trust in him. Even going all out was not enough, so how could Lao He dare to be distracted?
"Prepare for heparinization," Zheng Ren said in a deep voice.
As soon as he finished speaking, Lao He had already begun to move. Heparinization of the whole body was followed by extracorporeal circulation.
Extracorporeal circulation was established through the ascending aorta and the superior and inferior vena cava respectively. The ascending aorta was blocked and the right superior pulmonary vein was aspirated.
After the establishment of extracorporeal circulation, the next step was the most important part of the surgery — dissociating the aortic valve and stripping the abscess that invaded the heart and aortic wall.
Through the oblique incision at the root of the aorta, the cardioplegia was perfused through the left and right coronary orifices, and the cardiac arrest was satisfactory.
Zheng Ren was fully focused. Zheng Ren reached out and patted the hemostatic forceps in his palm.
The aorta had three valve lobes. A 15x10mm sized neoplasm could be seen in the left coronary valve. Under the left coronary valve and the coronary valve, an abscess formed at the junction of the aortic valve and the mitral valve. There were no neoplasms in the mitral valve.
After 16 '23 ″, Zheng Ren asked the technician outside to bring out the dynamic image of the patient's coronary angiography.
He raised his head and looked at the image. It was the same as the one displayed in the System's operating theater. He recalled that he had just done dozens of hours of surgical training, and all the operations were in his body's memory.
According to the normal surgical procedure, the diseased aortic valve should be removed first. Because it was a second surgery, there was abnormal hyperplasia in the local tissue. In addition, there was a huge abscess. The anatomical structure of the square inch was extremely complicated.
Zheng Ren lowered his head, reached out, and patted the lancet in his palm.
The lancet was cut down, 0.62cm away from the aortic valve. Then, he patted the lancet on the patient's leg. Xie Yiren patted the smallest under-scope forceps in Zheng Ren's palm.
Zheng Ren began to move carefully. Starting from the root of the aortic mechanical valve, he skillfully dissected the heart tissue and 'picked out' the ends and the slightly thicker capillaries.
It was only then that Su Yun understood what Zheng Ren meant by doing coronary angiography.
This method was not non-existent in previous surgeries.
When making a general specimen, the embalming fluid was perfused from the artery, and then an opening was left in the vein to let the excess embalming fluid flow out.
This way, the blood vessels of the cadaver would harden. Then, there would be a skilled anatomy teacher who would dissect the arteries, veins, and even the capillaries would be lifelike.
Of course, it was not easy to make a general specimen like this. The main reason was that it was not easy to find a skilled anatomy teacher.
He did not expect his boss to show off his skills in front of him.
Su Yun was speechless. How could the blood vessels of a normal human be compared to the blood vessels of a cadaver that had been perfused with embalming fluid?
This level of anatomy and surgical technique was so high! That was not all. Su Yun knew that the most difficult thing was to use the instantaneous contrast agent image of the coronary angiography to find the capillaries in the actual anatomical position.
The level of looking at the radiographic films was the same as the level of surgery. They were all f * cking inhuman, Su Yun thought to himself.
"Electrocautery, don't be distracted." Zheng Ren lowered his head and used the forceps to free a capillary under the microscope. He paused for a second and said in a deep voice when he saw that the electrocautery had not come.
Su Yun frowned. He was still a little stunned.
He had also seen the image of the coronary angiography just now. The black contrast agent flashed and disappeared, especially the capillaries at the end. There was only a trace of extremely difficult to see black color that appeared and then disappeared.
The boss knew at a glance? This was too unbelievable.
However, thinking about it was just thinking about it. Su Yun did not delay the surgery. He threw the distracting thoughts and surprise out of his mind. He used the electrocautery to gently touch the hemostatic forceps in Zheng Ren's hand.
A slight popping sound was heard, and a capillary was frozen.
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