Xie Ning looked at his "son-in-law" who didn't know his identity yet and found it very interesting.
The little guy looks a little silly and is honest, but the surgery was really good. At such a young age, he can go to Mayo and Heidelberg for surgery. This is not an ordinary ability.
"Zheng Ren..." Xie Ning just called out, and Zheng Ren's cell phone rang.
Zheng Ren smiled apologetically, his face full of exhaustion, and picked up the phone.
"Fugui, we are going to have dinner, please come with us," Zheng Ren said.
"Huh? Okay, I'll be there soon."
"No, it's faster for me to go by myself. You have someone pick me up at the door. Forget it, you pick me up yourself."
After Zheng Ren finished speaking, he hung up the phone.
"Boss, what's going on?" Su Yun was obviously unhappy. In Su Yun's opinion, this drinking party would cause more or less jokes. This would be the point of making fun of Zheng Ren in the future.
But the luck here is really good. The professor seems to have encountered some difficulties. Su Yun thought with a little regret.
"Fu Gui'er said that there is a thoracic aortic stent that has been inserted into the false cavity." Zheng Ren said.
The regret in Su Yun's heart dissipated, and he couldn't help but shudder.
Aortic dissection is the kind of disease Cui Heming suffered on the plane. As long as it is not type 1, it can be treated through interventional surgery. Type 1 is now possible, but it’s just too difficult and very few people do it.
But when removing the stent, there will be a complication. The stent is not placed in the thoracic aortic trunk. Instead, it enters the middle layer of the blood vessel through the torn opening and opens the false lumen.
In this way, the patient's condition will worsen and death may occur at any time.
This complication is extremely rare, and its occurrence is also due to the doctor's surgical skills. In China, it can be said to be a very serious medical accident.
You have to level it multiple times for this complication to occur!
Zheng Ren cursed in his heart.
Zheng Ren had only read similar reports in magazines about this kind of man-made injury, and he still didn't know how to treat it.
He smiled apologetically and said: "Uncle Ning, you go to eat first, I will perform an operation. If everything goes well, I will be able to go there in an hour."
"Use me?" Su Yun asked solemnly.
As a doctor, when I hear about emergency surgery, I put myself in the situation every time. This is a sense of mission.
"There's a rich man here. I'll go check on the situation. You can chat with Uncle Ning for a while," Zheng Ren said.
"Okay." Su Yun responded.
Although it is a pity, emergency rescue is still important. When he thought about the stent being lowered into the false lumen, which would worsen the condition... the blood flow from the aorta was pouring into the dissection crazily, and now he was afraid that the dissection would tear directly to the tips of his toes.
md, the medical level on Fuguier's side is not that good, Su Yun thought to himself.
Xie Ning felt helpless when he saw that his cheap and capable son-in-law was so busy even in Heidelberg, Germany. But that side was emergency rescue, so it was hard to say anything.
He is quite capable, Xie Ning smiled.
"Dr. Zheng, don't call for a taxi. Take my car." Zou Jiahua said.
"Then I'm welcome." Zheng Ren responded directly.
In fact, he had this idea when he talked to Professor Rudolf Wagner. Zou Jiahua is a human being, so there is no way he doesn't know what he means.
Zheng Ren never thought about whether it would be too ostentatious to perform surgery while sitting in an extended Lincoln.
After another apology to Xie Ning and Zou Jiahua, Zheng Ren turned and left. An attendant next to Zou Jiahua followed and led Zheng Ren to the extended Lincoln.
The car drove smoothly. Zheng Ren sat in the car and entered the system space, preparing for surgical training.
The system operating room rose from the ground. After Zheng Ren entered, he took a look at the film and started the operation directly. The catheter was inserted and once the image was taken, Zheng Ren was stunned when he saw the image.
The proximal end of the stent in the thoracic aorta of the experimental subject was in the thoracic aorta, and the distal end was in the torn false lumen. There was almost no blood flow in the true lumen of the thoracic aorta, and although the false lumen was not as exaggerated as he expected, it was torn directly to the common iliac artery.
This... is too heavy.
The severity of the condition exceeded Zheng Ren's expectation. It was already imminent and the patient could die at any time due to blood vessel rupture.
The outer layer of the thoracic aorta is relatively tough, and the patient was lucky, so there was no rupture or bleeding. The high pressure in the aorta continues to tear the blood vessels open and fills them all the way to the common iliac artery.
The blood vessels here are incomparable to the thoracic aorta in terms of thickness and thickness, and can be torn at any time.
As long as the blood vessel is broken, the patient will definitely die.
Cursing in his mind, Zheng Reng was just about to do it when he was immediately confused.
How to do it
This was an extremely unfamiliar operation, and even Zheng Ren, who was at his peak, began to feel a little confused.
Surgery is not something you just do.
Femoral artery puncture usually involves a built-in guidewire or catheter.
The patient's current situation is to remove the stent, and the true lumen and false lumen of the aorta cannot be operated at the same time.
One guide wire or catheter cannot be used in two places at the same time.
Zheng Ren thought for a while and decided to adopt an operation mode that he had never done before, placing bilateral femoral artery catheters.
It's just that I am the only one in the system operating room...
Sighing, Zheng Ren concentrated on dealing with the current situation. Even if there is only one person, so what
He was a man at the top of his game, so Zheng Ren cheered him up.
Under general anesthesia, the subject's bilateral femoral arteries were exposed and sheaths were inserted. Zheng Ren, regardless of the aseptic operation, knelt on the small operating table and began the operation.
After all, if it were time for actual surgery, the other side could be given to Professor Rudolf Wagner. Zheng Ren still gave strong recognition to the professor's level.
Bilateral femoral arteries were punctured, the right catheter was placed into the true lumen, and the left catheter was placed directly into the false lumen. After inserting the hard guidewire, a 5f, 95cm long wind guide sheath was placed at the level of the celiac trunk for angiography. The results showed that the celiac trunk, superior mesenteric artery and right renal artery supply blood to the true lumen, and the left renal artery and lumbar artery The false cavity supplies blood.
The left sheath was placed at the distal end of the original stent in the false lumen, and a multi-ring snare was inserted. On the right side, the 10f sheath is exchanged through a hard guidewire and placed in the true lumen so that it is 2cm away from the end of the original stent.
After several failed surgeries, Zheng Ren summed up his experience and began to have certain ideas about surgery.
A 5f catheter was inserted through the end of the 10f sheath and placed close to the snare in the false lumen. Follow up the 0.014-inch guidewire, and with the cooperation of the catheter, pass through the endocardial patch between the true and false lumens and enter the snare. The guide wire and catheter are then placed into the original stent.
After exchanging the hard guidewire, the window was continuously balloon-dilated to a diameter of 25 mm, and then a 36 mm wide and 77 mm long tx2 stent was placed, half of which was located within the original stent and the other half of which was located in the true lumen of the abdominal aorta above the celiac trunk.
Angiography showed increased perfusion of splanchnic arteries and renal arteries.
The operation was completed with a completion rate of 88%.