Zheng Ren made a mattress suture on the anterior adventitia of the ascending aortic root and inserted the hemostatic device.
Then, the cold cardioplegia infusion needle is exhausted and inserted into the central part of the mattress suture into the ascending aorta.
Tighten the hemostat and secure the cannula and hemostat together with thick wire. Connect the cannula to the perfusion device.
"Boss Zheng? What's the next step?" Lao He asked in advance.
"Left chamber."
"Okay."
As for the next step in surgery, there are two options.
Left atrial drainage or left ventricular drainage.
There are no pros and cons, only suitability. For extracorporeal circulation specialists, left atrial and left ventricular drainage are slightly different, and Lao He was showing off to Boss Zheng with his professional details.
I am definitely more suitable than my twin sisters! Boss Zheng, look at me, look at me!
Look here, look here!
Zheng Ren couldn't hear Lao He's inner cry, but he just felt that the operation was much smoother than doing it alone in the operating room of the system.
He made a large mattress suture at the connection between the root of the right upper pulmonary vein and the left atrium, and applied a hemostatic device.
After making a small incision in the mattress suture coil, insert the left atrial drainage tube into the left atrium, tighten the hemostat, tie it with a thick silk thread, fix the drainage tube and the hemostat together, and connect the drainage tube to the artificial heart-lung machine.
After completing all operations, Zheng Ren checked all the pipes and their connections again to make sure there were no errors. He made sure there were no obstacles in each channel and started extracorporeal circulation.
The moment Lao He started extracorporeal circulation, his hand speed increased wildly.
Although he knew he was firmly in first place, he wanted to leave a number that others could not surpass.
In the past, 912 did not perform many cardiac surgeries, and the surgeons' skills were average, so Lao He had no status in the group.
Although it is a group for chatting and spanking, people with high skills have a certain authority.
People who work in technology have similar common problems. Although it is just a group for chatting and communicating, it is not exempt from vulgarity.
This time he must fight for his words. Lao He glanced at the timer from time to time.
Although there is absolutely no point in arguing about this, it is completely different from the previous heart bypass surgery when the heart was stopped.
But even if extracorporeal circulation withdraws from the stage of history in the future, I can still leave a record in the domestic surgical community... and even in the world's surgical community!
5′05″!
When he saw this number, he felt a little dazed.
The previous record was 9′22″. Boss Zheng’s surgery actually nearly doubled the time to establish extracorporeal circulation!
What the hell, is this something humans do
After Lao He saw the time, he made a fist with his right hand and waved it violently.
Done, this must be a world record!
Although no one recognizes it, in my heart, this is a world record!
After the operation, you can go show off in the group, and now you should concentrate on arranging the stage for Boss Zheng. He who travels a hundred miles is only half a mile, but he must leave a good impression on Boss Zheng.
If you are careless before and after, all your previous efforts will be wasted.
The twin sisters, such a powerful opponent, put a lot of pressure on themselves. Lao He carefully observed the progress of Zheng Ren's surgery from the patient's head.
After several minutes of extracorporeal circulation, Zheng Ren blocked the superior and inferior vena cava and entered complete extracorporeal circulation.
At this time, the blood from the superior and inferior vena cava completely flows into the artificial heart-lung machine through the cannula and does not flow into the right atrium.
At the same time, the blood is cooled.
Lao He kept reporting the blood temperature.
36℃…
35℃…
32℃…
When the whole body temperature dropped to 30°C, Zheng Ren lifted the ascending aorta cuff and used an aortic clamp to block the ascending aorta.
Su Yun immediately infused 4°C cold cardioplegia through the perfusion tube at the aortic root. At the same time, Zhao Yunlong used 4°C ice saline or ice chips to cool the surface of the heart to quickly stop the heart.
Zheng Ren was very satisfied.
It is indeed much faster than the operation in the system operating room.
There are two doctors who are awesome enough to perform type 1 aortic arch replacement surgery as assistants. There is an anesthesiologist like Lao He who can perform anesthesia and extracorporeal circulation. The key is that there is also Xiao Yiren.
Without saying anything else, the little girl smiled with a crooked look on her face, and the fatigue of not sleeping the night before and only catching up on sleep on the plane was gone.
In comparison, the experience in the system's operating room was extremely poor.
After blocking the ascending aorta, Lao He concentrated and began to continuously report various values.
Extracorporeal circulation is quite difficult. If you are not careful, the patient will fall asleep.
"Arterial pressure, 70mmhg."
"Central venous pressure is 9 centimeters of water."
"Body temperature, 27 degrees Celsius."
"Lao He, lower your body temperature a little more." Zheng Ren looked down at the surgical area while communicating with Lao He.
Under normal circumstances, it is enough to maintain the body temperature at about 28 degrees Celsius under extracorporeal circulation.
However, if the surgeon judges that the operation is difficult and the procedure is particularly long, he will ask the extracorporeal bypass specialist to lower the body temperature further.
"How much?" Lao He asked.
"The low temperature is about 15 degrees Celsius." Zheng Ren said.
Lao He was awe-inspiring.
Cardioplepsy solution promotes cardiac arrest, quickly stops all bioelectrical mechanical activities of the heart, and helps preserve the heart's energy reserves.
Supplemented by local deep hypothermia in the heart, it can further reduce the consumption of myocardial energy and oxygen, and reduce the accumulation of harmful substances such as carbon dioxide, hydrogen ions, and oxygen free radicals.
Deep hypothermia means that the operation will take more than 3 hours.
He immediately began to operate the instrument and lower the temperature.
"Myocardial temperature, 15 degrees Celsius." Lao He said.
"enough."
"Flow rate, 50~60ml/kg."
"Lao He, take a look at the blood gas level." Zheng Ren held the blunt scissors in his hand and began to dissociate the pulmonary artery segment, communicating with Lao He.
Talking did not delay Zheng Ren's operation, and the operation was very precise.
After the extracorporeal circulation started operating, the patient's body temperature dropped below 25 degrees Celsius, and the myocardial temperature also dropped to 15 degrees Celsius. Zheng Ren first observed the coronary arteries.
There was no problem with the coronary artery, so Zheng Ren began to free the pulmonary artery.
The pulmonary valve is located between the right ventricle and the pulmonary artery and prevents blood flow from the pulmonary artery from flowing back into the right ventricle.
The heart has two atrioventricular valves and two aortic valves.
The pulmonary valve is one of the aortic valves and has three semilunar valves. The valve leaflets and valve annulus are relatively weak, and the valve annulus is connected to the right ventricular infundibular muscle and has no direct fibrous continuity with the tricuspid valve.
It was time for the main event. Zheng Ren paused briefly, took a deep breath, held his breath and concentrated, and began to cut the pulmonary artery. The location of the junction of the left and right valves.
When he dropped the knife, Zheng Ren was particularly careful, more careful than ever before.
He knew that cutting through the pulmonary artery wall might damage the aorta, and that the location was so deep that it would be difficult to stop the bleeding.
Use the lancet gently, and then use hemostatic forceps to separate layer by layer.
It was still the smallest hemostatic forceps. Zheng Ren couldn't put his fingers in it and had to rely on touch.
Up to this point, he still didn't use a microscope.
At this time, the assistant is relatively free. Su Yun did not speak, but concentrated on watching Zheng Ren separate the pulmonary artery.