After the aorta was opened, the intima of the aortic arch was torn in pieces.
The intima at the opening of branch 3 brachiocephalic vessels was peeled off to form a true and false lumen, the intima at the descending part of the arch was torn transversely by more than 2/3, and the diameter of the false lumen was 3.0 cm.
Most of the intima at the opening of the true cavity collapsed, with a diameter of about 2.0 cm.
"Fugui son!" Zheng Ren shouted.
"Okay." Professor Rudolf Wagner responded, "Shall we start now?"
"Get ready, it'll be a while."
After saying that, Zheng Ren reached out and took a stent-coated artificial blood vessel in his hand.
Bracket: 28 mm × 100 mm, the length is quite suitable.
Zheng Ren inserted and released the stent-graft artificial blood vessel from the true lumen to fully expand the stent.
Then the left subclavian artery was cut off from its origin, and the descending aorta was transected at its opening. Part of the proximal suture edge of the covered stent-graft artificial blood vessel was cut off, and the aortic adventitia and intima of the proximal descending aorta were connected with each other. The suture edge of the stent-graft artificial blood vessel is fixed with interrupted sutures.
Use 3-0 proleastervascular four-branch artificial blood vessel with a diameter of 30mm and the proximal resection edge of the descending aorta together with the covered stent artificial blood
The suture edges of the tube are anastomosed end-to-end.
Connect the spare arterial perfusion tube to the side branch of the four-branch artificial blood vessel, slowly inject blood into the descending aorta, block the four-branch artificial blood vessel at the proximal end of the side branch, and the descending aorta begins to supply blood.
The perfusion flow rate is 20ml/(kg·min).
The proximal ends of the incisions of the left subclavian artery, left common carotid artery, and innominate artery were anastomosed end-to-end with the corresponding branches of the four-branch artificial blood vessels using 5-0 prolene sutures.
One hour and 22 minutes into the operation, the anastomosis of the aortic arch was proceeding in an orderly manner.
…
…
At this time, in the observation room on the second floor, Dr. Charles was sitting on a chair, staring intently at the image on the big screen.
"Doctor, did the operation go well?" Rudy felt a little panicked.
The operation went very smoothly, but the more it went like this, the more panicked he became.
Will Bentall surgery go so smoothly
The surgical field is clean and clear, every step is methodical, and the surgeon's skills are so agile that they don't look like humans.
Although things were progressing in a good direction, Rudy became more and more frightened as he watched.
And it is said that the heart has stopped before the operation, so brain death will not occur.
"It's still a perfect surgery, as precise as a machine," Dr. Charles said.
His English is accented, but it does not hinder the communication between him and Rudy.
"Doctor, do you think the surgery can..." Rudy asked cautiously. Things had exceeded his expectations, and he was walking further and further down the unpredictable road like a wild dog that had lost its stiffness.
When he picked up Dr. Charles, he learned that the operation had already begun. Because the brachiocephalic artery tear worsened and was complicated by cardiac arrest, the condition could no longer be delayed.
After learning the news, Rudy almost fainted.
In fact, he didn't trust Zheng Ren either. It was because of the arrival of Dr. Charles that Rudy put his trust on Zheng Ren's side.
"I don't need to go." Dr. Charles said: "I haven't had an operation for many years. The pinnacle of surgery was only in the past. The picture you see now is the pinnacle of surgery today."
"..." Rudy was stunned.
Dr. Reiner clenched his fists and stood behind Dr. Charles, somewhat angry.
But it was just anger. He couldn't find any problem with the operation process in the picture.
If he were on the operating table, he would probably only be able to do this.
Of course, this is just Dr. Reiner's own thoughts. Deep down in his heart, Dr. Reiner was certain that he was not up to the level of a surgeon.
From the initial dissection, to the blockade, establishment of extracorporeal circulation, and incision of the aortic arch, every step is clean, simple and straightforward.
The surgery was done very quickly, but it was not just about speed. Although it is fast, it is not chaotic. Every step is measured, just like... Dr. Reiner knows that it is like he is doing this operation with the most serious attitude, and the speed is doubled.
Although he was unconvinced, he couldn't refute it.
The anastomosis was obviously a microsurgical anastomosis. The needle hole was not large, and there were no signs of tears or suspected tears in the inner and outer membranes of the blood vessels.
Each time an anastomosis is completed, move the blocking clamp to the proximal end of the anastomotic branch of the four-branch artificial blood vessel to ensure timely blood supply to each anastomotic vessel.
Every moving position is very standard, as if measured with a ruler.
Is this the pinnacle? Reiner was in a daze.
If the patient he judged to be dead was rescued, Reiner knew that his self-confidence would suffer an unprecedented blow.
"Reiner, vascular anastomosis has always been your weakness. I think you can learn a lot from this operation." Dr. Charles said suddenly.
Dr. Reiner was silent.
Although he knew this was the truth of the matter, he still refused to admit that his surgery was worse than that of the yellow-skinned young man.
If he was facing his teacher, Dr. Charles, Reiner would still think that the teacher no longer performed surgeries, even if his previous level was higher, but what was the point
But even this haze of nothingness brought almost unlimited pressure to Dr. Reiner.
That's why he accepted Cleveland's invitation to leave the Mayo Clinic.
This behavior also indirectly caused the Cleveland Clinic to surpass the Mayo Clinic in the field of cardiac surgery.
But the operation in front of me was a different concept.
The magician is younger than himself. In the era when he should have accumulated experience, the magician has already climbed to such a high level. What happens next? What kind of magician will he become
Reiner was in a trance. He felt as if he had just graduated and was watching Dr. Charles perform an operation.
I have infinite respect and admiration in my heart.
But he soon woke up and told himself that the person who performed the surgery was the younger surgeon.
The pressure that youth brings to Reiner far exceeds the pressure that Dr. Charles puts on him.
Because the magician is younger, his limit is not just here. Because the surgeon is younger, he will dominate the field of cardiothoracic surgery for many years.
When he thought of this, Reiner felt that his heart was already starting to hurt.
Before I could get out of the haze of Dr. Charles, was I enveloped by another layer of thicker haze that I could never get rid of
"Reiner, do you remember what I told you that a good surgeon can operate across disciplines?" Dr. Charles asked while watching the operation.
"Teacher, I remember." Reiner replied in a daze, his clenched fists loosening at some point.
"That's why." Dr. Charles said while looking at the image on the screen: "The purpose of surgery is simple and clear. As long as you understand the anatomy, there is actually no surgery that cannot be performed. But these are all rooted in one thing - the feel."