For Domingo Paulo, the sun is no longer shining brightly on this day.
Having just become the king of cardiac surgery, he had not yet had time to cause an uproar in the academic world and crown his crown before he had to face the challenge of another surgeon whose level was no less than his.
It’s just that Domingo Paulo is more curious than worried.
In his opinion, interventional surgery is simply impossible to complete the treatment of dilated cardiomyopathy.
He began to read the video materials left by the surgeons in the live broadcast room, and saw that various surgeries were performed wonderfully.
Although the percentage of surgeries related to cardiothoracic surgery is not high, facts have proven that whether the surgeons in the live surgery room are one person or a team, their level is extremely high.
If Batista surgery is performed, Domingo Paul feels that the other party has the possibility of success. But interventional surgery for advanced dilated cardiomyopathy...
Regarding this technique, Domingo Paulo has never figured out how to do it.
It was getting late, and he didn't even have the appetite for dinner. The flame of curiosity in his heart had ignited his whole person.
There was a laptop in front of him, and he had read the patient information countless times. The patient's condition was extremely serious, and Domingo Paul estimated that at least 400g of myocardium would have to be removed if Batista surgery was performed.
This is a restricted area for surgery, and the mortality rate of 20% has soared to almost 100%.
If he had the choice, he would definitely refuse surgery on this patient. No matter how much money the patient’s family donates to their medical center, they will not hesitate to refuse to do this kind of surgery with a 100% mortality rate!
After all, no one wants the patient who has worked so hard to undergo surgery not only to not be able to prolong his life, but to die in the dangerous period after surgery.
What should the surgeon do in the live surgery room? This question has been lingering in Domingo Paul's mind.
After thinking about it countless times, he finally concluded that this was an impossible technique.
Interventional surgery is used in the heart, mainly to open coronary blood vessels, seal valve insufficiency, and open stenotic valves.
There is an inherent logic to these operations. Interventional surgery is a surgical procedure that does not cause major trauma.
However, in advanced dilated cardiomyopathy, a large amount of dilated and hyperplastic myocardium needs to be removed. Logically speaking, interventional surgery is not suitable at all.
He refused all clerical activities and did not go home. Instead, he quietly waited for the operation to begin.
Time passed by minute by second, and at 21:50, the screen in the surgery live broadcast room lit up.
The double-skilled field appeared in front of Domingo Paul.
According to the previous brief introduction, Domingo Paul knew that the operation was performed by DSA-guided interventional surgery combined with a small thoracotomy incision.
The two skill fields were expected.
Although he believed that interventional surgery could not accomplish everything that Batista's surgery could accomplish, he always had a bad feeling in his heart.
Not for anything else, just because this is a live surgery!
If the surgeon is not completely sure, who would dare to perform an operation that is destined to "fail" in front of colleagues all over the world!
Domingo Paulo sent all his assistants home and stayed in his studio. In the quiet night, he seemed to be able to hear his own heartbeat.
With a few minutes to go before the operation began, Domingo Paul stood up and made a cup of coffee.
Back in front of the computer, a number came into view.
The number of people entering the live broadcast room has exceeded six figures, which means that more than 100,000 doctors around the world are watching this operation.
And as time approaches, this number continues to skyrocket.
The numbers were refreshing almost every second. This was the most surgeries Domingo Paul had ever seen at the same time in his memory.
It seems that everyone is very interested in the new interventional surgery method.
Domingo Paul watched quietly. For him, this was a wanton challenge, a challenge to his dignity as a king.
The time finally came to 22 o'clock and the operation began.
The first surgical field has not been moved, and the second surgical field is undergoing thoracotomy first.
A small incision of about 6cm was made on the left chest. A sharp scalpel cut open the skin, and blood slowly flowed out, making the whole picture look more textured. At this moment, Domingo Paul seemed to smell the smell of blood.
The scalpel is not standard. Every time he sees the beautifully curved lancet, Domingo Paul feels a little envious.
Such a blade costs $233, and it is not ready to use. This kind of blade needs to be customized.
What a luxurious magician, Domingo Paul thought secretly in his heart.
As soon as the blood gushes out, the gauze in the assistant's hand falls on it. Dip it in blood, wipe it clean, click the electric burner a few times, and the hemostatic forceps begin to bluntly separate the subcutaneous tissue and muscles.
Just looking at the open chest, everything is perfect.
The pleura was opened, the surgical field was expanded, and one-lung ventilation was performed.
At the same time, the first surgical field lit up. While the mediastinum was surgically incised and the heart was exposed, a guidewire entered from the jugular vein into the superior vena cava, then reached the right atrium, and entered the right ventricle through the tricuspid valve. .
Domingo Paul From the perspective of the artist, a huge heart appears before his eyes. Because the incision is relatively small, the entire heart cannot be seen.
Domingo Paul immediately inserted himself into the operation. If he had been in his shoes, he would have started preparing for extracorporeal circulation by now.
At this time, the guidewire in the first surgical field had reached the part of the right ventricle close to the interventricular septum.
The Gaiding tube with a J-shaped curvature is attached to the ventricular septum. The interventional surgeon then places a fixed anchor point and immediately starts puncture.
What do they want to do? Domingo Paul was stunned.
On the DSA-guided screen, you can clearly see the huge left ventricle beating hard. The puncture needle has passed through the interventricular septum and entered the left ventricular cavity.
Because of dilated cardiomyopathy, the patient's left ventricular cavity is extremely large.
How childish, Domingo Paulo thought to himself.
It seems that the surgeon wants to use the puncture needle to penetrate the entire left ventricle, but Domingo Paul has no idea how to do it.
But at this step, he judged that the possibility of success was extremely low.
Because it needs to be punctured into the J-shaped tube, the puncture needle has strong elasticity and is not a straight, hard steel needle.
Although the patient has dilated cardiomyopathy and a reduced ejection fraction, the blood flow in the left ventricle is still extremely fast as the heart beats.
Under the impact of high-speed blood flow, it is absolutely impossible for the tough puncture needle to maintain a straight line and reach the location where the surgeon wants to reach.
Domingo Paul really doesn’t know what the magician is thinking!
Although he didn't understand what the surgeon meant, from this step alone, he had to at least establish extracorporeal circulation and stop the heart from beating, so that the puncture would be successful.
But what the magician did was simply too childish!