Entering the operating room, Zheng Ren saw Xie Yiren tapping the instruments with the circulating nurse. Although Xie Yiren didn't look at him, he still smiled at Yiren.
After putting on clothes and gloves and going on stage, Hu Yanhui put the live broadcast glasses on him again, and the operation officially began.
Zheng Ren silently thought to himself that he must have better luck, then he stretched out his hand and patted the lancet in his hand.
Only the trunk of the tattooed plum tree was exposed in the surgical field. Zheng Ren chose to open the chest in the middle, slightly away from the scar left by the previous operation, and cut it layer by layer.
Unscrew and remove the wire that fixed the sternum during a surgery.
In the operating room, only the song of good luck was floating, and no one spoke. The medical team is like a machine, and all communication relies on tacit understanding and eyes.
The buzz of the chainsaw sounded, and bone fragments and blood drops splashed on the sterile gauze in Su Yun's hand.
Carefully protecting his thymus, Su Yun suddenly asked: "Boss, are the continuous valve diseases caused by the tattoo?"
"It's possible." Zheng Ren said while exploring the pericardium: "Dr. DKSatda of Papworth Hospital in Cambridge, UK, reported in 2001 a 28-year-old male patient with congenital bicuspid aortic valve. He received monthly tattoos. Once, for 5 years.”
"There are many case reports. Why does this child have such a big plum tree tattooed on his body?" Lao He said.
The extracorporeal circulation has not started yet, so he still has time to chat a few words to relax his nervous nerves. Lao He also felt a little regretful that Boss Zheng did not win the Nobel Prize. But he was older and didn't participate in the whole process, so he didn't feel very frustrated.
"For the sake of appearance, you, a man, won't think about it. If you change it to a girl, think about how ugly it would be to have such a big scar on the chest. You can't even wear a swimsuit." Su Yundao said.
Friends of women can look at this issue from a female perspective, and tattoos are quite necessary.
Zheng Ren opened the pericardium and found no adhesions in the pericardial cavity. He took out part of the pericardium and gave it to Xie Yi.
"Glutaraldehyde." The Shay man said softly.
The instrument nurse poured glutaraldehyde into the empty basin on the sterile table and soaked the pericardium slice that Zheng Ren had just cut.
Zheng Ren looked down at the "familiar" surgical area with some anticipation in his heart, hoping that his luck would be better during the surgery!
"Prepare for extracorporeal circulation!" Zheng Ren said.
Lao He did not ask his assistant to write anesthesia records. He went all out for all operations involving Boss Zheng.
Inject 75 mg of pethidine and 0.3 mg of scopolamine intramuscularly 30 minutes before surgery.
After entering the room, a mask was used to inhale oxygen, and the electrocardiogram and pulse oxygen saturation were routinely monitored. A radial artery puncture and catheterization was completed to monitor the arterial blood pressure. The blood pressure on entry was 143/74mmHg. During anesthesia induction, 3 mg of midazolam, 20 mg of etomidate, 10 mg of atracurium besylate, and 150 μg of sufentanil were given.
After intravenous injection, the trachea was intubated and mechanical ventilation was performed. The tidal volume was set at 500ml and the respiratory rate was 12 times/min.
Looking at the records on the anesthesia record sheet, Lao He felt that it was impeccable.
After just glancing at it to rule out any problems, his vision returned to the surgical area.
Boss Zheng rarely goes on stage now, especially rarely calls himself. But every time he shouted to go on stage, the operation was extremely difficult.
This is trust in himself. Going all out is not enough. How dare Lao He get distracted.
"Prepare for heparinization." Zheng Ren said in a deep voice.
As soon as he finished speaking, Lao He had already started to take action. Systemic heparinization followed by cardiopulmonary bypass.
Extracorporeal circulation was established through the ascending aorta and superior and inferior vena cava respectively, the ascending aorta was blocked, and suction was performed through the right superior pulmonary vein.
After the extracorporeal circulation is established, the next step is the most important part of the operation - freeing the aortic valve and dissection of the abscess that has invaded the heart and aortic wall.
An oblique incision was made through the aortic root, and cardioplegia solution was instilled through the openings of the left and right coronary arteries until the heart was satisfied with cardiac arrest.
Zheng Ren concentrated on it. Zheng Ren stretched out his hand and took the hemostatic forceps in the palm of his hand.
The aorta has three leaflets during exploration. A 15X10mm vegetation can be seen in the left coronary valve. Under the left coronary valve and non-coronary valve, an abscess is formed at the aortic valve-mitral valve fibrous junction. There is no vegetation on the mitral valve.
16′23″ later, Zheng Ren asked the outside technician to bring up the dynamic image of the patient’s coronary angiography.
Looking up at the image, it was the same as what was displayed in the system operating room. 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 proliferation of local tissues and a huge abscess, making the anatomical structure extremely complicated.
Zheng Ren lowered his head, stretched out his hand, and patted the lancet in his hand.
The knife was cut 0.62cm away from the aortic valve, and then the lancet was patted on the patient's leg. Xie Yiren patted the smallest microscopic forceps into Zheng Ren's palm.
Zheng Ren began to dissect carefully, starting from the root of the aortic mechanical valve, skillfully dissecting the heart tissue, and "picking out" the terminal and slightly thicker capillaries.
Only then did Su Yun understand what Zheng Ren meant by having a coronary angiogram just now.
This method did not exist in previous surgeries.
When making a gross specimen, preservative fluid is poured from the artery, and an opening is left in the vein to allow excess preservative fluid to flow out.
In this way, the average teacher's blood vessels will harden. Then a skilled anatomy teacher dissected the arteries, veins, and even capillaries lifelike.
Of course, it is not easy to produce a rough specimen in this way, mainly because it is difficult to find a skilled anatomy teacher.
Unexpectedly, my boss wanted to demonstrate anatomy and show off his skills in front of his eyes.
Su Yun was speechless. Can normal human blood vessels be compared with the blood vessels of an anatomy teacher filled with antiseptic fluid
This level of anatomy and surgical techniques are sky-high! That's not all. Su Yun knew that the most difficult thing was to use the fleeting contrast agent image of coronary angiography to find the capillaries in the actual anatomical location.
The level of watching movies is the same as the level of surgery. They are both inhuman. Su Yun cursed in his heart.
"Electric heat, don't be distracted." Zheng Ren lowered his head and used pliers to free a capillary under the microscope. After a second's pause, seeing that the electric burner hadn't come on yet, he said in a deep voice.
Su Yun frowned, he was still a little stunned.
I just watched the coronary angiography image myself. The black contrast agent disappeared in a flash, especially the capillaries at the ends. There was only a trace of black that was extremely difficult to see, and then disappeared.
The boss will know at a glance? This is incredible.
But thinking about it, Su Yun did not delay the operation. He put aside his distracting thoughts and surprises and used electric cautery to gently touch the hemostatic forceps in Zheng Ren's hand.
A small popping sound was heard, and a capillary was clogged.