abnabooks Chapter 1035 Chapter 1035 Chest First Battle (Part 1)
Chapter 1035 Chapter 1035 Chest First Battle (Part 1)
The scalpel in Chen Yang's hand accurately cut the left atrial wall along the interatrial groove.
The suction device quickly sucked away the small amount of blood that gushed out, and the "true appearance" of the mitral valve, along with the nightmarish huge calcified ring, was completely revealed before our eyes!
Even the experienced He Yonghua couldn't help but gasp when he saw the valve structure up close, which looked like it was cast in white cement and twisted and deformed.
The calcification not only completely engulfed the valve annulus but also affected portions of the leaflets, causing them to become rigid and deformed. The subvalvular chordae tendineae were stretched, fused, and even partially calcified. The massive calcified mass embedded itself deeply into the myocardium posteriorly and formed a sinister "bone spur" jutting forward, pointing directly at the LVOT passageway.
Many doctors who were watching the operation in the observation room and the doctors who were watching the live broadcast gasped.
"Under such circumstances, the operation is very difficult." Several directors of the hepatobiliary surgery department of the Affiliated Hospital of Shanghai Medical University were watching the live broadcast and talking in low voices.
"Yes, this is the first time I've seen such severe calcification."
At Union Hospital, someone in the cardiothoracic surgery department was also watching the operation.
"Director He gave this part of the operation to Chen Yang. Could it be that Chen Yang's skills are higher than Director He's?"
"Judging from the surgical plan, it is obvious that this surgical plan was not the work of Director He." Someone said.
"Is it Chen Yang?" Someone gasped, a little bit unbelievable.
In the operating room, the operation is in progress.
"TEE confirms the LVOT baseline status again." Chen Yang's voice sounded.
"The diameter of the narrowest part of LVOT is about 5mm, the peak flow rate is 3.5m/s, and the pressure difference is about 50mmHg!" reported Li Li, who is in charge of TEE.
“Severe stenosis!”
"Start carving." Chen Yang's voice was calm.
Chen Yang held out his hand, and the instrument nurse handed him a pen-shaped handle connected to a high-speed rotating drill bit. Meanwhile, another assistant held a flushing tube connected to a continuous flow of ice-cold saline and aimed it at the target area.
At this moment, the hearts of all the spectators were in their throats.
Especially Ichiro Yamamoto of Tokyo Juntendo, with a sneer on his face, waiting to see the disaster caused by "reckless" operations.
Chen Yang's hands were as steady as a rock.
As the drill started, a low humming sound echoed in the silent operating room.
The cooled saline forms a curtain of water that covers the area where the drill bit contacts the calcified tissue.
Chen Yang's movements were extremely gentle and delicate, just like a top-notch micro-carving master treating a rare treasure.
The drill bit touched the top of the hard calcified protrusion, and the fine white powder mixed with saline was quickly sucked away by the suction device.
"One layer... two layers..." Chen Yang was fully focused, all his senses focused on the subtle vibration feedback coming from his fingertips.
Chen Yang felt the changes in the hardness of the calcification and judged the nature of the tissue underneath. He only removed a thin layer at a time and never took any risks.
Chen Yang’s goal was clear: to flatten the “hill” that was pressing on the LVOT while avoiding damage to the myocardium and possible blood vessels below and around it.
Time passed by minute by minute.
The only sounds in the operating room were the hum of the drill, the flow of saline, the suction of the suction machine, and the regular ticking of the monitor.
Everyone's eyes were focused on Chen Yang's steady hands.
"The top of the front protrusion has been basically flattened! The turning bevel is polished." Chen Yang breathed a sigh of relief and said slowly.
"TEE monitoring: The diameter of the narrowest part of LVOT has expanded to 7mm, the peak flow rate has dropped to 2.8m/s, and the pressure difference is about 32mmHg! There is improvement!" Li Li's voice was a little excited.
"Okay! Continue!" He Yonghua stared at the surgical field and said in a deep voice.
Qiu Yunshan in the observation room didn't dare to blink.
Chen Yang's movements became more delicate, and he began to deal with the "slope" area where calcification and relatively normal myocardium meet, which is the place most prone to bleeding.
The drill bit carefully "trims" along the edge, creating a relatively smooth transition zone.
suddenly!
"Attention! Local bleeding is increasing!" Tang Yan exclaimed.
While polishing an area where calcification and the myocardium met deeply, a small blood vessel was ruptured and dark red blood began to seep out.
In the Tokyo Observation Room, Yamamoto Ichiro almost snorted, "Look! What did I say?"
At the same time, the atmosphere in the operating room suddenly became tense!
Faced with the sudden bleeding, Chen Yang's eyes did not show any panic, as if he had already made a plan.
"Focus the suction device! Low-power electrocoagulation pen!" His voice remained steady, and his speaking speed did not even speed up.
Tang Yan immediately aimed the fine suction tip precisely at the bleeding point, sucking away the gushing blood to keep the surgical field clear. The instrument nurse had already handed Chen Yang the electrocoagulation pen, set to the lowest power.
Chen Yang's hands were still as steady as a rock. He temporarily moved the drill away and used the tip of the tweezers to very gently push aside the tissue around the bleeding spot, exposing the tiny bleeding spot.
The tip of the electrocoagulation pen made a faint "sizzling" sound and accurately pointed at the broken end of the bleeding blood vessel.
Zhi…
A tiny wisp of green smoke rose up and the bleeding stopped instantly!
The entire process was quick, accurate, and steady, taking no more than ten seconds! The surgical field was once again clear and clean.
"Bleeding control." Chen Yang spoke slowly, as if he was just brushing away a speck of dust.
He put down the electrocoagulation pen, picked up the drill again, and continued the unfinished carving as if the previous incident had never happened.
"Beautiful!" Professor Muller of the Berlin Heart Center in Germany couldn't help but whisper in admiration: "Precise judgment and operation! Masterful control of the instrument's performance!"
The experts from the Cleveland Clinic also nodded, with recognition in their eyes.
Ichiro Yamamoto from Tokyo looked a little unhappy. He snorted and said nothing more.
The surgery continues.
Like the most patient craftsman, Chen Yang polished the hard calcification bit by bit, layer by layer. The convex part was completely flattened to form a relatively safe platform.
Next, he began to deal with the calcified nodules on the annular plane, with the goal of creating a relatively flat suture "foundation". For the basal calcification deeply embedded in the myocardium, he strictly adhered to the principle of "retaining the thin shell" and only removed the sharpest parts on the surface.
"The annulus plane is preliminarily smoothed." Chen Yang finally put down the drill. The delicate operation, which had lasted nearly an hour, had been a tremendous drain on both his mental and physical strength. Even he had beads of sweat on his forehead.
"TEE reports the latest situation of LVOT!" He Yonghua asked immediately.
"The diameter of the narrowest part of LVOT has expanded to 9mm! The peak flow rate is 2.0m/s, and the pressure difference is about 16mmHg! The obstruction has been basically relieved!" Li Li's voice was filled with excitement.
"Okay!" He Yonghua clenched his fist and looked at Chen Yang with admiration.
In the observation room, Qiu Yunshan was so excited that his eyes were slightly red. One of the toughest bones to chew was chewed down by Chen Yang with a technique that was like an art!
"The next step is valve implantation."
Chen Yang took a deep breath and looked at the instrument table. The instrument nurse had already prepared the selected biological valve with a low valve frame and a trumpet-shaped suture ring.