Chapter 1830 As accurate as a machine
He opened up his sternum, stopped the bleeding quickly, and exposed the operating field. Zheng Ren found that, just as he had expected, the adhesion in the diaphragm was very heavy.
This was the case for the second surgery. After the first surgery, the human body would have fibrous connective tissue hyperplasia and change the normal physiological anatomical structure.
Looking at the mess of tissues inside, Zhao Yunlong had a headache.
The elephant’s nose surgery was the biggest surgery in the cardiothoracic Department, and the second stage of the elephant’s nose surgery …
Difficulty X10!
Zheng Ren stretched out his hand and slapped the hemostatic forceps and blunt scissors on it.
Old he took a glance and felt that it would take at least a few minutes to open the aorta, and boss Zheng was the chief surgeon. If it were someone else, they would need at least 30 to 60 minutes to successfully separate the aortic arch.
He took out the USB drive, quickly found the audio file, and clicked on the song that had been delivered.
A familiar, melodious tune started playing, but Su Yun did not complain this time. It was as if he did not hear that the background music had changed, as he was completely focused on matching Zheng Ren’s movements.
The two hemostatic forceps flew up and down, creating a beautiful sight.
The blunt scissors drifted away, and the sound of the ultrasonic knife rang out.
“Prepare for heminification,” Zheng Ren said in a deep voice as he wandered.
Old he was a little surprised by boss Zheng’s confidence. Heminification did not take a long time. Usually, the surgery would only be carried out after the surgery area was prepared.
Boss Zheng, on the other hand, was confident in his ability to travel. He estimated the time and knew that he would need heminification early in the morning.
Old he started to prepare calmly while paying attention to the progress of the surgery.
After the incision of 3 ′ 12 “, the intact aortic arch appeared in the operating field.
He separated the bow of the patient’s main artery and its branches, and tied them on them separately.
“The heminification process is complete.”
Old he said the moment Zheng Ren was put on.
The timing was just right. Old he knew that it wasn’t because he cooperated well, but because boss Zheng had an extremely accurate assessment of his level.
If the medical team was a machine, he would be a spare part. Boss Zheng had already figured out the level of the patient’s skill and calculated it into the surgery process.
It looked like the cooperation was seamless, but it was actually the embodiment of boss Zheng’s calculation ability. Old he only sighed and did not continue to think about it.
The operation was still going on at high speed, and he could not afford to be distracted.
After undergoing heminification, Zheng Ren inserted the 24F artery catheter 2 – 3 cm into the right clavicar artery. He didn’t dare to insert too deep into this side, because if the tube went too deep, it would enter the nameless artery and seriously affect brain perfusion.
Then, he inserted the second level atrial septal tube, or the superior and inferior vena cava.
“Full – Flow turning point to lower the temperature.”
There was only one person talking in the operating room, and the quiet atmosphere in the operating room proved the difficulty of the operation.
Anaerobic blood was supplied to the whole body from the right inferior collarbone artery through the nameless artery to the aorta, and a reverse infusion tube was blindly inserted through the right atrium into the coronary artery.
“Report the temperature of the patient’s nape.”
“35℃。”
“33℃。”
“30℃。”
“27℃。”
When the temperature of the nasal cavity dropped to 26 – 28 degrees Celsius, the ascending aorta would be blocked, and cold – blooded cardioplegia would be poured in reverse through the coronary artery.
While he continued to lower the temperature, he completed the exploration of the lesion, artificial valve replacement, anastomosis of the coronary artery, and the anastomosis of the coronary artery during coronary artery bypass.
Zheng Ren’s actions were very fast, but the more he investigated, the more Su Yun … Panicked.
Marfan syndrome was a congenital disease. After the ascending aortic valve replacement surgery and the coronary artery transplant surgery two years ago, the patient’s local changes were greater than expected.
The adhesion was very heavy, and this was not even mentioned. There was a faint bubble sign in the middle section of the anastomosed section, which meant that there was a possibility of interlayer.
Did the surgery have to be done along with the bypass surgery?
Even Su Yun was caught off guard by such a situation and felt a headache.
When he saw the situation in the operating area, he raised his eyes and glanced at Zheng Ren.
Zheng Ren did not seem to have any emotional changes as he performed the surgery calmly.
Su Yun felt a little more at ease. With the boss around, there was nothing to be afraid of.
“22℃。”Old he continued to report the temperature.
“20°。”Zheng Ren said.
The values they were talking about were completely different. What old he reported was the temperature of the patient’s nasal cavity, which was the key point to pay attention to in a deep hypothermal hemostasis by heat surgery.
The 20° that Zheng Ren mentioned was the angle where the patient’s head was lowered. After Zheng Ren finished speaking, the three of them stopped the surgery at the same time. Old he started to adjust the angle of the operating table.
His head was facing down at a 20° angle.
Zheng Ren then blocked the nameless artery, the left common carotid artery, and the left subclavical artery in order to reduce the arterial flow to 8 ml/kg/min. He then performed continuous selective brain infusion and opened the ascending aorta blocking forceps to perform the surgery on the arch of the aorta and the bow descent part.
“20℃。”Old he was still concentrating on reporting the temperature.
This temperature was the signal for the general attack.
After old he reported the temperature, Zheng Ren immediately blocked the ascending aorta. The base of the aorta was cold – filled and the heart stopped beating.
“Ice mud,”
The ice paste that he had prepared was delivered to Zheng Ren’s hand.
Zheng Ren tried it first. There was ice and water, and it was four degrees Celsius. There were no large pieces of ice, only small pieces of ice, which could cool the heart as quickly as possible.
For normal heart surgeries, being able to make such perfect ice cream would at least increase the completion rate of the surgery by a few percent.
This was a small detail, but it was an indispensable one.
Zheng Ren was very satisfied. He placed ice mud on the surface of the heart to lower the temperature.
When the temperature of the nasophobia dropped to 18°C, Zheng Ren began to block the three brachiotomy blood vessels at the arch of the main artery. He changed the cardiopulmonary bypass artery infusion rate to 6 ml/kg/min to perform selectively annexing the brain.
He cut open the aortic arch along the long axis and positioned it near the original artificial blood vessel anastomosed area. He positioned it far away from the near end of the left clavicle artery.
Since the heart had stopped beating, the deep hypothermal cardiopulmonary bypass had been established. Hence, when the aortic arch was opened, no blood flowed out.
The aortic arch was clean, and the surgical field was clear.
The purpose of the deep freeze controlled circulatory surgery was precisely for this moment, and at this moment, it seemed almost perfect.
“Pay attention to the amount of blood clots in the brain.” Zheng Ren said in a deep voice as he cut open the aortic arch,””Old he, if you’re not familiar with it, turn the screen 22° so that I can watch it.”
Old he was a little ashamed. This was supposed to be the job of the anesthetist.
However, he was in the middle of a surgery, and he had just come into contact with a new machine. He did not have the time to familiarize himself with it, understand it, and get used to it.
He did not hesitate to do as boss Zheng said. The ultrasound probes were placed on the patient’s necks on both sides so that it would not affect the position of the surgery and the head. The screen was tilted to boss Zheng, and countless numbers were floating on it.
The amount of data was so huge that old he was helpless.
This should be a laboratory product, and it was still in the early stages. There was still a need for a computer to do precise calculations and output the results.
However, there was no final result yet. All he could see was countless data signals appearing on the screen like snowflakes.
Zheng Ren looked up at the color Doppler ultrasound screen from time to time, but his hands did not stop moving.