Chapter 1062 1063 The Level of Community Hospitals, Really Time

Xie Ning looked at himself as a "son-in-law" who didn't know his identity, and found it very interesting.

The little guy looked a little silly and honest, but the operation was really good. At such a young age, being able to go to Mayo and Heidelberg for surgery is not an ordinary ability.

"Zheng Ren..." Xie Ning just called when Zheng Ren's cell phone rang.

Zheng Ren smiled apologetically, his face full of exhaustion, and picked up the phone.

"Fugui'er, we are going to dinner, come with you." Zheng Ren said.

"Huh? Okay, I'll be there soon."

"No, I'll go faster by myself. You have someone pick me up at the door. Forget it, you pick me up yourself."

After Zheng Ren finished speaking, he hung up the phone.

"Boss, what's the matter?" Su Yun was obviously a little unhappy. In Su Yun's opinion, there will be some jokes about this wine party. This is the point of laughing at Zheng Ren in the future.

But this cargo is really good, the professor seems to have encountered some problems. Su Yun thought, a little regretful.

"Fu Gui'er said that there was a thoracic aortic stent that went down into the false cavity." Zheng Ren said.

The regret in Su Yun's heart dissipated, and he couldn't help but sigh.

Aortic dissection is the kind of disease that Cui Heming had on the plane. As long as it is not type 1, it can be treated by interventional surgery. Now type 1 is also possible, but the difficulty is too high, and few people do it.

However, when the stent is placed, there will be a complication-the stent is not placed in the thoracic aortic trunk, but enters the middle layer of the blood vessel through the torn opening to open the false lumen.

This will lead to aggravation of the patient's condition and death at any time.

This kind of complication is extremely rare, and it occurs because of the doctor's level of surgery. In China, it can be said to be a very serious medical malpractice.

The level has to be many times for this complication to appear!

Zheng Ren sneered in his heart.

Zheng Ren had only seen similar reports in magazines for this kind of man-made damage, but he still had no idea how to treat it.

He smiled apologetically and said, "Uncle Ning, let's go to dinner first. I'll have an operation. If it goes well, it's estimated that we can go in an hour."

"Use me?" Su Yun asked solemnly.

As a doctor, when I hear about emergency surgery, I always put myself into the bureau. This is a sense of mission.

"There are rich and noble children, I'll go check the situation, you can chat with Uncle Ning." Zheng Ren said.

"Okay." Su Yun responded.

Although a little regrettable, emergency rescue is still important. He thought of the stent going down into the false lumen, causing his condition to worsen... The blood flow of the aorta was frantically pouring into the dissection, and now he was afraid that the dissection of the blood vessel would be torn to the tip of his toe.

MD, isn't the medical level of Fugui'er not that good, Su Yun thought to himself.

Shainin looked helpless when he saw that his cheap and capable son-in-law was so busy even in Heidelberg, Germany. But that side is emergency rescue, and it's hard to say anything.

Pretty capable, Shainin smiled.

"Doctor Zheng, stop calling for a car, take my car." Zou Jiahua said.

"Then I'm welcome." Zheng Ren responded directly.

In fact, he had this idea when he spoke to Professor Rudolf Wagner. Zou Jiahua is a human being, it is impossible not to know what he means.

Zheng Ren never thought about whether it would be too ostentatious to just sit on the lengthened Lincoln for surgery.

After saying sorry to Xie Ning and Zou Jiahua again, Zheng Ren turned around and left. An entourage beside Zou Jiahua followed and brought Zheng Ren to the extended Lincoln.

The car drove very steadily. Zheng Ren sat in the car and entered the system space to prepare for surgery training.

The operating room of the system rose from the ground. After Zheng Ren entered, he glanced at the film and started the operation directly. The catheter entered, and as soon as the imaging was performed, Zheng Ren was dumbfounded when he saw the image.

The stent in the thoracic aorta of the subject, with the proximal end in the thoracic aorta and the distal end in the torn false lumen. The true lumen of the thoracic aorta has almost no blood flow, and although the false lumen is not as exaggerated as I expected, it is also torn directly to the position of the common iliac artery.

It's... too heavy.

The severity of the disease, beyond Zheng Ren's prediction, is imminent, and the patient may die at any time due to ruptured blood vessels.

The outer layer of the thoracic aorta is relatively tough, and the patient was lucky, so there was no rupture and bleeding. The high pressure of the aorta continues to tear the blood vessel, all the way to the position of the common iliac artery.

The blood vessels here are not comparable in thickness or thickness to the thoracic aorta, and can be torn at any time.

As long as the blood vessel is broken, the patient will surely die.

With a scolding in his heart, Zheng Ren just wanted to operate, but he was immediately stunned.

How to do this?

This was an extremely unfamiliar operation, and even Zheng Ren, who was at his peak, was beginning to feel a little confused.

Surgery is not just a matter of doing it.

Femoral artery puncture usually involves a built-in guide wire and catheter.

The patient's current situation is to remove the stent, and the true aortic lumen and false lumen cannot be operated at the same time.

A guide wire and catheter certainly cannot perform two operations at the same time.

Zheng Ren thought about it for a while and decided to adopt an operation mode that he had never done before - bilateral femoral artery catheterization.

It's just that I'm the only one in the operating room of the system...

With a sigh, Zheng Ren concentrated on dealing with the existing situation. What if there is only one person?

He is a man at the top, and Zheng Ren cheered him up.

Under general anesthesia, the experimental subjects exposed bilateral femoral arteries and placed sheaths. Zheng Ren did not care about the sterile operation, so he knelt down on the small operating table and started the operation.

After all, the other side can be handed over to Professor Rudolf Wagner if it is really an operation. Zheng Ren still gave strong recognition to the level of the professor.

Bilateral femoral arteries were punctured, the right catheter was placed into the true lumen, and the left catheter was directly placed into the false lumen. After the hard guide wire was placed, a 5F, 95cm long long wind guide sheath was placed at the level of the celiac trunk for angiography. The results showed that the celiac trunk, superior mesenteric artery and right renal artery supplied blood to the true lumen, while left renal artery and lumbar artery were the blood supply to the true lumen. False cavity blood supply.

The left sheath was placed distal to the original stent in the false lumen, and a multi-loop snare was placed. The right 10F sheath was exchanged through a rigid guidewire and placed in the true lumen so that it was 2 cm distal to the end of the original stent.

After several failed operations, Zheng Ren summed up his experience and began to have certain ideas about the operation.

A 5F catheter is placed through the end of the 10F sheath and close to the snare in the false lumen. Follow up with a 0.014 inch guide wire and, with the engagement of the catheter, pass the inner membrane between the true and false lumens into the snare. The guide wire and catheter were then placed in the original stent.

After exchanging the rigid guidewire, the window was continuously balloon dilated to a diameter of 25 mm, and a 36 mm wide, 77 mm long TX2 stent was subsequently placed, half within the original stent and the other half within the true lumen of the abdominal aorta above the celiac trunk.

Angiography showed increased visceral and renal arterial perfusion.

The operation was over, and the completion rate was 88%.