Chapter 2545 [2545] Operation
Holding the precautions on the note, Xie Wanying continued to communicate with the opposite teacher: "Mr. Ye, please make the length of the vena cava longer when pruning."
Oh oh oh. Ye Chuanguang heard something, and said, "What kind of technique are you planning to use? The child on your side is not yet ten years old, right?"
Heart transplantation is divided into orthotopic heart transplantation and heterotopic heart transplantation. Orthotopic heart transplantation is easy to understand. The patient's diseased heart is removed and a donor's heart is placed in place of the original heart. Heterotopic heart transplantation does not remove the diseased heart, but connects the donor heart with the original diseased heart to support and assist the diseased heart, which is equivalent to a purely biological heart assist device.
Heterotopic heart transplants are rarely done because there is no future in sight. Generally, cardiomyopathy like Zhu Xing's is in the terminal stage, even if a heart assist device is installed for transition, it cannot completely solve the root cause of the disease.
Heart transplantation basically revolves around orthotopic heart transplantation. Orthotopic heart transplantation sounds simple, as long as the patient's heart is removed and the patient's heart is replaced by a donor heart. It's not easy at all to actually do it.
There are a total of eight blood vessels in and out of the heart that need to be connected. The most difficult part is the pulmonary vein group of the left atrium. There are two blood vessel ports above and below the right pulmonary vein group and two blood vessel ports above and below the left pulmonary vein group on both sides of the left atrium's posterior wall. Do you think it is complicated enough?
Like the right atrium, it is not easy to connect the two anastomotic ports of the superior and inferior vena cava.
If the above-mentioned so many blood vessels are connected honestly, it is a whole-hearted magic method called heart transplantation. This type of operation is the most complicated, time-consuming and labor-intensive, and requires more stitches at the anastomotic stoma, which means that the risk of anastomotic leakage and complications is high. The principle of surgery has always been that the simpler the steps, the better, and the fewer sutures, the better.
In order to save operation time, protect the myocardium, and reduce postoperative complications, surgeons initially resorted to opportunistic operations for heart transplantation. Specifically, when removing the patient's heart, only the ventricle is cut off, leaving the recipient's heart. The left and right atria, the donor atrium and the recipient atrium are anastomosed directly, directly avoiding the complex connection of multiple anastomotic ports of the left atrium and right atrium. Referred to as the two-chamber method or the standard method of heart transplantation.
In pediatrics, if the child is very young, especially if the blood vessels of the newborn are too thin, it is difficult for the doctor to suture the multiple anastomotic ends carefully with a magnifying glass. Of course, the double chamber method is the best.
Other older children and adults rarely use the two-room method. The reason is that this operation has a big disadvantage.
We know that the heart has a conduction system that allows the heart to beat rhythmically. The highest pacemaker point of this conduction system is the sinoatrial node, which mainly controls how many times a person's heart beats per minute. The sinus node is located just above the right atrium of the heart.
The two-chamber method leaves the right atrium of the donor heart and the recipient, and becomes two sinoatrial nodes, which is equivalent to installing two engine control systems for the heart. If you say that the heart wants to listen to who tells you to beat, whether you want it or not Chaos, it must be chaos.
After seeing the disadvantages of this operation, the following surgeons improved this operation, with the following most commonly used double vena cava method, simply put, this double vena cava refers to the superior and inferior vena cava of the right atrium to be performed Matched.