Chapter 3655 【3655】Dimensionality Reduction Strike

It is called blind insertion, but it is impossible to completely blind insertion. It is difficult for patients to move to the intervention room for interventional surgery, but it does not mean that there are no other medical resources available. Referring to previous neurosurgery cases, localization using the convenience of ultrasound is an advisable strategy.

In the ward, there was indeed an echocardiography machine.

Here comes a question, if multiple wires can choose stimulation, ventricular stimulation should be the first choice for rescue. Because I have studied cardiac physiology and know that ventricular activity is more important.

On the other hand, the right atrial appendage is also difficult to visualize by transthoracic echocardiography and requires special positioning.

Using bedside transthoracic echocardiography can help doctors send electrodes through the tricuspid valve.

Shen Youhuan wanted to say that this little junior sister could hit the academic point without being in the ward for a long time, and it was clear that she had a medical clairvoyance or touched his senior brother Shen's brain.

The problem is, she said that the patient's tricuspid valve is not good, what is wrong, can't the echocardiogram show it?

Everyone looked back at the medical records, and it seemed that this item was not listed in the patient's existing heart examination results.

"His tricuspid valve has moved down." Xie Wanying said again.

"Did his tricuspid valve move down?" Everyone searched again, full of questions, "Which inspection report did you read that from?"

"Boobs."

Chest X-ray? ! Does advanced dimensionality reduction strike?

"She is too rich in medical associations." Dr. Zuo Jinmao, who is too easy to talk, couldn't help but make another high-spirited speech.

Is she thinking wildly? Everyone knows that ordinary chest X-rays refer to chest X-rays, which can only roughly capture the outer outline of the heart, but certainly cannot capture the structures inside the heart, including the tricuspid valve.

Let's say an echocardiogram. Echocardiography can observe the position of the tricuspid valve, using contrast. According to the comparison between the attachment point of the tricuspid valve on the tricuspid annulus and the attachment point of the mitral valve, and whether it exceeds the normal range of difference, it can be judged whether the tricuspid valve is abnormally moved down. At the same time, if the tricuspid valve moves down severely, it will cause the problem of tricuspid valve closure and bring about changes in the internal hemodynamics of the heart, which are also reflected in the detection of internal blood flow in the heart on echocardiography.

"I personally think that this patient is not the tricuspid valve downshift deformity we usually talk about clinically, but the overall structure of the heart leads to such a result." Xie Wanying said.

Some of the reasons for the failure of the operation have nothing to do with the disease factors. Some of the reasons are that the patient's own organs are abnormal. Even subtle abnormalities may catch the doctor by surprise. The human body that doctors study anatomy and surgery cases is based on the data of most people. Physicians for niche cases have no way of knowing what to do.

Everyone understands, the "downward movement" she said means that compared with most people, the patient's tricuspid valve attachment point may be lower than the mitral valve, which means that the tricuspid valve is longer, so the guide wire electrode passes through the tricuspid valve. The path of flap opening and closing becomes longer, and the process is inevitably difficult. Such a special case is very difficult for doctors who have never done such a case and have no relevant experience.

From the side, it can be reflected that Brother Shen, a master of intervention, is not bad. The powerful senior brother Shen can feel the danger, so it is right not to dare to circle the tricuspid valve too much.

What is the danger of coiling to pass the tricuspid valve level? Once it is not successful, the most feared is that the tricuspid valve will be trapped and torn, which will be a proper medical accident, and the life-saving will not become the life-threatening.