Chapter 1446 Deep Low Temperature

Zheng Ren made a mattress suture on the anterior adventitia of the root of the ascending aorta and put it into a hemostat.

Then, the cold cardioplegia perfusion needle was exhausted and the gas was pierced into the central part of the mattress suture into the ascending aorta.

Tighten the hemostat and fasten the cannula and hemostat together with thick wire. Connect the cannula to the perfusion device.

"Boss Zheng? What's the next step?" Lao He asked in advance.

"Left room."

"Okay."

As the next step in surgery, there are two options.

Left Atrial Drainage or Left Ventricular Drainage.

There are no pros and cons, just suitability. For cardiopulmonary bypass specialists, left atrial and left ventricular drainage are slightly different, and Lao He is showing off to Boss Zheng with his professional details.

I am definitely more suitable than twin sister flowers! Boss Zheng, look at me, look at me!

Look here, look here!

Zheng Ren couldn't hear Lao He's cry in his heart, but felt that the operation was much smoother than if he was alone in the operating room of the system.

He made a large mattress suture at the junction of the root of the right upper pulmonary vein and the left atrium, and covered with a hemostat.

After incising a small incision in the mattress suture coil, insert the left atrial drainage tube into the left atrium, tighten the hemostat, and ligate it with a thick silk thread to fix the drainage tube and the hemostat together, and connect the drainage tube to the artificial heart-lung machine.

After finishing all the operations, Zheng Ren checked all the pipes and their connections again, and there was no error. He was sure that there were no obstacles in each channel, and started cardiopulmonary bypass.

At the moment when Lao He started cardiopulmonary bypass, Hurricane speeded up.

Although he knew that he was already No. 1, he wanted to leave a number that no one else could surpass.

In the past, 912's heart surgery was not done much, and the level of the operators was average, so Lao He had no status in the group.

Although it is a chat and spanking group, people with a high level have a certain authority.

People who are engaged in technology have similar common problems. Although it is just a chat and exchange group, it cannot be exempted from the vulgarity.

This time, I must fight hard, and Lao He glanced at the timer from time to time.

Although it is completely meaningless to argue, it is completely different from the heart bypass surgery that was still performed before.

But even if extracorporeal circulation withdraws from the stage of history in the future, he can be regarded as leaving a record in the domestic surgical field... and even the world's surgical field!

5′05″!

When he saw this number, he was a little dazed.

The previous highest record was 9'22". Boss Zheng's surgery actually nearly doubled the time for establishing cardiopulmonary bypass!

What the heck, is this what people do?

After Lao He saw the time, he made a fist with his right hand and waved it violently.

It's a world record for sure!

Although no one recognizes it, in my heart, this is the world record!

Go to the group to show off after the operation, and now let's concentrate on setting the stage for Boss Zheng. Those who have traveled a hundred miles are half and ninety, but they must leave a good impression on Boss Zheng.

Don't be careless before and outside, and all previous efforts will be abandoned.

The twin sister Hua, such a formidable opponent, is under a lot of pressure. Lao He cautiously observes the progress of Zheng Ren's surgery from the patient's head.

After several minutes of cardiopulmonary bypass, Zheng Ren blocked the superior and inferior vena cava and entered complete cardiopulmonary bypass.

At this time, the blood from the superior and inferior vena cava completely flows into the artificial heart-lung machine through the cannula, and does not flow into the right atrium.

At the same time, blood cooling was performed.

Lao He kept reporting the blood temperature.

36℃...

35℃…

32℃……

When the whole body temperature dropped to 30°C, Zheng Ren lifted the ascending aortic cuff and blocked the ascending aorta with aortic blocking forceps.

Su Yun immediately poured into 4 ℃ cold cardioplegia through the perfusion tube at the aortic root. At the same time, Zhao Yunlong used 4°C ice water or ice chips on the surface of the heart to cool down to make the heart stop rapidly.

Zheng Ren is very satisfied.

It is indeed much faster than the operation in the system operating room.

There are two doctors who are so powerful that they can perform type 1 aortic arch replacement surgery as assistants, and there are anesthesiologists like Lao He who can perform anesthesia and extracorporeal circulation. The key is that Xiao Yiren is there.

Not to mention anything else, Xiao Yiren smiled with a curved brow and eyes, and the exhaustion from not sleeping last night, only to catch up on the plane, was swept away.

Compared to this, the experience in the operating room of the system is extremely poor.

After blocking the ascending aorta, Lao He Ningshen began to report various values ​​continuously.

Extracorporeal circulation is quite difficult. If you are not careful, the patient will not wake up.

"Arterial pressure, 70mmhg."

"Central venous pressure 9 cm H2O."

"Body temperature, 27 degrees Celsius."

"Lao He, drop the temperature a little more." Zheng Ren looked down at the surgery area while communicating with Lao He.

Under normal circumstances, the body temperature under cardiopulmonary bypass is maintained at about 28 degrees Celsius.

However, if the surgeon judges that the operation is difficult and the procedure is very long, the cardiopulmonary circulator will be asked to lower the body temperature.

"How much?" Lao He asked.

"Deep low temperature, 15 degrees Celsius." Zheng Ren said.

Lao He is awe-inspiring.

Cardioplegic solution promotes cardiac arrest, quickly stops all bioelectrical and mechanical activities of the heart, and is conducive to preserving cardiac energy reserves.

Supplemented by local deep hypothermia in the heart, it can further reduce the consumption of myocardial energy and oxygen, and reduce the accumulation of harmful substances such as carbon dioxide, hydrogen ions and oxygen free radicals.

Deep hypothermia, which means the operation will take longer than 3 hours.

He immediately began to operate the instrument, bringing the temperature down.

"Myocardial temperature, 15 degrees Celsius." Lao He said.

"enough."

"Flow, 50-60ml/kg."

"Lao He, take a look at the blood gas value." With blunt scissors in his hand, Zheng Ren began to free the pulmonary artery segment, and communicated with Lao He in his mouth.

The words did not delay the operation on Zheng Ren's hands, and the operation was done very delicately.

After the cardiopulmonary bypass started, the patient's body temperature dropped below 25 degrees Celsius, and the myocardial temperature also dropped to 15 degrees Celsius. Zheng Ren first observed the coronary arteries.

There was no problem with the coronary artery, and Zheng Ren began to dissociate the pulmonary artery.

The pulmonary valve is located between the right ventricle and the pulmonary artery and inhibits the flow of blood entering the pulmonary artery from flowing back into the right ventricle.

The heart has two atrioventricular valves and two aortic valves.

The pulmonary valve is one of the great aortic valves and has three semilunar valves. Both leaflets and annulus are relatively weak, and the annulus is connected to the right ventricular infundibulum muscle without direct fibrous continuity with the tricuspid valve.

When it came to the main event, Zheng Ren paused slightly, took a deep breath, held his breath, and began to cut the pulmonary artery. The location of the junction of the left and right flaps.

When he dropped the knife, Zheng Ren was very careful, unprecedentedly careful.

He knew that cutting through the wall of the pulmonary artery could injure the aorta, which was too deep to stop the bleeding.

The lancet was lightly tapped, followed by layer-by-layer separation with hemostatic forceps.

It was still the smallest hemostatic forceps, and Zheng Ren's fingers couldn't get in, so he could only touch it.

Here, he still did not use a microscope.

At this time, the assistant is more idle. Su Yun did not speak, but watched Zheng Ren separate the pulmonary artery intently.