"Forget it~" Ruan Bin didn't know what to say at this time.

After all, this is a fresh life!

Besides, what if it's someone else's child who is delayed this time? Whose child is not a child?

If we were all not so selfish, maybe the world would be a better place, wouldn't it?

"Where is Ruan Bin?" in the emergency department hall, Director Qian asked the nurses around him.

"Director Qian, what are you looking for me?" Ruan Bin heard the voice and walked over and asked.

"You come with me, Interventional Division. Director Qian said.

？？？

"What are you doing to intervene?" Ruan Bin looked confused.

"Consultation!"

Damn, this plot is not right. The interventional department is such a tall department, how can they need people from the emergency department, who are known as a department that knows everything and are not good at anything, to go to the consultation?

"Director, why did they ask us for a consultation in the interventional department? We are not proficient in interventional surgery. Ruan Bin asked puzzled.

"I'm not looking for us, I'm looking for you!" Director Qian glanced at Ruan Bin and said with a smile.

"Karma, looking for me, what are you looking for me? I'm not a master of intervention. Ruan Bin was stunned.

"I don't know the specifics, you'll know later. Director Qian shook his head.

............

Interventional Department, Consultation Room.

At this time, the doctors of the interventional department of Director Jia Yanguan, Deputy Director He Weicai, and Chang Wenwei were all present.

"Director Jia, do you think this Ruan Bin is reliable? He doesn't know how to perform interventional surgery at all. I don't think it's very useful to call him. Chang Wen Wei said.

"I don't think there's much hope. Although he made a pre-hospital reboa, he must have a strong technique for blind exercises. However, interventional surgery is not the same as resuscitation aortic balloon occlusion (REBOA). I don't think he can give any useful advice. He Weicai shook his head and said.

"Okay, we can't do it now, I called Director Qian of the emergency department just now. Said that Ruan Bin had done an interventional operation in the emergency department of our hospital - uterine artery interventional embolization!" Jia Yanguan said in a deep voice.

"What? He, he's had interventional surgery! Or is it a fourth-level surgery!" He Weicai and Chang Wenwei were both slightly shocked.

"So, did you succeed?" Chang Wenwei asked incredulously.

He wouldn't be surprised if the attending physician of the emergency department would have done some simple emergency interventional surgery, but the other party was just a resident doctor, so he should have been studying at the time, right?

"Successfully stop the bleeding!" Jia Yanguan said.

"No wonder we were able to do the first pre-hospital reboa in China, and there were really two hits. He Weicai pursed his lips and said.

............

Soon, Ruan Bin came to the consultation room of the interventional department.

After a brief introduction by the two sides, Jia Yanguan explained the situation to Ruan Bin.

"Dr. Ruan, we have a tricky operation at the moment, and we called you here to see if we can help and make suggestions. ”

"Here's how it goes!"

"The patient is a 67-year-old male. Revascularization of severe stenosis of the right crown is required. If it's a normal coronary stenting procedure, we're of course handy. However, this case is a bit more complicated. He has hypertension, gout, and chronic renal insufficiency. ”

"There was an acute myocardial infarction half a year ago, but at that time, the treatment technology and vascular revascularization were timely and a life was saved. However, because of his poor basic renal function at that time, coupled with the contrast agent used in coronary intervention during acute myocardial infarction, his kidney function was worsened, and his serum creatinine rose from 164 μmol/L to 369 μmol/L (the normal value is 41-111 μmol/L), and the urine output decreased for a time, and the urine output finally returned to normal after symptomatic treatment, but the serum creatinine level has fluctuated at 315 μmol/L. After being discharged from the hospital, he had chest tightness and chest pain after repeated activities, which seriously affected his health. ”

Since his serum creatinine level has been fluctuating at 315 μmol/l, he will still be prone to myocardial infarction in the future. So he had to do a second revascularization of the right coronary stenosis in this case! But because of his renal insufficiency. Continuing to use contrast media will further deteriorate his kidney function, and he will probably need dialysis treatment in the future!

"Our surgery can only be performed with zero contrast agent!"

"Blind exercise?" Ruan Bin frowned. He knew that coronary stenting is one of the routine surgeries in cardiology, and the use of iodine-containing contrast agents to visualize coronary arteries is an essential step. However, in the face of patients with abnormal kidney function, the use of contrast agents needs to be "cautious". So the other party is also helpless now.

"Yes, no contrast agent was used throughout the operation, and intravascular ultrasound-assisted coronary artery revascularization was used instead, and coronary stent implantation without contrast agent!" Jia Yanguan said solemnly.

"It's not easy!" Ruan Bin took a breath. This kind of blind manipulation is equivalent to blind groping in the blood vessels, and the difficulty is threefold: 1. difficulty in putting the catheter and guidewire in place, 2. difficulty in positioning the balloon and stent, and 3. difficulty in selecting the size of the stent.

Intravascular ultrasound is an auxiliary instrument for coronary intervention surgery by inserting a tiny ultrasound probe into a blood vessel and using ultrasound to probe the structure of the blood vessels. Only using intravascular ultrasound, the surgeon must have superb interventional surgery skills, strong spatial operation ability, deep understanding of coronary anatomy, with their own feel and experience operation, relying on their own set mark visual inspection for positioning, with the help of the image provided by intravascular ultrasound, little by little to explore the "road" ahead, to complete the operation, the difficulty coefficient of the operation is super high!

"Yes, it's very difficult. We know that you have completed the first pre-hospital REBOA in China, and you have some experience in intravascular blind exercises. So I want to ask Dr. Ruan, do you have any suggestions or experience sharing?" Jia Yanguan looked at Ruan Bin expectantly.

To be honest, Ruan Bin's resuscitative aortic balloon occlusion (REBOA) can achieve hemostasis blind manipulation in the pre-hospital arterial vascular aspect. But there is still a difference with your heart implanted stent!

"Ding-dong...... System Temporary Mission: Save the Taiwan Mission! To the Intervention Department to Save the Taiwan, the mission is successful, and the mystery gift box will be rewarded!"

"Mystery gift box?" Ruan Bin suddenly came to his senses. He had a vague feeling that the reward would definitely be good this time.

I don't know what the gift is, but the word mystery says it all.

"Yes, it's a big deal. ”

After deciding on it, Ruan Bin did not answer Jia Yanguan's words directly, but asked rhetorically: "Director Jia, if you do zero-contrast coronary stent implantation, you are sure of it?"

"We?" Jia Yanguan said lightly after thinking for a while: "I have been doing interventional surgery for 20 years, and my experience is considered to be pretty good.