Central Hospital.

In the office of the director of the heart, a big test is begining.

The examiners are three directors and one dean.

Two of them are old cardiac surgeons.

If you don't have some skills, it's impossible to fool the past.

Even if you have some ability, under this kind of aura, you will inevitably be nervous.

But Zhou Yi's mind was as calm as water.

The strength is all over the sky, so naturally there is no panic.

Zhou Zhou said: "After reading the previous film and examination report, it was found that the patient had a lesion of the whole valve, and the general rheumatic heart disease was mainly for mitral valve damage. At present, the patient is more like Rudenbach syndrome. ”

"The initial problem should be that the mitral valve starts, because the right ventricle is significantly larger than the left ventricle, and as the stenosis progressively worsens, it leads to the rapid development of pulmonary hypertension, hypertrophy of the right ventricle, and progressive enlargement of the right heart, which affects the other valves......"

The four people present are all years of medical practice and have rich clinical experience.

Even Fang Jianzhang and Dean Cheng also know a little about clinical heart disease.

At this moment, after listening to Monday's analysis of his condition, both of them nodded frequently.

Director Tian and Cao Xiangwen are even more experts here, and they naturally understand what Zhou Sheng said.

Although common rheumatic heart disease has damage to the valves, it is generally not so severe that all four valves are broken.

Rudenbach syndrome is much more complex than rheumatic heart disease. Clinically rare, long-term disease can cause irreversible multi-valve damage.

"Now the patient has palpitations, paroxysmal dyspnea, and it seems that the disease has entered the terminal stage. The only possible solution is to replace the whole valve. ”

Speaking of this, Cao Xiangwen said coldly: "We all understand this truth, but no one has ever done this operation, and you have also seen that the patient's physical condition is very bad, how to ensure the safety of the operation?"

In the face of Cao Xiangwen's aggressiveness.

Zhou Zhou responded in a deep voice, "No one can guarantee that there is nothing wrong with such a thing as surgery. Especially a difficult operation, but we can only do a good job of the preoperative plan and fight on the operating table. Of course, for the sake of safety, that's why I asked Director Tian to come on stage with you. In this way, the safety of the operation can be ensured. ”

Zhou Zhou's words were extremely face-saving to Director Tian and Cao Xiangwen.

Cao Xiangwen is not easy to make trouble at this time.

He looked at Fang Jianzhang beside him.

Fang Jianzhang said at this time, "Xiao Zhou is right, as a family member, as a doctor, I support him." I believe that there should be no problem with the joint surgery of Director Arita, Director Cao, and Xiao Zhou. ”

Cao Xiangwen saw that Fang Jianzhang also made a decision.

He had no reason to object.

He also knew that if it was a combined operation, he would definitely not take on too many surgical tasks. More of his own role should be a second assistant or something.

If something happens, there is no responsibility of their own.

This is followed by a discussion of the details of the surgery.

From preoperative examination, to the selection of surgical approach.

Along the way, we talked about the choice of artificial valve when it comes to replacement.

This is a very professional thing for valve replacement.

Fang Jianzhang and Dean Cheng are completely ignorant.

Only Director Zhou Zhou and Director Tian and Cao Xiangwen have the right to speak.

At present, the more popular artificial valves are divided into two types: mechanical valves and biological valves.

Mechanical valves are made of metal, have a long service life, generally more than 35 years, and are relatively inexpensive, but require lifelong anticoagulant medication.

Biological valves are generally extracted from animals, have a short service life, generally no more than 15 years, and are more expensive than mechanical valves, but do not need to take anticoagulant drugs.

Cao Xiangwen's opinion is to use biological valves.

There is no need to take anticoagulant drugs, and more than 10 years of life is enough for the elderly.

Director Tian did not make a decision immediately, because if this kind of large-scale heart surgery is successful, it is almost impossible to do it again in 10 years, considering the age of the patient.

Although the patient is now relatively old, only 70 years old, and there are no contraindications to anticoagulation. Changing a mechanical valve can be done once and for all.

In hesitation, Director Tian also gave his own opinion.

Neither Director Tian nor Cao Xiangwen had experience with total valve replacement.

They think exactly about the longevity of the artificial valve in the previous single-valve replacement. It is not fully considered.

Monday is not, in the copy, the operation must not only be successful, but also perfect.

For this reason, he did not have to redo the surgery.

At this moment, Monday is more comprehensive and thoughtful.

For total valve replacement due to Rudenbach syndrome.

Monday on the use of artificial valves, that is the use of mechanical and biological together!

This scheme has been verified countless times in replicas.

It's a lifetime of practical experience.

When Director Tian and Cao Xiangwen were still hesitating whether to use mechanical valves or biological valves.

Zhou Zhou said directly: "I think the two valves should be used together!"

Monday's voice fell.

Fang Jianzhang and Dean Cheng were both confused.

Director Tian and Cao Xiangwen were full of doubts.

Both of them wondered why they wanted to use the two valves together, this was not a combination of the shortcomings of the two valves.

Both mechanical and biological valves are used, which means that they have to take coagulants for life, and after more than ten years, the biological valve is broken, and the biological valve must be replaced by chest opening.

It's a stupid act.

At this time, Cao Xiangwen was even thinking that he was going to show his stuffing this week. Sure enough, he is still a child who only understands some clinical practice, and he probably has never seen what an artificial valve looks like.

Thinking of this, he smiled slightly contemptuously at Zhou Yisheng.

Director Tian is much older, he thinks that Zhou Zhou has been performing very well, and he will definitely not make such a low-level mistake, and the use of the two valves together must have his effect.