The instrument nurse handed over the flap forceps and a 15-gauge round knife.

Holding a forceps in his left hand and a round knife in his right hand, Monday began to remove the calcified aortic valve.

The flap clamp is fixed, and the circular knife is cut along the edge of the calcified valve.

The diseased valve was removed smoothly.

Next, measure the size of the valve and choose the appropriate valve replacement.

Suture.

This process is the most difficult.

The small artificial valve needs to be sutured precisely in place of the valve.

The distance between each stitch is precisely controlled between 2 and 3 mm.

The whole process can be said to be a vascular level suture requirement.

Do it on Monday and be skillful in action.

In half an hour, the aortic valve replacement is complete.

Zhou Zhou took a pair of tweezers with a rubber sleeve at the front and tested the "door" that had just been replaced, to see if the opening and closing of the door was flexible.

It's man-made, but it's small and delicate, and there's no problem with it.

The work of changing the "door" was successful.

This is only the first of four "doors".

Next, there are three more "doors" waiting for Zhou Yi to deal with.

Until then, though, the heart will have to be refilled with asystole fluid.

The effect of cardiac arrest is only about half an hour.

The second time the heart was given a high-potassium solution, and Monday had another half hour of surgery.

Although it is possible to inject multiple doses, it does not mean that the operation time on Monday is unlimited.

Cardiopulmonary bypass, as an auxiliary means, is generally used within 3 hours.

And the heart should not stop beating for too long.

In particular, patients are very old and have limited cardiac tolerance.

If you stop skipping for a long time, recovery is also a very dangerous thing.

If you don't get it right, it becomes a permanent stoppage.

On Monday, every second had to be done.

Monday immediately began to replace the mitral valve.

……

Two hours later, four doses of cardiac arrest fluid were given.

All four valves were replaced.

The cardiopulmonary bypass equipment is also operating normally, and the patient's physiological indicators are also normal.

All those present breathed a sigh of relief.

At this point, the operation can almost be declared a success.

The next step is to remove cardiopulmonary bypass.

Originally, this was not a complicated process.

After treating a few cannulations, restore aortic blood flow, and wait quietly for the patient to resume heartbeat.

But I didn't think about it.

After the arterial clamp was released, the blood entered the heart, and the heartbeat was back for just over a minute, and the heart rate immediately slowed down.

Fang Jianzhang was the first to get nervous, and he didn't care about whether to disturb Zhou Sheng, and shouted directly: "Xiao Zhou, the heart rate has dropped!"

Of course, Monday noticed it.

It's a cardiac resuscitation that is having a hard time!

After the heart rate is too slow, there is a high probability of cardiac arrest, which can be said to be very dangerous.

As for why recovery is difficult, there are many reasons.

On the side, many possibilities immediately appeared in Cao Xiangwen's mind.

Coronary air intake, poor oxygenation, low arterial pressure, high potassium, and even a reversed aortic valve can occur.

The possibility of the aortic valve being reversed can be ruled out immediately.

Monday's technology is there for all to see.

And Cao Xiangwen also "monitored" without stopping for a moment.

Finally, Monday also checked the flexibility of the valve's fitting, and if it was reversed, it was immediately noticed.

There are too many possibilities left.

For a while, Cao Xiangwen didn't know what the problem was, and only checked and ruled it out.

However, for an elderly patient, his heart can not withstand much time.

Failure of resuscitation is likely to mean that you will not be able to get off the operating table.

But at this moment on Monday, he is still very calm.

Because, with the assistance system in place, he can save a lot of troubleshooting time.

In a matter of moments, the system has given the exact reason.

High potassium!

At this moment, the patient's blood potassium content has reached 7.0 units. The normal human level is below 5.5.

Monday immediately said to everyone: "It is estimated to be high potassium, and the electrocardiogram has a towering T wave." ”

Director Tian and Cao Xiangwen looked at the electrocardiogram.

Indeed, as Monday said, there is a high probability of high potassium.

Zhou Zhou continued: "It could be four perfusions, and there was too much potassium absorption. Diuresis, calcium and insulin therapy must be given immediately. ”

At this point in the operation, Monday was already in control of the whole scene.

He gave him a doctor's advice.

The roving nurses sprang into action.

……

Intravenous therapy.

The patient's serum potassium drops significantly.

Bang......

Bang......

Bang......

The heart is alive again.

Fang Jianzhang's heart, which was originally hanging in his throat, fell again, and he breathed a long sigh of relief. I was secretly glad in my heart that it was really wise to choose Monday for surgery, this kid was not only skilled in surgery, but also did not panic at all when dealing with emergencies. The judgment is even more accurate.

Wait for your heartbeat to stabilize.

It is a chest closure operation such as suturing the pericardium, fixing the sternum, etc.

Compared to the previous one, this is already considered a non-technical job.

It's hard work and tiring work.

Generally speaking, after a long operation, the chief surgeon will not do such chores at this time.

This should be a matter for Ichisuke and Nisuke.

If at this moment, Bai Mingming and Su Quan were on the operating table, they would also let them take over on Monday, and they would be a little more relaxed, and they could also let them practice their hands.

Today, however, the situation is exceptional.

The first assistant is Director Tian, and the second assistant is Cao Xiangwen.

These are all well-known characters, usually others do chores for them, and once upon a time it was their turn to wipe others' butts.

Although Monday is the main knife, the scenery is the same. However, at this moment, he is still clear-headed, and "respect for the elderly" is still a traditional virtue. At this time, he didn't mention letting the first and second assistants take over.