Early in the morning of the third day, after Ou Zhou, Jiang Yang and Ke Fei'er, the four sisters and brothers had breakfast, they drove the business car in the villa and sent water to report to Wandao University for master's and doctoral studies.

Previously, Jin Cheng and Liao Yunhui, the two helmsmen, had already taken care of the matter at Bay Island University through their relationships.

Therefore, as soon as they arrived at the campus registration office, a special person came to greet them, and they ran diligently before and after, and took full authority to handle the registration and accommodation procedures.

The elective direction of Water Meditation is also the development and research major of artificial intelligence.

After everything was done, we had a meal together and spent the night in a hotel near the campus. The next day, I returned to the Shuishe Mountain Scenic Area in the evening.

Since then, every Friday, Ou Zhou will drive over to pick up the water and return to Shuishe Mountain, and the little couple and Jiangyang Kefeier will spend a happy weekend together, and then send her back to campus early in the morning on Monday.

The rest of the time, Ou Zhou and Jiang Yang devoted themselves to the construction of the Artificial Intelligence Heart Transplantation Research Institute. Hospital planning, recruitment of physicians and AI cardiac researchers, equipment procurement and installation, nurse training and a series of work. They all need to be hands-on.

Rich is capricious, other projects are progressing smoothly, and those who have not yet achieved results are the agent manufacturers of artificial intelligence hearts. Almost all the manufacturers who contacted were not optimistic about this project because they did not understand.

The first transplant of an AI-powered heart actually took place one morning two months later.

The main surgeon is the 21-year-old Dr. Ou Zhoushuang, and the first assistant is the 23-year-old Dr. Jiang Yangshuang.

The anesthesiologist is from Bay Island Medical College, and a cardiac surgeon monitors the ECG and a cardiac surgeon assists. Three nurses attend to the surgical instruments.

The patient, a middle-aged man under the age of 40, suffered from congenital mitral valve atresia, and at the moment the heart function was severely failed.

Jin Cheng and Liao Yunhui spent a lot of effort and ran no less than ten times before they moved their families, paid 500,000 Hong Kong dollars, and then signed an artificial intelligence heart transplant agreement.

The artificial intelligence heart used is still a product personally supervised by Ou Zhou and Jiang Yang during their master's and doctoral studies at Yenching University.

At that time, it was also repeatedly tested and used, and finally at the high price of one million yuan per artificial intelligence heart, a well-known medical device company was entrusted to customize ten payments, of which three pairs were used on three simulated human bodies.

Now the artificial intelligence hearts carried in the three simulated human bodies have become teaching props in the Institute of Artificial Intelligence and the Institute of Life Sciences of Yenching University.

The medical device manufacturers who entrusted Jincheng and Liao Yunhui to bid this time, because they did not have relevant technical reserves and research, those medical device companies did not dare to rashly accept this order even if they got a full set of technical information from Ouzhou and Jiangyang.

It's not that they can't look down on the order of 300 million, but because this product is too unbelievable and breaks through the cognition of most experts in the industry.

As the producers of the world's first artificial intelligence heart organ assembly, they have no bottom in their hearts and do not know what the prospects of this project will be, so they dare not take this risk.

And that patient who does not undergo a heart transplant at this moment may die at any time, so Ou Zhou and Jiang Yang decided to use their previous products after research.

At the very least, this is a product that has been repeatedly verified by the two of them during their studies, and it is relatively safe to use.

The medical equipment and surgical instruments in the operating room are configured according to the first-class level in the industry.

Several cardiac surgeons and anesthesiologists also have a certain reputation in the Bay Island industry, and they were poached by Jin Cheng and Liao Yunhui with high salaries. The recruitment and training of more than a dozen nurses is relatively easy.

As a result, a medical institution integrating artificial intelligence heart research and overall transplantation in the world was born in the Shuishe Mountain Scenic Area.

Jin Cheng and Liao Yunhui didn't know what means they used, but they unexpectedly got a prominent signboard and hung it at the gate of the villa: Shuisheshan Artificial Intelligence Heart Assembly Transplant Medical Practice Research Institute.

With this license, you can carry out relevant work research and artificial intelligence heart transplantation work in a bright and bright manner.

For this reason, Ou Zhou and Jiang Yang spoke highly of the two helmsmen and fully affirmed their achievements.

The establishment of extracorporeal blood circulation, also known as the heart-lung machine, is a major part of human heart transplantation, and the medical requirements and skills of the surgeon are very strict, and it requires the accumulation of many practical experiences to successfully pass the operation.

The first thing to do in the transplantation of human intelligent heart assembly is to eliminate all infectious lesions. The second thing to do is to correct the patient's nutritional problems, anemia, etc.

Third, it is necessary to adjust the functional impairment of the patient's various organs so that the patient is in the best condition during the operation.

The fourth point is to stop taking foxglove drugs and diuretics 48 hours before surgery.

Fifth, it is necessary to eat a normal diet 1 week before surgery to help adjust the electrolyte balance, if the patient is taking diuretics for a long time, the oral potassium chloride will be increased 1 week before the operation to help overcome the lack of potassium in the body.

Sixth, antibiotics should be used to prevent infection 3 days before surgery, and another dose of antibiotics should be given on the day of surgery.

Seventh, dextrose, insulin and potassium chloride solutions should be intravenously instilled in severe patients one week before surgery to protect the myocardium.

Eighth, psychological treatment should be given to patients before surgery to eliminate concerns and enhance doctor-patient cooperation. Let the patient understand the various situations that may arise during the surgical process, so that the patient can actively cooperate.

Anesthesia methods: Intravenous combination anesthesia, fentanyl anesthesia, and cryogenic anesthesia are the most commonly used anesthesia methods for cardiopulmonary bypass surgery.

Establishment of access: radial artery manometry, central venous manometry, and establishment of intravenous infusion channels can be performed before or after anesthesia on a case-by-case basis.

Surgical procedure: Incision site

The median sternal incision is a standard open-heart surgery incision for cardiopulmonary bypass, which is well exposed and suitable for any part of the cardiac surgery. The incision originates from the sternal notch and is slightly descended about 5 cm below the xiphoid process.

Then sawn open the sternum:

Cut the sternal periosteum along the median with an electric knife, and separate the sternal notch to the back of the sternum; The xiphoid process is then dissected and the retrosternal space is separated. After the xiphoid process is removed, the sternum is sawed longitudinally along the midline with a motorsaw. The periosteum is stopped by electrocoagulation, and the sternum is stopped by bone wax.

Then cut the heart pack with a scalpel:

Cut the pericardium in the middle of the longitudinal line, ascend to the reverse fold of the ascending aorta, descend to the diaphragm, and cut one side of the incorporate to each side of the lower part of the incorporation. The pericardial margins are then sutured to the soft tissues outside the sternum on both sides, and the sternum is opened with an opener to expose the heart.

Then there is the extracardiac exploration:

The aorta, pulmonary artery, left and right atrium, left and right ventricles, superior and inferior vena cava, and pulmonary veins are explored for tremor and tremor, and then the left superior vena cava and other extracardiac malformations can be examined.

Cardiopulmonary bypass is established at this point:

A. Vena cava cuff: first separate the space between the aorta and the pulmonary artery, perform the ascending aorta cuff, pull the ascending aortic band to the left, expose the medial side of the superior vena cava, and use right-angle forceps to bypass the posterior cuff along the medial side of the superior vena cava. Use the same method to circumvent the inferior vena cava with the inferior lumen cuff forceps for backup.

B. Arterial cannulation: At the distal end of the ascending aorta, two concentric purse sutures are made with wire 7, both of which do not penetrate the blood vessels, and are sutured to the adventitia of the aorta, and the opening of the purse line is one on the left and one on the left. Slip the purse wire into the hemostat in case the bleeding is stopped and secured during intubation. The outer membrane of the central part of the purse is removed. Heparin (3mg/kg) is injected into the right atrial appendage, and then an incision slightly smaller than the diameter of the arterial cannula is made in the center of the purse with a small sharp knife, and the arterial cannula is sent into the ascending aorta incision while exiting the blade, and the hemostat of the two purse lines is immediately tightened, and the arterial cannula and the hemostat are fixed together with thick silk threads. Finally, the arterial cannula is fixed to the edge of the incision or to the petiole of the propeller, and the cannula is connected to the artificial heart-lung machine.

C. Vena cava cannulation: sew a purse thread on the right atrial appendage and right atrium, put a hemostat on it, and then make an incision, insert the upper and lower vena cava cannulation (generally inserted through the upper lumen tube of the atrial appendage first), and tighten the hemostat. Use thick silk threads to ligate the appendage and atrial wall 2~3mm below the incision of the intubation, and fix the upper and lower cavity cannulation with this ligature to prevent slippage. The upper and lower cavity cannulations are connected to the artificial heart-lung machine.

D: Cold cardioaponsis perfusion infusion cannula: a mattress suture is made on the anterior adventitia of the ascending aorta root and inserted into the hemostat. The cold cardioaptor perfusion needle is drained of gas, and the central part of the mattress suture is inserted into the ascending aorta, and the hemostat is tightened, and the cannula and hemostat are fixed together with thick wires. Connect the cannula to the perfusion device.

E. Left heart drainage intubation: the usual practice is to choose one of the following methods:

Left atrial drainage: make a large mattress suture at the junction between the root of the right upper pulmonary vein and the left atrium, put a hemostat on it, make a small incision in the mattress suture loop, insert the left atrial drainage tube into the left atrium, tighten the hemostat, and tie it with thick silk threads to fix the drainage tube and the hemostat together. Connect the drain to an artificial heart-lung machine.

Left ventricular drainage: For individual patients, left ventricular drainage should be used for better effect, a mattress suture should be made in the avascular area near the apex of the left ventricle, a hemostat should be put on, a small incision should be made in the center of the mattress suture circle, and the left ventricular drainage tube should be inserted from the small incision, and the hemostat should be tightened to fix the drainage tube and the hemostat together. A drain is attached to an artificial heart-lung machine system.

Check that all the pipes and their connections are correct, and that there is no obstacle in each channel, you can start cardiopulmonary bypass, and after a few minutes of parallel circulation, block the superior and inferior vena cava, and enter complete cardiopulmonary bypass, at this time, the superior and inferior vena cava blood 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 is carried out.

F. Blocking the ascending aorta: When the whole body temperature drops to about 30 °C, lift the ascending aorta sleeve and use aortic blocking forceps to block the ascending aorta. Immediately perfusion of 4°C cold cardioaponsor (10~15ml/kg) from the perfusion tube at the aortic root, and at the same time, the surface of the heart is cooled with 4°C ice saline to make the heart stop rapidly.

The operating indicators of cardiopulmonary bypass are as follows:

Mean arterial pressure: 5.33~9.33kPa (60~90mmHg).

Central venous pressure: 0.59~1.18kPa(6~12cmH2O)

Body temperature: about 28°C for general surgery; Complex cardiac surgery can be performed at a cryogenic temperature of 20°C~25°C.

Myocardial temperature: keep at 15°C~20°C.

Flow rate: 50~60ml/kg is medium flow; 70~80ml/kg is high flow, and high flow is commonly used in clinical practice. It is important to note that the flow of children and infants should be higher than that of adults.

Dilution: Cytocrit is generally about 25%~30%.

Ordinary heart surgery establishes a cardiopulmonary bypass process that can be completed in as little as five minutes. However, this is the first case of artificial intelligence heart assembly transplantation, which requires extra care, so the establishment of cardiopulmonary bypass took almost two hours.

Then there is the removal of the heart, the implantation of an artificial intelligence heart, the connection of the aorta, pulmonary artery, superior vena cava, inferior vena cava, pulmonary vein, etc. After completion, the artificial intelligence cardiac circulatory system is activated, the operation technical indicators are checked, and then checked whether there are surgical omissions and instrument omissions, and after fully meeting the requirements, the extracorporeal bypass is cut off and the wounds are sutured.

Doing a regular heart transplant normally takes five to six hours. This is a groundbreaking artificial intelligence heart transplant operation, and Ou Zhou and Jiang Yang are particularly attentive.

It is difficult for the surgeon to complete this operation without good physical skills and mental quality.

During their master's and doctoral studies, Ou Zhou and Jiang Yang cooperated with each other to perform many such surgeries, and the tacit understanding between the two is not too much compared to that of two programmed intelligent robots.

Transplantation of AI hearts is relatively simple compared to matched heart transplantation.

The convenience is that the connection of the aorta, pulmonary artery, superior and inferior vena cava, and pulmonary vein does not need to be sutured, but can be cannulated and bagged by cannula and then clamped.

There is also no suturing of the cardiac coating.

Because this is the world's first physical verification surgery of an artificial intelligence heart assembly, it needs a good demonstration effect and psychological comfort.

Therefore, Ou Zhou and Jiang Yang's efforts in this operation have greatly increased compared with ordinary matching heart transplantation. The operation took two hours more.

After carefully checking the details of each operation, the operation of the artificial intelligence heart was started to observe whether the indicators were normal.

After that, the cardiopulmonary bypass machine was cut off, and then the operating status of the artificial intelligence heart was checked to see if it was in line with 85% of the normal human heart working state.

This is a basic guarantee. Above this standard, it means that the probability of success of the operation is high, and below this standard, it means that the operation is at risk of failure.