UCSF Medical Center, Cardiac Catheterization Laboratory.

In fact, in the past, traditional transcatheter aortic valve replacement was performed in a hybrid operating room with general anesthesia and cardiac surgeons and cardiopulmonary bypass equipment present.

Later, with the accumulation of experience and the development of technology, some people proposed the concept of minimalist TAVR.

Minimalist TAVR surgery can be performed in the general catheterization laboratory, using local anesthesia enhancement, transthoracic echocardiography, through the femoral artery approach, subcutaneous puncture, vascular stapler suture, and TAVR surgery is greatly simplified.

Because she was going to participate, this time, Ava carefully selected a dozen tunes and played them on a loop as background music. Of course, if you feel that this background music is not good, you can also process it again in the later stage and replace it with other audio.

In order to highlight Zhou Qiao's style, the first piece is still a Chinese song.

"I only sigh that she looks back at the autumn water being hidden, and only remembers that she broke through the days and suffered a lot ......"

In the very nice melody of "Yan Wuxie", Zhou Qiao began surgery.

Needless to say, the harm of aortic stenosis, once patients with severe aortic stenosis have angina, fainting and other discomforts, if they do not receive timely and effective treatment, the 2-year survival rate is only about 50%.

There are some patients with severe aortic stenosis, the initial symptoms may not be very serious, holding a fluke mentality, want to wait a little longer, as everyone knows, once this disease attacks, the danger is abnormal, it is likely to be too late to rescue, on the way to the hospital, no, before going out.

At present, the main treatment methods for aortic valve disease in the medical community are drug therapy, traditional surgery and minimally invasive surgery. If the patient is in the early stage and there are no obvious symptoms, it can also be treated conservatively with drugs. However, as symptoms worsen, the valve can only be replaced surgically.

Traditional surgical methods require general anesthesia, cardiopulmonary bypass, and chest opening, which is highly invasive and risky, which is really a last resort for the elderly.

Many elderly people may not be able to beat back at all when their hearts are beating again. That is, I often hear that he died on the operating table.

Because cardiopulmonary bypass is to suspend the heart, it uses an extracorporeal bypass machine (artificial heart-lung machine) to replace the body's cardiopulmonary function, so that the patient's heart is suspended and then operated, and then re-beats after the do.

Then, the doctor was shocked to find that there was no jump back, no then.

Transcatheter aortic valve replacement and repair is suitable for patients with complicated aortic stenosis, which can reduce mortality and has the advantages of small incision, fewer complications and faster recovery. Most importantly, there is no need for cardiopulmonary bypass.

In this operation, you only need to make a small hole in the root of the thigh, and use a catheter no thicker than a ballpoint pen lead to carry an artificial valve (mechanical valve or biological valve), enter from the blood vessel at the base of the thigh, and send the artificial valve to the diseased part of the heart through the femoral artery, and the artificial valve will replace the damaged valve when it opens.

This kind of surgery, which does not require surgery, and the operation that originally required "thoracotomy" to complete the operation has achieved "minimally invasive", and the concept has to be said to be ingenious.

Of course, it's easy to say, but it's actually very difficult to do. Doctors who are not experienced in this kind of interventional surgery are prone to medical malpractice.

Zhou Qiao's perfect-level surgical skills are naturally natural if there is divine help, and every move is natural......

……

In the monitoring room, the doctors of the Department of Cardiac and Vascular Surgery who came to watch were amazed.

"God, why is Dr. Zhou so powerful!"

"Is this really the first time he's had this kind of surgery?"

"Oh my God, this, this...... You're too good at it, right? ”

"Superb! Pretty! ”

"No, is he really doing it for the first time? Impossible, right? "Some doctors are suspicious.

Another doctor pouted and said, "What's impossible." That's the surgical genius Zhou Qiao! It is said that he received his medical education in China. ”

"Lord, is China's medical care so great? A 24-year-old young doctor is so powerful? I feel that with him, I can't win the championship! ”

"Haha, even if you don't have Dr. Zhou, you won't be able to win the championship! Whether or not you can make it to the National Finals is a question! ”

"Do you speak? One more chance to give you another chance to reorganize the language! The female doctor got angry and let out a cold snort.

"You guys, don't think too much, like Dr. Zhou, even if you look at the world, it's a top genius. Do you think there are really so many in China? If there were so many, the United States would have been ruthlessly crushed by them a long time ago! ”

"Yes. It's me who wants to get out of the way. ”

The female doctor said to herself, this is the first time I have seen Dr. Zhou for surgery, and I was just shocked. Although, she had heard of Zhou Qiao before and knew that he was powerful, but she didn't expect him to be so powerful.

A bit more than expected.

Someone posted a photo of Zhou Qiao's surgery on Twitter, with a text, praising Zhou Qiao and expressing his shock.

Then, it was seen by doctors in another department of the medical center, and the news spread far and wide, and soon it spread to the neurosurgery department.

The neurosurgeons shrugged their shoulders and looked very indifferent.

For example, Dr. Alona McCrolin, when she saw this news, she sneered, thought about it, and casually commented below: "Dr. Zhou can even do such a complex operation as our neurosurgery, and now it is difficult to do your minimally invasive surgery in cardiac and vascular surgery?" Is it hard to understand? ”

Reading between the lines, it is full of arrogance.

Then, it led to a "scolding war" between the two departments.

Of course, they are all cultural people, and basically do not carry dirty words. But the smell of gunpowder is full.

The neurosurgeons thought that Zhou Qiao was an expert in their field of neurosurgery, and now he was "downgraded" to minimally invasive heart surgery, which should have been caught.

But the doctors of the Department of Cardiac and Vascular Surgery naturally refused to accept it.

That's right, even within the medical center, there is a chain of contempt between departments, and there is a secret disdain for some other departments. For example, neurosurgery mainly does cranial surgery, and they think that the human brain is the most complex organ, so naturally they look down on other surgeries and orthopedics.

Because the human brain is really very complex, different areas are in charge of different functions of the human body, such as speech, movement, memory, emotions......

Human memory, breathing, first love, heartbeat...... are different neurons in the brain.

Neurosurgeons are arguably the hardest of all surgeons to grow, which is perhaps one of the reasons why neurosurgeons are so proud.

……

Outside the operating room.

Grandma Huang's son and grandson all came to the scene and stood stupidly in the corridor.

The father and son stared at each other, and the atmosphere was extremely dull.

A nurse came over and suggested that they wait in the rest area, saying that there was free coffee and doughnuts there, but neither of them was moved.

Where do you have the heart to drink coffee and eat donuts!

"Brother, how is Mom?"

A trembling voice came, and father and son turned their heads to look.

"Sister!"

"Auntie!"

The father and son hurriedly greeted them, and then greeted their brother-in-law (uncle) and niece (cousin).

"How's Mom?" Grandma Huang's daughter's eyes were red, obviously wiping tears all the way.

Grandma Huang's son said, "It's still in the operating room, and I haven't come out." Dr. Chow...... It should be okay. ”

"Alas~, it's useless to say anything." Grandma Huang's daughter choked up, and then couldn't help coughing.

"Sister, you ......"

"Uncle, my mother has not recovered yet and was discharged from the hospital early." The nephew hurriedly said.

Grandma Huang's son nodded.

Grandma Huang's daughter rubbed her temples, forcibly cheered up, and said: "I hope that my mother Jiren has her own natural appearance, and every evil turns into good fortune, this time she can be safe!" ”

She said secretly in her heart: "Some time ago, I went to the church to pray for my mother, but I don't know if it is useful. ”

"Come on, grandma!"

"Come on, grandma!"

Now that there are more people, the atmosphere is a little more "lively", and the juniors have clenched their fists and waved to call for their grandmother (grandmother) in the operating room.

The door of the cardiac catheterization laboratory opened, and Zhou Qiao walked out with Murphy, Stephanie and others.

"Dr. Zhou, how is my mother?" Grandma Huang's son took the lead and asked in a very eager tone.

When Grandma Huang's daughter saw Zhou Qiao, she immediately felt a bad feeling in her heart, because, after Zhou Qiao took off her mask, I went, this is too young, right? High school student?

Big brother is too child's play, let a high school student operate on his mother?

Zhou Qiao smiled slightly and said, "Congratulations, the operation went well!" The old man's life is not in danger for the time being! ”

"What?"

Grandma Huang's daughter thought she had misheard, so she rubbed her ears vigorously, and then she heard her brother shouting, "That's just great!" That's great! Thank you, Dr. Chow! ”

Grandma Huang's daughter couldn't believe it.

However, soon, Grandma Huang was pushed out of the operating room, and the doctor said that she would be temporarily transferred to the intensive care unit.

The whole family followed, running from the bedside to the bed, asking questions as they ran.

"Mom, are you alright?"

"Mom, how are you?"

"Grandma'......"

"Grandma'......"

Grandma Huang was very weak, because the operation was only a local anesthetic, not a general anesthesia, so she remained awake. When she saw that her daughter's family had come over, she couldn't help but be very relieved, and wanted to raise her hand to say hello, but she didn't have the strength to do so, so she couldn't help grinning slightly and smiled reluctantly.

Although the smile was very small, this scene made Grandma Huang's son shout excitedly: "Mom laughed, Mom laughed!" Haha, Mom should be fine! ”

At this time, they had reached the door of the intensive care unit, and the nurse stopped them outside and motioned for them to stop.

Grandma Huang's relatives stopped.

"Sister, you know what? Mom started last night, before entering the operating room, she has been confused, the feeling of dying, I didn't expect that just after the operation, it was immediate, she actually smiled softly, her eyes were still very clear, it seems, she should want to say hello to you! Grandma Huang's son shook his sister's shoulders excitedly.

"Brother, don't shake it, if you shake it again, I'm going to fall apart, cough cough ......"

Grandma Huang's son reacted at this time, his sister was still sick, and he couldn't help but stop and say: "Sister, why don't you also stay in the hospital here, recuperate your body, and accompany your mother by the way, haha!" ”

"Brother, it's really good, it's really good......" Grandma Huang's daughter murmured, not knowing how to express the excitement in her heart.

……

The intensive care unit of the University of California Medical Center is not a single room, nor is it the usual two-person or three-person room, but a huge hall, with many beds densely lined up side by side.

There are advanced monitoring equipment and rescue equipment above each bed and on both sides of the bed, and the environment is naturally very clean.

On the opposite side of the bed is the nurse's station, which is very close, and the medical staff are stationed, and if there is a problem, someone will come to rescue immediately.

To the delight of Grandma Huang's children, Grandma Huang only stayed in the intensive care unit for one day before being transferred to the general ward.

Three days later, his complexion improved, and the family was grateful to Zhou Qiao.

Grandma Huang's son made a reluctant request, hoping that the family could take a photo with Zhou Qiao.

For such a small request, Zhou Qiao naturally would not refuse.

So, Grandma Huang sat in a wheelchair and stood in the C position with Zhou Qiao.

Next to Zhou Qiao are the other people involved in the operation, Murphy, Stephanie, Elena, and Ava.

On the other side of Grandma Huang are her sons and daughters, their spouses, and children.

This is a super clear group photo.

Aunt Huang's son washed it out and hung it at home as the most precious memory of his life.

Because of Zhou Qiao's perfect surgery, Grandma Huang lived for more than 20 years, and did not die until she was 98 years old. Of course, I also come to the iris clinic regularly for follow-up and treatment for some other conditions. This time it's free, and the rest isn't free.

It's just that that's all for later.

This operation is still very valuable, first, Zhou Qiao's surgery video was completed. Second, Murphy and Stephanie have a deeper understanding of this technique, and they have both been promoted to the peak of specialization. It's also only one step away from the master level.

But there are several other techniques in the competition, so Zhou Qiao still needs more patients to practice.

Fortunately, there is also news from Luo Ya's side, and the families of eight employees are willing to come to the Iris Clinic for treatment.

There are some employees who are actually quite rich, but because they are men of the "Queen of Violence", they are willing to come. It doesn't matter if it's free or not, it's purely a sign of loyalty and support!

For example, there is an employee in the East Africa base, named Hrashvayo, who is from a local background, because of Zhou Qiao's actions in the East Africa base, he admires Zhou Qiao very much, and it just so happens that there is an old man in his family who has heart disease, and the medical conditions in East Africa are too poor, and he happens to have this opportunity, so after applying, he took the old man all the way from East Africa and rushed over.

In view of his excellent performance, Loya reimbursed them for the round-trip travel expenses.

This old man was Hrashwaryo's grandfather, but he was very young, only 55 years old.

Because Herashwaryo's grandfather gave birth to his father at the age of 15, and his father was even more powerful, giving birth to him at the age of 14.

Although Hrashhuayo's grandfather was only in his fifties, his health was no longer good. If I hadn't had this opportunity, I wouldn't have lived to be 60 years old if I had been in Africa.

The average life expectancy of Africans is actually only thirty or forty years old, and living to more than fifty is already considered a high lifespan!

Of course, there are also countries. Like Mozambique, because of the AIDS epidemic, many people died before they reached 30. Some countries, such as South Africa, are considered "big" in Africa, with an average life expectancy of 60 years.

After Hrashvayo's grandfather arrived at the Iris Clinic, although the other party was voluntary, the agreement still had to be signed. Although, even if you don't sign it, it's not a problem.

After Zhou Qiao was admitted to the hospital, he did many examinations. Naturally, this includes AIDS and so on.

Fortunately, Hrashwaryo's grandfather did not have any other messy problems except for heart disease, nor did he carry a serious virus.

A detailed preoperative examination showed that the patient's heart function was very poor, he had rheumatic heart disease, and the degree of mitral valve stenosis was severe.

In this case, in Africa, it is basically waiting for death. Fortunately, his son joined the East African base, and the family's economic conditions improved. There is also this "relationship" and channel, which can get him to the United States for treatment.

It can also be said that it is the welfare of the employees of the East Africa base.

Zhou Qiao took Murphy and Stephanie to discuss the condition and design the surgical plan together, and in the end, let Murphy take the lead, Stephanie as the first assistant, and Zhou Qiao as the second assistant, and carried out the operation on Herashvaio's grandfather.

The procedure they chose was thoracoscopic minimally invasive mitral valve replacement.

It was performed in the operating room of the UCSF Medical Center, as before. Then Ava also made a video recording.

It doesn't matter if it's useful, let's record it first.

They think so, record a few more, and when the time comes, pick the best performer, the most competitive, and take it out for the competition!

If you can't come twice, there's always a suitable one. Anyway, there are quite a lot of heart patients coming over from Luo Ya's side now.

Stephanie was slightly jealous, and said why didn't Zhou Qiao let her come first. I've dreamed with him hundreds of times.

But after thinking about it, this was just her dream, and Zhou Qiao didn't know it at all. Suddenly I felt like I was unrequited.

However, what she didn't know was that Zhou Qiao was also a "real body" participating in the dream, and her feelings were infinitely close to reality.

Zhou Qiao comforted her, wait for the next one, she must be the main knife, Stephanie became excited, and her eyes were full of tenderness and sweetness when she looked at Zhou Qiao.

This surgery is a small incision in the right chest.

An incision of about 5 centimeters was made from the fourth rib breast margin of the right chest, and Murphy's virtual 3D visualization modeling was very successful due to the detailed preoperative report and various data.

On the display screen of the operating room, it is only 2D, not three-dimensional enough, and the model she visualizes, holographic 3D virtual projection, can be rotated 360 degrees, can be seen through, and there are various annotation frames, and can be fine-tuned at any time, which is many times more advanced than the existing monitoring equipment.

So the surgery went very well. After this battle, Murphy's technique has brazenly stepped into the beginner level of the master level!

Afterwards, when she logged in to the e-sports simulation training server again, the level of performance made her ranking soar, from more than forty to eighteenth.

The main reason is that this is only one of the techniques, if all the six techniques advance to the master level, there is absolutely no problem in entering the top ten.

After the operation, Hrashvayo's grandfather spent two days in the intensive care unit of the medical center, then transferred to a general ward, and was discharged on the sixth day and followed Herashvayo back to Africa.

In the future, the re-examination will not come to the United States, but will be conducted directly in the East African base. Chen Zhining is now in charge of it, and it is not possible to treat major diseases, but it is still possible to treat ordinary minor diseases and postoperative reexaminations.

This kind of surgery, if it is a traditional operation, requires an incision in the middle of the patient's sternum, the incision is at least 25 cm long, and there is a lot of bleeding, and the patient will stay in the ICU for at least five days after the operation, and then stay for another week or two after coming out before being discharged.

In addition to physical sin, the cost is much more expensive! Not to mention anything else, the average family really can't bear living in the ICU for so long.

The first minimally invasive cardiac surgery arranged by Zhou Qiao for Stephanie was left atrial appendage combined with PFO (patent foramen ovale) closure.

The patient is from Mexico. The medical conditions there are also very poor, and she is a fifteen-year-old girl whose mother works as a logistics clerk in Luoya's organization.

About a year ago, the girl had always found herself with headaches, which often occurred during class, causing her studies to be delayed.

When the girl's mother found out, she took her daughter to the neurology department of a major hospital in Mexico for an examination, but no problems were found. Because of the headache, I thought it was some kind of disease in the head.

Later, I looked at many departments, but I found nothing in the pain department and orthopedics.

I took a lot of medicines, including painkillers, but they were all palliatives but not cures.

Later, a doctor advised them to have their heart checked.

Then, it was found that the problem was the left atrial appendage and the foramen ovale.

It just so happened that a notice was issued on the organization that Dr. Zhou, the man behind the famous queen, who had solved an unknown disease in the East African base, was recruiting heart patients.

The organization is also responsible for reimbursement of medical expenses, and the operation is carried out in the United States, and the mother of the girl brought her daughter over.

Coming from Mexico, it's pretty close.

Zhou Qiao led Murphy and Stephanie to arrange an examination for the girl, and after discussing the condition, the diagnosis was patent foramen ovale with atrial fibrillation, which required left atrial appendage combined with patent foramen ovale closure surgery.

The last operation was done by Murphy, so this one, the opportunity was given to Stephanie.

In this interventional closure, local anesthesia is sufficient, and the patient can undergo the operation while awake.

So when she was doing it, Stephanie chatted with the girl while carrying out very delicate operations. It's a double task.

She is a very highly accomplished psychiatrist and is very good at communicating with patients. A small mouth can speak well, which is much better than Murphy's doctor-patient communication skills!

The two blocking techniques took more than 30 minutes in total, and the girl and her mother were stunned! The girl feels that she can't have fun chatting with her big sister!

It is worth mentioning that on the second day after the operation, the girl got out of bed and moved. Where can I tell that I just had heart surgery yesterday?

He was discharged from the hospital in the evening of the same day.

The girl's mother decided to bring her daughter to the United States to study, not to mention educational resources, job opportunities, etc., just medical resources, she can enjoy better medical resources.

Mexico, it's too far behind.

Of course, after all, it is a "major operation" on the heart, and it is necessary to have regular follow-up after that.

Zhang Jianjun's side also had some patients coming, and Luo Ya's side had new patients sent over in the future, and in just one month, Murphy and Stephanie each performed minimally invasive heart surgery, more than 20 units.

The six techniques of the two of them have finally been upgraded to the beginner or intermediate level of the master level in reality.

Comparatively speaking, Murphy is more talented in surgery, and of these six techniques, Murphy has reached the intermediate level of master level in 4 ways, while Stephanie only has 1.

This is because Murphy has 3D modeling skills in his brain, which are not comparable to ordinary people, and he is born with an advantage.

However, Stephanie also has the specialty of a psychiatrist and can be hypnotic. Therefore, in terms of comprehensive strength, the two are not equal.

After the two of them greatly improved their surgical skills, they went to play a simulation match and gradually caught up. It has reached fifth and seventh.

If you rush forward, you won't be able to rush up.

There are really masters among those players, maybe they are older, I don't know which hospitals they come from, and with their current level, they may not be able to beat each other.

(End of chapter)