Because it was broadcast live on the whole network, the jury composed of eighteen academicians of the National Academy of Medicine commented online and asked questions online, so this time Ava did not play the song.

Not even the most soothing music.

I didn't feel like it was like watching the game, but it was really my turn to compete, and Ava and Elena still felt a little nervous.

"I hope my brother can perform well this time and win the championship in one fell swoop."

"Brother, come on! Behave well during the day, sister will treat you at night! Elena and Ava threw a look at Zhou Qiao, cheering him on in their hearts.

Zhou Qiao's surgery in this competition is "transcatheter aortic valve replacement under local anesthesia without intubation under compound sedation".

Before entering the operating room, Zhou Qiao had already introduced the patient's condition and the name of the next surgery to the audience and academician judges in the United States in front of the live broadcast camera.

Although it is out of script, it has actually been rehearsed many times in private. Including every expression, every gesture, the tone and frustration of language.

Including Murphy and Stephanie too, they have reached the kind of back-to-back like a stream.

Previously, there were three participating patients in the clinic who were hospitalized and waiting for live surgery, two were contributed by Luo Ya, a Mexican woman, an East African woman, and a Chinese patient, who was introduced by Zhang Jianjun.

This Chinese patient is Zhou Qiao's current surgical target.

The patient is actually a little old and not in good health, at the age of 93, he has been hospitalized in the clinic to recuperate, not only waiting for the operation, but also helping him to condition his body so that he can withstand the intensity of the operation.

When Zhou Qiao introduced the patient's information, the eighteen academicians immediately came to their senses, and the other competitors who watched the game also gasped.

There were five live broadcasts before, and the oldest patient was 61 years old, although the older the patient, the more difficult the operation was, and the higher the score was likely to be. However, the older you are, the greater the risk.

Ninety-three years old, oh my God, if this one doesn't get it right, he will die on the operating table.

The patients are all dead, what are the rankings? Properly the penultimate one! It is even possible to be kicked out of the game directly.

"Zhou Qiao, this is taking an adventure!" Competitors were amazed, but they didn't dare to let them choose this model for themselves.

Once a patient dies on the operating table, or in the case of live broadcast on the whole network, it will seriously affect their future career.

Not only the personal reputation, but also the reputation of the hospital is seriously affected, and the hospital will not let them go.

Of course, their hospital will not approve this kind of medical case competition.

However, what they didn't know was that "the soldiers were dangerous" was their standard, not Zhou Qiao's standard.

Using their level to do this surgery is naturally extremely risky, but in Zhou Qiao's eyes, his perfect-level medical skills are 99% sure, and he can be called a winner.

What's more, he can also secretly exchange healing attributes to ensure that the patient is foolproof.

Even Murphy and Stephanie were drumming in their hearts and were a little nervous.

At the age of ninety-three, even ordinary surgery is extremely risky, let alone heart surgery.

At this moment, the patient lying on the operating table is a "bombshell", the kind that will explode at any time.

However, when they saw that Zhou Qiao was indifferent and confident, they could only try their best to cooperate. In terms of professional skills, Zhou Qiao never needed their opinions.

Twenty years ago, he was diagnosed with chronic bronchitis, and he had a cough and chest tightness every winter, spring and autumn, and often needed to be hospitalized for recuperation.

A month and a half ago, although the weather was acceptable, it was already autumn, and it rained again, an autumn rain and a cold, maybe the sea breeze in San Francisco was cooler, and the old man's old problem had flare up again.

He had a worsening cough, chest tightness, palpitations, and shortness of breath. Then when you go to bed at night, you can't lie down, and as soon as you lie down, your chest tightness and palpitation will intensify.

The old man leaned on the head of the bed all night, and the rest was naturally very poor.

The old man had three sons and one daughter. The eldest son and the second son have passed away a few years ago, the third son is 62 years old, and the youngest daughter is 59 years old.

When his son found out, he thought it was another episode of chronic bronchitis, so he stayed in a community hospital for more than a month, but his condition not only did not improve, but became more serious.

Later, the respiratory physician recommended that he be transferred to a cardiology department for treatment, but he turned out to be a "heart disease" at all.

Cardiac ultrasound showed that Mr. Gao was born with bicuspid malformation of the aortic valve, accompanied by severe calcified stenosis of the aortic valve.

Generally speaking, the human aortic valve has three valves, and this old man is a little special, he was born with only two valves.

Due to the abnormal structure of the valve leaflets, it is easy to cause valve thickening, calcification, stiffness, fibrosis, and eventually valve stenosis due to the continuous impact of blood flow for a long time.

Everyone was surprised that the old man was born with two valves, and he could live so long, even more than his two sons.

The cardiology department recommended that he be transferred to cardiac surgery for treatment, but after the transfer, the expert assessed that surgery was not recommended, the risk was too great, and it was still conservative treatment.

It means that it can be delayed for as long as it takes, and it is ninety-three years old, so at such a large age, what treatment can be cured?

Of course, the doctor wouldn't say that, but that's what he said.

After discussing with Mr. Gao's son and daughter, he also decided to die, but later, he saw Zhang Jianjun's circle of friends.

After understanding the situation, I came to the Iris Clinic with the mentality of giving it a try.

Originally, they were still a little apprehensive, but Zhou Qiao easily won the championship twice in a row (the first two rounds of the California Division and the National Finals), which gave them great confidence.

"If after the operation, the old man will live for a few more years, not much, it will be good to have three or five years. If you can be more than 100 years old, it will be really auspicious. ”

There is an old man in the family, if there is a treasure. What's more, the elderly are deaf and clear-sighted, and there is no Alzheimer's disease, as long as the disease is cured, so that the elderly can eat by themselves, walk slowly, and take care of them at ordinary times, it is not so troublesome.

In addition, the old man himself wants to cure.

Ants are still stealing life, who doesn't want to live? Wouldn't it be nice to live a few more years and see the world?

Of course, the most important thing is that in Zhou Qiao's treatment, not only does he not need money, but he can also give a subsidy as a reward for the competition, why not?

When he arrived at the iris clinic, Zhou Qiao arranged a more detailed examination for the old man to improve the data.

The evaluation found that Mr. Gao's heart ejection fraction was only 30%, less than half of that of a normal person. Heart failure, lung infection, and then underlying diseases such as hypertension and diabetes mellitus, the STS assessment of surgical mortality is as high as 42% (generally more than 8% is considered high-risk).

Regarding Mr. Gao's condition, Zhou Qiao believes that only by "changing the door" to his heart through valve replacement surgery is the way to cure it. Other conservative internal medicine treatments can only alleviate the symptoms, and it will recur again after a short time, and the effect will become worse and worse.

Thoracotomy carries a huge risk of death, and if it doesn't, it probably won't survive the winter.

However, if minimally invasive surgery is used, although the risk is still very large, Zhou Qiao's perfect surgery can already be controlled.

While undergoing surgery, Zhou Qiao introduced to the jury in clear, standard and fluent English:

"The reason why I chose local anesthesia without intubation for aortic valve replacement without intubation under compound sedation is based on the following advantages, one is that it can reduce the stress and stimulation response of tracheal intubation to cardiovascular disease, and the other is that it can reduce the risk of postoperative lung infection......

His daily hard work in English was not in vain, and he was fluent in professional vocabulary than many native Americans.

This surgical method is minimally invasive, only needs to open a few needles, no cardiopulmonary bypass, no cardiac arrest, short operation time, less trauma, especially suitable for aortic valve disease in elderly and high-risk patients.

It's easy to say, but anyone in the know knows that the risks of this procedure are still extremely high.

The eighteen academician judges were unprecedentedly focused, because even if they came to do this operation, they didn't dare to say that they were absolutely sure.

93-year-old patients, heart surgery, high blood pressure, diabetes, chronic bronchitis, ......, super blockbuster!

Without the confidence and strength of absolute pride, I would not dare to do this bomb disposal work.

In addition to the jury and competitors, some doctors in the field of cardiac surgery, some doctors who know Zhou Qiao, and many viewers and friends outside the circle who are interested in this are all online or on their mobile phones to download the APP and watch.

For example, Loya, Talia, Jenna, Ling Qingqing, Veronica, Governor Hulk, and even Loya's uncle and aunt, Kevin Nix, the former mayor of Ellot Town, and his wife Tracy McKina.

Cathy, the Westins, the Clarks, and their daughters, Jessica, Taylor, and Felipe......

Zhang Jianjun and others in Chinatown.

Chen Zhining and others from the East Africa base.

Rachel, Vivica, Park so-joo, Kim Hee-jin left behind at the Iris Clinic, Ariel from the laundry next door, Murphy's grandparents, and so on.

Many, many people are watching.

Most of the patient's family, the family of the third son, the family of the youngest daughter, and the descendants of the eldest son and the second son, came to the UCSF Medical Center to wait outside the operating room and watch the live broadcast.

In the rest area outside the operating room, on the 55-inch large TV screen, the staff carried out high-definition projection.

For the patient's family, it is actually a good thing, and it can be regarded as a welfare.

After all, if you usually have surgery, especially the kind of major surgery that goes into the operating room, will the doctor let you see it? You won't see it at all.

And now, it is also a meaningful thing to be able to sit outside and watch the live broadcast on the big screen while praying for the old man together.

In addition, there are so many people in the family, and it has been a long time since they have gathered so together. More than the Chinese New Year.

It's a pity that Zhou Qiao was too low-key and didn't notify the teachers and classmates in China, if those people knew the level of competition he was participating in now, they would probably drop their jaws.

Talia is actually usually relatively timid, and when she takes blood during the physical examination, she twists her head in other directions, and she doesn't dare to look directly at the needle to pierce it, but watching the live broadcast at this time, she actually held back the timidity and discomfort in her heart, and forcibly stared at the screen, and even had some relish and interest.

Best friend Jenna wanted to laugh a little, and said that Talia was hopeless, and she was fallen, and she wanted to be killed by Dr. Zhou. If her fans know, it will probably hurt her heart.

She had known Talia for so long, and it was the first time she had seen Talia so proactive and show obvious interest in a man.

I saw that on the live broadcast screen, Zhou Qiao's smooth operation was pleasing to the eye.

He punctured the patient's thigh and transported a catheter less than 6 mm thick, carrying an artificial valve and device, from the blood vessel all the way to the patient's heart valve.

Then, the catheter is slowly rotated, the artificial valve is gradually released, and through extremely subtle adjustment, the implanted artificial valve blooms perfectly on the patient's heart like a flower petal......

Zhou Qiao's surgery, if the weight is light, it is obviously high, fine, and sharp super difficult surgery, which made him make a very simple feeling!

It's that kind of thing, anyone who sees it has a reaction: Wow~, this is so simple, I should be able to do it!

In fact, it's just that they learn it with their eyes, and if they really do it, they just learn it.

The live broadcast room of the operation has not been silent, and the eighteen academicians have asked questions from time to time.

Moreover, there are several academicians, wilted and wilted, who always ask questions suddenly when Zhou Qiao is carrying out the key steps.

It's like the kind of money counting contest, hundreds of bills, while counting, you have to memorize the data, and then there are people deliberately making trouble on the side, interrupting, the contestants have to answer the questions, but they can't stop in their hands, and they can't forget the numbers. Otherwise, you have to count again.

Zhou Qiao's situation at the moment is much more difficult than counting banknotes. If he were to pause the operation, it might not affect the final quality of the surgery, but it would definitely affect the final score.

"Dr. Zhou, please answer immediately, which patients are suitable for TAVR surgery?" An academician asked a question when Zhou Qiao's catheter head was about to reach the heart valve.

At this critical moment, how can you stop? Stopped showing your level out!

Therefore, Zhou Qiao was distracted and used for two purposes, while finely manipulating the catheter, like flowing water, while talking fluently.

"In general, there are 4 scenarios."

"First, elderly patients with severe aortic stenosis or regurgitation, the risk of conventional surgical thoracotomy is too high as assessed by the cardiac surgery team."

"The second is the decay of surgical aortic valve bioprosthetic valve replacement and the need to replace the valve again."

"The third is patients with severe aortic valve lesions with surgical contraindications, such as severe bleeding tendency, porcelain aortic changes, anticoagulation contraindications, history of thoracic radiotherapy, sternal infection, etc."

"Fourth, patients with severe aortic valve lesions with malignant tumors have a life expectancy of more than one year."

After answering, the valve also bloomed smoothly!

Perfect!

The academicians all nodded their heads, and some even gave them a thumbs up.

This is not over, another academician asked: "Dr. Zhou, why did you choose the surgical method of local anesthesia without intubation under compound sedation, and what is your understanding of this surgical method?" ”

"Contestants, please give a brief discussion on which is more important, the small incision or the fast operation."

These questions are very well stuck, and I have to say that the academicians are quite tricky, and they are often stuck when Zhou Qiao is in a critical operation, so he can answer immediately.

But naturally it didn't affect Zhou Qiao in the slightest, he kept his hands on it, and he came as soon as he opened his mouth, showing the demeanor of a grandmaster.

"That's how I understand this technique......

"Regarding the small incision and the speed of surgery, I think that both the patient and the surgeon want the incision to be small and the quality of the operation fast and good, but it is difficult to have both in the world, everything must be on the basis of ensuring the quality of the operation and the safety of the patient's life. Excessive pursuit of speed and small trauma, ignoring the quality of medical care itself, is to abandon the trunk of the tree and grasp the branches and leaves......"

(End of chapter)