MTL - I Can See Health-v3 Chapter 904 Intimate contact between balloon and stent

  Chapter 904 Intimate Contact of Balloon and Stent

   "Isn't the stent just the anterior descending branch?" Jin Miao said with a pause.

   There are three main branches in the coronary arteries of the heart.

   On the left, from the left main trunk down, it divides into the anterior descending branch.

   On the right is also the right coronary artery and circumflex branch

  Other blood vessels are tiny branches of these vessels.

  Lu Chen shook his head slightly, "Jin Miao, look here carefully!"

  He pointed to a stenosis in the coronary angiogram.

   Here is the bifurcation of the blood vessels, with a great angle.

   "Huh? No way...is it here?"

  Jin Miao showed a look of surprise.

   The narrowness here, he had noticed before.

   But he thought it was the stenosis of the blood vessel formed again after the first operation, and he didn't realize that it was the first stenosis.

  Lu Chen said sternly: "This should be the first narrowness, and the position of the bracket is just below the narrowness!"

  Jin Miao was stunned for a moment, "Director, you mean, the stent placed by the patient for the first time has shifted?"

  After the stent was displaced, the previously narrow place was exposed again.

  Lu Chen nodded slowly.

   He has carefully studied the coronary angiography images.

   Now there is only one possibility to explain the problem that the balloon cannot pass.

   But, this bracket has been in place for five months!

   Under normal circumstances, the stent has already been endothelialized, how could it be displaced?

   "Old Gu, where did the patient's first stent get done?" Lu Chen looked back at Gu Xinyue in confusion.

   "I heard from my family that it was done in the First Hospital of the Magic City." Gu Xinyue looked at the medical records, "The records in the medical records were also done in the First Hospital of the Magic City, and it was done by Professor Zhang Shuqing's team."

   "Huh? Was it done by my mentor?"

  Lu Chen was startled.

   "Yes." Gu Xinyue nodded.

   "Old Gu, then please suggest to my teacher, let them bring over the original video of the first surgery." Lu Chen ordered.

"OK."

  Gu Xinyue immediately began to act and contacted the doctor at the First Hospital of Magic Capital.

  …

   After half an hour.

  Gu Xinyue mentioned Lu Chen's name, and soon got the video of the operation.

   "Look, it really is here!"

   Opened Lu Chen and saw the narrow part at once.

   "Stand, shifted!"

  Although the problem was found, everyone was a little silent.

  Stent displacement, a complication, is extremely rare.

   No wonder patients still have chest tightness and chest pain after stent implantation.

   "There is another problem." Lu Chen said solemnly, "The narrow part is at the fork, the angle is too big!"

  The angle is too large, and the balloon is difficult to pass.

   This is also one of the reasons why the balloon cannot go in and out.

   "Stop the operation first." Lu Chen ordered, "All doctors who don't have surgery, come to the office to discuss first."

   It is extremely rare for Lu Chen to stop the operation.

  Everyone can also feel the difficulty of this operation.

   in the office.

  Lu Chen and Dai Wansong sat in the upper seats, while the other doctors sat scattered around.

   On the podium, on the projector, the patient's angiography images are constantly projected.

   At this moment, Lu Chen seemed to be silent and his eyes darkened.

   In fact, his consciousness has entered the virtual space of the system, and he has begun to perform virtual training of "bracket" displacement.

  There is no way, the bracket is shifted, and even Lu Chen has not operated it.

   Now you can only sharpen the gun on the spot and rely on the simulation of the system to perform common-sense operations.

   "Let's all brainstorm ideas."

   Dai Wansong saw that Lu Chen didn't say a word and thought he was stumped, so he asked the crowd.

When the people below    have seen such a situation, they can't say why.

   Watching the time pass slowly, if we don't come up with a suitable method, this operation can only be suspended.

  Jin Miao was a little impatient.

   As the chief surgeon of this operation, he was under enormous pressure.

   He looked at Lu Chen on stage from time to time.

   found that Director Lu had a serious expression and said nothing.

   In his heart, he was even more anxious.

   After half an hour.

  Dai Wansong shook his head slightly, seeing that there was no way to do it, "Forget it, why don't you choose another time?"

   He glanced at Lu Chen.

   At this point, Lu Chen's consciousness had virtually withdrawn from the system.

  He sorted his thoughts.

   "Dean Dai, let me do it."

   A simple sentence, but it surprised Dai Wansong.

   "Lu Chen, what did you say?"

   This kind of difficult surgery, once you take over, you have to be responsible to the end.

   In case of a miss, it will have a certain impact on the reputation of the Fifth Academy of the Magic Capital.

   More importantly, in the minds of everyone.

  Lu Chen is good at areas such as TAVR and electrophysiology.

   As for the coronary artery, Lu Chen's technical level has not been recognized by everyone in the magic capital.

   "I just thought about it, I can try it with a cutting balloon and a drug balloon."

   In the virtual space of the system, Lu Chen tried many methods, and finally locked on the cutting balloon.

   "Lu Chen, although you can try cutting the balloon, for such a large angle, the blade for cutting the balloon can easily hang on the mesh of the stent."

   Dai Wansong expressed his concerns.

  The heart stent is actually a special mesh structure.

  Cut the balloon, which combines the surgical blade with the balloon.

  When the balloon is opened, a plurality of longitudinally arranged blades will be propped up to a certain extent, and the soft plaque in the blood vessel and the intima of the blood vessel will be cut to a certain extent, making the balloon easier to open and the blood vessel to be more easily propped up.

   However, when the angle of the blood vessel is too large, the blade that cuts the balloon can easily hit the grid hole of the stent.

   If you touch it like this, the whole bracket will be invalid!

   "I try to control the strength and angle." Lu Chen said slowly.

"what?"

  Dai Wansong was stunned.

  Interventional surgery, this is not simply repairing a machine.

  Contrast images cannot fully show all the intravascular conditions.

  I want the blade that cuts the balloon to not touch the stent grid. This kind of operation is not so difficult!

   "Lu Chen, do you want to slow down?" Dai Wansong hesitated, "We don't need to be in such a hurry."

   "The patient's current condition shows that the symptoms of angina pectoris are obvious. If surgery is not performed as soon as possible, myocardial infarction or even other complications may occur." Lu Chen firmly said, "President Dai, you can rest assured, I am sure!"

   In the system virtual space, Lu Chen has been able to have a 95% success rate.

   Dai Wansong's mouth twitched when he heard the words.

   In just a few dozen minutes, Lu Chen was sure?

  Dai Wansong was about to reject Lu Chen's proposal for surgery. After all, the Fifth Magic City Hospital had just been established, and everything was still safe.

   But at this moment, Gu Xinyue hurried in.

   He quickly came to Lu Chen and Dai Wansong's side, and whispered in a low voice, "The patient has chest pain and tightness on the stage again, and the symptoms are still more severe!"

   (end of this chapter)