Antirejection medication generally leads to miscarriages in pregnant women and causes fetal deformities. If you choose pregnancy and stop taking these medications, the consequence could be that the condition rapidly deteriorates during pregnancy, potentially leading to death.

Under such circumstances, a patient who has access to extensive medical information will naturally make the best choice for herself, deciding to conceive anyway, since she will eventually undergo a heart-lung transplant.

However, what this patient didn’t expect was that a domestic doctor said she could undergo a non-transplant surgery before the procedure to treat her illness.

"Director Zhang believes a transplant isn’t necessary, while foreign doctors believe it must be done?" Du Haiwei reconfirmed to ensure there was no misunderstanding. 𝑓𝑟ℯ𝘦𝓌𝘦𝘣𝑛𝑜𝓋𝑒𝓁.𝑐ℴ𝓂

Internationally, medicine is more advanced, and domestic doctors have always learned from international medical advancements. Domestic doctors understand that most patients have a psychological bias towards favoring foreign expertise. It’s only natural that a patient who settled abroad for treatment first takes professional advice from foreign doctors. It’s also correct for Du Haiwei to inquire more now.

"Yes." Du Yeqing nodded, "Director Zhang, after carefully determining her condition, believes that this patient who had heart disease previously underwent a mitral valve replacement surgery once before. The current deterioration is due to the malfunctioning of an artificial mechanical valve replaced abroad, which became stenotic again and has thrombosis occurring, making the situation urgent, and the tricuspid valve regurgitation led to severe pulmonary hypertension. Considering the overall condition of the patient, the likelihood of secondary pulmonary hypertension is high, and we can attempt cardiac surgery first to improve the condition. Foreign doctors believe there have been substantial changes in her pulmonary vessels, necessitating transplant surgery."

The point of contention over whether to perform a lung transplant for pulmonary hypertension may lie in the domestic and foreign doctors’ assessment of the pulmonary vascular lesions in this patient. It depends on whether they consider the patient’s pulmonary vasculature to be incurably damaged. If the pathological changes such as vasoconstriction and stenosis are irreversible, there’s no medical remedy for such substantial vascular pathological changes. This is why primary pulmonary hypertension is later termed idiopathic pulmonary hypertension—unable to diagnose the cause, leaving transplantation as the only option.

In surgery, it’s impossible to say that these pulmonary vessels can be completely removed and reconstructed. From our perspective during the last pulmonary intervention, the distribution of pulmonary vessels is like a lush tree with densely packed branches and leaves covering almost the entire lung tissue. Removing these vessels equates to removing the entire lung. The only substitute for removing the whole lung is a double lung transplant.

Zhang Huayao cannot be said to be betting, rather he is relying on his skill and experience to judge that the patient’s pulmonary vessels have not undergone irreversible changes and can be attempted. Whether the doctors at Guo Zhi Hospital or the foreign doctors are right or wrong cannot be concluded in such a short time. The final judgment will rely on the outcomes post-surgery and the patient’s subsequent condition.

No matter what, the patient heard that a transplant might not be necessary, and even if it means taking a gamble, she is willing to quickly return to China to find Zhang Huayao.

This situation fully demonstrates that patients’ need from doctors is never about whether they are domestic or foreign doctors; it’s about who can get the job done.

Du Mengen, listening to this, furrowed his brows and blinked: Student Xie had hit the mark with her clever answer—it’s a heart disease patient with secondary pulmonary hypertension. Moreover, it’s an academic result strongly supported by Boss Zhang, the established leader. Student Xie isn’t just fixated academically; she’s smart.