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MTL - I Can See Health-v2 Chapter 870 Ablation of scar area (second more)
Chapter 870 Ablation of Scar Area (Second Update)
Conduit outdoor.
The high-level doctors from the Kyoto Affiliated Hospital were all very nervous.
"Director Yang, do you want to cut off the live broadcast signal?" An attending doctor hurried to Yang Feng's side.
"Okay, cut off first!"
Yang Feng nodded with a solemn expression.
In case the patient has any problems, it will be broadcast live, which is not very good for the reputation of the First Affiliated Hospital of Kyoto.
Just when the doctor in charge of Huaxia wanted to return, he informed the Information Section to cut off the live broadcast signal source, but Shen Wenguang, who was on the side, made a sound.
"Director Yang, wait a moment."
At this time, Shen Wenguang's face could not see the slightest bit of nervousness and worry.
"Director Shen, this situation is not very good, don't cut off the signal source, in case something happens..." Yang Feng gritted his teeth and looked serious. He put his hands behind his back and couldn't help clenching his fists.
"Don't worry, Lu Chen can handle it well." Shen Wenguang still looked calm, "This kind of ablation of ventricular tachycardia, after inducing the patient's ventricular tachycardia, ventricular fibrillation is inevitable, even if it makes I do it, and there is no way to avoid it 100 percent."
"That's fine."
Yang Feng was so calm when he saw that Mayo's director Shen Wenguang had said so.
What else can he say?
can only call back the attending doctor just now, "Wait a minute, don't cut off the signal source first."
After thinking about it, he also gave a grand reason, "Let everyone in the audience take a look at the rescue, don't think that the operation is all smooth sailing."
The attending doctor was a little confused.
The change before and after Director Yang Feng is too big!
However, as a low-level scoundrel, he can only do what Director Yang Feng said.
…
The scene of 's live rescue rescue really shocked the audience.
But after a brief surprise, they were even more amazed at Lu Chen's calm handling.
We all know that the ablation of ventricular tachycardia is very likely to induce ventricular fibrillation.
But how to deal with the occurrence of ventricular fibrillation is another matter.
As a practitioner, Lu Chen showed his extreme calmness in front of everyone without reservation.
Cardiopulmonary resuscitation, defibrillation, and intravenous CPR.
Everyone has been skeptical from the beginning to silence now.
Everyone was staring at the picture in the live broadcast room of the surgery, and they didn't want to move their eyes at all.
…
Finally, after the third defibrillation, the patient's ventricular fibrillation finally recovered!
"Dou rhythm restored!" Xiao Shikang took a deep breath and said to Lu Chen, "Continue the operation?"
Lu Chen nodded without hesitation: "Continue!"
VF is inevitable!
Even if the operation is stopped this time, who can guarantee that there will be no ventricular fibrillation in the next operation?
If surgery is not done, then this young male patient is likely to continue living under the pain of electric shock!
This situation is something that no one wants to see.
"Okay!" Xiao Shikang didn't say much, he just glanced at Lu Chen, as if recalling the time when Lu Chen had surgery in Kyoto.
Lu Chen was still quite young.
Seeing him, he has long since become calm.
After the patient's ventricular fibrillation recovered, Lu Chen immediately started ventricular tachycardia mapping.
"The distance and orientation of the bipolar mapping catheter to the contacting tissue can have an impact on the qualitative and quantitative signal, which in turn affects the results of matrix mapping based on voltage and abnormal potential."
Lu Chen said while talking.
What he said was naturally to Xiao Shikang next to him and the audience in the live broadcast room.
"In addition, the patient has dilated cardiomyopathy and is undergoing myocardial remodeling, so there are many scars in the heart, and the degree of delay of the local potential in the scar depends largely on its anatomical location."
These little skills are all knowledge points that are not accessible in textbooks or ordinary practitioners.
Lu Chen explained it to everyone without reservation.
There are many people in the live broadcast room who know the goods.
Many people immediately sat up straight and watched the live broadcast more seriously.
…
Twenty minutes later, Lu Chen stopped the mapping in his hand, he turned to look at Xiao Shikang beside him, "The mapping is done."
Xiao Shikang was stunned for a moment, the measurement was really fast!
In general mapping, even if it goes well, it will take at least half an hour.
Lu Chen's speed is so fast, which is entirely due to his familiarity with the anatomical position of the heart and electrophysiology.
This ability can be improved not just by simply increasing the amount of surgery.
Rather, it requires personal perception and understanding of surgery.
However, Lu Chen's expression did not relax at all.
Because the mapping is over, the next step is the more important ablation!
Patient has dilated cardiomyopathy.
In dilated cardiomyopathy, the heart gradually enlarges to compensate for the insufficiency of the heart.
In medicine, this enlargement of the heart is called "ventricular remodeling".
Myocardial remodeling means that there are many scars on the heart muscle.
The existence of scar area greatly affects the progress of ablation.
Xiao Shikang would like to see how Mayo's doctor handles the ablation of the scar area.
At this time, Lu Chen had prepared the ablation catheter, and he said solemnly: "The mechanism of VT in the scar area is mostly related to the diseased tissue near the valve annulus and the reentry mediated by scar tissue!"
Xiao Shikang thought for a while and asked, "How can it be accurately ablated?"
If the ablation is not careful enough, VT may recur.
The scope of ablation is too large, and it is likely to damage the heart muscle.
This is where the ablation is the most challenging for the practitioner. How to grasp the degree of it is the key to the success of the surgery!
Lu Chen put the ablation catheter in his hand along the channel and sent it into the patient's heart, smiling: "This is to formulate different ablation methods according to the individual."
"In general, we can divide the isthmus, outer ring, inner ring, and bystander according to the role of each part in the reentry ring, and the isthmus can be subdivided into the entrance, exit and central isthmus area. Regional determination of the scar area and isthmus-related areas, to find the key isthmus through drag mapping."
"In non-ischemic heart disease with VT, combined endocardial and epicardial ablation is often required due to the complex pathogenesis."
The experience of these operations was not something Lu Chen imagined out of thin air.
is extracted from previous surgical cases after hundreds of surgical experiences.
Lu Chen's greatest help is the system virtual space.
He has countless opportunities to try and make mistakes!
Every failure is Lu Chen's most valuable experience.
The surgical experience he has accumulated so far is something that many surgeons cannot comprehend in their lifetime.
Beside, Xiao Shikang listened to Lu Chen's explanation, his eyes became brighter and brighter.
If we talk about Lu Chen in the past, he only performed a little more surgery, but now he, whether it is surgical operation or knowledge reserve, has completely surpassed his cognition.
Surgery live room.
The audience also heard Lu Chen's explanation.
I have been watching the live broadcast, which is all because of my seriousness and understanding of electrophysiological interventional surgery in the Department of Cardiology.
Everyone has learned more or less experience from Lu Chen.
The number of live broadcast viewers has increased, but the barrage has decreased.
Everyone was immersed in Lu Chen's art-like electrophysiological surgery.
There are also updates
(end of this chapter)