Chapter 1447： Deep low temperature
Zheng Ren made a suture in the anterior lateral membrane of the ascending aortic root and put it into the hemostat.
Subsequently, the cold heart cardioplegia perfusion needle is drained from the gas and then inserted into the central part of the sacral suture into the ascending aorta.
Tighten the hemostat and secure the cannula and hemostat together with thick lines. Connect the cannula to the infusion device.
"Zheng boss? What to do next?" Laohe asked in advance.
"Left room."
"Well."
There are two options for the next step in the operation.
Left atrial drainage or left ventricular drainage.
There are no advantages and disadvantages, only suitable. For the cardiopulmonary, the left atrium and left ventricular drainage are slightly different, and Lao He is showing off to Zheng Bo with his professional details.
I definitely want to be more suitable than twin sisters! Zheng boss, look at me and see me!
Look here, look here!
Zheng Ren couldn't hear the cry of Lao He's heart, but he felt that the surgery was done much more than he was in the system operating room.
He made a large suture in the joint between the root of the right upper pulmonary vein and the left atrium, and was fitted with a hemostat.
After cutting a small opening in the sputum stitch, the left atrial drainage tube is inserted into the left atrium, the hemostat is tightened, and the thick wire is ligated, the drainage tube is fixed with the hemostat, and the drainage tube is connected with the artificial heart-lung machine.
After all the operations, Zheng Ren once again checked all the pipes and their connections, checked for no errors, and sure that there were no obstacles in each channel, and the extracorporeal circulation began.
At the moment when he started the extracorporeal circulation, Lao He was arrogant.
Although he knew that he had stabilized first, he wanted to leave a number that others could not surpass.
The heart surgery from the previous 912 did not much, the level of the surgeon is also general, so Laohe has no status in the group.
Although it is a group of chat and fart, but people with high levels have a certain authority.
People who engage in technology have similar common problems. Although it is just a group of chats and exchanges, it cannot be avoided.
This time, I must sigh with anger, and I will take a look at the timer from time to time.
Although it is completely meaningless to fight for this tone, it is completely different from the heart bypass surgery that was still stopping.
However, even if the extracorporeal circulation exits the historical stage, it is considered to be a record in the domestic surgical field... even the world's surgical community!
5'05′′!
When he saw this number, he was a little embarrassed.
The highest record in the past was 9'22′′, and Zheng’s surgery actually increased the time to establish extracorporeal circulation by nearly doubled!
What a special thing, is this a human thing?
After seeing the time, Lao He made a fist in his right hand and swung it fiercely.
Become, this is definitely the world record!
Although no one approves it, in my heart, this is the world record!
After the surgery, go to the group to show off, and now concentrate on giving Zheng boss a match. If you are a hundred and a half, you must leave a good impression on Zheng Bo.
Don’t make a big difference before and after.
Twin sisters spend, so powerful opponents, their own pressure on the mountain, Lao He cautiously observe the progress of Zheng Ren surgery from the patient's head.
After several minutes of extracorporeal circulation, Zheng Ren blocked the superior and inferior vena cava and entered the complete extracorporeal circulation.
At this time, the blood of the superior and inferior vena cava is completely intubated into the artificial heart-lung machine and does not flow into the right atrium.
At the same time, the blood is cooled.
Laohe constantly reports the blood temperature.
36c...
35c...
32c...
When the whole body temperature dropped to 30c, Zheng Ren lifted the ascending aortic band and blocked the ascending aorta with the aortic occlusion forceps.
Su Yun immediately injected 4c cold heart arrest from the perfusion tube at the root of the aorta. At the same time, Zhao Yunlong cools the surface of the heart with 4c iced water or ice particles to make the heart stop quickly.
Zheng Ren is very satisfied.
It is indeed much faster than surgery in the system operating room.
There are two doctors who can be the assistants who can perform the type 1 aortic arch replacement surgery. There is an anesthesiologist who can be anesthetized and can be extracorporeal circulation. The key is that there are Xiaoyi people.
Do not say anything else, Xiaoyi people smiled and bent, smiled yesterday, did not sleep yesterday, only tired on the plane to clean up.
In contrast, the experience in the operating room of the system is extremely poor.
After blocking the ascending aorta, Lao He Ning Shen began to report various values.
Extracorporeal circulation is quite difficult. If you don't pay attention, the patient will not wake up.
"Arterial pressure, 70mmhg."
"The central venous pressure is 9 cm water column."
"Body temperature, 27 degrees Celsius."
"Old, the body temperature dropped a little." Zheng Ren looked down at the surgery area and exchanged with him.
Under normal circumstances, the body temperature under extracorporeal circulation can be maintained at around 28 degrees Celsius.
However, if the surgeon judges that the operation is difficult, the procedure is particularly long, and the extracorporeal circulation device will lower the body temperature.
“How much?” asked Lao He.
"Deep low temperature, 15 degrees Celsius." Zheng Rendao.
Old He Haoran.
Cardiac cardioplegia promotes cardiac arrest and quickly stops all bioelectromechanical activities in the heart, helping to preserve the heart's energy reserve.
Combined with deep local hypothermia, it can further reduce myocardial energy and oxygen consumption, and reduce the accumulation of harmful substances such as carbon dioxide, hydrogen ions and oxygen free radicals.
Deep hypothermia means that the duration of surgery is more than 3 hours.
He immediately started operating the instrument and lowered the temperature.
"Myocardial temperature, 15 degrees Celsius." Old congratulations.
"enough."
"Flow, 50 ~ 60ml / kg."
"Old congratulation, take a look at the value of blood." Zheng Ren holding a blunt scissors in his hand, began to free the pulmonary artery segment, and his mouth exchanged with the old congratulations.
The speech did not delay the operation of Zheng Ren's hand, and the operation was quite fine.
After the extracorporeal circulation began, the patient's body temperature dropped below 25 degrees Celsius, and the myocardial temperature also dropped to 15 degrees Celsius. Zheng Renxian observed the coronary artery.
No problem with the coronary artery, Zheng Ren began to free the pulmonary artery.
The pulmonary valve is located between the right ventricle and the pulmonary artery, preventing blood flow into the pulmonary artery from flowing back to the right ventricle.
The heart has two atrioventricular valves and two large aortic valvesThe pulmonary valve belongs to one of the aortic valves and is a three-and-a-half-month valve. Both the leaflets and the annulus are weak, the annulus is connected to the right ventricular funnel muscle, and there is no direct fibrous continuity with the tricuspid valve.
To the main event, Zheng Ren took a sigh of relief, took a deep breath, held his breath and began to cut the pulmonary artery. The position of the boundary between the left and right valves.
When the knife fell, Zheng Ren was very careful and was careful as never before.
He knows that if the wall of the pulmonary artery is cut, the aorta may be injured, and the location is very deep and it is difficult to stop bleeding.
The lancet is gently tapped, and then separated by a layer of hemostatic forceps.
Still the smallest hemostatic forceps, Zheng Ren's fingers can't reach, can only rely on touch.
At this point, he still did not use a microscope.
At this point, the assistant is relatively idle. Su Yun did not speak, but focused on Zheng Ren's separation of the pulmonary artery.
Subsequently, the cold heart cardioplegia perfusion needle is drained from the gas and then inserted into the central part of the sacral suture into the ascending aorta.
Tighten the hemostat and secure the cannula and hemostat together with thick lines. Connect the cannula to the infusion device.
"Zheng boss? What to do next?" Laohe asked in advance.
"Left room."
"Well."
There are two options for the next step in the operation.
Left atrial drainage or left ventricular drainage.
There are no advantages and disadvantages, only suitable. For the cardiopulmonary, the left atrium and left ventricular drainage are slightly different, and Lao He is showing off to Zheng Bo with his professional details.
I definitely want to be more suitable than twin sisters! Zheng boss, look at me and see me!
Look here, look here!
Zheng Ren couldn't hear the cry of Lao He's heart, but he felt that the surgery was done much more than he was in the system operating room.
He made a large suture in the joint between the root of the right upper pulmonary vein and the left atrium, and was fitted with a hemostat.
After cutting a small opening in the sputum stitch, the left atrial drainage tube is inserted into the left atrium, the hemostat is tightened, and the thick wire is ligated, the drainage tube is fixed with the hemostat, and the drainage tube is connected with the artificial heart-lung machine.
After all the operations, Zheng Ren once again checked all the pipes and their connections, checked for no errors, and sure that there were no obstacles in each channel, and the extracorporeal circulation began.
At the moment when he started the extracorporeal circulation, Lao He was arrogant.
Although he knew that he had stabilized first, he wanted to leave a number that others could not surpass.
The heart surgery from the previous 912 did not much, the level of the surgeon is also general, so Laohe has no status in the group.
Although it is a group of chat and fart, but people with high levels have a certain authority.
People who engage in technology have similar common problems. Although it is just a group of chats and exchanges, it cannot be avoided.
This time, I must sigh with anger, and I will take a look at the timer from time to time.
Although it is completely meaningless to fight for this tone, it is completely different from the heart bypass surgery that was still stopping.
However, even if the extracorporeal circulation exits the historical stage, it is considered to be a record in the domestic surgical field... even the world's surgical community!
5'05′′!
When he saw this number, he was a little embarrassed.
The highest record in the past was 9'22′′, and Zheng’s surgery actually increased the time to establish extracorporeal circulation by nearly doubled!
What a special thing, is this a human thing?
After seeing the time, Lao He made a fist in his right hand and swung it fiercely.
Become, this is definitely the world record!
Although no one approves it, in my heart, this is the world record!
After the surgery, go to the group to show off, and now concentrate on giving Zheng boss a match. If you are a hundred and a half, you must leave a good impression on Zheng Bo.
Don’t make a big difference before and after.
Twin sisters spend, so powerful opponents, their own pressure on the mountain, Lao He cautiously observe the progress of Zheng Ren surgery from the patient's head.
After several minutes of extracorporeal circulation, Zheng Ren blocked the superior and inferior vena cava and entered the complete extracorporeal circulation.
At this time, the blood of the superior and inferior vena cava is completely intubated into the artificial heart-lung machine and does not flow into the right atrium.
At the same time, the blood is cooled.
Laohe constantly reports the blood temperature.
36c...
35c...
32c...
When the whole body temperature dropped to 30c, Zheng Ren lifted the ascending aortic band and blocked the ascending aorta with the aortic occlusion forceps.
Su Yun immediately injected 4c cold heart arrest from the perfusion tube at the root of the aorta. At the same time, Zhao Yunlong cools the surface of the heart with 4c iced water or ice particles to make the heart stop quickly.
Zheng Ren is very satisfied.
It is indeed much faster than surgery in the system operating room.
There are two doctors who can be the assistants who can perform the type 1 aortic arch replacement surgery. There is an anesthesiologist who can be anesthetized and can be extracorporeal circulation. The key is that there are Xiaoyi people.
Do not say anything else, Xiaoyi people smiled and bent, smiled yesterday, did not sleep yesterday, only tired on the plane to clean up.
In contrast, the experience in the operating room of the system is extremely poor.
After blocking the ascending aorta, Lao He Ning Shen began to report various values.
Extracorporeal circulation is quite difficult. If you don't pay attention, the patient will not wake up.
"Arterial pressure, 70mmhg."
"The central venous pressure is 9 cm water column."
"Body temperature, 27 degrees Celsius."
"Old, the body temperature dropped a little." Zheng Ren looked down at the surgery area and exchanged with him.
Under normal circumstances, the body temperature under extracorporeal circulation can be maintained at around 28 degrees Celsius.
However, if the surgeon judges that the operation is difficult, the procedure is particularly long, and the extracorporeal circulation device will lower the body temperature.
“How much?” asked Lao He.
"Deep low temperature, 15 degrees Celsius." Zheng Rendao.
Old He Haoran.
Cardiac cardioplegia promotes cardiac arrest and quickly stops all bioelectromechanical activities in the heart, helping to preserve the heart's energy reserve.
Combined with deep local hypothermia, it can further reduce myocardial energy and oxygen consumption, and reduce the accumulation of harmful substances such as carbon dioxide, hydrogen ions and oxygen free radicals.
Deep hypothermia means that the duration of surgery is more than 3 hours.
He immediately started operating the instrument and lowered the temperature.
"Myocardial temperature, 15 degrees Celsius." Old congratulations.
"enough."
"Flow, 50 ~ 60ml / kg."
"Old congratulation, take a look at the value of blood." Zheng Ren holding a blunt scissors in his hand, began to free the pulmonary artery segment, and his mouth exchanged with the old congratulations.
The speech did not delay the operation of Zheng Ren's hand, and the operation was quite fine.
After the extracorporeal circulation began, the patient's body temperature dropped below 25 degrees Celsius, and the myocardial temperature also dropped to 15 degrees Celsius. Zheng Renxian observed the coronary artery.
No problem with the coronary artery, Zheng Ren began to free the pulmonary artery.
The pulmonary valve is located between the right ventricle and the pulmonary artery, preventing blood flow into the pulmonary artery from flowing back to the right ventricle.
The heart has two atrioventricular valves and two large aortic valvesThe pulmonary valve belongs to one of the aortic valves and is a three-and-a-half-month valve. Both the leaflets and the annulus are weak, the annulus is connected to the right ventricular funnel muscle, and there is no direct fibrous continuity with the tricuspid valve.
To the main event, Zheng Ren took a sigh of relief, took a deep breath, held his breath and began to cut the pulmonary artery. The position of the boundary between the left and right valves.
When the knife fell, Zheng Ren was very careful and was careful as never before.
He knows that if the wall of the pulmonary artery is cut, the aorta may be injured, and the location is very deep and it is difficult to stop bleeding.
The lancet is gently tapped, and then separated by a layer of hemostatic forceps.
Still the smallest hemostatic forceps, Zheng Ren's fingers can't reach, can only rely on touch.
At this point, he still did not use a microscope.
At this point, the assistant is relatively idle. Su Yun did not speak, but focused on Zheng Ren's separation of the pulmonary artery.
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