Currently, the treatment of debakey1 type dissection aneurysms is mainly based on surgical replacement of artificial blood vessels.

Because the cause of Ma Fang syndrome cannot be eradicated and the distal residual lesions are still possible to develop further, there is a great possibility of recurrence after ascending aorta replacement surgery.

It is estimated that Dr. Rudy had a premonition about this and told his wife to go to Kings Hospital for treatment immediately if she felt unwell.

Therefore, the onset of the disease was discovered very early this time, and blood pressure should have been controlled in the intensive care unit to prevent the condition from further deteriorating, and waiting for the next step of treatment.

What is more troublesome about Ma Fang syndrome is that the large blood vessels in the whole body have pathological manifestations of middle-layer cystic necrosis. Even if the operation is successful, no one can predict when the disease will happen again next time.

Dr. Rudy continued to talk about the results of various tests, and he knew it well. Zheng Ren did not speak, but just thought.

After getting into the car, Su Yun asked: "Boss, the operation is very difficult to cut the sternum in the middle."

Zheng Ren knows what he means.

This is one of the key points and difficulties of the surgery.

Generally speaking, for the secondary operation, the original approach should be taken from the first operation, so that the patient's injury is relatively small.

Moreover, for aortic arch replacement surgery, sternum splitting is almost the only approach, and other incision fields are limited.

But the sternum with a thick callus is needed to be chopped against the side, and the sternum saw slipped... and then it was a tragedy.

If it is a normal operation, just change the incision. However, if you want to undergo aortic arch replacement surgery, you will be completely unable to settle down and you can only choose the largest gap in the field of vision.

The aortic arch cannulation surgery that Zhao Yunlong was thinking about was just an idea. I really could find out when it was not known.

However, when the secondary surgery is used to split the sternum, the heart, especially the right atrium, may experience secondary damage and bleeding or major bleeding in the aneurysm rupture.

This is a story of experience. It seems that Su Yun has had a similar operation, and the surgical effect is average.

Zheng Ren nodded and said, "I will get the way in. This is not difficult. The difficulty lies in the later stage. I have figured out several methods. Among them, I think the method of cooling down first is relatively safe."

"Heparinization, cool down first?" Su Yun was stunned.

This idea is a bit bizarre.

And to achieve this, the speed of the surgery is extremely demanding.

The body's blood is heparinized and will face a variety of complications. The patient rescued at Eicu two days ago is one of the examples.

"No, it's a little different from normal surgery."

“How to do it?”

"First heparinization, pass through the right subclavian artery or femoral artery, intravenous cannulation, and perform extracorporeal circulation and cooling. At this time, the chest opening can reduce the chance of heart or blood vessel rupture, and it is more conducive to the separation and exposure of mediastinal adhesions during secondary surgery." Zheng Ren said.

Well……

Cool down first...

After cooling down, all organs in the body, including the heart, will be subjected to certain impact. In other words, the speed of splitting the sternum and opening the mediastinum must be fast enough. It is estimated that 2-3 minutes will be the limit.

However, Zheng Ren's statement seemed to be the same as the same idea, and Su Yun followed Zheng Ren's statement and continued to think about it.

Unconventional surgery is not for sensationalism.

Why are there fixed surgery? It is because countless surgeons are constantly exploring clinical surgeries and using countless surgical failures to prove that a certain path is correct.

Once unconventional surgery is used, there will be huge risks.

But sometimes, actual situations force doctors to choose unconventional means to complete the operation.

However, compared with direct sternum splitting, the boss's statement seems to have a smaller complication. No wonder he asked Lao He and Yiren to come together. Only by cooperating with the team many times can this time be shortened to the limit.

"Ma Fang syndrome is difficult to deal with." Su Yun sighed.

"Well, I've thought about it, during the operation...I'll go, forget!" Zheng Ren suddenly patted his thigh.

"What have you forgotten?" Su Yun asked in surprise.

Zheng Ren did not answer immediately, but instead focused on it and finally sighed.

"What's wrong? It depends on your pain, can't you get the surgery?" Su Yun asked.

"No." Zheng Ren said: "I think the pathological changes in the middle layer of the aortic artery, such as Ma Fang syndrome, should be supported with a stent during surgery to avoid similar problems."

“…”

"The second chest opening is OK, but the third chest opening is probably going to be in trouble." Zheng Ren said bluntly.

"During the operation, do aortic replacement first, and then remove the stent?" Su Yun asked.

"Yeah." Zheng Ren nodded, "Fugui'er can't come. There is still surgery to do at the other side of the house, and neither he nor Lao Liu can move."

So that's it.

"The King's Hospital is not bad," Su Yun said: "You can use their doctor to remove the stent."

"That's all." Zheng Ren said: "You should find Lao Zhao. If there is any problem during the operation, you go and remove the stent and Lao Zhao and I will have the surgery."

Su Yun's face suddenly twisted.

"Boss, I am a doctor with my heart!" Su Yun complained.

"Old Zhao doesn't know how to intervene. If I do it, can you guarantee that you will complete the operation smoothly with Lao Zhao?" Zheng Ren asked.

"..." Su Yun recalled the surgical process, could he do unconventional surgery?

never mind.

It's better to do what the boss said.

Seeing Su Yun remain silent, Zheng Ren smiled and said, "It's okay, I'll check the situation at that time and try not to delay your surgery."

"Study?" Su Yun said contemptly.

"You can't do it, so you don't learn it. Do you still have to teach me how to do the surgery?" Zheng Ren retorted casually.

For this kind of confrontation, Su Yun has no winning rate at all.

After all, I couldn't get the surgery myself, so Zheng Ren was right after all.

"What should I do if the anastomosis is done?" Su Yun turned the topic stiffly and talked about the key points of the next surgery.

"I think to reduce the comorbidities of the anastomosis, the aortic aneurysm removed during the surgery should be long enough.

The rupture must be removed to ensure that the blood vessel anastomosis is on the normal blood vessel wall tissue. At the same time, in order to increase the strength of the blood vessel anastomosis, the method of strengthening the inner and outer of the dense felt strips at the end of the aortic anastomosis should be adopted. This not only increases the strength of the anastomosis, but also ensures that the entire vascular dissection is closed."

"The internal and external reinforcement method of tight felt strips with full perimeter at the aortic anastomosis end is very difficult," Su Yun said.

"It's okay, I'm there."

Su Yun didn't say anything, but just glanced at Zheng Ren. His simple and honest face seemed to have a layer of luster, which made people feel trustworthy.

"Okay, you seem to be thinking very thoroughly in terms of surgery." Su Yun said after a long time.
Chapter completed!