Chapter 706: Chapter 706: Too Hard on Yourself! (Extra for Alliance Hierarch Tian Shang You Keng!)
The nearly 60-kiloter highway was a severe test for everyone in the car!
The alarm from the monitor kept ringing.
Sweat had soaked Chen Cang’s clothes, and the hair at Xiaolin’s temples was also drenched; both of them were sweating profusely as they fought to save the patient!
In such cold December weather, the car was filled with warmth!
The man dared not make a sound, afraid to disturb the two of them.
Fortunately, the resuscitation efforts were effective. By the ti they got off the highway, the elderly patient’s vital signs had finally stabilized.
...
At this point, everyone let out a sigh of relief.
But Chen Cang started to quickly contact the ergency departnt at the provincial Second Hospital, activating a green channel to quickly complete the necessary examinations and prepare for surgery!
The patient had already had various biochemical tests done at the township health center, which was good news as it ant there was no need to delay further.
At eight o’clock in the evening, the car stopped at the entrance of the ergency departnt at the provincial Second Hospital, and everyone hurriedly got out to make preparations.
Upon entering, Chen Cang imdiately began to organize the dical orders thodically!
“Lele, take the family mbers to do the paperwork first.”
“Xiao Yan, prepare the inford consent for the condition.”
“Qian Ge, go to the operating room with Wen Fu to get ready…”
“Xiaolin, call the ultrasonography room, bedside echocardiography!”
…
After arriving, Chen Cang first took the patient to the resuscitation room.
At that mont, Tao Zi and Xia Gaofeng suddenly arrived, causing Chen Cang to be montarily stunned: “Director Tao? Director Xia, how co you’re here?”
Tao Zi frowned slightly: “The two of us were performing surgery at East University First Hospital. Director Li told us you brought in a patient with an acute myocardial infarction that led to a ventricular septal rupture and asked us to co and see if you needed help. He was in the middle of surgery and couldn’t leave, so we hurried over.”
Chen Cang nodded gratefully and didn’t waste any ti, going straight to the point: “Thank you, Directors, for your trouble. Here’s the situation: the patient is a seventy-one-year-old elderly woman who had an acute myocardial infarction seven days ago…”
After Chen Cang had fully explained the illness.
Tao Zi imdiately said: “Chen, for an acute injury like a ventricular septal rupture, I suggest observing for a period before deciding on elective surgery.”
Xia Gaofeng also nodded: “Yes, this is also why Director Tao and I ca here. We were afraid that you, being young and impetuous, would rush into surgery.”
“Now, in the acute phase, not only is the surgery more difficult, but it significantly increases the risk of surgery and the mortality rate. Moreover, the patient is an elderly woman, seventy-one years old, with a history of heart disease, who had an acute myocardial infarction seven days ago.”
“For such a patient, if you perform surgery now, the difficulty is too high. I suggest waiting until scar tissue forms around the rupture before scheduling surgery, and for now, she should be transferred to the departnt of cardiology for hospital treatnt.”
Chen Cang fell silent; the advice of both directors was sound and made sense.
At this ti, Li Baoshan called over the head of the cardiology departnt, Director Niu Tianfu.
The four directors gathered in the ergency room and began to discuss the patient’s condition.
Now was not the ti for rash actions. Chen Cang wasn’t foolish; creating the best possible rescue plan was the most important thing, not impulsively going for surgery.
Treating the disease through surgery was only a ans to an end, and before the operation, it was best for the patient to be in a state that provided a safe environnt for the surgery.
Soon enough, the results from the echocardiography ca back, and Chen Cang had also completed the heart CT scan.
In the resuscitation room, after examining the patient’s heart function, Tao Zi directly stated: “Currently, the heart function isn’t too bad, and the ejection fraction is sufficient for everyday needs. I suggest stabilizing her first and not recomnding surgery.”
anwhile, Niu Tianfu shook his head decisively: “Director Tao, look, with the current acute myocardial infarction, whether it’s interventional surgery or thrombolysis, the risk is very high. If the ventricular septum ruptures, the heart function will only deteriorate further.”
“Judging by the old lady’s condition, she won’t last a few days; there’s no ti to delay!”
Tao Zi imdiately started arguing with Niu Tianfu!
“You cardiologists can’t even maintain such a condition. Our cardiac surgery will only involve risk!”
Niu Tianfu directly said, “The patient has a ventricular aneurysm rupture caused by acute myocardial infarction! Once the disease occurs, it can lead to refractory heart failure, serious arrhythmias, peripheral arterial embolism, etc., with a very poor prognosis. How do you expect internal dicine to treat this?”
Xia Gaofeng and Chen Cang remained silent, listening patiently to the debate. Sotis, the answer appears within the argunt!
Studies have shown that when humans argue, their brain’s reactions are several tis faster than usual!
Especially when boyfriends and girlfriends argue, won often perform even better!
Seeing the two argue for a while, Xia Gaofeng finally sumd it up and suddenly said, “Actually, it’s not that surgery is impossible. The patient has already received inotropic diuretic treatnt, and at this point, the cardiac function is still acceptable. If we use intravenous infusion of dopamine and other positive inotropic drugs before surgery to maintain blood pressure, thus ensuring coronary artery perfusion, then it is not impossible.”
“But, Director Tao’s point is also correct, the surgical risk is indeed very high.”
“Now there are risks on both sides. I think we should fully respect the opinion of the patient’s family!”
At this ti, Tao Zi cald down, exchanged a glance with Niu Tianfu, nodded, and said to Chen Cang, “Xiao Chen, you go tell the patient and let him make the decision.”
Chen Cang nodded.
These senior directors are national treasures; with them present, it’s like a ship with a course to follow!
They can discuss all the risks and counterasures in advance, so even if a problem arises later, they can ensure the situation is handled.
This is about avoiding and reducing surgical risks.
After the discussion, the old lady’s son was already prepared to take a risky gamble, signing the consent for surgery!
Chen Cang stood up, while Tao Zi and Xia Gaofeng looked at each other. “I’m going too!”
Niu Tianfu was obviously washing dishes at ho, not even bothering to take off his apron. He threw it down at the nursing station, “I’m going too!”
Chen Cang couldn’t help but nod in gratitude.
Tao Zi told Chen Cang, “Xiao Chen, we can only remind you. The surgery will still be perford by you. The patient has a ruptured interventricular septum with concomitant myocardial infarction. You must rember not to damage the coronary artery, and the incision must be small! You must avoid affecting the left ventricular function!”
Tao Zi kept giving instructions…
Chen Cang also nodded appreciatively.
This surgery, due to the old lady’s own condition and the presence of complications, increased both the risk and complexity of the operation, making the difficulty continuously rise and the risk factor increase proportionally.
In Chen Cang’s heart, there was no certainty!
Perhaps, this is what surgery should be like, right?
It’s inherently full of risks and uncertainties!
No one can control life and death; all we can do is give it our all.
Even Tao Zi and Xia Gaofeng couldn’t guarantee the success of the surgery!
…
…
The surgery began, the hypothermic cardiopulmonary bypass machine was running, and the heart officially stopped working.
After opening the chest, looking at the aging heart, Chen Cang’s brow furrowed tightly!
Extensive anterior wall infarction, now one could see the color change of the heart!
Chen Cang could not afford to consider other factors; he could only very carefully determine the surgical approach and extent.
To possibly avoid damaging the ventricle.
The heart was aged, scarred all over, and suffering from ischemia and hypoxia, and the left ventricle, as the heart’s pumping muscle, if it were to be damaged again, the old man wouldn’t make it!
Chen Cang was well aware of the difficulty involved.
At this mont, it was necessary to determine the range and degree of myocardial damage and to observe for any other injuries.
Chen Cang’s hands cradled the heart, exploring the site of the ventricular septal rupture on the left ventricular surface.
He was striving to find a suitable entry point for surgery!
The patient had a ventricular aneurysm rupture caused by acute myocardial infarction; Chen Cang was determined to operate because surgical treatnt was more effective than conservative treatnt.
Everyone around was watching the heart, now in need of finding the most suitable entry point for surgery!
Chen Cang’s mind was racing, his hands feeling the heart for a long ti, until finally!
He discovered a spot, at the junction of the right ventricular surface and the atrium, which just avoided the coronary artery, and most importantly, caused minimal damage to the left ventricular wall.
Thinking of this, Chen Cang imdiately reached for the scalpel, and made the incision!
Tao Zi and several others imdiately frowned!
“Chen, is this position…easy for inserting the needle?”
Xia Gaofeng also frowned, “Yeah… It’s true, the damage and side effects here are minimal, but it’s not easy to operate!”
Chen Cang nodded, “Let’s try it!”
With this in mind, Chen Cang passed the suture needle with small pads, a non-invasive suture, through the alive tissue at the edge of the interventricular septum defect, performing an interrupted, mattress-style suture!
This process required ticulous care, not to damage the already weakened heart.
Chen Cang’s hands dared not tremble, his right hand struggled to maneuver, so he had to use his left!
The attending chiefs watched, their eyes wide!
The left hand???
Entering with the needle holder from the surface of the right ventricle, he first sutured the posterior edge of the septal defect alongside the patch, which was then sewn and tied on the left ventricular surface.
The entire procedure was completed by the left hand.
Although it looked clumsy, the difficulty was apparent to all.
Operating with the left hand was inherently unstable, and doing so increased the risk of the surgery; any inappropriate maneuver could lead to catastrophic consequences!
Therefore, Chen Cang himself was very cautious.
The whole process watched by others was thrilling!
Even the nurse Yuan Yuan frowned, wondering, his left hand… was it really that skilled?
The interrupted, mattress-style suture with small pads was placed to the right of the anterior descending branch of the coronary artery, then passed through the right ventricular wall and across the anterior edge of the interventricular septal defect patch, and then through the left edge of the left ventricular incision.
Due to the incision, it had to be done under operation by the left hand.
Chen Cang’s forehead sweat dripped, drenching his hat and surgical mask, and he dared not even breathe loudly!
His right hand, held aloft, dared not move a fraction, for fear of injuring innocent myocardium!
Ti passed by the second.
Chen Cang felt that today’s exhaustion was at least two to three tis more than usual!
Finally, when the sutures were tied, the septal defect and left ventricular incision were completely closed.
Everyone let out a sigh of relief!
Chen Cang was sowhat impatient already.
The process of stopping the bleeding thoroughly, rinsing the pericardial cavity, restarting the heart after surgery, and discontinuing extracorporeal circulation was to observe the effects!
At this mont, everyone was staring at the data on the heart monitor, waiting for the signal of success.
The anesthesiologist Liu Jian said, “All vital signs are completely normal!”
At that mont, everyone’s tension eased.
It was tough!
That mont was truly difficult.
Even Chen Cang felt that it had really not been easy.
Unable to contain himself, Liu Jian raised his thumb to Chen Cang, “Director Chen, you’re getting more and more formidable! More and more like a chief surgeon!”
The surrounding chiefs also smiled and nodded in satisfaction.
Chen Cang was soone they had watched grow up.
It’s just… this speed was more like fast-forwarding at 4X, not a normal rate of growth.
But then again… geniuses are always different from ordinary people!
This surgery, no one else could get involved, because if the left ventricular wall was damaged, the consequences were very severe, and if the coronary artery was damaged, it would be even more troubleso!
So, it was down to Chen Cang, going it alone, a solo journey of a thousand miles!
At the successful mont of the surgery.
Everyone smiled!
They realized that this young man was becoming more and more like a chief surgeon.
But, there was one question that lingered in their minds.
While washing up, Tao Zi couldn’t help but ask, “Chen… is your left hand always this good?”
Xia Gaofeng nodded, “Yeah! I see your left hand is very steady, have you trained it?”
Chen Cang contemplated for a mont, thought of his young foreign female teachers who had trained him to use both his hands, and nodded, “Yes, often.”
After hearing this, the chiefs had an epiphany.
Indeed, success was no coincidence!
How much effort had he put in?
At this mont, the way everyone looked at Chen Cang was full of admiration.
This young man, was exceedingly rigorous with himself!
…
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ps: Thanks to “Mo Chensui” and “xiaolei1028” for their generous support of 10,000 rewards. Thank you.
I was halfway through writing and about to upload, but I decided to complete writing the surgery. It’s more satisfying to read at once, so I ended up writing nearly two chapters’ worth.
Also, it’s the middle of the month, so I’m asking for monthly votes. The big nas behind are starting to ramp up, and we need to keep up the effort too.
So, I ask for your monthly votes! Monthly votes! Monthly votes!
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