In the operating room, when the nasopharyngeal temperature dropped to 32°C, Tanglou immediately issued an order:

"Oclude the aorta and superior and inferior vena cava, and infuse the aortic root with HTK solution to protect the myocardium."

Director Qian Gang immediately began to cooperate. At the same time, the nurse also provided perfusate. The entire operation was arranged in an orderly manner.

Tanglou continued to clarify the detailed operation: "Infuse HTK solution at 4°C with a single infusion dose of 30 ml/kg. During the infusion process, use a suction tube to suck away the HTK solution from the coronary sinus. The starting pressure of infusion is about 100 mm Hg.

After cardiac arrest, the perfusion pressure was reduced to about 50 mm Hg, and the total perfusion time was 6 minutes."

"Okay, Doctor Tang."

Under Tanglou's clear instructions, the other medical staff began to follow the instructions. In the observation room, several doctors were envious of their strong field control abilities.

Tanglou then looked up at the monitor and explained to Professor Liu Juzi on the other side of the screen:

"Of course conventional cold-blooded cardioplegia solution is not impossible, but since it requires multiple perfusions, it carries certain risks and increases the difficulty of the operation. So I used the more optimized HTK solution."

"HTK solution was invented by Professor Bretseider and his colleagues in Germany in 1975. In 1979, it was improved by adding histidine/histidine buffer system, α-α-ketoglutarate, etc. on the basis of low sodium and microcalcium.

,"

"The "balancing effect" is a significant feature of HTK solution. It can completely perfuse the intravascular spaces and tissue spaces, ultimately leading to the balance of temperature, ions, and oxygen metabolism inside and outside the cells, to achieve a better perfusion effect. Because cells

It takes 3 to 5 minutes for internal and external ion balance, 2 to 4 minutes for intracellular and extracellular temperature balance, and 5 to 7 minutes for oxygen metabolism balance. Therefore, the best myocardial protection effect can be achieved when the perfusion time of HTK solution is maintained for 6 to 8 minutes.

Moreover, the biggest advantage of HTK solution is that it only needs to be infused once to achieve a myocardial protection effect of 2 to 3 hours. It is convenient, long-lasting and does not affect the operator's operation. The only disadvantage is that it is relatively expensive."

After listening to Tanglou's analysis, Professor Liu Juzi was silent for a while. She didn't know the shortcomings of cold-blooded cardioplegia, but since she learned this technique, she has been operating it according to the industry's gold standard. In her

It seems that as long as the proficiency is improved, for a veteran like her, it can be avoided as much as possible, and she is even proud of using her own skills to make up for the shortcomings of the technique.

She had never thought that she could directly replace it with HTK solution. Based on her clinical experience, she knew that this small step would directly reduce the difficulty of the operation by an order of magnitude.

A single infusion of HTK solution can protect myocardium for 2-3 hours, which makes it possible for many attending physicians to perform this surgery.

For hospitals, being able to perform this procedure several times at once is undoubtedly a great boon to patients who are hard to find.

"Dr. Tang, you did a very good job."

Professor Liu praised him heartily.

In the operating room, Tanglou was involved in the next operation and began to cut the left atrium longitudinally along the interatrial groove and start the ablation line of the left atrium.

Seeing the operation of Tanglou on the screen, the doctors in the observation room were amazed.

Especially Tanglou’s switching and connection between bipolar ablation forceps and single-stage pen.

For the ablation of the left atrial isthmus, the bipolar ablation forceps could not reach the mitral valve annulus, so Tanglou switched to a monopolar radiofrequency pen to perform "supplementary ablation" to make the ablation line reach the mitral valve annulus.

After that, the heart is turned upward, and a monopolar pen is used on the epicardium to extend the mitral isthmus ablation line and fully ablate the coronary sinus.

"Sutures...scalpel..."

After completing the ablation of the main body, Tanglou began to treat the left atrial appendage.

Soon Tanglou completed the excision, suturing, tying, ligation, and inner suturing.

Twenty minutes later, Tanglou completed all ablation lines.

"With one help, the valve formation is completed."

Tanglou issued an order.

Qian Gang was slightly stunned, and the other doctors in the observation room were also slightly stunned.

Usually after the main operation is successfully completed, the remaining small work of valve molding is a gift from the surgeon.

However, the current situation is that Yisuke is Director Qian Gang.

Tanglou also felt a little guilty and whispered: "I'm not very skilled in valve valvuloplasty surgery."

Qian Gang glanced at Tanglou, I believe you are a ghost!

The Cox maze IV surgery is so successful, but this little valve can still be formed?

However, Director Qian Gang was in a very good mood now and his hands were really itchy, so he took the initiative to take over this small job.

Tang Lou was innocently promoted and retreated, but he really didn't know how to form a valve.

Twenty minutes later, the entire operation was officially completed.

"Bah bang bang!"

In the observation room, Professor Liu Juzi took the lead in applauding, while Director Huang was still unfinished and wanted to stop talking.

Deputy Director Qian immediately understood. He licked his face and said to Director Qian Gang: "Director Qian, can you send me the video of this operation so that the young doctors in our department can learn from it?"

Director Qian Gang, he was really flattered to hear that the director of the cardiovascular medicine department of Zijingang Hospital actually asked for the surgery video. This was something that he had never dared to think about before.

"Of course, of course."

Director Qian Gang nodded immediately. It must be said that Tanglou really single-handedly improved the status of the cardiovascular medicine department of Hecheng City No. 1 Hospital with just one operation.

While Director Huang and Deputy Director Qian were playing Tang Lou’s surgery video, Professor Liu Juzi immediately started thinking about Tang Lou’s ideas.

"Director Qian, after the operation, I want to hold a video conference. I would like to invite Dr. Tanglou to share his experience with the doctors in our department. This improvement in surgical technique is really shocking.

.”

"certainly!"

Qian Gang's face was dignified, but his heart was already filled with joy.

"Okay, we'll connect via video later."

Liu Juzi exited the video directly, then thought about it and prepared to go back to the office to dress up a little.

"Professor Liu, who do you think needs to participate in the video conference?"

Director Huang was a little unclear about Professor Liu's thoughts and asked.

"Ah, no need, you all should leave. If you are a doctor who has spare time, you can ask for Dr. Tang's video to study and study. After that, I will communicate with Tang Lou in person."

Liu Orange ruthlessly declined the participation of the others, and then walked towards his office lightly.

Director Huang and others were left with blank faces...

I didn’t just agree to share it with you, but I, Mr. Huang, also have a lot of questions for you in Tanglou.

On the contrary, deputy director Qian Zheyu rolled his eyes and an idea flashed across his mind: "Director Huang, do you still remember that Professor Liu still lacks a doctoral student spot?"

Director Huang blinked his eyes and glanced at the sparse back of Qian Zheyu's head. He thought, you deserve to be bald!

...

...

At this moment, Professor Liu Pingguo was taking Ma Shuya for ward rounds.

Suddenly, the cell phone rang. Seeing that it belonged to my elder sister, Liu Juzi immediately answered the call: "Hello, elder sister."

"Apple, have you told him what I told you about rejecting Tanglou?"

Liu Pingguo didn't know why her sister asked this, so she could only answer truthfully: "How dare I tell Tanglou that the recommendation failed? I want to lose face, sister, but I said you really don't think about it. Tanglou

Really excellent..."

But before Liu Pingguo finished speaking, a cheerful voice came from the other end of the phone, and then he said coldly: "What I said to you that day, just pretend it never happened. Don't let my good student Tang Lou know about it.

.Did you hear that?”

Without giving Liu Pingguo a chance to respond, Liu Orange directly hung up the phone.

Liu Pingguo: "Meow meow meow?"

Are you hallucinating?

At this time, the nurse waiting on the side urged: "Professor Liu, why has it taken so long for today's medical orders not to come out? Hurry up..."

Liu Pingguo was depressed and drove angrily: "Why don't you speak faster when you are with your husband?"

Isn't it easy for nurses to say: "But at the critical moment, it is better to hurry..."

Professor Liu: "..."

The well-behaved and sensible Ma Shuya's eyes lit up, alas!

Seeing Professor Liu's defeat, the experienced nurse took advantage of the victory and joked: "Professor Liu, my mouth was bruised last night just to get my husband to buy me a bag. Guess what I said?"

Mashua asked curiously: "What did you say?"

Professor Liu shook his head and knocked on Ma Shuya's head: "You are so poor with her, what else can you say? Of course you didn't say anything."

"ah?"
Chapter completed!