69novels Page 430
Page 430
Next to the head of the department were the director of Kanto General Hospital and the secretary.
"You really are willing to push this young man to such a difficult challenge right from the start!" Mononobe-kun
Dean Fujiwara looked at Aki Tomoya's figure and said something meaningful.
The chief of staff, standing to the side, was somewhat nervous, silently praying for a successful surgery.
As a VIP patient at the hospital, the administrative director was simply trying to prevent the surgery from failing and didn't think too much about it.
"Both Yoshida-kun and Sasaki-kun approve, so what can an old man like me say? However, the person Yano-kun recommended is indeed quite good, and it's no wonder that guy cares so much about this young man."
The head of the materials department explained.
He would also like to see someone among the younger generation who can take on important responsibilities.
He also likes people like Tomoya Aki, who have extraordinary potential and work harder than most people.
If a young, renowned doctor is trained by their cardiac surgery department, even if Aki Tomoya returns to the university hospital one day, his name will inevitably be associated with him.
In any case, Aki Tomoya is someone who came from the Department of Cardiac Surgery at Kanto General Hospital, and the medical team led by the former head of the Department of Cardiac Surgery at the University of Tokyo.
"It's a pity I don't want to take away what others love, otherwise I would really like to keep this person in our hospital. At least my two disciples will have someone who can inherit my mantle."
"But unfortunately, he is Yano-kun's man. I think this young man is definitely not an ungrateful or heartless person."
While the two were chatting, the surgery was about to officially begin.
Aki Tomoya stood in the lead surgeon's position, seeing everyone else ready as he was, he took a deep breath, completely clearing his mind of all distractions:
"We will now begin the re-operation of double valve replacement combined with aortic curtain reconstruction. Please give me your feedback!"
"Please give me more advice."
He nodded slightly to Yoshida Aoba and the others, and they responded with the same slight nod.
At 10:30, the surgery officially began.
Chapter 488 is here (1/4)
Aortic curtain reconstruction during double valve replacement is extremely technically challenging for surgeons, but it is suitable for patients with complex valvular disease, especially when no other surgical options are available.
In this surgery, aortic pleural valvuloplasty was performed to implant a larger-sized artificial valve in order to avoid postoperative pulmonary pulmonary complications (PPM).
The earliest report on the surgery for curtain reconstruction came from Professor David at Toronto Hospital in Canada.
Meanwhile, in 1994, Professor Bruce Wright of the Cleveland Clinic in the United States drew up an atlas of the surgery and named it the "Commando operation," symbolizing its high level of difficulty and the great challenge it poses to the surgeon.
Infective endocarditis, degenerative calcification, and damage to the aortic pleura from previous mitral valve replacement surgery made aortic and mitral valve replacements extremely difficult. Considering these factors, Mrs. Omi needed to undergo pleura reconstruction surgery.
The surgery has begun, with an incision made in the center of the chest.
"Prepare for cannulation of the aorta and superior and inferior vena cava."
The surgeon, Tomoya Aki, spoke up, saying that he was working with Dr. Yoshida to establish extracorporeal circulation for the surgical patient.
The operating room wasn't as tense as I'd imagined. Aki Tomoya, who was performing his first surgery, hadn't made any mistakes so far, and everything was going according to plan.
The entire surgery will be recorded, and the data within the surgical field will be transmitted in real time to the monitor in the observation room above.
This surgery required not only Yoshida Aoba and Sasaki Ichiru from the surgical team to oversee and pay close attention to Aki Tomoya's movements.
The head of cardiac surgery, who is also the nominal deputy head of the surgical department, is now paying attention to this matter.
He can also intervene at any time and issue instructions.
"Monobe-kun, Dr. Aki in your department is quite good."
Dean Fujiwara said in an appreciative tone.
In the operating room, Aki Tomoya, who was in charge of the surgery, showed no fear. Even though it was his first time performing the surgery, he did not exhibit the excessive nervousness that often occurs in novice doctors.
He really hoped the surgery would be successful.
Of course, he hopes that every surgery in the hospital can be completed 100% successfully.
At the same time, the emergence of a young, brilliant surgeon in the hospital can also be used for publicity.
Private hospitals need a good reputation, and wealthy medical corporations aren't there to throw money around for nothing.
Many poorly managed hospitals are later acquired and transformed into specialized hospitals to generate revenue.
Regional rankings, evaluation rates, and doctor-patient relationships are all things that need to be considered.
Patients are like gods, no, it's not that exaggerated, but we must be careful when dealing with patients.
"Don't say that yet, the surgery has only been going on for half an hour."
The head of the medical department remained expressionless, focusing intently on the situation in the operating room while also paying attention to the images and other data on the monitor next to him.
As time passed, in the operating room, the surgical team established extracorporeal circulation. The aorta, right atrium, and atrial septum were cut. The heart under the fixation device had stopped beating after perfusion, and the extracorporeal circulation machine began to operate.
Carefully avoiding blood vessels, the artificial mitral valve and aortic valve were gradually exposed in the surgical field.
"Begin removing the artificial mitral valve and aortic valve..."
As he spoke, Aki Tomoya's movements did not stop. The magnifying glass was already pulled down, making the situation in the surgical field clearer. He slowly began the excision.
"Wipe your sweat."
Yoshida Aoba, who was standing next to her, said something to the nurse.
So focused was Aki Tomoya that he didn’t notice the thin layer of sweat on his forehead.
Yoshida Aoba, who was closest to Aki Tomoya, naturally took his place in giving instructions to the nurses.
Heart surgery is a complex procedure that demands a high level of skill from the surgeon; the meticulous work is not something everyone can do.
No heart surgery is ever simple.
As the saying goes, no surgery is without risk.
Heart surgery is definitely one of the riskiest procedures.
After successfully removing the artificial mitral valve and aortic valve, Aki Tomoya breathed a sigh of relief.
"The mitral valve leaflets detached from the two commissural arches, causing leaflet prolapse with insufficiency, and subaortic valve..."
"White fibrous tissue proliferates, forming a narrow ring..."
Upon examination, the results showed no discrepancy with the pre-operative predictions or the information recorded in Mrs. Omi's medical history.
Aki Tomoya silently recited the instructions in his mind, pausing slightly as Yoshida Aoba and the others awaited his next command.
The artificial double valves from your last surgery, Mrs. Omi, have already been removed. If curtain reconstruction is not required, then we can start implanting artificial valves at this point.
Therefore, there is one more very important thing to do before proceeding with the reimplantation.
Aortic curtain reconstruction is a prerequisite for successful double valve replacement.
"Measure the inner diameter of the aortic valve."
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Chapter 489 A five-hour surgery (2/4)
The most difficult part of this surgery was not the replacement of the double valves, but the reconstruction of the diaphragm.
This is not only because it requires extremely high skill from the surgeon, but also because only a very small percentage of patients with heart valve disease actually need this type of surgery.
The patient cannot use the same type of artificial valve as in the previous replacement surgery, but needs a larger type of artificial valve. So the first step is to determine the inner diameter of the aortic valve and then enlarge it.
"Aortic valve diameter 19mm".
After taking the measurements, Dr. Nakagawa began to speak, then looked towards Tomoya Aki.
After quickly reviewing the surgical plan that the entire surgical team had discussed and finalized, Aki Tomoya made a decision immediately.
"Enlarge the aortic valve annulus to 23mm!"
The most important part of the surgery begins when the aortic curtain structure is completely cut from the position of the aortic noncoronary valve annulus towards the anterior mitral valve annulus.
"here we go."
In the observation room, the head of the surgical department looked at the surgical field, where the aorta and aortic curtain structure held by the forceps were clearly visible.
Meanwhile, in the operating room, Aki Tomoya and his team were clearly already beginning the most crucial step.
Both the aortic valve and the mitral valve annulus had been cut open. In this surgery, Aki Tomoya decided to use bovine pericardial slices to expand and reconstruct the aortic curtain.
Aki Tomoya acted without hesitation. The experienced surgeons Yoshida Aoba, Sasaki Ichiru, and Dr. Nakagawa didn't even need him to say anything; they were able to act immediately.
Following Aki Tomoya's instructions and after several discussions before the surgery, they knew what to do next.
Time passed, and as the surgery continued, about two and a half hours had already gone by.
"Number 27, bovine pericardial valve."
First, a size 27 bovine pericardial valve is implanted at the mitral valve location, and nearly two-thirds of the suture ring is placed along the posterior leaflet of the mitral valve.
The remaining gap faces the aorta.
Trimming triangular bovine pericardial smears to reconstruct the intervalvular fibrous tissue from the aorta to the mitral valve.
The base of the pericardial patch is sutured to the anterior third of the mitral valve suture ring.