Chapter 499: Double exits in the right ventricle, a competitor made a stupid move
Zhou Can examined the little girl and found that there was an obvious bulge in her precordial area and an obvious vibration between the 3rd and 4th ribs on the left edge of the sternum.
The vibration is especially obvious when pressing this area with the tip of your finger.
Try to use a stethoscope to check this area, and you will hear a very obvious murmur. This is the murmur made when the heart muscle contracts.
“Is there something wrong with the right ventricle?”
Zhou Can was not too sure and just made an initial diagnosis of the patient's lesions based on his experience.
He again listened carefully to the patient's intercostal murmur.
His brows furrowed slightly, this noise was very strange, he was sure he had never heard it before.
There are so many types of congenital heart disease .
What kind of lesion can produce such noise?
It is a good idea to give the patient an echocardiogram.
Considering the particularity of congenital heart disease, a cardiac X-ray should also be performed for auxiliary diagnosis.
After investigation, the test results came out quickly.
The patient's aorta was 2CM, left ventricle was 3.3cm, right ventricle was 2.6cm, pulmonary artery was 1.2cm, atrium was in upright position, ventricle had right loop, and both aorta and pulmonary artery originated from the right ventricle and were in an anterior-posterior position, with the aorta in front and the pulmonary artery in the back.
The ventricular septum echo was interrupted by about 2.2 cm, and the defect was located in the perimembranous outflow tract. The left ventricular blood flowed into the aorta through the ventricular septal defect. The echo of the pulmonary valve leaflet was enhanced, and the valve orifice was narrowed with a diameter of only 0.3 cm.
At this moment, Zhou Can finally understood what the strange noise was.
It turned out that the patient had a double outlet right ventricle.
The patient's pulmonary valve orifice is so narrow in diameter, no wonder his blood oxygen level is so poor.
Upon examination, the forward blood flow velocity at the pulmonary valve orifice was only 3.1 m/s, the transvalvular pressure difference was 10.44 kpa, and mild regurgitation signals could be seen at the pulmonary valve.
Cardiac X-ray examination showed that the patient had fine vascular textures in both lung fields, sunken pulmonary artery segments, enlarged right ventricle and right atrium.
At this point, congenital heart disease has been confirmed without a doubt.
The patient had double outlet right ventricle and pulmonary artery stenosis.
This requires surgery to cure.
The operation is risky and difficult.
The cost is not cheap either.
"Your daughter's condition is a congenital heart disease. It's serious and needs to be corrected with surgery as soon as possible. We can't do this kind of major surgery in the emergency department. We need to go to the cardiothoracic surgery department for further consultation. I'm going to the cardiothoracic surgery department now. If you'd like, I can take you there."
Zhou Can said to the family members.
Director Xueyan has already called twice to urge Zhou Can to come over.
However, because the girl's test results have not come out yet, Zhou Can can only wait.
After all, the little girl's condition was very serious, and Doctor Xie on duty lacked experience in rescue. If he couldn't handle it properly, it would be a life!
Seeing how enthusiastic Zhou Can was, the family members were naturally happy to follow him to the cardiothoracic surgery department.
Tuya Hospital is too big, and it was not easy for them to find the cardiothoracic surgery department late at night.
If they follow the procedures in the emergency room, they will probably have to wait a long time, or even until tomorrow, before a cardiothoracic surgeon will come to take them away.
When they arrived at the cardiothoracic surgery department, Zhou Can arranged a doctor to see the child, gave the doctor a few instructions, and then rushed to the operating room.
It seems that I won’t be able to have dinner tonight.
Director Xue had called him earlier and learned that he had just finished surgery and had encountered a patient with congenital heart disease. She guessed that he had not eaten dinner, so she had prepared two slices of bread and a bottle of milk for him.
Zhou Can didn't hesitate and finished the meal in a few gulps, and then he felt a little better.
There is still a tough battle to fight next.
Today's cardiovascular catheter intervention surgery must be extremely difficult.
…
In the interventional operating room, the patient made a special request.
"Doctor, can I live stream the entire surgical procedure?"
Because this operation does not require general anesthesia.
The patient is awake throughout the procedure.
He wanted to live broadcast the entire operation process and share the surgical treatment experience with his fans.
"Why do you have to live stream the surgery? You can also share your experience with netizens after the surgery!"
Director Xueyan was obviously not happy.
Under normal circumstances, the hospital would definitely reject such a request directly.
As for the reason, it only needs to involve patient privacy and not comply with relevant regulations.
Patients are a vulnerable group in hospitals and it is impossible for them to go against the hospitals.
Unless you don't want to be treated anymore.
"I have posted several videos before the operation and told my more than two million followers that I will live stream the operation tonight and share my treatment experience. If you can help me make the operation a success, it will be a great publicity for your hospital, your department, and even you, the doctor. This is equivalent to a free advertising opportunity!"
The patient does things in a very unkind way.
In order to increase the number of followers and to enhance the interaction with fans, they did it without consulting the authorities.
And I chose to go into the interventional room, and then discussed the live broadcast with the doctors.
Not a word was said while in the ward.
It's like the bride waiting until the groom has already invited the guests, and then suddenly asking for a higher price for the bride price on the wedding day, putting the groom and her future parents-in-law in a difficult position and forcing them to agree.
"Mr. You, please understand that live broadcasting the entire operation process will put considerable pressure on our medical staff. It will invisibly increase obstacles to the operation."
Director Xueyan is still trying to find a way to reject this matter.
"Pressure brings motivation! If you refuse to let me do a live broadcast, it can be seen as a sign of lack of confidence. You are afraid that something might go wrong during the operation, or even that the operation might fail."
The patient's words hit the nail on the head, leaving no room for turning back.
It is indeed as he said, if he was really confident in his surgical skills, why would he be afraid of broadcasting the surgical process live?
At this time, someone called Director Xueyan's cell phone.
She took a look and walked outside to answer the call.
Came back soon.
"Doctor Zhou, let's go out and discuss the patient's live broadcast of the surgery!"
"OK!"
Zhou Can looked at the patient deeply and followed him out.
The patient's face showed strong confidence.
It seemed that he expected the hospital to agree.
After coming out, Xueyan said directly to Zhou Can, "Vice President Ye will be here soon. He already knows about this matter. I guess President Zhu also knows about it. Let's go to the office first!"
Not long after the two arrived at the office, Vice President Ye arrived as expected.
He was very familiar with both Director Zhou Can and Director Xue Yan, and after greeting them, he went straight to the point.
"Director Xue, are you confident in today's cardiovascular intervention surgery?"
"Uh... the operation is very difficult. I'm afraid I can only try to challenge it."
Director Xueyan looked at Zhou Can subconsciously.
Because the real surgeon performing this operation was Zhou Can.
"Xiao Zhou was captured again to serve as a soldier, right?"
Vice President Ye looked at Zhou Can with a smile.
"I was born to work hard, there's nothing I can do about it! Sister Yan has called me, so I must come and help her."
Zhou Can's answer is considered the standard answer.
"Haha, you are the one who is more capable and does more work. You two should tell me the truth, who will be the lead surgeon for today's operation?"
Vice President Ye glanced at the two of them.
It would be crazy to lie to him.
No one would do such a stupid thing.
He asked about this matter directly in front of the two of them, which showed that he did not treat them as outsiders.
"We are going to let Zhou Can perform the surgery. He is very good at interventional surgery and his ability to respond during surgery is excellent. If he performs the surgery, there may be some hope."
Director Xueyan said seriously.
"Well, I have guessed a little bit. Xiao Zhou is indeed a young talent in our hospital! It's a good thing for young people to try their luck." Vice President Ye nodded, his eyes gently falling on Zhou Can's face. "How confident are you?"
"Very low. Probably no more than 30%."
Zhou Can answered truthfully.
"As far as I know, this patient had undergone surgery in two major hospitals. Both of these hospitals are not simple. The first one is the Imperial Capital Renhe Hospital, which is ranked as the strongest hospital in China in terms of comprehensive strength. At that time, more than ten cardiovascular experts gathered and performed an interventional surgery for more than four hours, but it failed."
Vice President Ye revealed a shocking news.
I really didn't expect that this was a patient that even Renhe Hospital couldn't successfully treat.
"When the patient came to see the doctor, he did not mention that he had been treated in other hospitals! This person is really cunning."
After hearing this, Director Xueyan felt shocked and angry.
If she had known that the patient had been treated at Renhe Hospital and that more than a dozen of the top cardiovascular experts in the capital had failed to perform the surgery successfully, she would never have agreed to perform interventional surgery on the patient.
"This incident has really reminded us that we should be extra careful when treating difficult patients in the future. It took nearly a hundred years for Tuya to stand up, and it took generations to accumulate, and it was not easy to get to where it is today. To destroy this reputation, all it takes is a doctor with some influence in our hospital to make a big mistake. Xinxiang Women's and Children's Hospital is a lesson for us. Of course, it has stood up again now."
Vice President Ye reminded the two in a serious tone.
Xueyan is already a famous doctor, and is being developed as a key famous doctor in cardiothoracic surgery.
Zhou Can is a potential famous doctor. Although he is still in the reserve queue, he has actually already shown his potential and has a certain degree of fame.
Whether in the emergency department or pediatrics, the number of patients seeking Zhou Can for medical treatment and surgery is increasing day by day.
"In addition to being treated at Renhe Hospital, this patient was treated again at the Third Hospital of this city not long ago. The Japanese cardiac surgeon performed the operation himself. You should know that the Japanese cardiac surgeon is very strong in endoscopic surgery and interventional surgery. This is also the signature of the Third Hospital. The entire operation was broadcast live, but unfortunately, the Third Hospital also failed."
This guy is simply a trouble maker.
Even though he is seriously ill, he still stirs up trouble everywhere.
Having slapped the faces of Renhe Hospital and the Third Hospital one after another, now it is the turn to tear down the sign of Tuya Cardiothoracic Surgery.
"That's not right. Logically, he has been treated at the Imperial Capital Renhe Hospital and the Third Hospital in this city. Both operations ended in failure. Why should he go through this again in our hospital? If the operation fails, the cost will definitely still have to be paid! The patient himself will suffer a lot."
Director Xueyan looked puzzled.
I went to the Imperial Capital Renhe Hospital for surgery because it is the strongest hospital in the country.
Later, I went to the Third Hospital for treatment because there was a Japanese cardiac surgeon there.
Since both of these two hospitals have failed, is it still necessary to come to Tuya Hospital for treatment?
No matter what, it is impossible for Tuya Hospital to have a higher level of cardiovascular interventional treatment than the first two hospitals, right?
"That's exactly what I want to say. According to reliable sources, after the Third Hospital failed to perform surgery on this patient, they had evil ideas and wanted to ruin our reputation. The patient came to Tuya Hospital for treatment this time, and all expenses were paid by the Third Hospital. After the operation is completed, the patient will be given a considerable 'hardship fee'. At the same time, through this live broadcast, the patient can also gain a lot of new fans and improve the stickiness with old fans. Kill two birds with one stone."
Vice President Ye is very well-informed.
Whether it is the Third Hospital, the Provincial People's Hospital, or even the Xinxiang Hospital, any movement will hardly escape his ears.
The relationship between large hospitals is actually a bit like that between countries sending spies to each other.
Intelligence gathering has been a top priority since ancient times.
Even Sun Tzu's Art of War said that only by knowing yourself and your enemy can you win every battle.
"Since this patient is a big deal, I think it would be better to directly refuse to let him live broadcast, rather than refusing to perform surgery on him and sending him away on the grounds that his health does not meet the surgical criteria."
Director Xueyan hates patients who deliberately cause trouble.
Because she has fallen many times.
"Xiao Zhou, what's your opinion?"
After listening to this, Vice President Ye turned to ask Zhou Can for his opinion.
"I..." Zhou Can looked at Xueyan.
"It's okay. If you have any opinions, just say it directly. We are just discussing it now."
Vice President Ye comforted him.
"I think we actually have no way out. The operation has already been arranged for the patient, and he has already entered the interventional room. If we suddenly cancel the operation at this time, it will only make people belittle the cardiothoracic surgery department of Tuya Hospital. The reputation loss caused by it may be more serious than the failure of this operation. A gentleman stands between heaven and earth, and he cannot stand without integrity. To put it another way, even if the operation fails, so what? Don't we already have the Third Hospital and the Imperial Capital Renhe Hospital to take the blame for us?"
Zhou Can talked freely and expressed his ideas.
In terms of strategy, even though Director Xueyan has a much higher degree than him, she is still far inferior to him.
Zhou Can has only taken the postgraduate entrance examination, and the written examination results have not yet come out. This means that he is still an undergraduate student, at most a little better than an ordinary undergraduate.
Xueyan is a real doctoral graduate and is currently a professor at Tuya Medical College.
Zhou Can is far inferior to her in academics.
"Xiao Zhou's analysis is very thorough and on point. Our hospital can only move forward this time, not backward. In my opinion, we cannot let the patient live stream alone. Our hospital must also record the entire operation. In case of failure, we can just admit failure. If successful, we will promote it as much as possible and try to seize this opportunity to push cardiothoracic surgery to a higher level. Even Tuya Hospital will become famous."
Vice President Ye is even bolder than Zhou Can.
That’s why we say that all leaders are very brave!
When doing things, in addition to the necessary steadiness, they will be extremely crazy when it comes to fighting.
Of course, some leaders are just as crazy when it comes to corruption, with more than a hundred lovers and billions of dollars in bribes.
This crisis is both a challenge and an opportunity for the cardiothoracic surgery department of Tuya Hospital.
The Third Hospital paid for patients to come to Latuya Hospital to take the blame, but it was a bad move and a stupid move.
Because the operation failed, Tuya Hospital's reputation would suffer some damage, but it would not be particularly great. If the operation was successful, it would reap unimaginable benefits.
