This is a right heart, and any surgery on the right side of the heart is more difficult to do than a normal left heart.

This is like the surgeon's habitual decision on anatomy, just like an old driver who drives on the left side of the steering wheel, and suddenly arrives in a country where the traffic rules are opposite, the right steering wheel and the driving is on the left, and it is difficult to adapt to it all of a sudden, and if it is still a very complicated traffic area, it is even more uncomfortable.

When the Fontan surgery was done back then, if it weren't for Academician Wang's superb skills, he would not have done the Fontan surgery on the right heart so well.

Demolition surgery is not so simple, the operation must be delicate, while the quality and integrity of the "parts" must be preserved, and the reorganization and reconstruction still rely on these dismantled "parts", rather than relying on substitutes.

The pulmonary artery connects to the superior and inferior vena cava, which is the core of Fontan's procedure, and now Yang Ping has to cut this connection from the original anastomosis and allow the pulmonary artery to reconnect with the right ventricle.

The interval between the left and right atria has been eliminated in the original operation, and the wall is now to be rebuilt.

The original plan to use the heart only for systemic circulation was completely dismantled and nullified, and now the heart must return to its normal position, assume the dual tasks of systemic circulation and pulmonary circulation, and change the similar double-chamber structure formed after the last surgical transformation back to a four-chamber structure.

But this is not enough, it is just to remove the original surgery and lay the foundation for the heart and large blood vessels to be restored to their original appearance.

Demolishing the house is only the first step, and the later construction of the house is the most complicated project.

After Yang Ping dismantled the original operation, all the "parts" inside were scattered, and the entire heart and major blood vessels had been fragmented.

Academician Wang stood up from the stool, so that the line of sight is more at the same level as the screen, which is more conducive to observation, and now it is only the first step of the operation, everyone can't help but start worrying that the current work is just to tear down the building, and the next recovery and reconstruction is the most difficult, and the difficulty of restoration and reconstruction is not to start from scratch, but to rely on this pile of ruins to rebuild a perfect building.

As several of the world's top cardiac surgeons, they have never had such an operation, and even after planning for a long time in their minds, they have no clue and can't believe that this surgery can be achieved.

With a knife and a cut, a needle and a thread, Yang Ping began to reconstruct the heart, which was a difficult task, not only testing technique, but also confidence and patience.

First correct the malformation of the heart, and then correct the malformation of the large blood vessels, Yang Ping's surgical steps are very clear, the big steps are set of small steps, step by step.

The atrial septum must be rebuilt, and the original large room is now divided into two isolated small rooms, which must not be sealed by the isolation wall and cannot leak blood, that is, after the atrial septum is reconstructed, the blood of the left and right atria cannot be mixed.

The entire reconstruction will use a combination of autologous and artificial materials if there are no materials in the ruins, in short, the goal must be achieved.

Not only the septal defect of the atrium, but now the septum of the ventricles is also defective, and after the partition wall of the atrium is rebuilt, the partition wall between the ventricles must be rebuilt.

Severe subvalvular stenosis of the pulmonary artery valve, which was solved by Academician Wang at the time of Fontan's surgery, otherwise Fontan would not have lasted for more than 10 years.

Atrioventricular valve insufficiency, now reconstruction must solve this problem, normal blood should be from the atrium to the ventricles, there will be no counterflow, and the atrioventricular valve is a one-way valve, this one-way valve ensures the unidirectional flow of blood, but the insufficiency of the closure will lead to the destruction of the function of the one-way valve, so that the blood will have a reverse flow phenomenon.

At this time, only the atrioventricular valve can be repaired or replaced, and if it can be repaired, it can only be replaced.

Fortunately, Yang Ping felt that his atrioventricular valve could still be repaired, but it was more difficult.

After repairing the atrioventricular valve, Yang Ping began to deal with the hepatic vein, and the operation was unhurried, methodical, fast and not chaotic.

Song Hanhui originally opened the hepatic vein directly in the right atrium, and now Yang Ping wants to remove it and let it connect with the inferior vena cava, there are two ways to deal with this step, the hepatic vein is directly anastomosed end-to-side with the inferior vena cava, that is, a small opening is trimmed on the wall of the inferior vena cava, and then the hepatic vein is docked to this small opening.

Another method is to find a branch on the inferior vena cava to join the vein, which also has a sibling vein, and then cut the vein to anastomosis the hepatic vein.

Relatively speaking, the latter is much better, Yang Ping took the latter method, and the original hepatic vein outlet of the right atrium had to be blocked.

Later, there is also the correction of the double outlet of the right ventricle, the adjustment of the opening position of the aorta and pulmonary artery, etc., and the operation is very complicated.

Academician Wang kept staring at the screen, Yang Ping's operation looked very comfortable, it was originally a complicated and messy thing, but through Yang Ping's hands, it turned out to be concise and orderly, and the whole operation reflected a transcendent sense of art.

Each step seems to have been tempered by a thousand times, and there seems to be some kind of precipitation in it.

A few graduate students also gathered in the demonstration room to see the surgery, but the graduate students took the time to come to see the surgery, some saw that half of them wanted to go back, and some came in to see it in the middle of the field.

——

The operation lasted for more than 3 hours, Yao Xiurong couldn't wait, she ran to the door of the operating room again, but the door was closed, she couldn't see anything, so she wanted to raise her fist and punch a few times, but she was afraid that her husband would scold, so she couldn't help but move.

"Concentration! Be focused! ”

Lao Song reminded his wife.

Yao Xiurong was walking in front of the door of the operating room, when the graduate student who rushed back to the ward hurriedly came out of it, and another graduate student hurriedly entered.

"How's the surgery inside? Is there cardiac arrest? ”

"It's been a long time, let's go in and see."

"I'm just done."

"Move quickly, if you don't hurry, it's gone."

Yao Xiurong wanted to catch a graduate student and wanted to ask what was going on, but the one who came out had already entered the elevator, and the one who went in had already entered, and the door was closed.

"Arrest?"

Yao Xiurong was stunned in her heart, cardiac arrest, that is, cardiac arrest, isn't that gone?

Yao Xiurong seemed to understand everything, she couldn't help it anymore, and knocked on the door of the operating room hard, bang!

Lao Song pulled her away: "What are you doing?" You're crazy, it's the operating room, and it's your son doing the surgery. ”

"The heartbeat has stopped, and no one has come out to tell me what the situation is, just like you, don't do anything, you don't care, is it hard-hearted, it's our son inside." Yao Xiurong scolded.

"Did you listen to the doctor's preoperative conversation? This surgery is done only if the heart is stopped, and it is not the first time, as it has been the case in the previous three surgeries. Lao Song tried his best to explain.

Yao Xiurong was so anxious that she couldn't tell the difference between the southeast and the northwest, because she was in a hurry, she didn't listen to every preoperative conversation at all: "You know, you know everything, I don't understand anything, don't I understand cardiac arrest?" ”

Regardless of thirty-seven twenty-one, Yao Xiurong knocked vigorously on the door, and soon the door opened, and a nurse came out inside, wearing a mask and a sterile cap.

"What's the matter, don't knock on the door like this, there is surgery going on inside, it will interfere with the doctor's operation." The nurse said.

Lao Song immediately apologized and pulled Yao Xiurong aside: "I'm sorry, I'm sorry!" ’

Yao Xiurong shook off Lao Song's hand: "How is Song Hanhui inside, it's been more than three hours, why hasn't there been any movement at all?" We are his parents, and we are very anxious. ”

"I'm still doing surgery inside, and everything is going well." The nurse explained.

"My heart has stopped, and everything is going well? I asked you if your heart had stopped? ”

Yao Xiurong's questioning tone.

The young nurse was also confused by the sudden question: "Yes, the heart is now in arrest-——"

Yao Xiurong's head was dizzy, and the nurse hurriedly helped her: "What's wrong with you?" You okay? ”

"Why did the heart stop—" Yao Xiurong's face turned pale, and she collapsed into the nurse's arms and fainted.

The nurse realized that it was a misunderstanding, and every parent with congenital heart disease knew what was going on, but why didn't she know it.

Because she was worried about the child's operation, Yao Xiurong had no appetite in the morning, didn't eat breakfast, and now she has low blood sugar, and when she is in a hurry, she directly has a hypoglycemic reaction.

The nurse is more experienced, and when she saw this, she knew that it was hypoglycemia, and immediately called: "Come on, rescue!" ”

This is the operating room, not the ward, everyone is busy with the operation, the nurse shouted, a doctor ran out of it, and the nurse said, "Quick, open the bottle of glucose." ”

Lao Song was really speechless, he knew that he had low blood sugar and didn't eat breakfast, saying that he was anxious for the child, isn't this adding to the chaos, the surgery inside was done well, and now you are crying, and the doctors and nurses have to allocate people to rescue the family.

If it weren't for his wife, Lao Song really wanted to kick it, the starting point was good, and he was anxious for the child, but the result was to add chaos.

This is not the first time that this kind of thing has happened, in the past, the child had just entered primary school, and his academic performance was poor, and his wife and father-in-law discussed a way together, and as a result, the parents-in-law listened to the recommendation of selling health care products and bought a course of "smart medicine", which cost a total of 20,000.

You said that if this "smart drug" is flour, it contains something similar to stimulants, something completely harmful, and Lao Song resolutely refused to eat it after discovering it.

As a result, the wife and father-in-law were very aggrieved, saying that for the sake of the children, they took out their savings to buy medicine, and you still don't appreciate it.

Oh my God, they believe the words of the people who sell health supplements.

As a result, the father-in-law and mother-in-law had a problem with this matter, and wanted to secretly give it to the child several times, but they were discovered by Lao Song, and they also said that Lao Song was impersonal, did not understand the old man's mind, and regarded the old man's kindness as a donkey's liver and lungs.

Isn't this the case now, I'm really anxious, but isn't this kind of impatience a disservice, isn't this kind of thing still rare?

Doctors and nurses immediately rescued Yao Xiurong on the spot, let her drink a few sips of glucose, and then inhale oxygen through a nasal cannula, about ten minutes later, Yao Xiurong woke up: "What about my child-——"

"It's still operating, don't worry."

"You lied to me, my heart stopped, I'm not in a hurry?"

The nurse couldn't help but laugh: "The doctor should have told you before the operation that this kind of surgery requires artificially stopping the heart and re-beating the heart after the operation, which is a normal step in the operation." ”

"The heart has stopped, can people still live, you are my three-year-old child, people have no heartbeat, then they are still called living people? You let me go in and have a look. Yao Xiurong didn't give up, he thought that the doctors and nurses lied to her.

Lao Song shouted: "What's the trouble, the operation is good, you have to make trouble to be happy?" ”

"How do you speak, you don't care about me, your heart has stopped, you are still humming here, is there a father like you?"

Yao Xiurong was so angry with Lao Song that she vomited blood, the child's heart stopped, he didn't react here, and was fooled by doctors and nurses.

Lao Song was so angry that Yao Xiurong vomited blood, this brain was stupid out of the sky, when the doctor talked, he knew that he shed tears, and he didn't listen carefully, and now at this time he doesn't know what cardiac arrest means, Lao Song can even memorize the approximate steps of the operation.

The anger of the "smart drug" incident came out again, and Lao Song almost spurted out a mouthful of old blood.

If you are not afraid of God opponents, you are afraid of pig teammates!

And it's also a pig teammate who has been cultivated for thousands of years!

——

"What's going on out there?"

Academician Wang asked, although the sound of knocking on the door outside could not be heard in the operating room, but he had just learned from the itinerant nurse that the family had fainted at the door of the operating room and was being rescued.

"Are the family alright?"

Yang Ping also knew about this and asked.

Because Xiao Su was on vacation, the instrument nurse on the stage was Zhou Can, and the itinerant nurse was the new nurse Wang Xiaowen, Wang Xiaowen said: "Low blood sugar, I just drank a few sips of glucose, and when I woke up, I should be fine." ”

"I heard she was banging the door of the operating room, clamoring to come in." Wang Xiaowen said.

Song Zimo didn't understand why the family suddenly behaved abnormally: "Why did she come in?" ”

"She said her child's heart was in arrest and we didn't tell him in time—"

"How so? Didn't you make it clear to them about the surgery? Cardiac arrest is a normal step. ”

Song Zimo came forward to talk about the operation, he said: "I said it, and I said it in great detail, and I emphasized it again and again, and said that there was a possibility that I could not rebound after stopping the beat, but the possibility was very small, and they all said they understood, and then signed." ”

"Then how could there be a misunderstanding?"

"I don't understand either."

"Before, the nurse entertained Chu clearly about fasting and drinking before the operation, but they also violated the doctor's instructions and ate secretly, I heard that the egg yolk pie was secretly left by his mother to Song Hanhui, his father didn't know, his mother was afraid that the child would be hungry, and it shouldn't be a big problem to eat something."

"How do you know"

"Today, the baby in the next bed was going to be transferred back to the general ward, and the baby's parents told the nurse that his father packed all the snacks for his mother to take away, and his mother secretly stuffed two egg yolk pies under the pillow when he left."

Isn't that harmful?

I don't know how to say that this parent seems to be good to the child, but in fact it is harmful to the child, which has been discovered in advance, if it is not found, the anesthesia on the operating table causes vomiting and suffocation, and it is really suffocated to death, how can this be done.

"The baby's parents told the nurse not to speak out, otherwise the child's father would definitely scold his mother." Said the graduate student.

After saying this, the fat man immediately put down Erlang's legs, checked the monitoring data of the child's tracheal intubation and screen, and had a normal blood oxygen saturation, and the fat man couldn't help but pinch a cold sweat.

"Fatty, are you alright?"

Yang Ping saw that the fat man was moving and asked.

The fat man, who has always been confident in anesthesia, has no confidence to speak: "It's okay for the time being!" ”

Because I don't know if this kid has food in his stomach now, if there is food, it will be a time bomb at any time.

Academician Wang wanted to go out and have a look, and criticized Song Hanhui's parents a few words, but the operation is now a critical moment, Academician Wang doesn't want to miss it, and Song Hanhui's mother is fine, and Academician Wang doesn't want to go out again.