Back in 2002 as a doctor

Page 497

It took Dr. Miyamoto 32" to confirm that there was no problem, and then inserted the laser catheter without hesitation.

After calculation of all the previous inspection data, the reference vessel diameter of the patient's anterior descending artery is 3mm.

Dr. Miyamoto first used a 1.4mm laser catheter to release energy of 40mj/square millimeter.

Everything was ready, Dr. Miyamoto determined the position by angiography, stepped on the line and pressed the energy button to release the laser.

He was so concentrating that he even entered a state of subtlety, and could "see" the high-energy laser being emitted, like a laser weapon in a sci-fi movie, killing the enemy and removing those blood clots.

In response to Dr. Huang's doubts before the operation, Dr. Miyamoto did not choose the best right crown first surgery as if he was out of breath, but directly chose the anterior descending artery that Dr. Huang said was "not beautiful" for laser ablation.

However, the first accident... appeared without any accident.

The energy of 40mj/mm[-] seemed not enough, and the thrombus in the patient's anterior descending vessel was tougher than Dr. Miyamoto expected.

This kind of energy didn't make any progress, as if the laser irradiated on a hard and stubborn meteorite, the meteorite was completely intact, mocking Dr. Miyamoto quietly in the blood vessel.

Dr. Miyamoto was taken aback.

According to his speculation, the energy of 40mj/square millimeter is enough.

But the facts were right in front of him, and Dr. Miyamoto's mind suddenly echoed the voice of Mr. Huang's speech at the medical record seminar yesterday.

Looking ugly, excimer laser ablation cannot be completed...

Under the sterile mask of Dr. Miyamoto, the corners of his slightly raised mouth were tightened, and at the same time, his eyes were narrowed.

"Doctor." Seeing that Dr. Miyamoto hadn't moved, the assistant called softly.

"Increase energy, 50mj/mm[-]!" Dr. Miyamoto said calmly.

It's just a thrombus, so there's nothing difficult about it.

Since the energy of 40M joules is not enough, it becomes 50M joules.

I can't believe it's a rock!

Even if it is a stone, it must be melted away!

Dr. Miyamoto's assistant adjusted the energy and tried again.

1 minute later.

Dr. Miyamoto looked at the stubborn Shuanzi on the screen with a trace of anger in his eyes.

It's really a damn thing, is the patient's usual maintenance too good? !How is it different from the emboli in the coronary arteries of ordinary patients? !

Countless question marks and exclamation points danced in Dr. Miyamoto's mind.

The energy of 50mj/square millimeter already belongs to the upper middle level of energy. If it is higher, it may cause side effects, especially the patient's vascular endothelium will be affected by the energy, resulting in unexpected consequences.

But the damn embolus is unmoved by the energy of 50mj/square millimeter.

Blessed by God Amaterasu, Dr. Miyamoto said silently in his heart, and said softly, "The energy has increased, 60mj/square millimeter."

"PhD!"

"I said, increase energy!" Dr. Miyamoto said coldly.

"Yes."

60mj/mm40 is almost the upper limit energy of excimer laser ablation surgery. The operation experienced by Dr. Miyamoto's assistant is basically 50-[-]mj/mm[-], which can successfully open the thrombus in the coronary artery.

And the patient's age...

Dr. Miyamoto also knew that it would be dangerous to increase the energy to 60mj/mm[-], but the blood clot was different from what he had encountered before!

Is Dr. Huang right again? !

Dr. Miyamoto couldn't believe this fact.

In the field he is best at, Dr. Huang has obviously never been in contact with it, and even his descriptions are so monotonous and boring-not beautiful!Is this what a doctor said? !

60mj/mm[-] made Dr. Miyamoto's hands tremble.

Even if such a large amount of energy burns the thrombus in the coronary arteries successfully, it will have a great impact.

Dr. Miyamoto has no expectations as to whether the coronary vessels can withstand it.

Various complications of excimer laser ablation—including coronary artery dissection, coronary artery spasm, thrombosis, no-reflow phenomenon, embolism, and coronary artery perforation—were on the mind of Dr. Miyamoto.

He took a deep breath to calm himself down.

There is no problem with the operation, the energy must be improved, otherwise it will always be an unsolvable problem.

As a doctor, you have to be responsible, Dr. Miyamoto comforted himself.

After a few seconds, his emotions stabilized, trying to forget what Dr. Huang said yesterday, which was still echoing in his ears, and pressed the energy button hard.

60mj/mm[-] irradiated, laser catheter...passed and failed.

Dr. Miyamoto was speechless.

No matter how high the energy is used?He didn't dare to try it lightly.

In animal experiments, the energy of 60mj/square millimeter is the upper limit, who knows what will happen if the energy threshold of 60 is exceeded.

Dr. Miyamoto tried again, but unfortunately there was still no improvement, and the laser catheter could not pass through the thrombus at all.

This means that the highest threshold energy of 60mj/mm[-] is of no use to thrombus.

"Dr. Miyamoto." The experts from Wellington Hospital had already noticed something was wrong, and said softly behind Dr. Miyamoto.

"It's okay, I have another way." Dr. Miyamoto tilted his head, but no one knew what he meant.

"Wipe your sweat!" Dr. Miyamoto began to growl irritably, "The staff in your operating room don't even know such a simple thing?"

"Doctor, what should we do with the surgery?" The experts at Wellington Hospital asked while helping Dr. Miyamoto wipe off the sweat that had penetrated the sterile cap with a sterile drape.

"Using a thinner laser catheter, the 1.4mm catheter is still too thick." After roaring, Dr. Miyamoto tried to calm down his emotions.

This is not Shuntian, and what I am facing is not a subordinate doctor.

The management of Wellington Hospital is not as strict as that of Shuntian Hospital. The key is...the operation cannot continue.

The image does not look beautiful...Surgical treatment is recommended...

This damned sentence echoed around Dr. Miyamoto's ears like a curse.

Chapter 0855 It Was Just an Accident

After replacing the laser catheter with a thinner one, Miyamoto, who was already in a state of confusion, spent 10 to [-] minutes before successfully inserting the catheter.

Dr. Miyamoto's operation is not as smooth as it was at the beginning, everyone can see this, but no one speaks.

The surgeon's mind was a little confused, and no matter what he said at this time, the operation would lead to an unpredictable future.

But the ending without talking must be perfect?

The 0.9mm laser catheter gave 50mj/square millimeter of energy, and the operation started again.

Although the energy decreased, the number of repeated cauterizations by Dr. Miyamoto increased.

Multiple erosions are likely to cause various secondary injuries, but Dr. Miyamoto can no longer take care of so much. In a trance, he has already regarded the thrombus blocked in the coronary artery as Dr. Huang.

Kill him with a laser!

Kill him with a laser! !

Kill him with a laser! ! !

This idea became more and more intense, and instantly became an obsession. Along with years of grievances and the "humiliation" not long ago, Dr. Miyamoto had become paranoid.

Surgery must not fail!

Unknowingly, cold sweat broke through the sterile cap again, but Dr. Miyamoto didn't seem to notice, and all his attention was projected on the operation.

After a full sixteen energy releases, the doctor at Wellington Hospital looked pale, and he felt that Dr. Miyamoto could no longer be allowed to do this.

Failed surgery... There are other ways to solve the problem that can be considered.

But what if the coronary artery ruptures!

Although the surgeons and anesthetists have been waiting outside the operating room, if there is an accident, they will rush in immediately.

but!

The problem of allergies to anesthesia is still unresolved. If there is an emergency rescue, the queen will inevitably bear greater risks.

"Doctor!" The experts from Wellington Hospital stopped him.

"The operation should have been successful!" Dr. Miyamoto fell into a state of madness, his eyes were red, and he said viciously.

"..." The experts at Wellington Hospital finally made up their minds to stop the operation after hearing Dr. Miyamoto's words.

There is absolutely no way to give that life to such a bastard who has lost his mind.

"On behalf of the expert group, I recommend that you stop the operation." The person from Wellington Hospital said in a deep voice.

The simultaneous interpreter immediately translated his words to Dr. Miyamoto.

Dr. Miyamoto did not stop the operation, but hissed, "The operation has been successful! Damn, you don't even know what excimer laser radiofrequency ablation is!"

While speaking, Dr. Miyamoto followed the laser catheter into the coronary artery.

"PhD!"

The experts at Wellington Hospital quickly scolded him, but he was stunned at the next scene.

The 0.9mm laser catheter went in along the blood vessel. Although the position of the radial artery was seen, the laser catheter did go inward at least 3cm along the strength of Dr. Miyamoto!

"I'll just say it!" Dr. Miyamoto flushed with excitement, even the sterile mask couldn't stop his excited expression.

"!!!"

"!!!"

The experts at Wellington Hospital were also overjoyed.

A successful operation is a good thing, as long as the coronary artery is opened, even if it is only half opened, as long as the TIMI blood flow rating is Ⅲ.

"Get ready..." Dr. Miyamoto started his sentence when suddenly the ECG monitor frantically called the police, and the patient lying on the operating table twitched, and a painful moan came out.

Acute heart attack!

Dr. Miyamoto was stunned for a moment.

It is said that the 0.9mm laser catheter can pass through the thrombus, and the patient's condition will only get better, and it will never get worse.

But the sudden change caught everyone off guard.

After a pause of 0.5 seconds, the emergency team from Wellington Hospital rushed up. The emergency treatment had nothing to do with Dr. Miyamoto.

Listening to the various voices constantly coming from around him, Dr. Miyamoto was a little at a loss.

It is still early to say that the operation was successful, after all, no radiography was done, but at least the light of success has been seen.

But why does this kind of thing still happen.

My luck was really bad, and the queen had an acute myocardial infarction at the moment of success.

In this regard, Dr. Miyamoto was very speechless.

It is also possible that when the laser catheter penetrates the thrombus, it induces coronary vasospasm, which aggravates the already serious coronary heart disease, so this happens.

The operation could not continue for the time being. Dr. Miyamoto watched the professional rescue at Wellington Hospital and waited silently.

After half an hour of rescue, the Queen's condition improved slightly.

"Doctor, can the operation continue?" Experts from Wellington Hospital asked for Dr. Miyamoto's opinion.

"Do an optical tomography scan." Dr. Miyamoto's mood is relatively relaxed now.

I have already done ablation with excimer laser, but because the patient's condition is relatively serious, I can't even bear such a small surgical blow.

This is already the most minimally invasive surgery in the world, okay?

Dr. Miyamoto knew in his heart that the operation had already been performed by himself, and even if he was responsible, he could leave it to Wellington Hospital.

If they had found themselves earlier, this kind of thing would never have happened!

only……

In Dr. Miyamoto's ears, Dr. Huang's words suddenly sounded again.

Damn!