"Sister Juan, prepare the operating room."
Qin Feng swapped positions with Liu Juan and said to her.
"I'll go right away! Xiaozhang, Xiaoxiao, come with me."
Liu Juan nodded, leading two nurses into the operating room to prepare.
An aortic rupture, this situation is extremely dangerous, even the slightest mistake can be life-threatening in minutes!
A couple of minutes later, the little girl's condition finally stabilized.
However, the shock had not subsided; they merely maintained the vital signs.
Soon,
Director Zhou from the emergency department and Director Zhang Fan from cardiothoracic surgery rushed over with an assistant. The anesthesia and ICU critical care directors also arrived, immediately beginning a consultation.
All of the patient's examination results were presented, and the details were explained to the doctors present.
"Now the patient's descending aorta has ruptured, and there's been a significant loss of blood."
Qin Feng looked at Director Zhou and Director Zhang Fan in front of him and said gravely,
"We must perform surgery immediately. My suggestion is a descending aorta artificial graft replacement!"
"This is indeed the most suitable plan at the moment, but…"
Director Qi from the ICU glanced at the examination report in his hand and suddenly turned to Director Zhang Fan beside him,
"Old Zhang, this surgery is very difficult. The patient is young with narrow cardiovascular vessels, making artificial graft replacement prone to complications, especially since the spinal cord has a pressing demand for ischemia prevention.
I estimate you have only 15 minutes. Exceeding this time would result in spinal ischemic necrosis, causing paraplegia or complete paralysis.
Can you do it in time?"
As he finished speaking, everyone's eyes focused on Director Zhang Fan.
"Cao Ke is at a provincial meeting, now in cardiothoracic surgery, I'm the only one who can operate as the chief surgeon, otherwise what can we do?"
Upon hearing this, Director Zhang Fan frowned immediately and said curtly.
Director Qi quickly nodded: "Old Zhang, I understand what you mean, I just wanted to know who the first assistant would be?"
"Cui Yong then, he's Cao Ke's student and has served as the first assistant for both Old Cao and me."
Zhang Fan looked at the doctor beside him.
Seeing Director Zhang Fan's approving gaze, Cui Yong immediately straightened his back and puffed out his chest.
"Alright then, as long as you're confident, who's the second assistant?"
"Let Qin Feng go."
Director Qi had just finished speaking when Zhou Xianren spoke first,
"There's no need to say much about him, and since he discovered and brought the patient to the emergency room, let him follow Old Zhang and learn."
After he finished speaking,
everyone's eyes instantly focused on the handsome face seated at the head.
Qin Feng was also a bit surprised that Director Zhou took the initiative to help secure the second assistant position for him.
He hadn't even had the chance to speak yet?!
"No problem, I agree."
Zhang Fan looked at Qin Feng and nodded in satisfaction.
Last time when Deputy Director Chen Yuanfang was in trouble, Qin Feng's exquisite vascular suturing technique left a lasting impression on him.
It was truly remarkable!
Hmm?
Isn't he the best choice for the first assistant?
Oh well, given that Cui Yong is Old Cao's student.
If Old Cao found out that a cardiac surgery was performed using emergency department personnel as the first assistant without involving cardiothoracic surgeons, he would surely be displeased.
Sometimes hospital departments also face realistic dynamics, after all, nurturing one's own departmental talent is essential.
And talent, besides requiring aptitude, also needs experience.
...
"Yiyi! Where's my Yiyi?"
Just as everyone was ready, waiting quietly outside the operating room, a frantic voice pierced the calmness.
"Here she comes."
The crowd immediately moved towards the sound.
"Are you Qiao Yiyi's mother?"
Zhang Fan spoke first.
"Yes, yes, yes, where's my daughter? How is she?"
Upon hearing her daughter's name, the woman instantly burst into tears, grabbing him tightly.
"I'm Zhang Fan, the director of cardiothoracic surgery at City Hospital No. 1. Your daughter's aortic dissection has ruptured, which is life-threatening. She urgently needs surgery."
Zhang Fan quickly explained,
"We need your signature to proceed with the surgery, so if you wish to save your daughter, please sign quickly."
With this news, the woman's face turned ashen, her legs gave way, nearly collapsing.
Qin Feng reached out to hold her, noticing that her attire and demeanor were not ordinary.
A woman of considerable grace!
The woman suddenly seemed to remember something, frantically digging out her phone and dialing a number.
"Hello, our daughter's artery has ruptured; it's very dangerous, what should we do?"
"I'm at City Hospital No. 1 right now, the doctor is right in front of me, sob, sob~"
Whatever the man said on the other end, the woman cried even harder before hanging up.
"My, my husband said he's bringing experts from the province over, we... we should wait for him."
Hearing this, everyone around furrowed their brows slightly.
What's going on here?
Bringing in provincial experts?
"How long until your husband arrives?"
"Half... half an hour."
As soon as she finished speaking, everyone was left speechless.
She clearly didn't understand the severity of an arterial rupture!
If they hadn't quickly controlled the situation, the little girl might not be alive anymore.
"I can only tell you that in half an hour, your daughter likely won't make it, we can't wait!"
Director Zhou, observing the situation, spoke in a similarly serious tone,
"Every minute that passes adds to the risk to your daughter, make a decision quickly."
"Alright, I'll sign, as long as it saves my daughter's life."
After a moment's hesitation, the woman finally conceded, shakily signing the surgical consent form.
Seeing the woman sign, everyone breathed a sigh of relief.
Inside the operating room,
the little girl lay on the table, already under general anesthesia.
Qin Feng stood in the second assistant's position, quietly watching Director Zhang Fan begin the surgery.
"It's now 6:58 PM, patient Qiao Yiyi, descending aorta artificial graft replacement surgery.
Starting now!"
Chief surgeon Zhang Fan's voice rang out, making an incision on the left posterolateral chest of the little girl, entering the thoracic cavity between the 6th or 7th intercostal space.
This time utilizing the "simple occlusion method," which, under normothermia, involves occluding the upper and lower ends of the descending aorta around the aneurysm to excise or open the aneurysm and transplanting the artificial graft.
The hazard to avoid here is that once the aorta is successfully occluded, the left heart bears an increased load, simultaneously affecting key organs distal to the occlusion.
Such as the liver, kidneys, and spinal cord, with the spinal cord being at the greatest risk!
The spinal cord is most susceptible to ischemic and hypoxic damage; other organs tolerate occlusion for over 30 minutes, but the spinal cord only for half that time!
Once the tolerable time is exceeded, brain cells begin to die, resulting in irreversible severe damage.
...
Squeak, squeak, squeak, squeak~
As the sternum was opened, Zhang Fan skillfully cut off the back end of one of the ribs to enlarge the incision and reveal the surgical field.
A small, beating heart appeared in front of everyone.
Sure enough!
The artery had ruptured, causing massive bleeding.
There was already a significant amount of fluid in the thoracic cavity that needed immediate clearance.
"The situation is indeed critical, let's begin the separation."
Zhang Fan frowned slightly and said calmly.
This step required extreme caution because the artery was adhered to the lungs. If something went wrong, it could damage the lungs.
If the blood entered the lungs, it could cause embolism, which is highly fatal.
Moreover, the patient was very young, with underdeveloped organs, requiring precision beyond the norm.
Qin Feng watched as Zhang Fan began to separate the tissue, proceeding slowly and cautiously.
5 minutes...
10 minutes...
20 minutes...
Finally, two-thirds of the tissue was successfully separated.
"Wipe the sweat."
Zhang Fan paused for a moment and said softly.
The nurse beside him quickly blotted the fine beads of sweat from his forehead to avoid affecting his vision.
After a full half hour, all the tissue was finally completely separated.
The section of the aortic dissection was detached and successfully separated!
"Whew~"
Zhang Fan withdrew the instruments and exhaled deeply.
Separating the arterial tissue in such a young child was something he rarely encountered even after decades of practice.
It took much longer than he anticipated, with a waste of a full 2000CC of blood.
However,
the more challenging part was yet to come; the patient's arterial vessels were very thin.
This was the real test!
Next, they proceeded to occlude the aorta.
"Alright, inject heparin intravenously at 1.5mg/kg, sodium nitroprusside, reduce blood pressure..."
Upon hearing this, the nurse swiftly began the operation, injecting into the patient.
A dozen seconds later, the arterial pressure began to gradually decrease, stabilizing at 90~100 mmHg.
"I'm going to start the occlusion now."
Zhang Fan looked at Cui Yong beside him and Qin Feng opposite him, his gaze serious.
This was a crucial race against time.
Because, he had only a safe window of: 15 minutes!
...
Outside the operating room,
the sound of hurried footsteps approached, leading the way was a man in a well-pressed suit, his face flushed.
Behind him followed two or three people, one of whom appeared to be around fifty, with a shiny forehead and furrowed brow.
"Yiyi, where is Yiyi?"
Hearing the call, the woman pacing back and forth at the entrance of the operating room quickly lifted her head and rushed over.
"Husband! Yiyi is in surgery."
"Didn't I say to wait until the specialists I invited arrived before doing it?"
The man heard this and immediately yelled in an angry tone,
"Who authorized the surgery? If anything goes wrong, can you bear the responsibility?!"
"Please, sir, calm down. I am Zhou Xianren, the Director of Emergency Department."
Zhou Xianren, hearing the commotion from the observation room, stepped out, his expression somewhat displeased.
"Your daughter's condition is very urgent. If she hadn't been operated on promptly, she wouldn't be with us now."
Saying this, he handed over the examination report.
The middle-aged man with a receding hairline standing next to him reached out to take it, and after a quick glance, his expression became grave.
"Mr. Qiao, your daughter's situation is indeed precarious; her arterial aneurysm has ruptured."
After reading, he shook his head at the man, speaking in a low tone.
Upon hearing this, the man finally calmed down.
Even the expert he had invited said so; it seemed the situation was indeed severe.
"Director Zhou, correct? Hello, I'm Liang Donglai from the Cardiothoracic Department of Jinling First Hospital. I would like to know who is performing the surgery on the patient?"
The man proactively extended his hand and looked towards Zhou Xianren inquiringly.
"Hello, it's our hospital's Cardiothoracic Department Director, Zhang Fan."
Director Zhou realized that this was the expert from the province.
"Oh? It's him?"
Liang Donglai's eyes lit up upon hearing this, and he nodded,
"Zhang Fan is my classmate and also one of the cardiovascular experts in Su Province.
How long has the surgery been going on?"
"About 35 minutes."
Zhou Xianren glanced at his watch and said.
"It should be completely separated by now, and they must have started occluding the artery."
Liang Donglai hummed softly, then raised his head and asked,
"Director Zhou, can we enter the observation room to view the surgery process?"
"This..."
"I am also quite familiar with your vice president, perhaps a phone call?"
"That won't be necessary. Families have the right to view the surgery process, but please don't interfere. Come in."
Zhou Xianren nodded and opened the door to the observation room.
At this moment, on the monitor,
Zhang Fan had already placed the occlusion clamps on both ends of the aortic dissection.
Success!
"Suction!"
In the next second, the scalpel sliced through the artery, quickly cutting into the dissection area, and the suction device cleaned up the blood before suturing the right intercostal artery incision.
It was completed in one go!
"Artificial graft, quickly!"
Zhang Fan extended his palm, his expression serious.
The nurse tore open the artificial graft and handed it to him.
"4-0 polypropylene suture!"
After placing the artificial graft, he promptly began the proximal anastomosis.
Just as he was about to position the needle, Zhang Fan's hand paused in mid-air, and suddenly a blank whiteness filled his eyes.
Buzz~
Not good!
Qin Feng's expression changed, noticing something amiss.
The suture needle in Zhang Fan's hand on the forceps inexplicably began to tremble slightly.