Chapter 747: Chapter 746: Tired of Running

It was Monday again. Yan Feifan brought his student, Pan Jichuan, to the Cardiac Surgery Department. He had been assigned to act as Dr. Zhang Shi’an’s surgical assistant and learn about coronary artery bypass surgery.

Coronary artery bypass surgery is a common procedure in the Cardiac Surgery Department, used to treat the vascular stenosis associated with coronary heart disease.

It is often compared to the placement of cardiac stents via vascular intervention.

Both are effective surgical methods for treating the blockage and stenosis of coronary arteries.

The interventional placement of a cardiac stent is a minimally invasive surgery that falls under the purview of the Cardiology Department.

The general procedure involves making an incision in the radial artery of the arm or the femoral artery of the thigh. A thin, long catheter is then threaded through the blood vessel into the body.

Under X-ray fluoroscopy, the doctor guides the catheter from the peripheral artery all the way to the coronary artery on the heart’s surface. The stent is then deployed at the site of the narrowing, propping the vessel open.

Coronary artery bypass surgery, on the other hand, falls under the purview of the Cardiac Surgery Department and generally requires open-chest surgery.

Open-chest surgery involves a median incision in the chest and cutting open the pericardium to completely expose the heart.

The vessel for the bypass graft is usually taken from the great saphenous vein in the thigh, the internal thoracic artery in the chest, or the radial artery in the arm.

One end of the vessel is sutured to the aorta, and the other end is sutured distal to the narrowed section.

This is equivalent to building a "bridge" over the stenosis, allowing blood to bypass the blockage and supply the myocardium.

During bypass surgery, the decision to use a heart-lung machine to stop the patient’s heart depends on the difficulty of the surgery, the lead surgeon’s technical skill, and the hospital’s equipment.

The attending-level physicians in the Affiliated Hospital’s Cardiac Surgery Department all had the skill to complete bypass surgery on a beating heart.

Bypass surgery and interventional stents each have their own optimal indications, and the choice requires a specific analysis of the patient’s individual condition.

However, because these two methods belong to two different departments, the recommendations given can inevitably be biased.

Generally speaking, for acute myocardial infarction, simple vascular stenosis that can be resolved with no more than three stents, or for elderly and frail patients, cardiac stents are the preferable option.

For complex vascular stenosis in a patient whose physical condition allows, coronary artery bypass surgery is the chosen option.

The male patient Yan Feifan was to treat alongside Dr. Zhang Shi’an was fifty-one years old and required two bypass grafts to resolve his heart’s blood supply problem.

However, just as Yan Feifan and Dr. Zhang Shi’an were scrubbing in, someone came rushing over to find them.

It was Yu Suye!

"Dr. Zhang, I’m sorry to interrupt. The Trauma Surgery Department received a batch of accident victims, and one of them was assigned to me."

"I’ve come for emergency backup."

As she spoke, Yu Suye showed a gory picture on her phone to Yan Feifan and Dr. Zhang.

"This is an eighteen-year-old boy. He graduated from high school and has only been working with his family for a little over a month."

"Look at his right hand. It was smashed to a pulp by an I-beam."

"Feifan, I thought about it over and over, and you’re the only one with the skill to restore his hand as much as possible."

Looking at the photo on the phone of the right hand, which had been crushed into a single mass, Zhang Shi’an spoke before Yan Feifan could even say a word.

"Yan, if you have the skill, then go. He’s only eighteen. Losing his right hand would have a huge impact on his entire life."

"You can learn about this bypass surgery another day."

Yan Feifan thanked Dr. Zhang for his understanding and ran out of the Cardiac Surgery Department with Yu Suye, heading straight for the Little Red House.

Yu Suye told him that a steel structure under construction had collapsed, injuring dozens of people.

The operating rooms in the Emergency, Trauma Surgery, and General Surgery departments were all full, so this patient, whose only severe injury was to his right hand, was sent to an operating room in the Little Red House.

Yan Feifan and Yu Suye arrived at the third-floor surgical area of the Little Red House. Just as they walked through the isolation doors, his phone rang.

It was a call from Liang Qing, the Vice President of Medical Affairs.

As soon as Yan Feifan answered, Liang Qing’s urgent voice came through, "Mr. Yan, are you free to come to the Emergency Department?"

"There’s a patient in critical condition with a cranial hemorrhage. The Neurosurgery Department can’t spare anyone, and the Emergency Department can’t handle it."

"Right now, only you, Mr. Yan..."

"I’m on my way!"

Yan Feifan cut him off brusquely. After replying, he turned to instruct Yu Suye.

"Start the debridement. Take it slow. Wait for me to get back."

After saying this, he bolted out of the isolation doors.

This scene left Yu Suye feeling rather helpless.

’A life versus a hand. Obviously, it was the life that required Yan Feifan’s immediate attention...’

「A few minutes later.」

Yan Feifan ran, panting, to the Emergency Department, then up to the second floor, and began to prep for surgery.

When he was ready and entered the operating room, he saw a doctor already performing abdominal surgery on the patient lying on the operating table.

Yan Feifan approached the operating table and saw that an elliptical surgical window, about four by five centimeters, had already been cut into the right side of the patient’s cranium. Blood was still gushing out...

He followed the blood flow and located one arterial and one venous bleeding point inside the brain, which he then sutured.

After Yan Feifan had dealt with some other intracranial injuries, he left the rest of the cranial surgery’s closing work to the surgical assistant from the Emergency Department and dashed off.

On his way back to the Little Red House, Yan Feifan complained for the first time about the hospital’s stupid rule prohibiting bicycles.

He decided that after this incident, he would propose to the hospital that they add electric two- or four-wheeled vehicles for internal use only.

After all, the hospital campus was not small. It took more than ten minutes to walk from east to west or from south to north.

During emergencies, medical staff could only rely on their own two feet to run back and forth.

Just as Yan Feifan ran up to the front of the Little Red House, his phone rang again.

This time, it was a call from Liu Jin.

"Feifan, there are three medical experts from Switzerland visiting our hospital."

"They specifically asked to meet you!"

Yan Feifan replied directly, "Mr. Liu, I’m about to go into an emergency surgery. I can’t get away right now."

"Let’s talk later..."

After getting ready, Yan Feifan walked into the operating room in the Little Red House and saw Yu Suye sorting the patient’s broken finger bones.

He stepped up without hesitation, taking the lead surgeon’s position that Yu Suye had yielded, and began to observe the patient’s right-hand injury.

’It was a truly thorough injury!’

As far as Yan Feifan could see, all the phalanges were fractured, especially the thumb’s, which was crushed to dust.

"The bones of the thumb... there’s no chance of recovery."

Having made his assessment, Yan Feifan pondered for a moment, his gaze falling on the young face of the patient, unconscious from anesthesia.

His brow was furrowed in a knot, and a trace of fear lingered on his expression, as if he could still feel the pain and terror even in his unconscious state.

Yan Feifan gave an order, "Wake him up. I need him to make a choice."

"Multiple phalanges in his right hand are unusable."

"One option is to transplant toe bones to serve as finger bones. The other is to take a rib and shape it into finger bones."

Yu Suye couldn’t help but ask, "Or we could use a 3D printer to print artificial phalanges?"

Yan Feifan shook his head. "First, it’s too slow and time-consuming. Second, there are issues with rejection and acceptance."

"Don’t forget that total hand bone replacement surgery we did with Mrs. Chen."

That surgery, replacing the shattered bones with 3D-printed ones, was, strictly speaking, a success.

But nearly two months post-op, that patient reported increasingly unbearable pain and itching in his hand.

Chen Yu had no choice but to operate on him again, replacing the artificial phalanges with his own toe bones.

"There’s one more thing..."

Yan Feifan pointed out, "The cost."

"If problems arise after the 3D-printed phalange surgery, it will be much harder for him to seek compensation for the surgical fees from the responsible party."

Yu Suye nodded, turned to the anesthesiologist, and signaled that he could wake the patient...

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