Chapter 482: Chapter 277: Shining at Yanjing University People’s Hospital (3)

"Directors, although we’ve run a complete blood count, biochemical tests, a cardiac enzyme panel, an EKG, and abdominal and cardiac ultrasounds, the results all appear normal. We haven’t found any signs of an aortic dissection aneurysm..."

"But, look at this plasma D-dimer level..."

The directors from Gastroenterology and the Emergency Department were drawing a blank as they looked at the coagulation marker Wu Ting was pointing out.

Director Liu from Emergency Cardiac Surgery was suddenly alarmed. He had actually overlooked this obscure marker.

"It’s not a mainstream indicator, but there have been studies showing that D-dimer is a degradation product of fibrin. Its level of elevation is positively correlated with the extent of the aortic dissection and negatively correlated with the duration of the condition..."

Now that he had a direction, Director Liu’s experience and skill immediately allowed him to formulate a plan for further examination.

Soon, Director Liu personally performed a CT angiography on the patient.

Following Wu Ting’s tip, Director Liu, being a cardiovascular surgeon, took the lead from the directors of Gastroenterology and the Emergency Department. He quickly drew upon his vast and comprehensive expertise to confirm the diagnosis: a ruptured aortic dissection aneurysm!

The patient needed immediate emergency surgery.

However, the patient’s condition was extremely poor. He was hypertensive, elderly, and the dissection aneurysm had ruptured. His blood vessels had undergone degenerative changes, and the quality of the elastic fibers and smooth muscle in the tunica media of his aortic wall had declined. A conventional open-heart surgery would likely cause a secondary rupture...

Another complication was that the patient was already in shock and on the verge of death. If they used cardiopulmonary bypass, even if the aortic repair was successful, there was a high probability of damage to other organs, including the brain.

Another option was a minimally invasive endovascular repair. However, this technique required finding the optimal surgical approach.

Director Liu quickly thought of one person: He Guangzong, the chief of Ward 1 of Vascular Surgery at Fuwai!

In such a perilous situation, and under these extreme therapeutic conditions for the patient, their only option was to attempt using Hybrid Technology, which was still in its infancy in the country.

This involved creating a specially customized, surgically assisted access route for the patient, then performing a modified endovascular aortic repair.

This kind of customized Hybrid Technology required an experienced Technician to specifically design and perform the procedure.

Director Liu considered the situation. ’Given the patient’s current condition, even if I notify He Guangzong now, he most likely won’t make it in time.’

The only possibility was to have He Guangzong assist via remote consultation to formulate a surgical plan.

Director Liu and Director Chen would follow He Guangzong’s surgical plan, performing the initial resuscitative measures. Meanwhile, He Guangzong would rush over from Fuwai to take over the rest of the procedure. If they coordinated well, there was still a glimmer of hope.

The hospitals in Qinghe City had long been equipped with remote consultation and surgical systems.

In the trauma room, Director Liu immediately called He Guangzong.

After hearing the details, Director He immediately logged on and connected to the remote consultation system.

Once connected, Director Liu began to brief He Guangzong on the latest test results.

At that moment, the patient’s condition deteriorated again. Despite continuous chest compressions and bag-valve-mask ventilation, his heartbeat and breathing remained faint, and his major arterial pulse was weak. Both pupils were beginning to dilate and fix... He was on the brink of death.

At this point, Wu Ting could no longer keep a low profile.

As a master of Hybrid Technology, Wu Ting considered the patient’s condition and came up with a plan.

’A brand-new Hybrid surgery for the patient, using prosthetic vascular replacement and the stent-graft elephant trunk technique...’

’Use traditional open surgery as an auxiliary measure... an ascending aorta replacement and a Bentall procedure to create the bypass...’

’Then, use the elephant trunk stent-graft to reconstruct the aortic arch. This will be done with a covered stent, but we have to be careful with the method for inserting the guidewire into the true lumen...’

At the very moment Wu Ting was formulating this specialized surgical plan for the patient, He Guangzong, through the remote system, proposed nearly the exact same idea.

"Using Hybrid Technology, a prosthetic vascular replacement and the stent-graft elephant trunk technique..."

As He Guangzong explained his plan, all the doctors in the operating room listened intently. But Wu Ting’s plan was voiced at the same time, so everyone heard it with perfect clarity.

The two plans were identical!

Jiang Ming, Director Liu, and the others were in disbelief.

He Guangzong was even more stunned. He had designed this plan on the fly, specifically for this patient—it was the optimal surgical approach, born from his decades of clinical experience.

Yet he never expected that in this very operating room, another, younger doctor had come up with the exact same plan.

’Who is he?’

He Guangzong had always been confident that Ward 1 of Fuwai Cardiovascular Surgery was the pioneer and pinnacle of Hybrid Technology in Jin Country, and that he was the ward’s "number one scalpel!"

He never thought he would encounter such an unknown expert today in the emergency department of Xingke University Hospital.

Clearly, to be able to propose such a sophisticated Hybrid Technology procedure, this young doctor’s understanding of the technology was in no way inferior to his own.

But Wu Ting wasn’t focused on any of that. The patient’s condition was too critical; there was no time to waste.

"Jiang Ming, Directors, we need to start the surgery now. The patient can’t wait another second..."

"I need to start dissecting the right femoral artery... and perform the Bentall procedure..."

Director Liu and Director Chen looked to He Guangzong, who nodded, giving his silent approval for Wu Ting to proceed.

With He Guangzong’s approval and support, the surgery began under Wu Ting’s command.

They watched as Wu Ting skillfully dissected the right femoral artery...

Isolating the brachiocephalic artery, systemic heparinization...

Clamping the open ascending aorta...

Inserting the elephant trunk stent-graft... closing off the stump of the left subclavian artery...

Anastomosing the four-branched graft to the elephant trunk stent-graft and the stump of the aortic arch...

His deft technique made it a textbook-level surgical demonstration.

Through the screen, He Guangzong was filled with admiration. ’This young doctor is the most formidable person I’ve ever seen when it comes to understanding and performing Hybrid Technology!’

In certain steps, he was just as good, if not better.

A deep appreciation for this young man’s talent began to grow in He Guangzong’s heart.

’A young man like this should join my Blade Team to realize his full potential!’

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