The blood vessels in this patient's body were so weird that even experienced doctors couldn't feel them. This situation gave him a very bad premonition, and Dr. Fang didn't think he could succeed if he tried again.
Jin Tianyu's skills are better than his, and his intuition should be the same as his. The risk of forcing the operation like this is too high.
"Otherwise, I'll go and say, their cardiothoracic surgery department is here -" Dr. Fang thought about it in his mind and whispered to Jin Tianyu to give up. If Jin Tianyu was afraid of losing face, he would go and say it.
After hearing this, Jin Tianyu glared at him, unable to believe that such words could come out of his mouth.
How could he not seek a surgeon because of his face? He, Jin Tianyu, has a bad temper. He is a doctor after all. How could he consider his own face on such an issue?
There is no robot among us who understands him, and he is almost bored to death. At least the robot knows how to reply to Dr. Xu, and telling the other party will not be a hindrance to face.
What will happen if the surgeon comes?
Fu Xinheng is here. This robot is as precise as a machine in doing things, and it doesn't care about anyone's face. Fu Xinheng doesn't interrupt or speak. The only reason he can explain is that he feels the same. Such a patient will die if he is put on the surgical operating table.
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This was the main reason why he hesitated to send the patient to surgery.
For coronary artery bypass grafting, the first choice for elderly patients like this should be the great saphenous vein, but this patient's great saphenous vein is not working. So he wants to say that the patient's previous attending physician, Dr. Xu, did not do his job well. How can he have the nerve to tell others?
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A doctor also has responsibilities for postoperative management of patients, not to mention that this patient trusts Dr. Xu.
If the patient does not cooperate with the subsequent examination and treatment, you must urge him. Doctors must be good at coercion and inducement. If you do not do these tasks well, the next time the patient becomes ill, you or your colleagues will be stumped. The worst thing is that
The patient himself.
Well, we all know that the patient’s veins in the lower extremities cannot be chosen as bypass material.
Choose an artery? It is better to connect the artery to the artery than to cut off the vein and connect it to the artery. It is more original.
Patients who are under 70 or 80 years old can try to choose arteries. But if you look at the current situation of PCI, the condition of the arteries in the upper body is probably just as bad.
Of the upper body arteries to choose from, surgeons like the internal mammary artery the most. However, the internal mammary artery is a very short length. Regardless of whether the internal mammary artery can be used like the great saphenous vein, this length alone is not enough to solve difficult cases.
Not enough for surgeons to use.
If a thoracotomy is performed, it will appear that the internal mammary artery is not needed for a complex condition like a three-vessel disease. This patient's situation is precisely estimated to have poor layout of the coronary blood vessels of the heart. Surgical bypass surgery does not rule out the need to re-layout the distribution of the heart blood vessels.
At this time, more circulatory collaterals need to be established, and more of the patient's own good-length blood vessels are needed as materials.
If the great saphenous vein does not work and the internal mammary artery does not work, where should the surgeon prepare to find vascular materials?
Setting up a path in a hurry to end the operation? Bypass is not PCI, it is to extend the interval of postoperative restenosis to more than ten years. How high is the risk of a patient having a thoracotomy? Can you be allowed to open the thoracotomy multiple times? Thoracoscopic surgery? Like this
A patient with complex conditions can undergo thoracoscopy? Let’s prepare for the worst outcome first.
What junior sister Xie Wanying said when she argued with Dr. Xu on the phone was true.
