The foreign literature and the surgical cases they tried to use in Guozhi mainly involve atrial septal defect repair, ventricular septal defect repair, valve replacement, and myxoma removal. These surgeries have an obvious feature, involving the structure of the heart. Detecting the inside of the heart is esophageal ultrasound.
Strengths. The purpose of using esophageal ultrasound for this type of surgery is very simple. It can detect these intracardiac structures in real time so that doctors can adjust the surgical plan and observe the postoperative repair results.
From this point of view, Xie's use of tee to perform hepatobiliary surgery is definitely a national initiative. Guozhi has never used it in such a case. This is something he, Mr. Zhang, dares to vouch for.
At that time, he, like other hospital doctors at the exchange meeting, wanted to know who came up with the first idea. However, Tao Zhijie was confused at the exchange meeting, and everyone in the National Association pretended to be mute. Even though he later went to the National Association because of his mother's affairs,
A group of people still kept it from him.
Now he is more and more certain that Classmate Xie did this. Look at the calm expression on her face through the leaded glass window. Don’t think she is faking it. As a boss, he can see that Classmate Xie really has no idea.
Pretending, and then catching the intriguing faces of those National Association people, two pieces of evidence supported his speculation.
When a group of people from the National Association realized that Mr. Zhang was looking over from the corner of his eye, they pretended to be stern.
In the operating room, Xie Wanying was thinking about what Teacher Du wanted to detect by using this esophageal ultrasound during the operation. It was definitely not what she had used in the extrahepatobiliary surgery.
"What could it be?"
The voice was close to her ear. Xie Wanying turned her head and saw Senior Brother Shen wearing a surgical mask, with only two bird-like eyebrows and bright bright eyes exposed outside the mask.
Shen Youhuan gave her a smile: You are familiar with vascular ultrasound, and you also know something about esophageal ultrasound, right?
The senior brother wanted to have a technical exchange with her. It was a rare opportunity. Xie Wanying didn't think twice about seizing the opportunity and said: "According to the preoperative examination results of the patient, intraoperative esophageal ultrasound and repairing defects to monitor valves are out of reach."
"There are only two possibilities left. One is that there may be a tumor in the right ventricle that needs intraoperative monitoring, and esophageal ultrasound can help. Secondly, Teacher Du may want to use esophageal ultrasound to find fistulas."
Everyone knows what she said about the former, but what about the latter?
"Fistula?" Dr. Pang immediately turned around and expressed surprise, "What kind of fistula?"
After all, cardiopulmonary bypass specialists are not professional cardiovascular clinicians, so their response is a little slower.
"It's a coronary artery fistula." Shen Youhuan answered for the junior sister.
Senior Brother Shen immediately understood what she said, and his skills are amazing. Xie Wanying thought.
Will there be a fistula in the heart? The definition of fistula has been mentioned before. Two places that are not connected are connected. This abnormal opening is called a fistula, and the abnormal channel is called a fistula tract.
The heart is the same, except that it is connected to a few large blood vessels. It is a closed organ. As long as it is closed, it is normal for a fistula to open to the outside. There is a distinction to be made here. The rupture of the heart causing internal and external communication is the same as the rupture of other organs, so it cannot be called a fistula.
Therefore, cardiac fistula refers to the abnormal communication channels between the blood vessels of the heart, such as the left and right coronary arteries, and the heart or other large blood vessels. Most of these fistulas are congenital, and patients may be asymptomatic.
Considering the patient undergoing surgery today, the surgeon probably suspected that the patient might have a fistula after being injured. Some fistulas may not be obvious until they are fully lengthened. If the knife moves, the original shape of the fistula will be revealed.