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"Let's go!" Qin Sifeng waved his hand and walked towards Catheterization Laboratory No. 3.

The female doctor and Lu Chen on the side saw this and followed closely behind.

Along the way, the young female doctor had been silently observing Lu Chen.

Didn't Professor Qin go to pick up a big shot just now? Why did a young man suddenly appear?

…

Outside the No. 3 conduit.

Qin Sifeng was not in a hurry to go in, but wanted to understand the patient's condition first.

"what's the situation?"

The young doctor outside the cath lab said immediately: "The operation went smoothly at the beginning, but there seemed to be some problem during the puncture."

After speaking, the young doctor handed the patient's medical record to Qin Sifeng.

Qin Sifeng opened the medical record. The first page contained the patient's cardiac ultrasound report.

"This ultrasound... the patient's interatrial septal puncture is indeed a bit tricky." Qin Sifeng frowned.

Compared with coronary intervention, the talent pool of electrophysiology is relatively small, and Xiao Shikang is already a leader among the younger generation.

Even the surgical problems that he couldn't solve were not routine minor problems.

Lu Chen also saw the patient's heart ultrasound and said solemnly: "Fossa ovale bulge tumor?"

Qin Sifeng nodded, his expression quite serious. .

Atrial septal puncture is the most basic step in atrial fibrillation ablation, and it is also the most dangerous step!

Generally, the puncture point for the interatrial septum is the fossa ovale.

When puncturing, be sure to only puncture the fossa ovale.

If it exceeds the fossa ovale, it may cause cardiac tamponade!

In addition, the location of the puncture point is also related to the patient's body shape, heart shape and structure, etc.

Some people have a slender body shape and a downturned heart, so the puncture is generally a little higher.

If it is lower, the catheter passes below the fossa ovale and reaches the bottom of the atrium. The left atrium of some people is very small, and when it hits the left atrium, it reaches the opposite side of the left atrium, causing cardiac tamponade!

If the heart is in a transverse position, the puncture should be lower. If it is higher, it may penetrate through the roof or even penetrate into the pulmonary artery. If it is farther forward, it may penetrate into the aorta.

Also, don’t puncture too fast. If the puncture is too deep at once, it may penetrate to the opposite side.

"Teacher Qin, can I get you a lead coat?" said the young female doctor on the side.

Usually at times like this, Qin Sifeng would come on stage in person.

But today...

Qin Sifeng looked at Lu Chen beside him and saw that there was no need for him to take action himself!

"No need." Qin Sifeng shook his head slightly and pointed at Lu Chen beside him, "Find him a suit that fits him well."

After hearing Qin Sifeng's words, everyone around looked at Lu Chen with surprised expressions on their faces.

There was a high turnover of people in the cath lab. A few people thought Lu Chen looked familiar, but they didn't recognize him for a while. They just thought Lu Chen was a doctor in the general ward upstairs.

Lu Chen smiled faintly, he had expected this situation for a long time.

Mr. Qin brought him to the cath lab, but he was not prepared to let him "watch the show" on the sidelines!

"Find it for him?" The young female doctor had never seen Lu Chen before, and her expression was slightly hesitant. Should such a young doctor handle a problem that even Teacher Xiao couldn't solve?

"Don't waste time!" Qin Sifeng urged.

The young female doctor did not dare to neglect, and she put aside all the distracting thoughts in her mind, and hurriedly prepared to find a lead coat for Lu Chen.

"No need to trouble you, I'll go find it myself." Lu Chen smiled.

He once stayed in the cath lab of Kyoto University First Affiliated Hospital for a month.

I am relatively familiar with the environment here.

He found a set of lead gowns with ease, put them on and walked into the cath lab.

…

Inside Catheter Room No. 3.

Xiao Shikang was staring closely at the contrast image in front of him.

This was a case of radiofrequency ablation of atrial fibrillation, but he ran into trouble when performing atrial septal puncture.

Because in the contrast image, he saw a bulging tumor in the fossa ovale of the patient's atrium.

The fossa ovale bulge is very soft and elastic, and it is not easy to penetrate.

Since the left atrium is small, special care must be taken during puncture. Once the puncture needle passes through the bulging tumor, it will hit the free wall of the left atrium, causing the risk of cardiac perforation.

Even under the guidance of cardiac ultrasound, Xiao Shikang still flinched.

Because if anything goes wrong, the patient's heart is at risk of perforation!

"Did you tell Professor Qin?" Xiao Shikang asked the graduate student following him.

"I told you, Professor Qin will come right away," the graduate student said.

Xiao Shikang nodded slightly, and now he could only wait for Qin Sifeng's arrival to see if he had any better way to puncture.

Just as Xiao Shikang was looking at the radiography images in a daze, a familiar yet somewhat unfamiliar voice suddenly sounded in his ears.

"Teacher Xiao, I'm here."

Xiao Shikang immediately looked back, and at some point, a doctor wearing surgical clothes appeared next to him.

He was wearing a mask and a hat, and Xiao Shikang couldn't see his face clearly.

But listening to his voice and looking at his bright eyes, Xiao Shikang felt very familiar.

"Who are you……"

Lu Chen narrowed his eyes and smiled, "Teacher Xiao, I am Lu Chen. I haven't seen you for a year. Don't you remember me?"

When Lu Chen came to Kyoto Institute of Electrophysiology for the second round of assessment, he studied under Xiao Shikang.

"Lu Chen?" Xiao Shikang was startled. The figure in his mind slowly overlapped with the person in front of him. There was a look of surprise on his face, "You, why are you here?!"

"Mr. Xiao, let's catch up on old times after the operation is over. Let's take a look at this patient first." Lu Chen said with a smile.

"Okay!" Xiao Shikang nodded slightly and began to tell Lu Chen about the patient's condition.

The patient is a female patient in her sixties who was diagnosed with paroxysmal atrial fibrillation.

In recent years, she has suffered from frequent atrial fibrillation attacks, and each time she has symptoms of angina pectoris, the patient has suffered a lot. UU read www.uukanshu.net

After much consideration, I finally made up my mind to have atrial fibrillation ablation surgery!

When the surgery started today, everything went smoothly.

But when it was his turn for interatrial septal puncture, Xiao Shikang felt something was not right.

…

"Lu Chen, have you seen the patient's preoperative heart ultrasound?" Xiao Shikang asked.

"I've seen it." Lu Chen nodded, "The patient has a fossa ovale bulging tumor. This tumor is soft and large and difficult to puncture. Once it touches the free wall of the left atrium, the heart can easily perforate. "

"Yes, I am considering this possibility now, so I dare not take action." Xiao Shikang sighed.

He turned back slightly and glanced at Lu Chen beside him, and found that he was staring closely at the patient's angiography image.

"Lu Chen, is there any safe way?"

Lu Chen did not answer directly, but asked: "Have you done intraoperative ultrasound?"

"I just asked the teacher from the ultrasound department to do it." Xiao Shikang said, "Do I need to do it again?"

Lu Chen looked at the contrast image and nodded, "Push the ultrasound machine over and let me take a look at the specific location of the fossa ovale bulge."

"Okay." Xiao Shikang immediately ordered the graduate student beside him to push in the ultrasound machine outside the catheter room.

Qin Sifeng, Xiao Shikang and others were not surprised by Lu Chen's superb ultrasound technology.

But outside the catheter room, when other young doctors saw Lu Chen showing off his ultrasound skills, they knew that this young man was something special!

Lu Chen did not waste too much time. He mainly used ultrasound to determine the approximate location of the bulging tumor to facilitate the puncture direction.

"Now even puncture under ultrasound guidance is very risky!" Xiao Shikang frowned deeply.

Anyway, he didn't dare to pierce it like this. The risk was extremely high. If he failed, he would be ruined!

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