I Can See Health

   Chapter 945 Severe Plaque

  Time cannot withstand memories.

  A lot of things passed by early in the long river of time.

  Lu Chen "investigated" in Jinghua for a week.

   During this period of time, it can be regarded as a long vacation.

Before   , Lu Chen was too busy!

  Clinical and scientific research is too messy.

   Take advantage of this time to have a proper rest.

  In Jinghua, Lu Chen discussed with Li Yao about Jieqing and asked what precautions should be taken.

   On the other hand, he helped the intervention room of Jinghua Second Hospital to explain the key points of new surgeries such as TAVR.

   With Lu Chen's current ability, this is a big opportunity for the entire Jinghua Second Academy.

Under the leadership of Lu Chen and Gu Xinyue, many doctors of Jinghua Second Hospital have made great progress in interventional surgery.

   A week later.

  Lu Chen, Ke Yue and Gu Xinyue successfully completed the task and returned to the Fifth Academy of the Magic Capital.

  Jinghua trip officially ended.

   Back at the hospital, Lu Chen continued to bury his head in sorting out the matters related to the application for "Jie Qing".

   He has to work hard to win the "Outstanding Youth"!

   Ke Yue is continuing to handle the work of the national key performance laboratory.

   And Gu Xinyue also returned to the clinic and continued to start her surgical career.

   At this time, it has been less than two months since Lu Chen's final application for outstanding youth.

  …

   With Lu Chen's current conditions, he has actually reached the "Outstanding Youth" review.

   But, as Ke Yue said.

  The assessment of outstanding youth is no longer just an academic issue.

   also involves the medical background and human resources behind each person.

   This is no longer a fight for academics!

   is the resource behind everyone!

When    was in Beijing, Li Yao also talked about these things with him.

   But Lu Chen's stubbornness made him not intend to go through the back door.

   On the other hand, Lu Chen started from scratch.

   If you want to learn from the second generation and compare resources with those, you will definitely not be able to win!

   Except this way.

  Lu Chen decided to use his ability to fight against the selection system of "Jie Qing".

  If your ability is one or two grades higher than your opponent, the result may be different!

   "If one new type of project doesn't work, then two!"

  Lu Chen muttered to himself.

   He currently has a project.

   is about transcatheter mitral valve replacement in patients after acute myocardial infarction.

   On top of that, he's looking for another project!

  …

   After Lu Chen's search and thinking.

Hard work pays off!

   He took a different approach and did not continue to look for projects in valve intervention.

   After all, the valve project is about to be cleaned up by himself.

   Except for valve intervention.

   Coronary intervention is still one of the most popular among all surgeries in the Department of Cardiology.

   The idea of ​​Lu Chen's new project this time came from a patient's coronary intervention.

  …

  Modu Fifth Hospital, outpatient building.

   Today, Director Lu Chen's consultation number is hard to get a ticket!

   In the hands of some scalpers, Lu Chen's consultation and registration fee even exceeded seven or eight hundred yuan!

   Once approached thousands of dollars!

   For this reason, the Fifth Academy of Magic Capital is now severely cracking down on scalpers.

   Today, in Lu Chen's consultation room, an old man came to see a doctor.

   The patient is a 66-year-old male.

   Suffering from grade 2 hypertension (very high risk, 10-year history of hypertension), type 2 diabetes.

  Three months ago, due to chest tightness, he went to a local hospital for treatment. Coronary angiography showed severe coronary stenosis and underwent PCI.

   This time, because of "more than 3 months after PCI", I came to the Fifth Hospital of the Magic City again.

  The original words of the old man were: "I don't really believe in the small hospital below. After the operation, I still have chest tightness. The technical level is too poor!"

  Lu Chen could only explain while helping the uncle see a doctor.

   "Master, I just read your interventional surgery information, and the surgery was a success!" Lu Chen said, "There is no such thing as a failed surgery or bad technique!"

   It is said that literati are indifferent to each other.

   It is also easy to have a conflict between medical staff.

   But Lu Chen has always upheld his own point of view.

  Between peers, don't be light on each other!

   "Professor Lu Chen, then tell me, I just finished the operation, why did the chest tightness flare up again?" The old man wondered.

  Lu Chen smiled, "This is caused by many reasons. Intervention in PCI cannot solve all problems, and everyone has individual differences."

   The patient has a USB flash drive with surgical video data in his hand.

After Lu Chen got it, he opened it.

   Coronary angiography at the local hospital showed.

  The patient's anterior descending branch, diagonal branch, and obtuse marginal branch all had moderate to severe stenosis, with stenosis and calcification mainly in the proximal and middle segments of the anterior descending branch.

  Lu Chen frowned after watching the video, "This is not easy to do, the calcification of blood vessels is too heavy!"

   "Can't you? You can't do surgery!" When the old man heard this, he panicked instantly.

  Lu Chen smiled, "Don't worry, you can do it, but the blood vessels are severely calcified, and the operation is risky."

   "Okay, I trust you!"

  The old man said seriously.

   After coming to the hospital, he already understood the intervention level of the Fifth Hospital of the Magic Capital, which is the level of NO1.

   And Lu Chen also found an opportunity at this time.

   Maybe from the perspective of coronary intervention, we can think of a new project!

  …

   Soon, under the leadership of Lu Chen.

   There was another big discussion inside the department.

   The angiography indicated that there were severe calcifications on both sides of the lesion vessel, and the length of the lesion was long.

  So Lu Chen decided to use the Sonico-CX shock wave balloon technology solution.

   Impact precisely impacts the coronary intima and submedial calcifications to loosen them.

   Subsequently, OCT was used to evaluate the rupture of the calcified ring and the lumen after shock wave balloon therapy.

   Finally, the stent was re-implanted, and the postoperative effect was re-evaluated under OCT and contrast-enhanced ultrasound.

  …

   After a brief discussion, coronary intervention began.

  This operation mainly deals with lesions of the anterior descending artery.

   Preoperative examination indicated that the patient's anterior descending artery had 70% stenosis in the proximal and middle segments with severe calcification (the length of the lesion was about 30 mm, and the diameter of the heaviest calcification was 3.0 mm).

  The FFR pressure microcatheter was sent into the anterior descending branch and the FFR was 0.73.

  OCT examination showed diffuse annular calcified plaques in the proximal and middle segments of the anterior descending artery.

  …

   During surgery.

  Lu Chen used a 3.0mm*12mm Sonico-CX Coronary Shock Wave Balloon.

   In the proximal and middle calcified lesions, 70 shock waves were triggered successively for 7 cycles.

  In each cycle, 10 pulsed shock waves are excited at 4atm, and then pressurized to 8atm to expand and form.

  In the case of calcified plaque fragmentation, under DSA, it can be seen that with the release of shock wave, and after 8 atm expansion, the balloon dilation is sufficient at the most severe calcification.

  …

   The entire operation will be broadcast live globally again.

   China, Europe, America, Japan and other countries, the whole process of live broadcast.

  After sufficient shock wave balloon pretreatment, the calcification ring was released, the vascular compliance was improved, and the stent was successfully implanted at the lesion.

  Re-examination of OCT and angiography showed that the stent adhered well and the expansion was satisfactory. The stent expansion rate was 86.24%, and there was no dissection and residual stenosis.

   (end of this chapter)