Chapter 1402: Do not show off
The technique of manipulating the guidewire alone during PCI surgery is complex enough to keep doctors discussing at length.
Alright, the next step is to advance the contrast catheter along the guidewire. Jin Tianyu, who advises the juniors to take it slow, proceeds much more swiftly himself. With the juniors having promised to pave the way for him, he has roughly figured out this patient’s vascular condition and can speed up without wasting ti.
Catheter in position, connect the syringe at the tail end, retract, and exhaust air.
Connect the three-way valve and completely exhaust air again, to prevent air from entering the coronary arteries, causing fatal air embolism.
During the air exhausting process, the three-way valve connects separately to the pressure sensor, contrast dia, and physiological saline or heparin for flushing. Among them, the pressure sensor links to a display device, allowing the operating doctor to observe the invasive pressure patterns of the aorta on the screen.
The normal pressure pattern is smooth waves, with peaks as systolic pressure and troughs as diastolic pressure.
Observing this throughout the coronary angiography procedure is critical as any change to a V-shaped pattern indicates catheter mouth embedding in the coronary vessels, which may result in coronary spasms and blockage requiring urgent treatnt.
Doctors check that all the patient’s intraoperative indicators are normal, with no risk overflow.
Ready to power up for fluoroscopy.
Powering up, the yellow light turns on.
The angiography screen displays the catheter within the human coronary arteries, and the doctors can see the dark silhouette of the patient’s heart, like paper-cut art. The shots can be static images; connected, they form dynamic movie footage, which viewers might feel resembles watching a folk shadow play. The heart’s two-dinsional dynamic imaging showcases the heart’s contraction and expansion activities, lively like a mischievous child. Thumping rhythmically, the patient’s heart beats on a plane, causing the coronary arteries where the catheter is located to pulse as well. The contrast agent, injected with the blood flowing through the arteries, allows doctors to clearly see the vessel’s path and diater. If there is arterial narrowing, the blood, along with the contrast agent, cannot pass through, displaying a missing image segnt—transitioning from black to white—within the vessel, evidencing coronary angiography.
Under fluoroscopy, doctors repeatedly confirm whether the guidewire is in position as the guidewire carries the contrast catheter to sequentially enter the patient’s left and right coronary arteries for angiographic examination. As previously ntioned, the X-ray system is a two-dinsional image; to reform into a three-dinsional image, multiple position fluoroscopy of the patient’s cardiac vessels must be conducted to input all information into a computer for reconstruction, aning the machine must frequently emit X-ray beams during operation.
“You guys, go out,” Jin Tianyu orders the juniors to leave, preventing them from excessive radiation exposure.
Avoiding troubling the senior, Xie Wanying and Pan Shihua follow orders and exit the angiography room.
Outside waits a nurse to help them remove their surgical gowns and lead aprons.
With the lead aprons removed, their scrub suits are soaked with sweat. Xie Wanying and Pan Shihua wash their hands and casually wipe away sweat, anxious to return to the control room to monitor the subsequent developnts.
The person on the phone with Fu Xinheng has shifted from Doctor Seo to Dr. Shim.
“Was she the one who helped?” Dr. Shim asks after hearing about the progress, curious whether his “reckless” suggestion had successfully turned the situation around.
Yu Xuexian wants to tell this senior not to brag.
“This confirms our Director Zhang’s sharp vision,” Dr. Shim laughs heartily, very pleased with the outco.
Doctors are always happiest seeing patients get saved.
Doctor Seo leans toward the phone asking, “What’s the situation with the angiography now? Are there triple lesions?”
Certainly not, as previous electrocardiograms showed no such signs.
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