It turns out Song Zimo and Xu Zhiliang can establish their own practice, and Dean Xia has discussed this matter several tis. However, these two have expressed that they currently don’t want to leave and wish to stay at the institute. Since they don’t want to establish their own practice, Dean Xia is powerless.
Finally, Dr. Jin and Wen Zhong were placed in the Spinal Surgery departnt, with Dr. Jin serving as Director and Wen Zhong as Deputy Director. Once these two went to the Spinal Surgery departnt, the departnt suddenly seed to grow wings and improve day by day.
"The family’s desire is still very strong, and there is a brain-dead patient in the ICU at Affiliated Hospital No. 1. The family has agreed to donate the heart, and there is no problem with matching," Tian Yuan said, implying that if the patient can undergo a heart transplant, everything is ready except for the technical challenges. Currently, there is no shortage of donors, so as long as it is technically feasible, a heart transplant can be done imdiately without waiting for a donor.
Yang Ping finished reviewing the record without speaking imdiately and handed the dical record to Xia Shu, who turned it over and then passed it to Director He and Director Xiang.
"What’s your opinion?" Yang Ping asked.
"The patient clearly has pulmonary hypertension, and I’m afraid the transplanted heart cannot withstand such pressure. This is a contraindication, and forced transplantation is bound to fail."
Director He Xiangjun spoke.
"It’s estimated that a heart-lung combined transplant needs to be perford, solving both heart failure and pulmonary hypertension at once. In this case, the surgery might be quite extensive, and the donor’s lung at Affiliated Hospital No. 1 is problematic and unsuitable for heart-lung combined transplant."
Director Xiang spoke.
Yang Ping nodded slightly. It’s true – performing a single heart transplant for such a patient will certainly fail, just as Director He said, it’s a contraindication for heart transplantation.
Every surgery has its indications and contraindications, where indications are the scope where the surgery can be perford and contraindications are the scope where it cannot be perford.
"And you, what do you think?" Yang Ping asked Xia Shu, narrowing his eyes slightly.
Xia Shu took the dical record again, flipped through it, and after a mont of thought said: "Actually, there is another thod we can use."
"What thod?" The directors imdiately looked at him with anticipation.
Xia Shu glanced at Yang Ping and said, "Piggy-back heart transplant!"
"Piggy-back heart transplant?" Director He and Director Xiang looked at him in surprise.
This is actually a form of heterotopic heart transplant, which is rarely used for heart transplants. There are very few cases in the world; it’s difficult and risky, used only in very special situations.
"Yes, piggy-back heart transplant. The patient’s original heart does not need to be excised. Instead, an additional heart is transplanted near the original one, perhaps placed in the right thoracic cavity, allowing the patient to have two hearts. This way, the high pressure of the pulmonary artery is distributed to both hearts, reducing the pressure on the transplanted heart. I think this type of heart transplant is more suitable for this type of patient," Xia Shu explained.
Yang Ping nodded slightly. He was right. The most suitable surgical approach for this patient is a piggy-back heart transplant, aside from a heart-lung combined transplant, which is the only option.
Of course, it would be better to perform a heart-lung combined transplant if possible, but there are no conditions for that now. The heart and lung donor are not readily available. It’s already challenging to have a matching heart. To further seek a qualified lung donor is unimaginable as to when it can be found. Given the patient’s current illness, he might not even be able to hold on until a qualified heart and lung are available.
Both Director He and Director Xiang are convinced; compared to Xia Shu, there’s still a gap in skill level. After all, Xia Shu is a physician trained by the Institute, and he follows Professor Yang daily. Not to ntion Xia Shu, who’s an academic genius – even Zhang Lin and Little Five, who used to be diocre, have now beco outstanding experts.
"Can I bring the patient’s family here? They’ve been very anxious and want to hear your opinions." Director Tian sought Yang Ping’s approval.
Yang Ping said, "Sure, bring them over."
The family consists of the patient’s parents. Actually, this patient’s family situation is rather special. This young chap was stolen by human traffickers and sold to a remote mountain area when he was just a few months old. The buyers, his adoptive parents, were very poor. He ran away to work before finishing high school due to Congenital Heart Disease, slowly leading to heart failure. It was at this ti that his biological parents finally found him.
His biological parents are successful businessn worth billions. Upon learning about their son’s illness, there was no way they would give up. Originally, when he was young, as parents, they didn’t look after him carefully and he was stolen away. Now, after finally finding and reuniting with their son, they are determined to save him. No matter how good their financial situation is, even without money, they would do anything to save him.
The patient’s parents were brought over. They looked distressed, and Director Tian introduced the directors present, and upon hearing Professor Yang’s na, the wrinkles on their faces smoothed out.
They ca because of his fa, so they know Yang Ping’s achievents quite well.
"Professor Yang and these directors have just reviewed An Chenfeng’s dical record. We’re inviting you here to allow you to hear Professor Yang’s opinion," Director Tian invited the two parents to take a seat.
Yang Ping paused and said: "I have just carefully studied your son’s dical record, and preliminary judgnt is that a heart transplant can be perford in this situation, but the surgical approach is not a typical heart transplant."
At this mont, Xia Shu had already taken out the office’s heart and thoracic cavity models, placing them on the office desk.
Yang Ping then used the model to explain to the patient’s family, making it much more visual.
"Look, this is the heart and thoracic cavity model. Now, there are two main issues with your son: one is heart failure. What is heart failure? It ans the heart, as the engine of the human body, is now thoroughly exhausted, with insufficient power unable to drive the body’s blood circulation. This bad situation cannot be reversed by dication or other ans; that’s to say, this engine cannot be repaired. What to do? It can only be replaced, which is what we call heart transplant, removing his heart and replacing it with soone else’s heart."
"But he also has a second issue, pulmonary hypertension. What does this an? You see, the heart has two sets of circulations, one of which is the pulmonary circulation. The pulmonary circulation now has a problem; its pathway is not smooth, causing the heart to exert greater pressure to pump blood in than usual. This presents a huge issue that the transplanted heart cannot provide such power. Even if it can temporarily provide it, it will soon be ruined by excessive pressure."
"So ultimately, the heart transplant will fail. What can be done now is a rarely used heart transplant thod."
"The original heart does not need to be moved, does not need to be removed, still remains inside, and we transplant another heart for him, so he has two hearts."
"Why does this work? Because although the original heart has failed, it still has so functionality and can provide a little power. We fully utilize this little power. At the ti, there will be two hearts, with two hearts sharing the pulmonary artery’s high pressure, thus reducing the burden on the new heart, allowing the new heart to work for a long ti."
"I don’t know if you understand. If there is anything unclear, you can ask . I’m not sure if I’ve explained it clearly."
The patient’s parents nodded imdiately:
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