"I have a terrible idea, and it's very risky."
Amidst everyone's anticipation, Liu Banxia pressed the call button.
"Speak," Chen Xuehai said in a deep voice.
"The current difficulty is that the patient's heart is inside the thoracic cavity, resulting in a poor surgical field and preventing the operation," Liu Banxia said.
"If we extract the heart and remove the tumor externally, the surgical field should be sufficient then, right? After removing the tumor, what about an autologous transplant? Could that work?"
The people listening were startled. Liu Banxia's suggestion indeed had a degree of feasibility, but it was too risky; it truly was a terrible idea.
Autologous organ transplantation has certain advantages over allogeneic organ transplantation regarding organ rejection. However, considering the entire operation, this is its only advantage.
Considering the patient's current condition, the plan would involve extracting the already damaged heart and cleaning out the tumor. After cleaning, the heart's shape would undoubtedly change, and re-transplanting it would be extraordinarily difficult.
This would be far more dangerous and much more difficult than an allogeneic heart transplant; after all, a heart transplanted from another body is a healthy one.
"President Liu, this procedure would be too difficult to perform," Chen Xuehai said after a mont of consideration.
"It's not just a test of vascular anastomosis during transplantation; even placing it on an ice tray to lower the heart's temperature will affect the operation.
And restarting the heart is also a key issue. Although I couldn't see it clearly just now, the sinoatrial node also seems to be affected by the myxoma, so a pacemaker would need to be implanted."
The issues Chen Xuehai raised were critical.
Although this approach would provide a surgical field, it didn't an the operation itself would be easy; it would be even more difficult. A clear surgical field alone wasn't enough; it also required exceptional dexterity.
The heart must be kept at a low temperature once extracted. Otherwise, before you even finish removing the tumor, the heart might no longer be viable for transplantation. Low temperatures will definitely impair hand mobility.
"That's why I said it was a terrible idea, but it seems to be the only feasible thod at present, right?" Liu Banxia said.
Chen Xuehai frowned. "You co with to talk to the family."
Liu Banxia was stunned and felt a bit helpless, wondering why he was being dragged along. In his opinion, even if it was more dangerous, the patient's family would agree. The patient was already prepared: this surgery would either cure him or kill him. He didn't want to continue living in such a dazed state, causing his family constant anxiety.
"Dr. Chen, Dr. Liu, is the surgery not possible?"
Seeing Liu Banxia and Chen Xuehai co out so quickly, the patient's wife had an ominous premonition. If the surgery were going well, they would have continued smoothly. Since they've co out midway, there must be a problem.
"The myxoma's spread is much more severe than we anticipated. We've made two incisions, but in both cases, the surgical field is too obstructed, preventing its removal," Chen Xuehai explained.
"Then... does that an it can't be done?" the patient's wife asked.
"So, we've discussed a very risky alternative: to remove the heart, excise the tumor externally, and then transplant it back," Chen Xuehai continued.
"During our exploration just now, we also found that the tumor has affected the sinoatrial node. Therefore, to ensure the heart restarts successfully, we'll also need to implant a pacemaker."
"If we proceed with the thod we've just discussed, the surgery's difficulty will be much higher than anticipated. If we previously estimated a 30% chance of success for a more standard procedure, this current approach might not even have a 10% success rate."
"What if we wait for a heart transplant?" The patient's wife hesitated.
"Waiting for a heart transplant is an option, but he won't be able to undergo a second thoracotomy anyti soon," Chen Xuehai said.
"He needs a recovery period; otherwise, his body won't be fit for surgery. This recovery process could be quite long. Even if a suitable donor heart becos available, he wouldn't be able to undergo the transplant then."
"For us, we're back to the dilemma we faced yesterday: either suture him up and wait for him to recover, or take this gamble on a much smaller chance of success."
"Alternatively, if a suitable donor heart happens to beco available during our current procedure, we could switch to an allogeneic transplant."
"I'll give you twenty minutes to consider. Any longer, and it will definitely affect his condition. Don't make a hasty decision; take these twenty minutes to think it over carefully."
After Chen Xuehai finished speaking, he led Liu Banxia aside.
"Old Chen, why did you drag into this?" Liu Banxia asked.
"This 'solution' was your idea. If the patient's family chooses to go ahead with the surgery, you have to help," Chen Xuehai said.
"Linlin definitely won't be able to last long in such low temperatures, so I plan for you to do it. The patient's myxoma is very large and also prone to seeding. We need to remove the tumor as quickly as possible and ensure it's completely excised."
"Otherwise, who else could I ask? Let alone in our Ergency Center, even in the entire Second Hospital, is there anyone with faster hands than yours?"
Liu Banxia scratched his head. "But I've never perford such a surgery, nor have I ever removed a tumor from a heart. Even though this thod was my idea, you must have thought of it too, right?"
Chen Xuehai gave a wry smile and nodded. "I did have such a thought cross my mind, but I dismissed it imdiately. I wasn't confident I could perform it well. I've never done an autologous heart transplant, and I've only perford three heterotopic heart transplants."
"Then I thought of you. With your cooperation, the ti the heart is outside the body can be significantly reduced. The shorter that ti, the higher the chance of a successful transplant."
"During the procedure, we'll have to place the heart in crushed ice. This is to ensure the heart's viability after removal. Our hands will definitely be in contact with the crushed ice while we operate."
"The two of us alone probably won't be enough; removing the tumor completely isn't sothing that can be done in just a few minutes. Zhang Xiao is here too, let's get him involved as well," Liu Banxia suggested after a mont's thought.
Then he took out his phone and called Zhang Xiao.
Zhang Xiao, waiting in the observation room, was a bit confused when he saw Liu Banxia's call. "Banxia, what's up?"
"Hey, can you co outside for a mont? We need your dical opinion on sothing," Liu Banxia said.
Zhang Xiao was even more bewildered. He had no idea what they wanted to consult him about. They should be consulting a cardiothoracic surgeon; Chief Director Li Mingwu would be the most appropriate person.
However, he didn't dare to delay and went over imdiately.
"Has the patient's family agreed?" Zhang Xiao asked.
"They're still considering. If the family agrees, we might need you to scrub in too. It was Banxia's suggestion," Chen Xuehai said.
"What the hell? scrub in? I'm a neurosurgeon!" Zhang Xiao practically exploded.
It was a good thing he retained so composure and knew to restrain himself; otherwise, he might have alard the families anxiously waiting outside.
"There's no other way. We need to operate on the heart while it's in ice, which will be a real test of hand stability. Old Chen and I will start, and you can be ready as our top backup," Liu Banxia said.
"I was railroaded into this by him too. He said that since I proposed the plan, I have to be in on the surgery. Otherwise, the pressure on Linlin would indeed be imnse. How well do you handle the cold?"
Zhang Xiao gave a wry smile and nodded. "It's passable, I guess. Constantly being in surgery does build up one's physical resilience. You can count in, but it would be best if I'm not needed."
"I've pretty much forgotten everything I knew about the heart; my most recent relevant mories are from dical school. Besides, the operating conditions are different. Honestly, I'm not confident I can keep my hands steady in that environnt."
"Sa here," Liu Banxia said. "He probably isn't confident himself, so he dragged in. Since he dragged in, I can only drag you in."
His words might have sounded a bit shaless, but his underlying motive was sound—it was all for the patient.
Even though Zhang Xiao wasn't a cardiothoracic surgeon, he frequently perford neurosurgery, and his hand stability was impeccable. Even without extensive experience in cardiac surgery, Chen Xuehai or Liang Xiaolin could provide guidance from the sidelines if needed.
Being just a 'tool' was fine; Liu Banxia had even ntally positioned himself that way.
Of course, if the patient's family truly agreed, he would also need to intensify his training in the 'dream space.' Operating in such conditions was sothing he had never experienced. It wasn't as simple as just talking or thinking about it; he would need to suppress his body's natural reflexes and rely on sheer willpower to persevere.
"If we really go through with this, successful or not, Old Chen, you owe us drinks," Zhang Xiao said.
"Banxia should be the one treating," Chen Xuehai chid in.
Liu Banxia rolled his eyes. "Even if you're just trying to lighten the mood, you shouldn't be scheming to make pay."
"Who else if not you? You're the one who proposed the plan that showed its feasibility," Chen Xuehai retorted, sounding perfectly justified.
"That makes sense. We don't need to go to a fancy restaurant; our hospital cafeteria will do. It won't cost much, so why be so stingy?" Zhang Xiao said.
"Of course, going to Jinbao would also be fine. That's your turf anyway, right? I've only been to Jinbao once, but the food there is really delicious."
"Alright then, it's settled! We'll all clear our schedules and go to Jinbao," Chen Xuehai declared decisively.
"Fine, to help you guys relax, I'll give in to your 'extortion'," Liu Banxia said.
"But I'm not responsible for the wine. The quality of wine we get to drink will depend on a certain soone... who should have so good stuff stocked at ho. Right, Old Zhang?"
"I'll handle the wine. Enough talk—the patient's family is approaching," Chen Xuehai said, his expression suddenly tensing.
"Dr. Chen, we've decided to proceed with the surgery. I'll sign the consent form," the patient's wife said.
Her words brought a montary wave of relief to Chen Xuehai, which was imdiately replaced by intense pressure.
User Comments
0 comments from readers