novel for you Chapter 1032 Focus on Kyoto
Chapter 1032 Focus on Kyoto
A week passed quickly in the intense preparation and coordination.
Zhang Tiezhu's condition improved significantly under the treatment of Xun Jiahong and Lin Yi.
The traditional Chinese medicine Zhenwu Decoction combined with Tingli Dazaoshaifei Decoction with modifications played a powerful role. The roasted aconite warmed the yang and transformed the qi, the Tinglizi drained the lungs and promoted diuresis, the red ginseng greatly replenished the vital energy, and combined with salvia miltiorrhiza, red peony root and other herbs to promote blood circulation, plus daily warm acupuncture on the Xinshu, Shenshu, Tanzhong, Neiguan and other acupoints, Zhang Tiezhu's fear of cold and cold limbs were significantly reduced, the urine volume increased significantly, reaching more than 2500ml per day, the edema in both lower limbs subsided for the most part, and the weight dropped by 5 kilograms!
Orthopnea and nocturnal paroxysmal dyspnea have basically disappeared, the patient can tolerate semi-recumbent rest, and sputum cough has decreased.
Western medicine monitoring showed a significant decrease in NT-proBNP (a marker of heart failure) levels.
With the combined efforts of Western medicine to strengthen the heart, promote diuresis, dilate blood vessels, and control blood pressure and blood sugar, a follow-up echocardiogram revealed an increase in EF from 35% to 42%. While still severely hypotensive, it had moved him from an absolute contraindication for surgery to a relatively safe zone. Cardiac function assessment improved to NYHA class III.
The thick and greasy white tongue coating becomes thinner, the dark purple tongue texture becomes slightly lighter, the sublingual veins become less dilated, the pulse remains deep and fine, but the feeling of astringency and knotting is reduced, and the sense of strength is slightly increased.
On the third day after Zhang Tiezhu was admitted to the hospital, Chen Yang received an invitation letter from Borg to the New York International Medical Conference in his mailbox. Borg also called Chen Yang that night.
Even Borg's voice had changed a bit by then.
"Chen...you're actually involved in cardiothoracic surgery?"
After the Kyoto International Medical Center released the news of Zhang Tiezhu's surgery, not only were major domestic hospitals in an uproar, but the international medical community was also in an uproar.
Theoretically speaking, to get involved in a certain field, one needs professional qualifications in that field. Chen Yang was not the lead surgeon in his previous extrahepatic surgeries. It was a bit like an intern following the attending physician.
Although he has excellent skills, he is not actually qualified to perform surgery independently. However, as long as he is not the main surgeon, he can perform surgery with the approval of a senior doctor. This is like an intern writing a prescription and the attending physician signing it.
However, after Wilson's operation, it was easy for Chen Yang to obtain the qualification of hepatobiliary surgery.
For Zhang Tiezhu's operation this time, Chen Yang asked He Yonghua to be the chief surgeon. On the one hand, he was not qualified, and on the other hand, Chen Yang had never performed this kind of operation before, so it would be safer to coordinate the overall situation.
However, except for some insiders, most people actually don’t know this, especially foreign medical institutions. They don’t know whether Chen Yang is qualified. They only know that Chen Yang is very good at extrahepatic surgery and now he is going to perform a difficult thoracic surgery.
This is still a human being.
Borg, in particular, was stunned when he heard the news.
"Chen, I will definitely watch the operation. Many people will be interested in this operation. When you come to New York, there will definitely be many people who admire you." Borg said with a smile.
In fact, Chen Yang agreed to He Yonghua's open surgery and even agreed to more international medical institutions to join in, in order to build momentum for the center and lay a good foundation for the trip to New York.
......
"good, very good!"
He Yonghua looked at the latest examination report and excitedly waved his fist: "Director Chen, the treatment provided by the Department of Traditional Chinese Medicine is truly amazing. With this physical condition, surgery can be arranged!"
Chen Yang was also pleased with Zhang Tiezhu's improvement. After taking his pulse, he said to him, "Mr. Zhang, you're recovering well. You've laid a solid foundation. We'll be operating on you in two days. Don't worry, the entire team is fully prepared."
Zhang Tiezhu held Chen Yang's hand tightly. Although he was still a little short of breath, his eyes were full of trust and expectation. "Doctor Chen... Director He... I'm counting on you! I... I'm waiting... to go home when I'm better... to hug my grandson!"
The news of the surgery date was like a stone thrown into a calm lake, causing quite a stir in the cardiothoracic surgery community at home and abroad.
The live surgery system of Kyoto International Medical Center has been debugged.
Hundreds of member hospitals of the National Association of Cardiothoracic Surgeons were notified.
Many medical institutions abroad also received accurate information about the operation.
The German Heart Center Berlin and the Cleveland Clinic's Department of Cardiac Surgery also received Borg's notice. Borg even asked Chen Yang for anonymous key patient imaging data and detailed medical information.
Conference room, Department of Cardiothoracic Surgery, Juntendo University Hospital, Tokyo.
Several senior professors sat around the screen, looking at Zhang Tiezhu's CT images and the summary of the surgical plan that briefly described "high-speed drilling to carve out calcifications" and "trumpet-shaped valve + inversion suture".
"Humph, a high-speed drill? Carving calcifications into a stopped heart? That's child's play!"
A gray-haired, arrogant professor named Ichiro Yamamoto snorted disdainfully, "The calcification is so tightly adhered to the myocardium and blood vessels that the vibration and heat from the drill could easily cause uncontrollable bleeding and myocardial damage!"
"And this 'inversion suture', I've never seen any reports of large-scale application in official literature, so its reliability is questionable! The Chinese always like to come up with flashy 'innovations'."
A relatively young associate professor nearby, Ken Kobayashi, stared at the LVOT obstruction simulation diagram thoughtfully. "Professor Yamamoto, although the risks are extremely high, their approach to treating LVOT obstruction is...very ingenious. If successful, it would be a breakthrough in this internationally recognized problem."
Yamamoto Ichiro's eyes were sharp. "Then let's see how this young doctor, Chen Yang, performs this 'dance on the edge of a knife' in front of so many people. I hope it won't be a disastrous live broadcast."
There was obvious doubt and anticipation in Ichiro Yamamoto's tone.
Yamamoto Ichiro said to his assistant, "I don't think they can succeed in publishing an analysis report in my name."
Heart Center, Berlin, Germany.
Several top cardiac surgeons and engineers are also involved in the discussion.
"This proposal... is bold, but the logic is clear."
Chief Surgeon Professor Mueller highlighted the key points of the plan: "High-speed drilling requires state-of-the-art precision control and cooling systems. The choice of a 'flared' valve and the concept of inverted suturing are clever solutions for addressing LVOT obstruction. If they can truly achieve precise 'sculpting' without damaging critical structures... this will be a landmark case."
"Their TCM pre-operative conditioning was amazing. The EF value increased by 7% within a week. It's really incredible," added a doctor in charge of heart failure management.
"Inform the team that on the day of surgery, all doctors who are not performing emergency surgeries should gather in the conference room to observe the procedure. This may give us new ideas for handling similar complex MAC cases."
Professor Mueller made the decision.
The Cleveland Clinic's cardiac surgery department had a similar reaction, expressing surprise at the innovative nature of the plan while also remaining cautious about the high-risk procedure.
For a time, many medical institutions and cardiothoracic surgery experts at home and abroad focused on Kyoto and this operation at the Kyoto International Medical Center.