It is said to be blind insertion, but it cannot be completely blind insertion. It is difficult for patients to move to the interventional room for interventional surgery, but it does not mean that no other medical resources can be used. Taking advantage of the convenience of ultrasound for localization is a desirable strategy based on previous neurosurgery cases.
When I saw the ward, there was indeed an echocardiography machine.
Let’s talk about a problem here. If multiple leads can be used for stimulation, ventricular stimulation should be the first choice during rescue. Because I have studied cardiac physiology, I know that ventricular activity is more important.
On the other hand, the right atrial appendage is also difficult to observe by transthoracic echocardiography and requires special positioning.
Using bedside transthoracic echocardiography can help doctors send electrodes across the tricuspid valve.
Shen Youhuan wanted to say that this little junior sister, who was far away from the ward and could not reach the ward, was able to say that she had hit an academic key point. It was obvious that she had great medical clairvoyance or that she had touched the brain of his senior brother Shen.
The question is, the patient she said had a bad tricuspid valve, what was wrong with it, couldn't it be seen on the echocardiogram?
Everyone looked back at the medical records, and it seemed that this was not listed among the patient's existing cardiac examination results.
"His tricuspid valve has moved downward." Xie Wanying said again.
"Did his tricuspid valve move downward?" Everyone looked again, filled with questions, "Which examination report did you read this from?"
"Chest X-ray."
Chest X-ray? ! Advanced dimensionality reduction strikes?
"She has a lot of medical associations." Dr. Zuo Jinmao, who is so talkative, can't help but make lofty remarks.
Is she just imagining things? Everyone knows that ordinary chest X-rays refer to X-rays of the chest. They can only roughly capture the outer outline of the heart, but they certainly cannot capture the inner structures of the heart, including the tricuspid valve.
It's better to look at an echocardiogram. Echocardiography can observe the position of the tricuspid valve using contrast. Based on the comparison of the attachment point of the tricuspid valve on the tricuspid valve annulus with the attachment point of the mitral valve, whether the difference exceeds the normal range can be judged whether the tricuspid valve is deformed and moved downward. At the same time, if the tricuspid valve is severely displaced, it will cause tricuspid valve closure problems and cause changes in the internal hemodynamics of the heart. These are also reflected in the internal heart blood flow detection on echocardiography.
"I personally think that this patient is not a deformity of the tricuspid valve that we usually talk about clinically, but the overall structure of the heart leads to such a result." Xie Wanying said.
Some of the reasons for surgical failure have nothing to do with disease factors. Some of the reasons are abnormal growth of the patient's own organs. Even subtle abnormalities may catch the doctor off guard. Doctors learn anatomy and surgical cases of the human body based on data from most people. Niche case doctors don’t know what to do if they don’t encounter something they don’t know.
Everyone understood. What she meant by "moving down" was that compared to most people, this patient's tricuspid valve attachment point may be lower together with the mitral valve. This is equivalent to the length of the tricuspid valve, so the guidewire electrode passes over the tricuspid valve. The path for the valve to open and close becomes longer and the process is inevitably difficult. Such special cases are very difficult for doctors who have never done such cases and have no relevant experience.
From the side, it can be seen that senior brother Shen, an intervention expert, is not bad. The powerful Senior Brother Shen can sense the danger and is right to not dare to circle the tricuspid valve too much.
What are the dangers of Panquan trying to get past the tricuspid valve? If the procedure is not successful, the tricuspid valve may be trapped and torn, which would be a serious medical accident and endanger human life instead of saving lives.
(End of chapter)
