After the female reporter left, the cardiac surgery department quickly returned to calm.
At 3 o'clock in the afternoon, 6 hours after the operation, the patient finally woke up from anesthesia in the extracardiac ICU ward.
The doctors who heard the news surrounded the patient and carefully checked her physical condition.
"The patient's blood supply has recovered well. The skin temperature is 36.7, the pulse is 78, the heart rate, and the blood pressure have all returned to normal."
Yunfeng completed the physical examination of the patient and compared it with the parameters on the monitor one by one. After confirming that they were correct, a smile appeared on his face.
When the operation began, he had already been busy for a day and fell down from exhaustion, so he did not participate.
Now that I see the success of the operation, I can't help but feel a little regretful. It would be great if I could do such a major operation with the director.
But he didn't show any emotion and gave the doctor's orders like a precise machine.
"The patient will then be monitored closely to prevent signs of bleeding and infection, as well as any neurological complications and liver and kidney damage."
"The patient is young and in good physical condition. He should be able to recover quickly. It is estimated that he can be extubated tomorrow and the day after tomorrow. As long as he survives the first three days without any problems, he can be sent to the general ward for rehabilitation treatment."
The doctor next to him couldn't help but exclaimed: "It's amazing. After a meter-long blood vessel was replaced, the patient's condition recovered so well."
Yunfeng said with a smile: "The director's aortic replacement surgery is the signature of our department. Three months ago, a patient had a 40-centimeter artificial blood vessel. He recovered well after the operation and was extubated the next day. I was discharged from the hospital in less than ten days.”
"The imported polyester blood vessels from McVei were used that time. Wasn't the effect very good? Why did the length of 1 meter this time be replaced by Sanqing's new product?" A young resident doctor asked in confusion. road.
Yunfeng glanced at the patient and found that the other person had fallen asleep, so he replied in a low voice: "Isn't it that imported artificial blood vessels are too expensive? One tube costs 20,000 to 30,000 yuan, and a 1-meter-long blood vessel replacement surgery must be used at least. Three tubes, which is almost 100,000, plus the surgery fee and ICU hospitalization fee, the financial burden on the patient is too heavy."
"Because Sanqing's artificial blood vessels are still in clinical trials, they are all free, including surgical fees and hospitalization fees. If you don't have money to treat patients, which one will you choose?"
The resident doctor scratched his forehead in embarrassment: "Of course I choose the free one, I understand."
Yunfeng smiled slightly and explained: "Besides, Sanqing's artificial blood vessels are no worse than MaiKeWei's. MaiKeWei's blood vessels are polyester polyester, but the surface is impregnated with a natural silk fibroin coating, which improves the maneuverability and It is biocompatible and the patient’s rejection reaction is lighter than that of ordinary polyester blood vessels.”
"But Sanqing's artificial blood vessels are all made of biological elastin materials. There is basically no polymer in them. The technical content of the materials is naturally different, and the biocompatibility is even worse."
"Not only has the patient's rejection reaction been greatly reduced, but the stability and tensile strength are also very high. Most importantly, it also has a certain degree of growth."
"I read the animal experiment data of artificial blood vessels. Sanqing's bioprotein artificial blood vessel implant can perfectly replace the original aorta and integrate perfectly with the native blood vessels at both ends 14 days after implantation."
"Before this total aortic replacement surgery, we also performed two replacement surgeries of about 20 centimeters last week, both of which used Sanqing's artificial blood vessels. The surgical results were very good. Not only was the implantation process easy to operate, but it was not easy to penetrate. The elasticity of the blood and material is also very high, and it can still maintain high stability after the stent is placed."
Another doctor suddenly interjected: "You don't have to be superstitious about imported artificial blood vessels. That Mai Kewei, I heard that there was a recall incident a few years ago. It is said that the anastomosis of the branches of the artificial blood vessels leaked during the operation, and then it was I complained, but within two years, the product was recalled again due to packaging issues.”
"In my opinion, imported products are increasingly being overshadowed by domestic products. If we can use domestic products, we will use domestic products. At least Sanqing has not had any recalls in the world so far."
Yunfeng nodded in agreement and said: "I agree with you, but it's not because of product quality, but because of supply issues. You may not know that the recent relocation of Mai Kewei's factory has caused a sharp drop in supply, and imported artificial blood vessels are now basically Demand exceeds supply.”
"There are currently only two manufacturers of artificial blood vessels, Terumo from Sakura Country and McVei from Europa. The latter, in particular, occupies more than 70% of the market."
"In the past, only a few hospitals could perform artificial blood vessel replacement. Now more and more hospitals can do it, but the production of artificial blood vessels has not caught up, so it has become increasingly scarce."
"In addition, there was a problem with the relocation of Mai Kewei's factory. The old factory was closed, but the new factory has been unable to start operations. Now, imported artificial blood vessels are still in stock except for the tertiary hospitals in Beijing and Haishi, and hospitals in other regions are out of stock. ”
"The domestic demand for artificial blood vessels has always been huge, with 20,000 to 30,000 artificial blood vessels needed every year, accounting for 10% of global consumption."
"If you think about it carefully, if there is a problem with the supply of foreign manufacturers, the first guarantee must be their own market supply. As for whether we are out of stock, or whether the patients are in danger, waiting for life-saving artificial blood vessels, they don't care. .”
"That's why we have to support domestic artificial blood vessels. This is a matter of principle. Otherwise, we will always be controlled by others and choked by foreign manufacturers."
"This is not only a quality issue, but also a matter of life and death. Even if the domestic artificial blood vessels are not as good as the imported ones, we still have to use them, not to mention that Sanqing's artificial blood vessels are inferior to the imported ones, so we have no reason not to use them."
The doctors around him were silent for a long time and nodded.
"That's the reason. When it comes to the patient's life or death, you still have to hold it in your own hands."
"I can't even think about it. What if I need an aortic replacement surgery and need an artificial blood vessel, but there is no supply at all?"
"That's right, when have domestically produced products ever been out of stock? Only imported products are out of stock all day long, either because of strikes, relocations, or various reasons. Even if the factory has a power outage, they are out of stock. This is frustrating. No."
"That's right, since the production capacity is not enough, don't let them spoil it. We can produce it ourselves and we can have as much as we want."
Seeing that everyone was getting excited, Yunfeng quickly waved his hand and said, "As long as everyone understands, let's go, let's go see the next patient."
****
Guangdong Province, Yangcheng Zhongshan Hospital.
In the dark night, Dr. Cao, who was on duty in the emergency department, was extremely busy.
Suddenly, a rapid siren sounded, and a 120 ambulance rushed into the hospital.
Dr. Cao heard the familiar and harsh voice, looked at the long queue of waiting patients, and suddenly became desperate: "Again?"
Soon, a 40-year-old male patient was lying on a trolley and was pushed in by a nurse.
"The patient had a fishbone stuck in his esophagus while eating. He suddenly had difficulty breathing and continued chest pain. So he quickly called 120 and was sent to the hospital."
Dr. Cao was a little upset when he heard this: "The fish bone punctured the esophagus can't be so serious, it can't be that it penetrated and entered the trachea."
He immediately checked the patient's esophagus. After checking for a long time, he could not find any trace of fish bones.
"I suspect the fish bone has penetrated the trachea. Let's take a film."
After issuing the examination order, Dr. Cao lowered his head and continued to serve other emergency patients as he watched the patient being pushed into the night CT room.
Not long after, family members came over with the CT scan results.
Dr. Cao took the film and took a look at it, and couldn't help but take a breath.
On the CT scan, a white fish bone more than 2 centimeters long was clearly displayed, but it did not appear at the tracheal location where he predicted.
Instead, it pierces the patient's aortic arch like a sharp arrow.
Thinking that with the slightest movement of the patient, the fish bone would pierce the thoracic aorta at any time, like a fish swimming into the sea, leaving a ruptured gap where blood would spurt out, Dr. Cao's forehead instantly became beaded with beads of sweat.
"Go through the hospitalization procedures first. I have already notified the experts to come for consultation."
He warned his family members, then stood up in a flash, picked up the phone at the speed of light, and called the doctors on duty at the Department of Gastroenterology and Cardiac Surgery.
When the patient was admitted to the ward, the doctors from the gastroenterology department and cardiac surgery department all gasped after looking at the CT images.
The fish bone had penetrated the esophagus, breached the mediastinum, and pierced the thoracic aorta near the sixth thoracic vertebra, causing two fatal injuries in the patient's body.
First, it penetrates the esophagus, and the risk of fatal infection increases exponentially.
Then it penetrates the aorta and forms a false aortic aneurysm. Once the aneurysm ruptures, the huge arterial pressure will cause the patient to quickly die from massive bleeding.
The thoracic aorta is the largest arterial blood vessel in the human body. The pressure in the blood vessel is very high. Once a breach occurs, the bleeding will be like a spurt, just like a dam bursting, making it difficult to rescue.
"Based on the experience and data of colleagues at home and abroad, there were a total of 23 similar cases of patients with similar situations, 20 died, and only 3 were saved. It was a narrow escape."
The cardiac surgeon said with a serious face: "I can't handle such an operation. I have to wait for the director to come and perform the operation."
The gastroenterologist also shook his head and said: "The hospital in Haishi has shared a successful example. The operation needs to be carried out in stages. In the first stage, an esophagostomy is performed, and at the same time, the thoracic aorta is removed and replaced, and in the second stage, an esophageal reconstruction surgery is performed. Not only is the cost high, patients will also lose their esophagus and their quality of life will be greatly affected.”
An hour later, the directors of the cardiology and gastroenterology departments arrived one after another for a joint consultation.
Direct surgery? Or a combination of interventional and endoscopy?
Time passed by, and after many discussions, the experts finally made a decision and chose to perform surgery to save the patient.
At this moment, the nurse suddenly rushed in.
"It's not good. The patient suddenly vomited blood and was in hemorrhagic shock."
The director of the gastroenterology department looked at everyone, stood up and said: "Time waits for no one, and the operation must be performed immediately. I will go to the family to discuss it immediately, hoping to gain their support."
"Wait a minute, if you want to have surgery, there is still a big problem." The director of cardiology frowned and said.
"The patient's thoracic aorta had fishbones stuck in it and hemangiomas formed. No matter what, it had to be replaced with an artificial blood vessel."
"But," he spread his hands and said helplessly: "Now all the tertiary hospitals in Yangcheng have no inventory of artificial blood vessels. We must find supplies from Beijing and Haishi."
"Oh, there is such a thing?" The director of the gastroenterology department showed an expression of disbelief for a moment: "Don't you use a lot of artificial blood vessels? Are they still out of stock? Why don't you stock more?"
The cardiac director coughed lightly and explained: "Imported artificial blood vessels are all purchased through agents, and now the agents have no surplus."
"Originally, we had two suppliers, one in Sakura Country and one in Europa. Logically speaking, they should be very safe, but we never expected that two manufacturers would have problems at the same time."
"Because in Sakura Country, it seems that the manufacturer replaced the anti-leakage coating inside the artificial blood vessel, which failed to pass the domestic preparation review. Then the European manufacturer closed the old factory, but the new factory has not been opened, and the production capacity has been exceeded. Big problem."
"These two foreign manufacturers had problems at the same time?" The director of the gastroenterology department looked at him in shock: "Why is it such a coincidence?"
Director Xinwai smiled awkwardly: "Although the chance of two manufacturers having problems at the same time is small, it does happen."
"Aren't there any substitutes for domestic manufacturers?"
"It's difficult. There doesn't seem to be one at the moment. In fact, artificial blood vessels are a technology that was developed fifty years ago. Although there has been slow progress, it is not something that is too high-tech. I don't understand why it is so late. No domestically produced artificial blood vessels have been released yet.”
Director Xinwai touched his forehead and said speechlessly.
"Okay, then you hurry up and contact the higher-level hospital to get the goods as soon as possible. I'll go find the family members." The director of the gastroenterology department was also speechless. It was originally a major operation with extremely high risks and many difficulties.
As a result, before the operation started, we encountered a problem and the artificial blood vessel was out of stock.
The reason turned out to be that the two major manufacturers dropped the chain at the same time, which is simple.
It was so outrageous that the director of the gastroenterology department swore he had never seen anything so ridiculous in his life.
"Isn't this holding me back? Whose fault is it if it delays my illness?" He thought angrily in his heart when he went out.
"It's better to make it domestically. At least it won't be so ridiculously out of stock."
The director of cardiac surgery also quickly took out his mobile phone and the first call was made to Professor Zhang, director of cardiac surgery at Beijing Anzhen Hospital.
Professor Zhang is a leading expert in the field of cardiovascular surgery in China. He performs 600 aortic dissection operations every year. The amount of artificial blood vessels has been guaranteed by the manufacturer, so he should not be out of stock.
"Professor Zhang, I am Lao Wang from the Zhongshan Hospital in Yangcheng. Haha, I want to ask you something. Artificial blood vessels have been out of stock recently. You are an authority in this field in China and also a VIP of MaiKeWei. You Is there any stock left?"
】
"Hey, Lao Wang, what a coincidence. There is a shortage of artificial blood vessels everywhere recently. I don't have many in stock here. I only have five. You should have told me earlier. I have already booked 5 surgeries. It’s all been used up.”
However, what I never expected was that Anzhen Hospital also had a shortage of artificial blood vessels.
The Director of Cardiology was stunned for a moment, and then said in a trembling voice after a while: "Well, what if there is no goods and something happens to the patient?"
There was a long silence on the other side, and after a while, a difficult voice came.
"It can only be used for the most dangerous patients, and other patients should be delayed first."
The director of cardiac surgery lost his voice and said: "But my patient has begun to go into hemorrhagic shock. If we don't save him, he will die at any time."
"Hey, it's the same for us. Now we can only dig through the inventory, find some blood vessels of the wrong model, and make do with processing. Use whatever you can find." Professor Zhang said with a sigh.
Director Xinwai fell silent, finally holding back a thank you, and then hung up the phone.
Even Anzhen Hospital, the first brother in the heart, is out of stock. It seems that there is really no other way.
As for the last solution the other party said, it was considered a solution, but it just wasn't suitable for him.
It is a manual job to process the wrong blood vessels into a model that matches the patient's blood vessels on site. Changing a large-caliber blood vessel into a small-caliber one requires stitches and stitches. If you are not careful, the blood vessels will easily bleed.
The feasibility of changing small-caliber blood vessels to large-caliber is extremely limited, and only materials with a very small range of differences can be used at risk.
The other party's family has a big business, so they can still find old goods in the warehouse and renovate them.
But here, no matter whether large blood vessels or small blood vessels, there is no stock.
"It's hard for a clever woman to make a meal without rice. If you want to make changes, you have to have something." Director Xinwai sighed, feeling a hint of despair.
He rubbed his brows, opened his phone's address book, and prepared to continue dialing the number of Xiangshu Hospital in Haishi.
At this moment, a resident doctor timidly raised his hand.
"Director, it seems that the artificial blood vessel is made in China and can be used. Should we try it?"
