BXBX NOVEL Chapter 2545: 【2545】Surgery
oh oh oh. Ye Chuanguang heard something and said, "What technique are you planning to use? The child over there is nine years old but not ten years old, right?"
Heart transplantation is divided into orthotopic heart transplantation and heterotopic heart transplantation. Orthotopic heart transplantation is easy to understand. The patient's diseased heart is removed and a donor heart is placed in its place. Heterotopic heart transplantation does not remove the diseased heart, but connects the donor heart with the original diseased heart to support and assist the diseased heart, which is equivalent to a pure biological heart assist device.
Heterotopic heart transplants are rarely done because there is no future in sight. Generally, when a cardiomyopathy like Zhu Xing is at the end stage, even installing a cardiac assist device for transition cannot completely solve the root cause of the disease.
Heart transplantation basically revolves around the orthotopic heart transplantation. Orthotopic heart transplantation sounds simple, as long as the patient's heart is plucked, and the donor heart replaces the patient's heart. It's not easy at all to actually do it.
The heart has a total of eight blood vessels that need to be connected. The most difficult part is the pulmonary vein group in the left atrium. There are two upper and lower vascular ports in the right pulmonary vein group and two upper and lower vascular ports in the left pulmonary vein group on both sides of the posterior wall of the left atrium. Are you complicated enough?
Like the right atrium, it is not easy to connect the two anastomotic ports of the superior and inferior vena cava.
If the above blood vessels are connected honestly, it is a whole-heart spell called heart transplantation. This kind of operation is the most complicated and time-consuming and labor-intensive, and there are many anastomotic stitches, which means that the risk of complications of anastomotic leakage is high. The surgical principle has always been that the simpler the steps, the better, and the fewer sutures the better.
In order to save the operation time, protect the myocardium and reduce postoperative complications, the surgeons used opportunistic surgical methods to carry out heart transplantation at first. The left and right atrium, the donor atrium and the recipient atrium are directly anastomosed, and the complex left atrium and multiple right atrium anastomosis connections are directly avoided. Referred to as the two-chamber method or the standard method of heart transplantation.
In pediatrics, if the child is very young, especially the neonatal blood vessels are too thin, it is difficult for doctors to use a magnifying glass to suture multiple anastomotic ends. Of course, the double chamber method is the best.
Other older children and adults rarely use the twin room method. The reason is that this operation has a big disadvantage.
We know that the heart has a conduction system that allows the heart to beat rhythmically. The highest pacemaker of this conduction system is in the sinoatrial node, which controls how many times a person's heart beats per minute. The sinoatrial node is located just above the right atrium of the heart.
The two-chamber method leaves both the donor heart and the recipient's right atrium, and has two sinoatrial nodes, which is equivalent to installing two engine control systems for the heart. Chaos, sure to be chaotic.
After seeing the drawbacks of this operation, the later surgeons improved this operation, with the following most commonly used double vena cava method. match.
(end of this chapter)