Chapter 2137: Chapter 2137: Encountering Obstacles
Turning his head to look at the operating table again.
The surgery had now reached the critical stage.
The surgeons exerted great effort to remove the old artificial mitral valve from the patient’s stopped heart, which was stubbornly stuck with blood clots.
The doctors had to cautiously remove it to avoid leaving any clots behind. Otherwise, once the heart resumed pumping, the clots could be propelled by the heart’s blood flow, inevitably causing a pulmonary embolism or cerebral thrombosis.
In the corner, Du Mengen and Zhang Shuping stood until their ankles were sore; it’s not easy being medical students. Observing and learning here without working, the more they watched, the more anxious they became, yearning for the surgery to end sooner than anyone else. In reality, during a surgery, technical displays were rare, and medical students typically saw doctors having to grind away slowly like this. They must be meticulous; a single careless mistake could bring many postoperative problems to the patient.
Doctor Du Yeqing was conservative and would execute each surgical detail more meticulously within a limited time.
Rubbing his own sore neck, Du Mengen realized he had no interest in becoming a cardiothoracic surgeon. Cardiothoracic surgeries were too long and torturous. In comparison, gynecological routine surgeries were relatively short, and obstetric procedures even shorter.
Zhang Shuping, standing beside him, had a stiff face, obviously enduring the strain.
"Something’s off here," murmured the surgeon on the table.
"What’s not quite right?" Du Mengen asked Student Zhang, who was relatively knowledgeable.
Zhang Shuping, merely an intern and usually not interning at his uncle’s hospital, rarely saw such surgeries; after pondering for a while, he replied, "Is it, the valve opening is the issue—"
The valve opening? Student Zhang probably referred not only to the valve’s opening but more to the section where the valve was located.
While removing the faulty artificial valve, the surgeons needed to simultaneously consider what type of valve to use next, exploring the surrounding environment of the valve site to choose the appropriate valve type was essential.
In simple terms, artificial valves are roughly divided into mechanical and biological types. The previous patient had used a mechanical valve that caused issues. Logically, when something doesn’t work, you might switch to the other type, possibly opting for a biological valve to prevent the same problem from happening.
However, in medicine, problem-solving never follows such a straightforward thought path.
Firstly, let’s review why this patient chose a mechanical valve in her first surgery.
The surgeon who performed the first surgery should have known that this patient was a young woman with pregnancy needs. Mechanical valves require long-term use of anticoagulants like Warfarin postoperatively, which can easily cause thrombosis and affect her ability to conceive. These disadvantages suggest that a mechanical valve might not have been the best choice for a young woman with such needs.
For this patient, the special hypercoagulable state during pregnancy caused the mechanical valve to become clogged with blood clots, necessitating urgent reoperation.
Does this mean the doctor who performed the first surgery was inconsiderate of the patient’s needs?
On the contrary, preoperative cardiothoracic surgeons customarily explain the various valve options to the patient. In other words, as long as the patient’s physical condition allows, the choice of valve can be entirely up to the patient. The reason for letting the patient decide first is that the patient considers the economic costs. How much they are willing to spend on treatment is beyond the doctors’ decision.
