The patient has unconventional mitral valve prolapse.

But a special type of barlow disease!

Common mitral valve prolapse is generally a local lesion, which only affects a single leaflet or a partial leaflet, and rarely has diffuse lesions.

However, when prolapsed mitral valve leaves have extensive mucous lesions, the valve leaves are redundant, and there is extensive prolapse, it is barlow disease!

It causes mitral valve insufficiency and is the most challenging surgery in mitral valve repair!

"Oh no, it's barlow disease!" ъìqυgΕtv.℃ǒΜ

"In the case of barlow disease, the patient's heart will have more obvious lesions, covering up the appearance of valve prolapse of ultrasound... She is severely combinatorial prolapse!"

"I'm having trouble, the tendon chords are prolonged and ruptured. And some of the papillary muscles are elevated, with multiple heads, several of which are very small, and completely lack the support of the tendon chords!"

The papillary muscle controls the movement of the mitral valve and ensures the normal opening and closing of the mitral valve.

The tendon chondrup is a fiber cord connecting the papillary muscle and the valve, which can prevent the valve from entering the atrium when the heart contracts.

And now, there are serious problems with both structures...

Director Zheng's face was heavy and said, "It's more serious than ultrasound. If it were before, if you did a joint suture and inverted suture, you would have a good repair effect.

However, now, whether it is 'French forming' or 'American forming', it is very difficult..."

The doctors present also looked very embarrassed.

French shaping is the precious wealth left by the pioneer of cardiac surgery in the surrendered country and left for mitral valve shaping. It means to restore the normal morphological structure of the mitral valve as much as possible from an anatomical perspective.

If you have a big skill, you have to be handsome.

American-style forming does not pay attention to appearance, just restore the function of the mitral valve.

Just work well with big tools, black and white can be used.

At present, Niu Niu's condition is much more serious than expected, such as barlow disease, joint prolapse, tendon chords, and even lack of natural tendon chords. How to repair the disease in this case?

It needs to be cut, supplemented, implanted, and the prolapse side must be replaced.

The worst thing is that the distance between the papillary muscle tip and the edge of the leaflet is too small to use a new chondrome…

Under the many difficulties, "mitral valve repair" has become an almost impossible task.

Director Zheng took a deep breath and told him rationally that he would never do repair surgery. He whispered: "Don't show off. Doctors should not consider money on the operating table. What we can do is choose the best solution - to do mechanical valve replacement."

However, Xu Qiu did not respond.

He looked up and Xu Qiu's eyes were turning rapidly, his eyes kept jumping in his heart, as if he was calculating something...

"You are--" Director Zheng was stunned.

Xu Qiu did not answer, and he focused all his energy on the operation in front of him.

He quickly analyzed a suitable surgical plan.

Tenocyst replacement repairs communion prolapse.

Carpentier papillary muscle displacement surgery, shortening of group tendon chondria, and repairing the missing area of ​​tendon chondria with autologous tendon chondria!

The next moment, Xu Qiu's dull voice sounded: "Continue, mitral valve repair."

...

“gore-tex PTFE suture.”

When Xu Qiu's voice sounded again, everyone came back to their senses from the shock, no one questioned it, and immediately entered the surgical state.

The same kind of equipment fell into Xu Qiu's hands accurately.

He first used a simple u-shaped suture, passing the two pieces of the suture through the fiber part of the front of the medial papillary muscle, and placing new strings.

The other quickly passes through the edge from the prolapsed joint of the anterior leaf...

Everyone hasn't reacted yet,

Xu Qiu's hand flipped again, and the suture passed through the second time from the left ventricle to the left afferial side.

Director Zheng stared at the art area intently. The more skilled he was, the more familiar he felt.

After Xu Qiu took turns to suture it back and forth, his pupils suddenly shrank, "Is this... a mobile chondrochlear replacement surgery?!"

At this moment, Director Zheng's expression was extremely shocked.

Mobile chondrochal replacement is a top repair technique that is highly praised in the country of Berry. The advantage is that it does not require removal of valve tissue, and can retain the shape of the valve leaflets, fluidity and the maximum possible opening area of ​​the mitral valve!

However--

This technique is quite difficult, which discourages many doctors.

Regardless of the string support between fiber muscles and lobular tissues; height control of tendon chords, etc., just to ensure the effect, you must use gore-tex sutures to make at least twelve safety knots!

In such a small place, twelve safety knots were tied in a row...

This alone is enough to make countless doctors shake their heads and give up.

"Ten...ten!"

"eleven!"

"twelve!"

Suddenly, the quick counting sounds beside him woke up Director Zheng.

He suddenly came to his senses and when he looked at the operation area again, the twelve safety knots were already neatly lying tightly on the fiber part of the head and the prolapsed joint section of the posterior leaf.

“…”

Director Zheng opened his mouth wide.

Just finished like this?

On the other hand, Xu Qiu did not give any chance to breathe.

After completing the replacement, he picked up the scalpel again.

To everyone's surprise, Xu Qiu did not wedge-shaped removal of the lengthy tendon chondros.

Instead, a longitudinal crack was made on the papillary muscle, and the 5-0 suture was used to wrap around the tendon chondria, and through both sides of the longitudinal groove, tighten the suture and bury the tendon chondria in the groove, and then suture the papillary muscle incision.

Some papillary muscles are very small.

Xu Qiu simply sutured the word "8" directly, folding the tendon chondrup and fixing it on the papillary muscle.

Then, he changed to a 4-0 expansion polytetrafluoroethylene line, drifted slightly with his wrist, and sewed the needle from the ventricle edge of the anterior valve to the atrial surface, and then passed through the papillary muscle 3mm from the tip of the papillary muscle, and lifted the suture while adding gaskets, quickly tied the knot...

His speed is too fast.

One stitch after another, the hands flew and moved in the operating area, like a dancer.

The stitches also flashed with crystal color under the shadowless lamp, as if they were glowing.

In everyone's shocking eyes,

Xu Qiu put out the last stitch and tied the knot easily.

So far—

The chondrome was successfully implanted on the edge of the leaf that lacked the natural chondrome, and the head was re-sued to the lower part of the papillary muscle...

This technique is like stealing the sky and changing the sun.

Once the crack is slit, the plant is planted, and then the string support is used. In an instant, the places that should be shorter are shorter, and the places that lack chondroins are well supplemented!

"This is OK?"

"Like magic, it's so shocking..."

"Repaired? Can such a complex mitral valve prolapse be repaired?"

The doctors exclaimed.

Director Zheng couldn't believe his eyes. Is there really someone who can repair this difficult mitral valve prolapse?

"Check." At this time, Xu Qiu put down the needle and urged calmly.

Director Zheng couldn't wait to pick up the balloon syringe.
Chapter completed!