The techniques of manipulating the guidewire during PCI surgery are enough to make doctors discuss for a long time, and many of them are very complicated.
Okay, the next step is to insert the angiography catheter along the guidewire. Jin Tianyu, who asked his juniors to take their time, got the hang of it much faster. With his juniors ready to explore the way for him, he had a rough idea of the patient's vascular condition and could speed up without wasting time.
The catheter is delivered to the right position and the tail end is connected to a syringe to draw back and exhaust the air.
Connect the triple three-way head and then exhaust the air thoroughly to prevent air from entering the coronary arteries and causing fatal air embolism.
During the exhaust process, the three-way head is connected to the pressure sensor, contrast agent, and saline or heparin for flushing the tube. Among them, the pressure sensor is connected to the display instrument, and the operating doctor can observe the invasive pressure graph of the aorta on the screen.
A normal pressure graph is a smooth wave with the apex being the systolic pressure and the trough being the diastolic pressure.
It is very important to observe this during the entire coronary angiography process. Once the graph changes into a V shape, indicating that the catheter opening is embedded in the coronary artery, coronary artery damage and blockage will occur, requiring emergency treatment.
The doctor checked the patient's intraoperative indicators and found that all indicators were normal, with no risk of spillover.
Prepare to start the perspective.
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...
Turn on the computer and the yellow light comes on.
The image of the catheter in the human coronary artery appears on the angiography machine screen, and the doctor can see the dark outline of the patient's heart, like a paper cut. The projection can be a static picture, and when connected together it becomes a dynamic movie picture. The viewer will feel a bit like watching a folk shadow play. The two-dimensional dynamic image of the heart can show the movement of the heart contracting and expanding, as lively as a naughty child. The patient's heart beats on the plane, driving the coronary artery where the catheter is located to beat together. The injected contrast agent travels in the artery with the blood. At this time, the doctor can clearly see the direction and diameter of the blood vessel with the help of the contrast agent. If the artery is narrowed, the blood cannot pass through the contrast agent, and the missing image in the blood vessel segment will be displayed, that is, the black changes to white. This is coronary angiography.
Under fluoroscopy, doctors repeatedly confirmed whether the guidewire was in place, and then the guidewire led the angiography catheter to enter the patient's left and right coronary arteries for angiography. As mentioned before, the X-ray system is a two-dimensional image. To convert it into a three-dimensional image, the patient's heart and blood vessels must be fluoroscopically examined in multiple positions to collect all the information and enter it into the computer for the computer to reconstruct a three-dimensional image, which is equivalent to emitting X-rays frequently while the machine is turned on.
"You guys get out." Jin Tianyu ordered his junior sisters and brothers to leave so that they would not be exposed to radiation.
In order not to cause trouble for their senior brother, Xie Wanying and Pan Shihua followed the instructions and left the angiography room.
The nurse was waiting outside and helped them take off their surgical gowns and lead coats.
After taking off the lead suit, the scrubs were all sticky with sweat. Xie Wanying and the others washed their hands, wiped the sweat off their hands, and hurried back to the control room to see what was going to happen next.
The person who spoke to Fu Xinheng on the phone changed from Dr. Xu to Dr. Shen.
"She helped, right?" Dr. Shin asked after hearing the progress of the matter, wanting to know if his "reckless" suggestion had successfully turned the situation around.
Yu Xuexian wanted to tell this senior brother to stop showing off.
"This shows that our Director Zhang has a very sharp eye." Doctor Shen laughed out loud, very happy with the result.
Doctors are happiest when they see their patients being saved.
Doctor Xu leaned over to his phone and asked, "What's the angiography result now? Are the three vessels diseased?"
Definitely not. The previous electrocardiogram did not show any such sign.
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