The right atrium of the recipient is removed, leaving only the left atrium, and the rest remains unchanged. This can avoid the disadvantage of having two sinus nodes and save the most troublesome time of left atrium pulmonary vein anastomosis.
Dr. Ye Chuangguang quickly realized that they might be going to adopt the bicaval method or the whole heart method, because if the bichamber method was used, there was no need to specifically instruct them to retain enough vena cava length to facilitate the subsequent donor heart recipient surgery anastomosis.
Whether such a nine-year-old child can challenge the most difficult whole-heart method will have to wait until the donor heart is delivered to the operating room of the Capital Children's Hospital and placed in the pericardium of the child's chest cavity to see the situation.
Finally, knowing what surgery they might be planning, Dr. Ye Chuan-guang said to them, "I will help you trim it as carefully as possible to make it easier for you to operate. After all, the journey is quite far."
The hospital across the street was willing to offer help, and Xie Wanying and Shouer’s teacher must be very grateful.
When it comes to the donor heart being taken out of the donor's body, the surgeon will do some preliminary trimming. Like before, if there was no requirement from Shouer, the surgeon would do it on his own and would not specifically leave the right atrium or the superior and inferior vena cava length.
Knowing that they might need a bicaval or whole heart anastomosis, Dr. Ye Chuan-guang, who is also a cardiac surgeon and has performed heart transplants, knows that the anastomotic ends of the pulmonary vein groups on both sides of the left atrium are the most difficult to handle. As a doctor who takes the donor heart, he can help his colleagues to fix this area in advance: remove all the tissue between the left and right pulmonary vein groups on the posterior wall of the left atrium, turning them into two large cuffs, and the anastomotic ends with the recipient are reduced from four to two, reducing the suturing steps.
In this way, the matters that needed to be coordinated were basically completed, and after verifying that other conditions were correct, Dr. Duan and Pan were just waiting to fly to the First Affiliated Hospital of Zhongshan Medical University to get the donor heart.
It will take several hours to fly back and forth, so there is no need to rush to send the child to the operating room. Xie Wanying and Wei can go to the PICU to accompany Zhu Xing first.
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Zhu Xing looked at his brothers and sisters and said, "When will my sister come back?"
After staying in the PICU for a while, this kid actually became aware of being a big brother. He stopped worrying about himself and started worrying about the little sister in the next bed.
Regarding Xiaohui's surgery, Xie Wanying and Wei remembered that they seemed to have heard other doctors mention it in the doctor's office: the donor heart Xiaohui needed was not far from the capital. Dr. Han took the hospital ambulance to the destination hospital and back, and it was estimated that it would take four hours. No wonder Xiaohui was pushed into the operating room early to prepare.
According to this timetable, Xiaohui should be anesthetized and ready for thoracotomy. The specific start time of the thoracotomy should be when Dr. Han confirms that he has obtained the donor heart from the donor's hospital.
The operation cannot be started too early. A long operation time is harmful to the child. More importantly, there is a fear of variables when the donor heart is taken. For example, when Dr. Han goes there, he finds that the donor heart does not match the one reported before and is not suitable for his patient, so he can only refuse it. The probability of this variable is very low, but no one can say for sure before the thing is in hand.
You will find out later that the size of the donor heart, like the liver transplant that Xie experienced last time, is by no means the most frightening thing in organ transplantation.
After little Zhu Xing fell asleep, Xie Wanying and Wei Shangquan walked out of the PICU.
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