Chapter 412 - 254: Success
Chapter 412: Chapter 254: Success
After another round of discussion and analysis of the patient’s condition, the surgery began. The procedure would utilize Director Pang’s new approach, employing a modified, mechanically adjustable delivery system—a semi-finished product still in the exploratory phase of clinical trials.
Director Pang personally operated as the lead surgeon, with Wu Ting as the first assistant. Director Shao and Shen Siyuan were on standby.
This surgery was intended as a training and development opportunity for Wu Ting, so the directors gave him plenty of chances to participate.
The surgery began, and Director Pang handed the initial, routine procedures over to Wu Ting.
Aided by the yellow-tiered entry from Teacher Shen, his technique wasn’t extraordinary, but completing the surgery in a competent, by-the-book manner was no issue.
Watching Wu Ting operate, the directors were quite satisfied.
Wu Ting chose the most conventional approach: the femoral artery in the groin.
This was in line with the current mainstream concept of minimally invasive surgery—transcatheter aortic valve replacement. It was relatively less invasive and allowed for faster recovery, but the trade-off was the high difficulty of implantation, which demanded immense control from the surgeon.
Wu Ting made an incision in the patient’s groin, exposing the opening of the femoral artery.
Next was inserting the introducer sheath into the artery. Wu Ting’s technique was very delicate as he controlled the insertion of the soft catheter.
"Flexible guidewire..."
This was another critical step. He had to control the entire guidewire, advancing it along the femoral artery all the way to the aorta. Then, using skillful and precise control, he pushed open the valve and entered the left ventricle.
At this point, the second step began. This part of the procedure still had some inherent technical flaws. It involved inflating a balloon at the catheter’s tip to push the diseased valve leaflets open and to the sides, creating space for the new artificial valve.
This patient only had simple valve calcification and aortic dilation. Lou Musaang’s condition, however, was far more complex, involving a complicated aortic deformity. It would be incredibly difficult to guide the balloon at the catheter’s tip to the right position, let alone implant the artificial valve afterward.
This was a major challenge that needed to be solved in the future.
Returning to the current surgery, once the valve was propped open and space was created, it was Director Pang’s turn to take over.
The new, modified, mechanically adjustable delivery system advanced the artificial valve to the opened position. However, due to the patient’s severe valve calcification and aortic dilation, the position and angle of the implanted artificial valve were not accurate.
At this moment, Director Pang began to operate the modified system’s graspers, pulling and adjusting the head of the delivery system to control its trajectory.
Because this patient’s condition was relatively ideal, he managed to achieve coplanarity with the valve plane after a mechanical adjustment of 9 degrees.
After the new artificial valve was in the correct position, the balloon was deflated. Once the stent was secured in its precise location, the catheter and guidewire were removed.
Under Director Pang’s precise control, this highly difficult surgery was finally completed.
Compared to this surgery, Lou Musaang’s complex and deformed blood vessels would require a delivery device head that could bend and be controlled with fine angular precision. Moreover, simply pulling it with mechanical graspers like these would definitely not be enough.
They had to develop an automated, controllable system that could be adjusted to any angle and also allow for a self-expanding balloon. Only then could they ensure continuous coplanarity during the entire valve deployment process.
’This really is a difficult task.’ But with Director Pang’s core concept, Wu Ting believed that the development of this new, controllably adjustable, self-expanding valve delivery system was not far off.
[Ding! Congratulations to the host for completing a high-difficulty aortic valve replacement surgery with Director Pang, Shen Siyuan, and Shao Yuqiao. You have obtained an entry from Director Pang: Mechanically Adjustable Artificial Valve Replacement (Yellow). This is a technique still in the exploratory clinical phase with significant application limitations. Its key feature is the concept of a controllable angle for the delivery system’s head. When combined with a 3D imaging system and artificial intelligence algorithms, a brand-new technology can be developed.]
[Recommended Entry Synthesis Path: Mechanically Adjustable Artificial Valve Replacement (Yellow) + Aortic Valve Replacement (Yellow) + 3D Visualization System Technology (Purple) + Self-Expanding Balloon (Yellow) + Controllable Automated Adjustment Delivery System Head (Hardware & Software) Technology (Purple) = Controllably Adjustable Self-Expanding Valve Delivery System (Purple). This is a brand-new, world-first aortic valve replacement technology that integrates multidisciplinary techniques. It can treat patients with various vascular deformities, aortic dilation, and severe aortic valve calcification.]
[Note: This technology can solve the long-standing clinical pain points of transcatheter artificial valve replacement.]
[1. In challenging anatomical situations, such as a severely horizontal heart, ascending aorta dilation, and severe leaflet calcification, advancing the valve delivery system through the aortic arch and across the aortic valve is relatively difficult. Using excessive force can easily cause damage to the aortic wall.]
[2. During the deployment of a self-expanding valve, it is often impossible to achieve coaxial alignment between the valve and the perpendicular bisector of the annular plane. This leads to instability during deployment or, after deployment, different implantation depths in different sinuses, causing paravalvular leakage. This is a common problem both domestically and internationally.]
[Missing Entries: Self-Expanding Balloon (Yellow), Controllable Automated Adjustment Delivery System Head (Hardware & Software) Technology (Purple)!]
Seeing the recommended synthesis path, Wu Ting grew ecstatic. ’It’s here! The path is finally complete!’ All he had to do now was acquire the two missing components.