Chapter 487 - 279: He Guangzong’s Astonishment
Chapter 487: Chapter 279: He Guangzong’s Astonishment
The junior doctors who met his gaze quickly lowered their heads in a panic.
Director He smiled faintly. He hadn’t really expected these young doctors to diagnose such a complex disease anyway. He was already preparing to give them a detailed explanation of Berry syndrome. The condition was often masked by a variety of complex deformities, causing doctors to focus on superficial symptoms while missing the complete picture.
A missed diagnosis could lead to an incomplete surgical plan, resulting in a failed operation or the risk of postoperative complications.
Over the years, from accumulating cases of this rare disease, He Guangzong had developed some insights. He had also summarized several easily overlooked characteristics, the most typical of which was the "butterfly sign"...
As He Guangzong continued to observe, he noticed something unexpected. Dr. Jiang Ming, who had just presented the report and was the patient’s attending physician, was staring off into space in a peculiar way. He wasn’t feigning deep thought, nor did he seem the least bit nervous.
He Guangzong considered it for a moment. ’This young doctor has probably just given up,’ he thought. ’Since he can’t understand it and isn’t expected to contribute, he’s just spacing out, waiting for the directors to talk. No intention of joining the discussion at all.’
Of course, this attitude was understandable. In a major consultation like this, junior doctors rarely had a chance to join the discussion anyway.
Still, He Guangzong was surprised that Jiang Ming didn’t even bother to pretend.
Seeing that it was about time, He Guangzong took the initiative to ask:
"Well, doctors, what are your thoughts?"
He Guangzong randomly picked an attending physician to share his opinion.
Hearing He Guangzong’s question, Director Liu, Director Gan, and the others understood that he must already have a clear diagnosis in mind.
The doctor who was called upon was caught off guard, but he braced himself and presented his line of thinking:
"The patient has a congenital heart defect combined with a lesion of the aortic arch, which has led to pulmonary hypertension..."
Although it wasn’t a comprehensive diagnosis, it showed that the young doctor’s fundamental skills were solid.
The idea he proposed did have some basis and a degree of accuracy.
He Guangzong remained noncommittal and called on another doctor.
"My opinion differs slightly from Dr. Huang’s. I believe the pulmonary hypertension is just one of the complications. The true cause of the patient’s condition is an interrupted aortic arch, which caused aortic coarctation and subsequently led to pulmonary hypertension..."
"Due to the interrupted aortic arch, the patient’s left ventricular load has increased significantly, which in turn has caused severe pulmonary hypertension..."
Listening to this doctor’s analysis, many of the others nodded frequently. This was, indeed, the conclusion most of the doctors had reached.
After a few of the junior doctors had finished their analyses, Director Liu gave a summary.
"Director He, this is basically our current diagnostic approach. The patient has a complex congenital cardiovascular malformation with multiple complications. The main issue is the aortic lesion, which has led to aortic coarctation and triggered a series of subsequent problems, including pulmonary hypertension, heart murmurs, acute respiratory distress syndrome, heart failure, and so on..."
"However, an interrupted aortic arch alone shouldn’t theoretically cause such a wide range of issues. Based on our department’s past experience, we have no precedent for a case like this. That’s why we invited you, Director He, to join the consultation and give us your guidance."
"After all, with a cardiovascular malformation, if we don’t have a sufficiently complete plan and approach before the operation, any oversight during the procedure could have extremely serious consequences."
After speaking, Director Liu looked toward Director He.
He Guangzong was just about to give his judgment when he suddenly noticed Jiang Ming off to the side, who looked like he had a different opinion and was eager to speak. So, he asked casually:
"Dr. Jiang, do you have a different line of thinking?"
Seeing Director He question Jiang Ming, Director Liu quickly explained:
"Dr. Jiang was in the emergency surgery department before this. He just rotated to our cardiac surgery team, so he has very little experience in diagnosing and treating such complex vascular malformations."
"However, since this is a consultation, it’s good to brainstorm. Xiao Jiang, feel free to share your thoughts. I hope you’ll indulge us, Director He."
Jiang Ming hadn’t been with the cardiac surgery team for long and had no prior experience in the field. Therefore, Director Liu’s arrangements for him so far had been limited to following along on rounds, managing inpatients, and occasionally getting the chance to assist in simple, minor surgeries.
Naturally, Director Liu didn’t think Jiang Ming could offer any useful insights on such a complex case.
However, as it was a consultative discussion, Director Liu still welcomed everyone to speak freely. That was how a good academic atmosphere was maintained.
Explaining this to Director He beforehand was also a way to prevent any awkwardness in case Jiang Ming couldn’t come up with anything to say.
Normally, in a situation like this—facing He Guangzong, one of the nation’s top cardiac surgery experts, and with the brilliant analyses of Director Liu and the other directors preceding him—Jiang Ming would never have dared to speak carelessly.
But yesterday, Wu Ting had already told him the diagnosis, and it was clearly more systematic and comprehensive than the conclusions reached by the directors.
According to Wu Ting’s analysis, basing the surgery solely on an interrupted aortic arch would result in an incomplete diagnosis. It would lead to other postoperative complications, and if the condition relapsed, the mortality rate for a second surgery would increase exponentially.
At a time like this, Jiang Ming didn’t dare hold back. He took a deep breath and recited Wu Ting’s diagnosis verbatim: