Mrs. TOPT restrained her surprise and felt that Wu Mian must have obtained the information on the educational administration''s side in advance. Otherwise, there is no way to explain the contents of the document in hand.


    After 1 ′ 22 ", the anesthesiologist felt that the induction of anesthesia was not ideal and began to give another dose.


    Fentanyl as like as two peas in the document, 0.11mg.


    Mrs. TOPT frowned and looked at the document in her hand. It didn''t open and turn to the current time marked page, but she seemed to see the words written on it.


    "Wu, how do you know that the induction of anesthesia is not ideal and you have to give it again?" asked Mrs. TOPT.


    "All anesthesiologists in Cambridge and London tend to be conservative, especially Mr. winter. I think he was there during the consultation."


    Mrs. TOPT nodded.


    "Dr. winter must be afraid of the sudden allergic reaction of principal TOPT, so the final plan must be conservative," said Wu Mian. "Principal Stephen TOPT was a football player when he was young, and he was in good health. How can this dose of induced anesthesia reach the ideal level."


    "Did you guess all this?" asked Mrs. TOPT.


    "Madam, this is a basic judgment based on the patient''s basic physical condition and my understanding of other anesthesiologists." Wu Mian said, "this is not magical or cool. In fact, there is a touch of sadness in my heart."


    Mrs. TOPT knew what Wu Mian was going to say. Instead of continuing Wu Mian''s words, she stared at the screen to see the operation process.


    After injecting fentanyl again, the induction of anesthesia was ideal, but the blood pressure decreased temporarily. Mrs. TOPT was not particularly surprised because this was mentioned in the document.


    What surprised her was how Wu Mian predicted it.


    Wu Mian''s explanation just now? Mrs. TOPT didn''t fully understand. That''s amazing. It''s like a Danish fairy tale. Only children believe it.


    After a brief panic in the operating room, as the numbers on the monitor stabilized, the emotions of all doctors and nurses also stabilized. After a few minutes of symptomatic treatment, the vital signs did not change significantly, and then continue to the next step.


    Anesthesia maintenance: Propofol 4.2mgkg · h, remifentanil 0.45mgh, CIS atracurium 10.25mgh were continuously pumped.


    It is still the same as that written in Wu Mian''s document.


    The anesthesia was satisfactory and the operation officially began.


    Stephen dedley, a cardiac surgeon at Mayo Clinic, stood in front of the operating table after brushing and disinfecting his hands. He seemed to know that Wu Mian was watching him after monitoring. Instead of direct surgery, Dudley stared at the surveillance camera.


    Stephen Dudley looked at him like he looked at Wu Mian across the air. After 10 seconds, he raised his hand to his chest and raised his middle finger.


    Mrs. TOPT''s expression was slightly stagnant when she saw this scene.


    The disputes and differences between Wu and Dudley are so serious that if the operation is carried out according to Wu''s imagination, what will he do at that time?


    Just when Mrs. TOPT was restless, Stephen Dudley made a gesture to his assistant and the operation began.


    During skin cutting, the anesthesiologist continued to give fentanyl 0.2mg, and Dr. dedley opened the skin to stop local bleeding and blunt separation to the sternum.


    The technique is clean and beautiful, and the speed is very fast. Mrs. TOPT glanced at the time. She vaguely remembered that the time seemed to be marked in the documents given by Wu Mian since the opening of the stage.


    It''s just that she can''t remember the little time.


    Open the file and turn to the page of the operation. Mrs. TOPT saw 12 ′ 03 "after the opening and was ready to split the sternum. Fentanyl 0.2mg and CIS atracurium 5mg were given again before splitting the sternum.


    Do you want any more medicine? She raised her head. Just 12 minutes later in the upper left corner of the screen, Dudley took the sternum saw handed by the instrument nurse and began to split the sternum.


    In the picture, the figure of the anesthesiologist only shows a corner, and the words appear on the right screen - give fentanyl 0.2mg and CIS atracurium 5mg again before splitting the sternum.


    Mrs. TOPT was stunned. She suspected that she was wrong. How could Wu''s prediction be so accurate! Once again, I looked at the documents carefully, turned back and thought about what I had just seen. I was surprised and began to have fear.


    If we continue to follow Wu''s prediction, the operation will be successful, but Stephen can''t get out of cardiopulmonary bypass at all. Once offline, there will be a weak heartbeat until the heart stops beating.


    impossible! Mrs. TOPT comforted herself.


    This is Wu''s guess. At the beginning, the situation was relatively simple. He can guess the next step according to the existing data. With the further operation, every small detail may disrupt Wu''s guess.


    This is the most reasonable judgment, as Mrs. TOPT thought.


    From splitting the sternum to seeing the heart, Stephen TOPT''s blood pressure remained basically stable, with a fluctuation range of 85 ~ 10058 ~ 65mmhg.


    After splitting the sternum, Dr. Dudley waited for 1 ′ 22 ", saw that Stephen TOPT was in a stable state and began the next operation.


    The cardiopulmonary bypass group was immediately given 150mg heparin sodium for heparinization.


    To start cardiopulmonary bypass and reduce body temperature, Dr. Dudley raised the sternum on the free side with a modified favaloro retractor, and the operating table tilted to the opposite side of the operator.


    Using a low-power electric knife, first, the pleural reflexes behind the sternum were separated gently downward between the intrathoracic fascia and the pleural wall to expose the internal mammary artery.


    Dudley closed it with a titanium clip and cut it off with an electric knife to stop bleeding. After the loose tissue of pleural reflexed was swam away, he began to free the internal mammary artery at a 45 ° angle from the middle segment to the lower segment.


    A 3cm incision was made on the inner thoracic fascia inside the artery and vein. Dade clamped the edge of the inner thoracic fascia with fine tweezers to expose the internal mammary artery.


    Then, gently dissociate the internal mammary artery, internal mammary vein, fascia, lymph and a little adipose tissue along the downward segment of the chest wall with the tip of an electric knife.


    The operation was very delicate. Dade used the elasticity of subcutaneous tissue to pull up the internal mammary artery, and the tweezers never touched the artery.


    This is a surgical detail, an extremely important surgical detail.


    Because principal Stephen TOPT''s blood vessels are full of arterial plaques, tweezers may crush plaques and cause cerebral infarction.


    For those who can understand the operation, Dr. Dudley''s operation is extremely exquisite, which is already the world''s top surgical level.


    But Mrs. TOPT was not in the mood to appreciate Dr. Dudley''s surgical skills, no matter how perfect it was.


    Mrs. TOPT''s eyes looked back and forth in front of the screen. Dr. dedley''s every operation step was clearly written in Wu Mian''s documents, and even the operation time was recorded.


    The operation went smoothly, but Mrs. TOPT, who should have been in a relaxed mood, had no sense of lightness. She was holding the document desperately, and her heart was full of an absurd feeling.


    All this is under Wu''s control, even if he doesn''t have surgery.