Chapter 2545 [2545] Technique


    Holding the precautions on the note, Xie Wanying continued tomunicate with the teacher on the opposite side: "Please keep the length of the vena cava longer when Teacher Ye is pruning."


    oh oh oh. Ye Chuanguang heard something and said, "What technique are you nning to use? The child over there is nine years old but not ten years old, right?"


    Heart transntation is divided into orthotopic heart transntation and heterotopic heart transntation. Orthotopic heart transntation is easy to understand. The patient''s diseased heart is removed and a donor heart is ced in its ce. Heterotopic heart transntation does not remove the diseased heart, but connects the donor heart with the original diseased heart to support and assist the diseased heart, which is equivalent to a pure biological heart assist device.


    Heterotopic heart transnts are rarely done because there is no future in sight. Generally, when a cardiomyopathy like Zhu Xing is at the end stage, even installing a cardiac assist device for transition cannotpletely solve the root cause of the disease.


    Heart transntation basically revolves around the orthotopic heart transntation. Orthotopic heart transntation sounds simple, as long as the patient''s heart is plucked, and the donor heart reces the patient''s heart. It''s not easy at all to actually do it.


    The heart has a total of eight blood vessels that need to be connected. The most difficult part is the pulmonary vein group in the left atrium. There are two upper and lower vascr ports in the right pulmonary vein group and two upper and lower vascr ports in the left pulmonary vein group on both sides of the posterior wall of the left atrium. Are youplicated enough?


    Like the right atrium, it is not easy to connect the two anastomotic ports of the superior and inferior vena cava.


    If the above blood vessels are connected honestly, it is a whole-heart spell called heart transntation. This kind of operation is the mostplicated and time-consuming andbor-intensive, and there are many anastomotic stitches, which means that the risk ofplications of anastomotic leakage is high. The surgical principle has always been that the simpler the steps, the better, and the fewer sutures the better.


    In order to save the operation time, protect the myocardium and reduce postoperativeplications, the surgeons used opportunistic surgical methods to carry out heart transntation at first. The left and right atrium, the donor atrium and the recipient atrium are directly anastomosed, and theplex left atrium and multiple right atrium anastomosis connections are directly avoided. Referred to as the two-chamber method or the standard method of heart transntation.


    In pediatrics, if the child is very young, especially the neonatal blood vessels are too thin, it is difficult for doctors to use a magnifying ss to suture multiple anastomotic ends. Of course, the double chamber method is the best.


    Other older children and adults rarely use the twin room method. The reason is that this operation has a big disadvantage.


    We know that the heart has a conduction system that allows the heart to beat rhythmically. The highest pacemaker of this conduction system is in the sinoatrial node, which controls how many times a person''s heart beats per minute. The sinoatrial node is located just above the right atrium of the heart.


    The two-chamber method leaves both the donor heart and the recipient''s right atrium, and has two sinoatrial nodes, which is equivalent to installing two engine control systems for the heart. Chaos, sure to be chaotic.


    After seeing the drawbacks of this operation, theter surgeons improved this operation, with the following mostmonly used double vena cava method. match.