Wrestling "falls out" of the aortic dissection, two surgeries "reborn after the disaster"

On January 18, Mr. Liu, who was doing rehabilitation training in the orthopedic ward, cheered himself up from time to time, hoping to get better soon and spend a good new year with his wife and children. In the previous two weeks, Mr. Liu had experienced a series of dangerous conditions such as aortic dissection, lower extremity thrombosis, rhabdomyolysis, and coagulation disorders, and he could not imagine how he was rescued from the "ghost gate".

At the end of December 2021, Mr. Liu was working on the construction site, completely ignoring the 2-meter-high steps behind him. Suddenly there was a muffled "bang", and Mr. Liu stepped on the air with one foot, and his back fell heavily on the cement floor. In an instant, a sharp pain struck, and after 10 minutes he found that his right leg could not move, and the workers rushed him to the high-tech branch of the Zhengzhou Central Hospital affiliated to Zhengzhou University nearby. The receiving physician suspected that Mr. Liu may have had aortic dissection due to a violent impact on his body. The emergency department CT and cardiac ultrasound examination found that Mr. Liu's cardiac aorta to the right internal iliac artery all underwent dissection.

Blood is filled in the false cavity of the vascular dissection, at this time the patient's internal organs can not get more blood supply, huge pressure, thin blood vessels and serious complications, once the blood vessel rupture occurs, Mr. Liu may not have a chance to survive again.

In order to get better treatment, Mr. Liu was immediately transferred to the headquarters of Zhengzhou Central Hospital affiliated to Zhengzhou University, and on the way to the referral, Liu Xiaogang, director of the ICU of the high-tech campus, has reported the patient's situation remotely to Xu Lanjuan, director of the ICU of the headquarters, Wang Haibo, director of the Department of Peripheral Interventions, and Xie Yixu, director of cardiac surgery. Everything is ready when the patient arrives at the hospital.

Wang Haibo and Xie Yixu cooperated closely to block the incision of the vascular lining using a stent to prevent blood from flowing to the false cavity, but due to the long-term insufficient blood supply to the heart and kidneys and serious electrolyte disorders, the sudden recovery of blood flow triggered a cardiac arrest in the patient! After the successful rescue of electrical defibrillation and cardiac resuscitation, the heartbeat was restored, but the vital signs were extremely unstable, and Mr. Liu was transferred to the ICU for comprehensive treatment.

Although blood circulation stabilizes quickly, the patient's right calf arterial vessel is completely blocked due to thrombosis caused by aortic dissection. If this problem is not solved quickly, Mr. Liu will face the consequences of amputation of his right leg.

Xu Lanjuan considered that the patient had just undergone major surgery, and there was a cardiac arrest during the operation, coupled with the lack of oxygen and the impairment of consciousness, I am afraid that she can no longer withstand another thrombotic surgery. Fortunately, the next day Mr. Liu woke up! After improving the relevant examinations, Xu Lanjuan invited Liu Hansong, president of the High-tech Branch of Zhengzhou Central Hospital affiliated to Zhengzhou University, and departments of vascular surgery, medical imaging, orthopedics and other departments to conduct comprehensive consultations, and decided to perform interventional vasectomy and embolectomy for the patient's emergency department.

However, death did not seem to want to concede defeat so easily, and Mr. Liu had rhabdomyolysis, renal insufficiency, and coagulation disorders. After surgery, it is necessary to recover blood clotting, but to prevent the thrombus from re-forming, which is very difficult to grasp. Xu Lanjuan consulted a large number of data and decided to give patients small metering anticoagulation applications after the coagulation function was stabilized. Finally, on the third day after the operation, Mr. Liu pulled out the endotracheal tube, and his vital signs gradually stabilized, and he was transferred to the general ward a week later.

Coordinator: Liu Yang

Editor-in-charge: Zhang Chi