Listen to surgery
▓ Ma Peijun
Cardiography Headline Gallery
On the morning of May 8, 2024, I lay on the operating table in the catheterization laboratory of the Cardiology Department of Nanjing First Hospital, and soberly listened to a life-threatening operation during the whole process.
In the past, I have been lying on the operating table several times due to the removal of the appendix and the removal of intestinal polyps, all of which are under general anesthesia, as if I had slept beautifully, and woke up as usual, without knowing what the operation process was like. It was precisely the two surgeries in the heart of the body's engine, and the whole time it was awake.
A year ago, on May 18, 2023, I had a sudden myocardial infarction and underwent cardiac interventional surgery in a hospital near my unit, where a drug balloon and a stent were implanted in the completely occluded right coronary artery to open the blood vessel and save my life. The two left vessels are extremely complex diffuse lesions, ranging in severity from 70% to 90%. The doctor told me to go for treatment in 3 months, and at least 5 stents need to be implanted, and if I get all the stents, I may have to undergo bypass surgery.
I was horrified and repulsed by the need to put so many stents in my tiny heart. In addition, there were no symptoms of chest tightness and chest pain since then, so it has been delayed again and again until this year.
On April 18 of this year, I suddenly fainted and was still procrastinating. Lao Wu, an old colleague who is also a "terrier friend", knew the danger of this matter, and on May 6, he pushed me in front of Professor Zha Mingfan, the chief physician of the cardiology department of Nanjing First Hospital, who had been dispensing medicine for him.
After listening to my situation, Director Zha decided to perform a coronary angiography examination as soon as possible, and arranged hospitalization on the spot, and asked Chen Shaoliang, director of the Department of Cardiology and vice president of Nanjing First Hospital, to take care of him. Professor Chen Shaoliang is also the vice president of the cardiovascular branch of the Chinese Medical Doctor Association, and has been engaged in interventional diagnosis and treatment of coronary heart disease for a long time, and has rich experience and skilled skills in the interventional treatment of complex high-risk lesions. Director Zha said that Vice President Chen Shaoliang is a world-class cardiology expert, and the double pair kiss squeezed stent technology (DK-crush technology) that cardiology experts around the world are concerned about was first proposed by Professor Chen Shaoliang in 2004. In 2018, this technology was included in the new version of the Guidelines for Myocardial Revascularization published by the European Society of Cardiology.
Dean Chen scheduled my surgery for the morning of May 8th.
After lying on the operating table, the observation instrument should change the orientation above my body from time to time, and the display screen blocked my vision, in fact, I couldn't see any surgical scene, and I relied more on hearing during the whole process.
Dr. Li Xiaobo, the first assistant to President Chen, and Dr. Zhu Hao, the second assistant, carried out various preoperative preparations in an orderly manner, and applied local anesthesia to my right wrist with anesthetic. I couldn't see the operation of Dean Chen and his assistants, and I could faintly feel the catheter traveling upward in my veins. Dean Chen seemed to sense my nervousness through my hand, and turned his head from the side of the monitor to say to me, "Don't be nervous, let's take a look at the stent that was implanted on the right side of your heart last year." A few minutes later, I heard Dean Chen say, "It's not bad, it's in good condition." ”
My nervousness eased a little and eased a little.
Dean Chen said, "Let's look at the left. ”
At that time, I wanted to hear Dean Chen say "the situation is good" again.
However, no.
I only heard Dean Chen instructing his assistants to change positions from time to time. Hearing the whispered and brief conversation between Dean Chen and his assistant, which paragraph is 70% narrow, which paragraph is 80% to 90%, and where there is a mezzanine.
I also heard Dean Chen ask his assistant to deliver catheters and balloons from time to time. I heard the sound of assistants moving their shoes against the floor as they moved quickly in the operating room.
Finally, I saw Dean Chen poke his head out from the monitor screen and said to me: "Mr. Ma, there is a place that has been completely occluded, there is no blood flow through, and I will use a drug balloon to expand you for 60 seconds, you may be a little uncomfortable, you have to be patient." ”
Balloon dilation begins. I heard a female voice announcing every ten seconds, 10 seconds, 20 seconds, 30 seconds...... In fact, at the 20th second, I felt tightness in my chest, by the 40th second it was extremely uncomfortable, and after 50 seconds, I felt like I was almost holding my breath. I think this is probably how it feels before sudden death from a heart attack.
After 60 seconds, the balloon was removed, and there was a feeling of resurrection.
After a while, to another section of the vessel, the process is repeated again.
I wondered what kind of rot my veins must be.
I heard that Dean Chen asked his assistant to find a kind of bracket of what size. I asked, "Do you still want to put on a bracket?" Dean Chen said: "There is a dissection of a blood vessel, and it will be more dangerous if you don't use a stent. A few minutes later, I heard Dean Chen ask the assistant to adjust the position of the observation instrument and ask the assistant to inject some contrast agent. Then, I heard something that made me happy: "Great, the bracket just covers the mezzanine completely." ”
The assistant used a wheelchair to transport me out of the operating room. Director Zha Mingfan, who had been watching the operation in the observation room of the catheterization laboratory, also breathed a long sigh of relief, saying that your imaging results were very dangerous, and Dean Chen's superb skills not only did not allow you to implant five or six stents, but also avoided thoracotomy bypass. Director Zha reminded me to drink a small amount of boiled water several times after surgery to promote the excretion of contrast agent and prevent contrast nephropathy.
The operation lasted more than an hour, and 5 balloons were used to dilate, two of which were drug balloons, and only one stent was implanted. I'm finally free from my phobia of multiple stents and I'm in a good mood.
I was admitted to the CCU ward after surgery a year ago, and this time I was sent back to my original ward after coming out of the operating room, and I am in good spirits. I asked Dr. Wang Jianping, the inpatient bed-doctor why my heart vessels were blocked like this, and I didn't have angina pectoris symptoms for a year. Dr. Wang told me that you are slowly blocking, plus your blood sugar is high, you are not very sensitive to myocardial ischemia, and you have no symptoms for the time being, but once you have symptoms, it may be fatal. Severe stenosis without symptoms, he says, is actually more dangerous.
On May 11, when I was discharged from the hospital, Director Zha Mingfan repeatedly advised: "The "time bomb" on your body has been dismantled, it is not that you will have peace of mind in the future, take medicine on time after discharge, and have regular rechecks, LDL must meet the standard, and it must be below 1.4!" to prevent restenosis in the stent, at both ends of the stent, and other vessels. He said that in 2005, an 80-year-old man was implanted with multiple stents due to a very serious condition, and for nearly 20 years, LDL has been controlled at about 1.4, which has been very good, and last year the old man was 98 years old on the day of the diamond wedding, and the old man's lover also called to express his gratitude.
Director Cha said that there are many long-lived people who have had heart stents.
I found a recent news about Director Zha on my mobile phone: From March 28 to 31, 2024, at the 27th Interventional Cardiology Conference of the Chinese Medical Doctor Association and the 13th China Chest Pain Center Conference held in Guangzhou, when the National Health Commission People's Health Channel had a dialogue with experts in the cardiovascular field, Zha Mingfan, chief physician of the Department of Cardiology of Nanjing First Hospital, pointed out that the management of hyperlipidemia is very important, and prevention is more important than treatment. It is important to control the patient's LDL cholesterol below 1.4, which is his decades of clinical experience.
I had a coronary angiography one year after surgery, and the results showed that my condition was already very dangerous. Friendly reminder to people in the world who have similar situations to me, to seek medical treatment in time and get the best treatment in a timely manner, and not to be like me, either dragging or carrying it. Fortunately, I met nobles along the way to help me and saved my life several times.
There is still a long way to go in life, so take care.
May 12, 2024 Yunanjing
