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    The so-called division of the left and right atria and ventricles is just a rough division, just to give it a good name. From the perspective of the real heart structure, there is no complete line of symmetry between the left and right.

    Not only the internal structure of the heart hinders the doctor's scalpel, but also the coronary arteries, the important blood supply network on the surface of the heart, are also asymmetrically distributed.  Doctors need to avoid important blood supply vessels when cutting.

    When it comes to how many cuts to make, the fewer the better. Only one cut is best.  As the old saying goes, doctors need to be responsible for every cut they make. Only a stupid doctor would think about making more cuts.  The location of the incision must be planned based on the surgical site planned before surgery.  If it is just a simple mitral valve replacement, and the mitral valve is located on the left side, you can directly make a cut in the left atrium.  Today's patient needs surgery on both the mitral and tricuspid valves, one on the left and the other on the right. According to previous experience, the conventional surgical approach in this case is to start from the right atrium. Cut the right atrium, see  The interatrial septum is then cut upward and downward in the center of the fossa ovale, and the mitral valve can be seen.

    After these parts are incised, the doctor uses sutures to lift the surrounding edges to expose the surgical field inside.

    Preoperatively, the surgical team only considered the mitral and tricuspid valves but not myocardial hypertrophy. The surgical approach used did not consider the latter, and the exposed surgical field did not take into account the full view of the left ventricle.  No wonder Dr. Yu stood on tiptoe.  With such a surgical field of view, he couldn't see the complete inside of the left ventricle, so how could he determine myocardial hypertrophy.

    The surgeon has rich surgical experience and has accumulated a larger database of surgical anatomy diagrams than a resident like him. Maybe he can look at a corner of the picture and rely on his brain to judge other parts, just like putting together a jigsaw puzzle.

    As for classmate Xie, anyone who knows her will know that she is different.

    Xie¡¯s only embarrassment now is how to connect ordinary people¡¯s thinking with her special brain so that everyone can understand the picture in her mind.

    After receiving further questions from the surgeon, Xie Wanying continued to organize her words: "Please look at it from this angle, Teacher Du."

    Others listened to her words like the voice broadcast of the navigation system.

    "Here, at this point, at an angle of 35 degrees below the large chordae tendineae that were retained by the patient's original surgery, this muscle is relatively convex. The thickness of the bulge is not obvious, but the area is wide, and it just involves*  *Muscle and valve opening."

    This time, not only the surgeon can see clearly.  Doctor Yu didn't need to stand on his toes, tilted his angle of view, and almost exclaimed in his throat: he can see.  It turns out that it is not completely impossible to get a full view of the ventricle within a limited narrow field of view. You have to make full use of the viewing angle.

    How to open and close the mitral valve leaflets relies on two ovarian muscles, such as a mechanical opening and closing locking mechanism to pull the two leaflets.  The cardiac muscle is connected to the myocardium of the ventricle and relies on the rhythmic beating of the myocardium to generate power.  When a patient has a valve problem and needs to be replaced with an artificial valve, how to deal with the vaginal muscles is a technical issue.

    Based on the accumulated experience of previous people, the current mitral valve replacement surgery is very mature. Conventional surgery can preserve the subvalvular structure of the mitral valve, that is, the chordae tendineae.  The specific method is generally to trim the part of the original valve leaflet connected to the tendineae into a piece and retain the tendineae and tendineae.  (Remember the website address: www.hlnovel.com
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