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    Holding the precautions on the note, Xie Wanying continued to communicate with the teacher opposite: "Teacher Ye, please leave a longer length of the vena cava when trimming."

    ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Ye Chuanguang heard something and said, "What kind of magic are you planning to use? The child over there is between nine and ten years old, right?"

    Heart transplantation is divided into orthotopic heart transplantation and heterotopic heart transplantation.  Orthotopic heart transplantation is easy to understand. The patient's diseased heart is removed and a donor heart is placed in the original heart's place.  Heterotopic heart transplantation does not remove the diseased heart, but connects the donor heart to the original diseased heart to support and assist the diseased heart. It is equivalent to a purely biological heart assist device.

    Heterotopic heart transplant surgery is rarely done because there is no future.  Generally, when cardiomyopathy like Zhu Xing reaches the end stage, even installing a cardiac assist device for transition cannot completely solve the root cause of the disease.

    Heart transplantation basically revolves around orthotopic heart transplantation.  Orthotopic heart transplantation sounds simple. It only requires removing the patient's heart and replacing the patient's heart with the donor heart.  It¡¯s not simple at all to actually do.

    There are a total of eight blood vessels in and out of the heart that need to be connected.  The most difficult one is the pulmonary vein group of the left atrium. There are two upper and lower blood vessel ports of the right pulmonary vein group and two upper and lower blood vessel ports of the left pulmonary vein group on both sides of the posterior wall of the left atrium. You think it is complicated enough.

    Like the right atrium, it is not easy to connect the upper and lower vena cava anastomoses.

    ?? If the above-mentioned blood vessels are connected honestly, it is a comprehensive procedure called heart transplantation.  This kind of surgery is the most complex, time-consuming and labor-intensive, and requires many anastomotic sutures, which means that the chance of complications from anastomotic leakage is high.  The principle of surgery has always been that the simpler the steps, the better, and the fewer sutures, the better.

    In order to save operating time, protect myocardium and reduce postoperative complications, surgeons initially adopted opportunistic surgical methods to perform heart transplantation. Specifically, they did this: when removing the patient's heart, only the ventricle was cut off, leaving the recipient's heart transplanted.  The left and right atria, the donor atrium and the recipient atrium are directly anastomosed, directly avoiding the complex multiple anastomotic connections of the left atrium and right atrium.  It is referred to as the two-chamber method or the standard method for heart transplantation.

    In pediatrics, if the child is very young, especially if the blood vessels of newborns are too thin, it will be difficult for the doctor to use a magnifying glass to carefully suture multiple anastomosis ends. Of course, the two-room method is best.

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

    We know that the heart has a conduction system that allows the heart to beat rhythmically.  The highest pacemaker point of this conduction system is 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 intact, creating two sinoatrial nodes, which is equivalent to installing two engine control systems for the heart. Whose word does your heart want to beat? Do you want it?  Chaos, there will definitely be chaos.

    After seeing the shortcomings of this operation, subsequent surgeons improved this operation and came up with the following most commonly used double-caval method. In simple terms, this double-caval method refers to the upper and lower vena cava of the right atrium.  It matched.

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