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Chapter 2158: ?2158?Clear
Chapter 2158: ?2158?Clear
?? Chapter 2158 [2158] Clearly
??Kukcheok Operating Room
She was named and put on a surgical gown and stood beside the operating table. Xie Wanying helped the teacher to observe the surgical field of vision again, verifying the three-dimensional picture that appeared in her brain, and pointed out: "Mr. Du, there are several types of cardiac hypertrophy. This patient has deep central hypertrophy. ."
??Myocardial hypertrophy, also known as hypertrophic cardiomyopathy, is divided into three types. No obstruction and occult obstruction can not be ruled out reversible, are not within the indications of surgery, so myocardial hypertrophy does not necessarily require surgery. Among them, only the obstructive type requires surgery.
?? Obstructive myocardial hypertrophy, in which the left ventricular outflow tract is blocked. Doctors used to call this type sub-aortic stenosis. Because the previous doctors opened the hearts of such patients and found that the abnormal hypertrophy of the heart muscle was mainly located under the aortic valve.
?? Under the aortic valve is the aortic root, which is connected to the left ventricle, and the area is relatively wide. If there is myocardial hypertrophy in this place, it is impossible to say the same thing. The types Xie mentioned refer to the anatomical classification of the lesion structure, not the above classification.
??Through surgery and anatomy, doctors roughly define five types according to the location of cardiac hypertrophy. The simplest one is the hypertrophy of the muscle under the aortic valve found at the beginning, and other types of myocardial hypertrophy are deep and troublesome.
??Some hypertrophy is a whole piece of ventricular septal muscle hypertrophy, and the hypertrophy extends across the left ventricle side in depth. Some aortic valve is not hypertrophic at all, and the hypertrophic place reaches the apex of the heart, completely subverting the definition and name of the disease by doctors at the beginning, which is why the original name has become history. Regardless of the location of the hypertrophy, these hypertrophies compress the volume of the normal left ventricle, creating an obstacle to healthy left ventricular hemodynamics. The doctor will definitely need to perform surgery on it.
?? The point of contention has returned to the original place again: Does the cardiac hypertrophy of the patient in front of him conform to what Xie said, one of the pathological structures of obstructive cardiac hypertrophy? Or is it because the preoperative examination report failed to clearly point out such problems, and it was judged as a reversible occult obstruction, so that the surgeon did not need to consider this aspect of surgery before surgery?
??Which result is correct?
?? If it wasn't for the problem of the mitral valve orifice, no one would have considered this at all. Sometimes when there is a problem somewhere, we find the crux of the problem and go to another problem.
?? "Can you explain again, is the entire interventricular septum hypertrophy?" Du Yeqing continued to confirm what she said.
?? "Is that so?" Doctor Yu, the assistant on stage, was trying to stretch his neck on tiptoe, trying to get a clearer view of the internal structure of the heart in the surgical field.
?? Open heart valve surgery, the valve is located inside the heart, the doctor must see that the heart must be cut open for the operation. This must not be cut randomly. The doctor cannot say that in order to make it easier to see and operate, the patient's heart is completely opened and cut.
It is even more impossible to say that one knife can cut out the whole picture of the patient's heart, because the heart is not an apple or a pear, it has several cavities, and these cavities and the walls separating the cavities are all asymmetrical. Asymmetrical, asymmetrical in volume, with no point of symmetry.
?? (end of this chapter)