Over the phone (4)
Trampling.
Team CPR staff were walking down the hallway.
Their lips were tightly closed, and their steps were full of restraint.
The first surgery performed without an instructor and performed solely by team CPR staff.
The meaning it gave was extraordinary.
So-called standing alone.
It may be a bit harsh for residents who have just entered the field of thoracic surgery, but the four people did not think so.
Standing alone is a prerequisite to becoming a great surgeon.
However, I decided that the time had come a little early.
“Dr. Choi.”
When we arrived at the operating room, an old man stood up.
This is Anna, the guardian of Gulliver, a patient about to undergo surgery.
She approached Choi Ki-seok and squeezed his hand.
“Please take care of him. In fact, we were finally trying to make our children independent and live our own lives. I bought a house nearby a few months ago. But I don’t have the confidence to live alone without my husband.”
“….”
“Please take care of him.”
Anna’s harsh words weighed on Choi Ki-seok’s shoulders.
“Don’t worry too much. The doctors here worked hard to save Gulliver’s life. “There will definitely be good results.”
“yes. “I believe it.”
Anna held the cross necklace in both hands and lowered her head.
After finishing the conversation with the guardian, the team CPR staff took a seat in front of the F rosette.
“I was fine until morning, but now that I’m here, I’m nervous all over again.”
“me too. “I think the biggest thing is that there is no one watching the surgery.”
“I don’t have any problem. “It will definitely succeed.”
Unlike Charles and Emma, who were nervous, Jeremy appeared resolute.
“Then shall we start the last briefing before we go in?”
“okay.”
Charles’ briefing continued.
The patient’s name is Gulliver.
He is 60 years old and was diagnosed with mitral valve stenosis through a test performed at the MHC outpatient clinic.
Currently, the patient’s mitral valve is greatly thickened, calcification is progressing, and even a blood clot was discovered.
“What happened to the echocardiogram taken before surgery?”
“Let’s check it out together.”
At Charles’ suggestion, the team members gathered in front of the monitor.
“The left ventricle is no different from before, but the right ventricle is a little worse. “AT (acceleration rate of blood flow), PV (maximum rate of blood flow), and DR (deceleration rate of blood flow) have decreased overall.”
“That means…”
Emma’s eyes turned to Choi Ki-seok, and Choi Ki-seok nodded slightly.
“I think the tricuspid valve will need to be repaired during the surgery. Otherwise, the patient would have to enter the operating room one more time.”
“Isn’t our team really blessed?”
Charles smiled mischievously.
“You were in charge of a patient with a serious illness at an advanced age, and you also had to undergo additional surgery. The level of difficulty compared to other team surgeries is heaven and earth. “Who is this all because of?”
“I do not know. Look at me…”
Choi Ki-seok fell silent as his colleagues all gave him stares.
It felt like a fight would break out if I said even one word here.
“Enough of the joke. If this continues, I will run away before Mr. Choi’s surgery.”
“is it so. “He’s my doctor, so I have to take care of him.”
“Let’s all do our best and do well. Shall we fight and go in?”
Four people joined hands in response to Jeremy’s suggestion.
Hands soaring to the ceiling with a loud cheer.
Their eyes showed determination to complete the surgery safely.
Buck. Buck. Buck. Buck.
The staff members who thoroughly rubbed their hands and wrists with the povidone brush entered the rosette all at once.
“Are you Gulliver, a 60-year-old patient undergoing mitral valve replacement surgery?”
“yes. you’re right.”
Gulliver answered with a trembling voice.
“You don’t need to be too nervous. “After a good night’s sleep, everything will be over.”
“You’re not going to wake up in the afterlife, are you?”
“of course. “You and your wife should live comfortably in the new mansion.”
Gulliver showed a faint smile at Choi Ki-seok’s words.
“I will only trust you, teacher.”
“yes. “I will never disappoint that trust.”
While Choi Ki-seok was taking a time-out, the rest of the staff were busy.
Patient monitoring and echocardiography connectivity.
Preparation of surgical tools and general anesthesia continued without hesitation.
‘It’s full today too.’
Choi Ki-seok looked up at the observation room and muttered to himself.
Teachers Song Myeong-jin, Yashada, Kwon Il-soo, Katarina, and even Benson.
The main players of MHC Thoracic Surgery gathered together for a long time. However, rather than being intimidated, I became motivated to make the surgery more successful.
Shouldn’t there be a live demonstration someday?
You shouldn’t be nervous about this much audience.
“General anesthesia is over.”
After reporting to the anesthesiologist, Ki-Seok Choi took the place of surgeon.
Today’s surgeon is Choi Ki-seok. First assistant is Emma. Second assistant is Charles. Third assistant is Jeremy.
“….”
“….”
The tense silence continued.
Soon, the team members exchanged glances and nodded at the same time.
This is a signal that all preparations are complete.
“From now on, we will begin mitral valve replacement and tricuspid valvuloplasty for mitral regurgitation.”
Following Choi Ki-seok’s words, Charles disinfected the patient’s chest and covered it with a cloth.
“Meth.”
Choi Ki-seok cut down from the patient’s neck to the solar plexus with a scalpel. So Charles and Jeremy inserted a retractor into the incision and fixed it.
In that state, when the retractor was opened to the left and right, the incision was expanded and the surgical site was revealed.
thud. thud. thud. thud.
When I lifted the lung slightly to the side, I could see the beating heart.
This is the battlefield of thoracic surgery.
“I blocked the aorta. “Please inject cardioplegia.”
Under Emma’s instructions, Jeremy injected cardioplegia and Charles inserted a cannula into the femoral artery and right atrium. The process of connecting the heart-lung machine was smooth and smooth.
Drurr.
The heart-lung machine started working with a mechanical sound.
My heart, which was showing its presence by beating hard, suddenly fell asleep.
“Now, shall we begin? “Meth.”
Choi Ki-seok held the scalpel handed to him by the disinfection nurse.
The scalpel feels particularly light today.
At this moment, I felt like I could save any patient.
Suuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu
A sharp blade split the left atrium.
To check the mitral valve, the left atrium must be opened.
“Hmm… It’s not that easy?”
“It will take some time.”
Charles and Emma said a word after checking the exposed left atrium.
Mitral valve between the left atrium and left ventricle.
The degree of stenosis of the valve was even worse than the test results, and blood clots were attached to various parts of the valve like leeches.
“I guess we need to remove the blood clot first?”
“I’ll administer a thrombolytic agent.”
Emma filled a syringe with thrombolytic medication and injected it around the mitral valve.
As the dissolving agent spread around the valve, the hardened blood clots were loosened.
Choi Ki-seok sucked out the blood clots with an aspirator and carefully scraped off the blood clots that were not removed with a scraper.
The pre-operative treatment alone took 30 minutes.
“I will continue with the replacement surgery. Charles and Jeremy work on sutures for valve replacement.”
“okay.”
After completing the instructions, Ki-Seok Choi proceeded to remove the leaflets of the mitral valve.
The valve leaflet can be seen as the door portion of the valve, but in the patient’s case, this door leaf was abnormally narrow.
As a result, when blood flow was not smooth, blood that had gone down to the left ventricle sometimes flowed back into the left atrium.
Ki-Seok Choi removed the front part of the valve leaflet with Emma’s help.
Hand movements have become more careful than ever.
If the resection is not clean, problems may arise during the process of inserting the mechanical valve.
It is an added bonus that the surgery time becomes longer during the process of reconstructing the valve leaflets.
‘This is worth it.’
As he was in the process of undergoing abstinence, his eyes became as sharp as an eagle.
The hand movements, which were slow at first, gradually gained speed.
Responsibility to save the patient.
The burden of having MHC staff watching over him was suddenly erased from his mind.
Now he was a church itself.
Empty!
The valve leaflet fell onto the curved plate and made a clear sound.
After a struggle of nearly 20 minutes, the thickened valve leaflet was removed.
As the valve door disappeared, the space between the left atrium and left ventricle became completely empty.
“Emma. “You did well and you did well, but please pay extra attention from now on.”
“Sure.”
Emma nodded slightly.
“Charles, are you ready for the suture?”
“no problem.”
“Work to fix the valve annulus begins.”
Ki-Seok Choi fixed the sutures prepared by Charles around the valve annulus.
If the valve leaflets are the door leaf, the valve annulus is the door frame.
Securely fixing this door frame with sutures and then connecting it to the mechanical valve could be seen as the core process of mitral valve replacement surgery.
Geek. click. Geek. click.
The only sounds of the needle holder being tightened and the suture being cut were heard in the deadly quiet rosette.
The number of sutures to be fixed to the valve annulus is twenty.
Choi Ki-seok handled this like roasting beans in lightning. Even if a fellow sutured the wound, it would have taken over an hour, but it was shortened to a whopping 20 minutes.
The hard work in the training room and the skills I have accumulated over the years.
These two were demonstrating incredible synergy.
“Is it okay for a resident to be like that?”
Katarina, who was watching the surgery, clicked her tongue.
In addition, her eyes never left Choi Ki-seok.
I knew for a long time that he was unusual, but I had no idea he would be this active.
The most impressive scene is of course the suturing.
Ki-Seok Choi showed off his spirit by finishing one knot every minute.
“Katarina. Do you know what Mr. Choi’s nickname was when he was interning in Korea?”
Song Myeong-jin smiled and continued.
“well.”
“I was a super intern. Now that I have become a resident, I think I have surpassed even that.”
“You’ve been flying around since you were an intern.”
“If you’re aiming for a triple board, you have to do something like this.”
Yasada, who had been silent, joined the conversation.
As the breathless observation continued, Benson frowned and his legs trembled.
‘I can’t stand it because my eyes are so cold.’
I didn’t like the picture of the staff praising Choi Ki-seok.
No matter how fast I fly, I’m still in my first year as a resident.
If you stick with the surgery that is not suitable for you like now, your wings will be broken sooner or later.
“Why didn’t Benson say anything earlier?”
“Mr. Choi was doing so well that I didn’t have anything to say.”
“If you’re going to spy, you have to do it properly. “That way, the vice hospital director will like it.”
Benson remained silent in response to Yasada’s point.
After friction over the pulmonary artery stenosis incident, Yasada completely turned his back on her.
Now the only person he could rely on was Deputy Hospital Director Parker.
‘I like it like a child. The surgery isn’t over yet.’
Benson shot a cursing look at Choi Ki-seok, who was undergoing surgery.
“Mechanical valve.”
At Choi Ki-seok’s words, the disinfection nurse handed over a mechanical valve.
If the suture fixed to the valve annulus is connected to the mechanical valve, today’s surgery will be over one hurdle.
Choi Ki-seok told himself not to lose concentration until the end.
“Emma. Please fix the mechanical valve.”
“yes.”
But it is that moment.
Bleep. Bleep.
The moment I was about to take the first step in connecting the mechanical valve, the patient monitoring device made an ominous electronic sound.
The staff’s eyes are focused on the patient monitoring device.
What on earth is wrong?
