I, Tomoya Aki, am not a bootlicker

"The right atrium and ventricle are enlarged, the periventricular septum is defective, and there seems to be a valve-like structure near the anterior leaflet that connects to the septal side of the left ventricular outflow tract... There are also small tendon tractions under the valve..."

After reading the complete examination report, Aki Tomoya confirmed that the condition of the child transferred from other hospitals to their hospital was somewhat complicated.

There is a large cleft in the anterior leaflet of the mitral valve. The anterior leaflet of the mitral valve has a large cleft, which is suspected to be a mitral valve. Color Doppler shows a moderate left-to-right shunt signal at the ventricular septal defect.

"Mitral valve attachment, anterior mitral leaflet cleft and ventricular septal defect!"

It is not just a ventricular septal defect, but also accompanied by AMV and anterior mitral leaflet cleft.

"Doctor Sagara, do the child's parents know?"

"I'll explain the condition later. You can see it very clearly. The problem is a bit serious. Please explain it later."

"Shall I come?"

"Use what you just said, polish it up, and explain it to them."

Dr. Sagara patted his shoulder, as if entrusting him with an important responsibility.

It was just a description of the condition, but it was made as if he was asked to perform the surgery.

Sagara is the supervising doctor, so whatever he says is what matters.

They can see what is happening inside the child's body, but parents are not doctors and do not need them to explain it properly.

Chapter 441 Mitral valve attachment, anterior mitral valve cleft, and ventricular septal defect

The patient is a one-year-old girl who was previously examined at a nearby hospital for jaundice. Auscultation revealed a heart murmur and an echocardiogram revealed congenital heart disease and ventricular septal defect. A follow-up examination was recommended.

So I came to this better hospital for treatment and underwent a more detailed examination.

Dr. Sagara had already seen the problem, and then used it to test Aki Tomoya, and his answer was the same as his own judgment.

Next, he planned to ask Tomoya Aki to explain the condition.

Symmetry, there is nothing for An Yilun to refuse. The doctor does not just take a look, examine, and then treat the patient. The doctor also needs to let the patient and his relatives know the detailed condition of the disease. Only with their informed consent can the follow-up treatment be carried out.

When Dr. Sagara took the girl to meet her parents, Akitomo saw that the couple looked very nervous and seemed very worried about their child's condition.

"Doctor, how's it going?"

"Please don't worry, calm down first, we will explain it later."

Dr. Sagara comforted the girl's mother, then signaled with his eyes that Tomoya Aki should come up quickly.

After receiving his instructions, An Yilun also put the examination report on the table, and at the same time called up the echocardiogram, and said directly: "The child has mitral valve attachment, anterior mitral valve cleft and ventricular septal defect."

Put it this way, it's clear they don't understand.

But precisely because they can't understand it and it's so long, it easily increases their worries.

"The child was not fully developed during the embryonic period, resulting in a ventricular septum defect, abnormal communication, and left-to-right shunt at the ventricular level. This is a congenital condition and may seriously affect cardiopulmonary function."

Aki Tomoya first pointed out the damaged area and then continued speaking.

"There is a large tear in the anterior leaflet of the mitral valve, and the leaflet cannot close. There is a valve-like structure near the edge of the anterior leaflet that connects to the septal side of the left ventricular outflow tract, and the thin tendon chordae under the leaflet are pulled."

"The normal anterior leaflet of the mitral valve is formed by the fusion of the left and posterior tubercles of the anterior endocardial cushion. If the apposition is poor, a gap is likely to remain in the anterior leaflet of the mitral valve. The remaining tissue in the gap forms the mitral valve accessory tissue."

"That is to say, due to congenital malformation, the anterior leaflet of the mitral valve splits, and then an accessory valve is formed, which leads to regurgitation and left ventricular outflow tract obstruction. In severe cases, symptoms of heart failure occur in infancy and other symptoms may also occur, such as tetralogy of Fallot and transposition of the great vessels."

After listening to what Tomoya Aki said, even though they only had a vague understanding, it was enough to make them start to worry about their children's future.

They subconsciously turned their eyes to Dr. Sagara and Tomoya Aki in front of them for help.

"But fortunately, although there is mild to moderate regurgitation, the mitral valve appendage has not yet caused left ventricular outflow tract obstruction. In this regard, the two children are still very lucky."

At this time, Tomoya Aki also told good news.

The examination showed that there was a mild reflux reaction, but there was no left ventricular outflow tract obstruction.

In this respect, the child is still very lucky.

However, such good news could not make the couple optimistic all of a sudden.

"Is surgery necessary? The child is so young and the condition is so serious. Will he really be OK after the surgery?"

The girl's father asked worriedly, his eyes already a little panicked.

It is not just a ventricular septal defect phenomenon, but also accompanied by two other concurrent symptoms.

This is undoubtedly extremely bad news for them.

The only thing we can be thankful for is that the situation has not gotten worse, such as the left ventricular outflow tract obstruction that Tomoya Aki just mentioned.

Generally speaking, once the AMV tissue, also known as the mitral valve appendage, is formed, it can easily cause left ventricular outflow tract obstruction. This time, the mitral valve appendage did not cause left ventricular outflow tract obstruction, which is rare.

"Surgery is necessary. We will carefully study the specific surgical plan. After this period of time, the child will be observed in the hospital. We will come up with a plan as soon as possible."

This time it was Doctor Sagara who spoke.

Surgery was necessary, and the child was a one-year-old girl.

The specific methods of performing the surgery must be studied in great detail and discussed with experienced doctors in the department before they can be finalized.

"Please, doctors, please save our daughter!"

……

After explaining the child's condition to the parents, Sagara took Aki Tomoya back to the department.

"Now there's something to do."

"It hasn't caused left ventricular outflow tract obstruction, the child's growth and development haven't been significantly delayed, and there's no obvious shortness of breath or cyanosis. That's good news, right?"

The situation is certainly not very good, but it is not too bad either, and there are some things to be thankful for.

"But it's not going to get much better. I have to have surgery as soon as possible."

Dr. Sagara shook his head slightly, seeming to find the situation a bit tricky.

"If you were the surgeon, Dr. Sagara, what would you do?"

At this time, Aki Tomoya asked again.

He really wanted to know what Dr. Sagara, the attending physician for this child with a complicated condition, was thinking.

"What do you think?"

At this moment, Dr. Sagara asked Aki Tomoya a question in return, as if he also wanted to hear his thoughts.

Aki Tomoya was slightly stunned, then thought about it for a few minutes, and finally said seriously: "Ventricular septal defect repair, mitral valve resection and mitral and tricuspid valvuloplasty, all three operations were done at once."

"… Indeed, for a one-year-old child, if all three surgeries can be completed at once, it will reduce her burden to a minimum. However, the difficulty of the surgery and postoperative care must be strictly controlled."

Three different operations were performed at one time, which was indeed suitable for this patient.

However, the difficulty of the operation has also increased accordingly. It depends on who is performing the surgery, and postoperative care cannot be sloppy at all.

This is a big project and also a difficult problem.

"Doctor Sagara will be the lead surgeon, can I be your assistant?"

"You want to go into the operating room before we're even sure whether this is the right thing to do? And if this is the case, will I have to be the lead surgeon? Maybe I'll be the assistant. This possibility is still very high."

Dr. Sagara looked at Tomoya Aki with some helplessness, and at the same time, there was some surprise in his eyes.

"But you really don't miss any chance. Unfortunately, I can't decide on this matter. Even if I help you, it may not succeed."

Dr. Sagara sighed.

However, Tomoya Aki was not disappointed, but felt that Dr. Sagara seemed to be trying to fight for him.

Since I can’t perform the surgery now, I can be an assistant!

Chapter 442 Reducing Risk

"Mitral valve attachment, anterior mitral valve cleft and ventricular septal septum... Show me this. Do you want me to be the surgeon? My surgery schedule is full..."

Sasaki Ichiru looked at the medical records that Sagara gave him, his face looking somewhat embarrassed.

His surgery schedule is already full, so if Sagara wants him to be the lead surgeon, it won't be easy.

"Dr. Sasaki, I haven't even started talking yet, would you like me to finish?"

"You speak."

"I just want to ask you, if it were Dr. Sasaki, how would you consider the surgical plan?"

"Tell me what you think first."

Sasaki Ichiru didn't rush to answer Sagara's question, but instead asked about his thoughts.

"Ventricular septal defect repair, mitral valve resection and mitral and tricuspid valvuloplasty, three operations done at once!"

Sagara directly quoted Tomoya Aki's original words.

After hearing the conversation of Dr. Sagara not far away, Akitomo couldn't help but look over there.

Tomoya Aki finally understood why Dr. Sagara had said before that he would not be the surgeon. It seemed that Dr. Sagara was planning to have someone more confident perform the surgery.

"Three operations performed in one go. A very good case, isn't it, Dr. Sasaki?"

Dr. Sagara looked seriously into Sasaki Ichiru's eyes.

The latter was silent for three or four seconds, and then replied calmly: "If you have any ideas for surgery, please leave them for the preoperative seminar."

"But if you, Dr. Sasaki, do it, the risk will be minimized and it will be easier to pass, right?"

"Doctor Sagara..."

Sasaki Ichiru's eyes were quite helpless.

He still looked embarrassed in the face of Dr. Sagara's request.

It’s not that he doesn’t want to help, but his surgery schedule is indeed full, including some VIPs, who are given priority.

"But it would be best if this patient is handed over to you, Dr. Sasaki. You are the most skilled person in our cardiac surgery department besides the director of the Department of Physics."

Dr. Sagara had a look of admiration on his face, and in order to get Sasaki Ichiru's help, he decided to use everything he could and say.

But even so, it doesn't mean that Sasaki will agree as soon as he enters.

There are other things to consider as well.

"If Dr. Sasaki takes over, the operation can be performed next week. I think everything will go smoothly. You are not only the star of our cardiac surgery department, but also the hope of the patients!"

"That's enough, Dr. Sagara, stop talking, I'm getting goosebumps!"

Sasaki looked at Dr. Sagara with a confused look.

He really admired the other party for being able to say such words. Such words of praise really sounded good.

But when Sasaki first came here, he felt a little uncomfortable.

At the same time, Sasaki Ichiru also understood Sagara's feelings.

However, he also had a lot to consider.

To put it bluntly, half of the work in cardiac surgery falls on him. He is really busy and at the same time he is directly responsible for most of the VIPs.

VIP is very important for a private hospital, and this is also true in university hospitals.

Some people are just born to rank ahead of others.

Even if we don't talk about this, his surgery schedule is actually very full and many people are waiting for him to operate on them.

"Will you let me think about it?"

Sasaki Ichiru did not give Sagara a direct answer, but said he would think about it.

Although he did not agree on the spot, this gave Sagara hope.

It's always better to consider it than to say no outright.

"Dr. Sasaki, please consider this carefully."

"Okay, I'll give you an answer as soon as possible."

Sasaki nodded.

After getting rid of Sagara, he sighed again.

Looking at the patient's medical records left by Sagara, Sasaki Ichiru gradually fell into thought.