Chapter 2299: with translation of chapter title

Xiba, Saint Paul Hospital Heart Treatment Center.

Duomingge·Baoluo Doctor personally retrieved various data and conducted a preoperative assessment.

Just like solving a math problem, left ventricular reduction surgery first needs to calculate, via clinical numerical values, the amount of heart muscle to be removed.

According to Laplace's law: T=2P×r, i. e., the larger the volume and internal diameter, the higher the fluid tension (P), the greater the container tension (T).

Batista, after observing a large number of animal heart specimens and human dilated cardiomyopathy heart specimens, drew a similar conclusion: M=4.18×R³, where M is left ventricular wall tension and R is left ventricular internal diameter.

Left ventricular enlargement leads to a disproportionate increase in ventricular wall tension and oxygen consumption, reducing ventricular function. He hypothesized that the function of all enlarged hearts improves after internal diameter reduction.

The purpose of left ventricular reduction surgery is to reduce the left ventricular diameter, thereby re-establishing a new relationship among left ventricular volume, tension, and diameter.

As research deepens, recent studies show that the Frank-Starling mechanism cannot be used to explain end-stage heart failure.

In end-stage cardiomyopathy, left ventricular enlargement may be a maladaptive compensation for myocardial damage, and left ventricular reduction surgery may affect this vicious cycle.

In end-stage cardiomyopathy, simply performing mitral valve reconstruction can improve cardiac function in some patients, and other contemporaneous surgeries such as coronary artery bypass grafting also aid left ventricular recovery.

After ventricular remodeling, the ventricle is no longer spherical, making ventricular contraction more coordinated and reducing cardiac torsion. Other possible influencing factors include changes in blood volume and peripheral blood vessel tension, as well as adjunctive drug therapy.

Theoretical research is just theoretical research; math problems still need to be done.

Because heart donors are scarce, the Saint Paul Hospital Heart Treatment Center in Xiba leads the world in research on left ventricular reduction surgery.

The annual number of surgeries also far exceeds that of other hospitals. Duomingge·Baoluo Doctor is outstanding among them; since Dr. Randas Batista pioneered left ventricular reduction surgery in 1996, up to now he has performed the most such surgeries.

After extensive and complex calculations and surgical simulations, Duomingge·Baoluo Doctor was astonished to discover that this patient's surgical complexity far exceeded imagination.

Left ventricular reduction surgery requires removing a large amount of heart muscle; in a sense, the amount of myocardial tissue excised can serve as an indirect indicator of the surgery's difficulty.

To date, the case with the most myocardial resection removed 302 g of heart muscle.

However, according to his own calculations, the patient before him needed to have at least about 330 g of heart muscle removed for the surgery to be considered successful.

After careful study, Duomingge·Baoluo Doctor's first thought was to abandon this surgery.

But after the patient's related personnel who were in contact with him subtly expressed that, if the surgery succeeded, they would donate to the Heart Treatment Center, he changed his mind.

Especially upon seeing the patient's son receive a check, Duomingge·Baoluo Doctor decided to give it a try.

The patient's condition was poor, having flown halfway around the globe by plane, with extremely severe heart failure symptoms. Even with the application of a left ventricular assist system, the condition continued to deteriorate inevitably.

On the third day, the critical care medicine team from Johns Hopkins was invited to Saint Paul, and Duomingge·Baoluo Doctor performed the surgery as the lead surgeon.

The surgery was extremely difficult, and only after 11 hours and 22 minutes was it barely completed.

Although the surgery was successful, Duomingge·Baoluo Doctor finally measured the excised left ventricle—and it turned out to be 343 g!

He personally increased the previous record by a full 41 g!

Know that every additional 10 g resected is a hurdle, and the surgical difficulty rises geometrically.

Because it indicates a more severe left ventricular hypertrophy; the patient's own condition is worse; and both surgical and perioperative risks are enormous.

But!

No matter what, he successfully completed the surgery.

Duomingge·Baoluo Doctor felt proud of this.

The patient was sent to the intensive care unit for postoperative treatment and nursing, carried out by the professional team of Johns Hopkins Hospital.

On the third day after surgery, Duomingge·Baoluo Doctor stood outside the transparent isolation ward, watching the values displayed on the monitor, and he was very satisfied.

This is the world's highest level of combination, whether it is the surgery or perioperative management, it is so. The best surgeons, the best critical care team, and the patient's mortality rate has greatly decreased.

"The patient looks like he will recover soon," said Duomingge·Baoluo Doctor's assistant happily.

"Hmm."

"Doctor, your left ventricular reduction surgery is now fully mature; you are truly the world's number one," the assistant said happily.

Duomingge·Baoluo Doctor believed that his assistant was speaking the truth.

Regarding the surgical data and case records, he is compiling them into a paper for publication. This paper is like a bomb that will shock the medical community, Duomingge thought inwardly.

"Doctor, it is estimated that within 20 years, the record for myocardial tissue excised by left ventricular reduction surgery will be held by you." His assistant continued, "This is your field; others simply cannot break into it!"

"Hahaha~" Duomingge·Baoluo Doctor laughed happily.

The previous record was held by his competitor, Nai·Amaraal. Metrics such as surgery time cannot prove anything; surgery is not a race, and being fast does not prove anything.

Moreover, the two of them complete roughly the same number of successful surgeries each year; Nai has consistently been ahead of Duomingge·Baoluo Doctor precisely because he once performed a surgery that removed 302 g of left ventricular myocardium.

This is a heavenly moat that separates Doctor Nai·Amaraal from other physicians performing the same type of surgery.

This time, Duomingge·Baoluo Doctor surpassed that record, and he increased it by a full 41 g!

Duomingge believes that this record could last 20 years, and this is still a conservative estimate. Without exaggeration, this record could possibly remain eternally enshrined on the pedestal.

And Nai... is no longer anything like the king of left ventricular reduction surgery; the victor's crown has already fallen upon his own head.

Now you know how formidable he is, right? Duomingge laughed happily. Leaving the ICU, he happened to run into Nai·Amaraal.

Duomingge·Baoluo Doctor strode past with his head held high, completely ignoring Nai's presence.

In the past, Nai treated him this way, and now he can finally look down on him! Duomingge was overjoyed.

"Doctor, I've started organizing the materials; should I send the paper to Willow Leaf Blade or..." Duomingge·Baoluo Doctor's assistant asked for his opinion.

"Willow Leaf Blade it is." Duomingge, in a particularly good mood, smiled and said, "That would make me more interested in new breakthroughs in surgery."

"This paper will surely change the views of those stubborn Americans regarding reduction surgery." Duomingge·Baoluo Doctor's assistant added, "343 g! That's an astonishing figure; I expect those Americans will again question the authenticity of our surgery."