Surgery Godfather
Chapter 926 - 803 Fontan Surgery_2

Chapter 926: Chapter 803 Fontan Surgery_2

"I was just about to book," said Director Chen as he searched for flights on his phone.

Academician Wang was extremely pleased with the trip, feeling a sense of fulfillment.

At that moment, Xia Shu took a heart model out of his bag, placed it on the coffee table, and studied it. He examined the model pondering over the surgeries he had seen that day, not letting even this small amount of time go to waste.

"Do you carry a model with you?" Academician Wang asked with curiosity.

Xia Shu said, "This model is something I always carry with me, no matter where I go."

"Let me see, your model is quite exquisite," he commented.

Academician Wang picked up the model to fiddle with it and felt a flood of emotions as he looked at the heart model.

The heart—as the pump that powers human life—had been the field where Academician Wang had been working for more than forty years, still striving in his research.

A heart, four chambers, connected to five blood vessels.

The left atrium connects to the pulmonary vein; the left ventricle connects to the aorta; the right atrium connects to the superior and inferior vena cavae; the right ventricle connects to the pulmonary artery.

This pump and conduit system circulates blood throughout the body, then recovers it, over and over again, until the moment of death.

The pulmonary artery delivers blood to the lungs, the pulmonary vein recollects the blood from the lungs to the heart, the aorta pumps the heart’s blood to the entire body, the superior vena cava recollects the blood from the body above the heart back to the heart, and the inferior vena cava does the same for the blood below the plane of the heart.

The left and right sides of the heart are isolated from one another, completely separated by the interventricular septum and the interatrial septum.

Between the left atrium and ventricle, separation and connection occur intermittently; this is accomplished by the one-way open mitral valve—which allows the blood to flow unidirectionally from the atrium to the ventricle without backflow.

Similarly, the valve between the right atrium and ventricle—the tricuspid valve—is alike, and the roots of the aorta and pulmonary artery have similar valves to perform the same one-way valve function.

The whole heart constitutes the systemic and pulmonary circulation loops.

Oxygen-rich blood in the left ventricle is sent out through the aorta with each heartbeat, reaching all parts of the body, then going through various capillaries, entering various veins and finally being collected by the superior and inferior vena cavae, returning to the right atrium.

Due to the consumption of oxygen by cells and tissues all over the body, the blood that flows back to the right atrium contains very little oxygen.

What to do? It needs to be re-oxygenated, a task accomplished by the pulmonary circulation.

In the right atrium, with little oxygen content, the one-way open tricuspid valve opens, the blood enters the right ventricle and is pumped into the pulmonary artery with each heartbeat. It then undergoes gas exchange in the lungs, acquires oxygen, becomes oxygen-rich blood again, and is returned to the left atrium through the pulmonary veins.

The blood goes from the left atrium through the one-way open valve into the left ventricle, and the next cycle begins.

Of course, when the heart beats, all of these tasks are carried out simultaneously.

Academician Wang held the heart for a long time, reminiscing about these basic principles. He had spent his entire life devoted to this field. After studying the heart model, he closed his eyes to rest, seemingly deep in thought, looking worried.

Xia Shu could not ask for the model back as it was taken from him.

Professors Cao, Xin, and Chen watched Academician Wang’s expression, unsure of the meaning behind his actions and could only sit beside him.

Studying the model, frowning, studying the model again, heaving a few sighs—this repeated for a full half-hour.

"Yue Liang!"

Academician Wang called Professor Chen Yueliang over, and from his expression, he seemed to have something important to say.

"Come sit! All of you, come sit over here."

Academician Wang asked Professor Cao and Professor Xin to come over and sit down.

"I’d like to say a few words," Academician Wang said.

Everyone kept quiet, not speaking, and Academician Wang began with a sigh, "Just now, seeing this model really moved me, because when I first started working, I too carried a heart model in my bag. I’ve been practicing medicine for over forty years, saved countless lives, and inevitably have some regrets. When we started the Fontan surgery, due to lack of experience, some infants on the operating table didn’t make it to the second stage, some didn’t survive to the third stage, and those who did make it past the third stage, after living a few more years, still passed away."

Director Xin wasn’t sure what deep meaning Academician Wang had in bringing this up at the moment. Which surgeon pioneering in innovative work didn’t have regrets?

"Teacher, now our post-Fontan surgery survival rates and longevity are the highest in Asia, and this is all thanks to your hard work back then."

Academician Wang waved his hand dismissively, "It’s nothing. What I wanted to say is, Weicong, do you remember a patient of mine named Song Hanhui?"

"I remember, Teacher. You operated on him, and now he must be in his twenties," Director Xin recalled the patient.

Academician Wang said in a somber voice, "He came back for a check-up recently, and the kid is not doing well. He probably won’t last much longer. If the surgery had been more exquisite back then, it wouldn’t have come to this."

"Technology always progresses slowly. Besides, Fontan surgery is meant to be palliative, not curative. It’s not your fault."

Academician Wang waved his hand again, "At the time, if the capability wasn’t there, it simply wasn’t there. Those of us in medicine must always be honest with reality."

Everyone still didn’t understand Academician Wang’s point and waited quietly for him to continue.

"My point is, I’ve always been ruminating on the fact that, as a palliative surgery, Fontan allows patients to experience symptom relief after the third stage, achieving the goals of improved quality of life and extended lifespan. However, it is just palliation, not radical treatment. I’ve been mulling over whether, after the palliative surgery, these patients could undergo another operation in adulthood—that is, a fourth surgery, total heart reversal, and reconstruction!"

This was an extremely bold idea; Academician Wang had always had it on his mind but had never turned it into reality because such a surgery was incredibly difficult, beyond human capability, as he reckoned.

Academician Wang spent most of his medical career researching congenital heart disease, accumulating extensive experience in the field and was among the first in the country to perform Fontan surgery, saving countless lives.

"I’ve always had this idea myself, but my ability is limited. Today, after seeing Professor Yang’s surgery, I suddenly had a thought. We could refer this patient to Sanbo Hospital or invite Professor Yang to come to Fuwai with us to study this case together and see if we can achieve a total heart reversal and reconstruction!"

This would be an extraordinarily difficult surgery. If they were to proceed, the complexity of this procedure could be several times more challenging than Mai Zijing’s, potentially ranking as the most difficult heart surgery in the world today.

"There’s no better solution, and I think we should give it a try," agreed Professor Xin.

Then Professor Chen also voiced his agreement.

"Yue Liang, just recently you had an infant case scheduled for Fontan surgery, but due to poorly developed major vessels and fragile blood vessels, the surgical difficulty increased. You were prepared to have me as the chief surgeon. I think we should let Professor Yang perform the surgery instead, and we can take the opportunity to learn."

The two cases Academician Wang mentioned were regrets in his medical career; in one case, the lack of refined skills and surgery quality at the time now left the patient in dire straits.

And in the other case, an earlier failure of Fontan surgery with similar vascular underdevelopment now presented the same kind of case again.

"I’ll go contact the patient’s family," Director Chen took note.

Academician Wang thought for a moment and then said, "Contact the family about the infant, but I’ll personally contact Song Hanhui."

With the matter settled, Academician Wang felt much lighter. They rested for a while at the Sanbo Hotel before hurrying to the airport.

When Yang Ping finished the surgery, he learned from Professor Cao that Academician Wang, Professor Xin, and Director Chen had already left, as they had a great deal of work to do and couldn’t stay long.

Professor Cao mentioned Xia Shu to Yang Ping, expressing the hope that Xia Shu could stay in the general surgery department and learn from Yang Ping for a few years.

A doctorate from Xiehe, with an eight-year program—nothing could be better. Yang Ping had a penchant for such proactively learning doctors.

Yang Ping agreed immediately, suggesting that Xia Shu come in for an interview and, if there were no issues, be directly hired.

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