When the Doctor Uses A Hack
Chapter 1076 - 1079: Marfan Syndrome! (Subscribe please)

Xu Ziming heard that a patient with aortic dissection had arrived and personally rushed to the emergency department.

After arriving, he saw Chen Cang and directly asked, "Teacher Chen, what happened?"

Xu Ziming had always respected Chen Cang; without him, how would he have known about mitral valve replacement during an uninterrupted heartbeat?

That would have been impossible!

The surgery without stopping the heartbeat is now increasingly sought after, and he and Wang Tong from Xiehe are the two benchmarks in this field.

But they are very clear that all this came from Chen Cang.

After hearing about the emergency department's consultation, Xu Ziming immediately stood up and rushed over.

Aortic angiography is done by injecting a contrast agent and then visualizing it under CT, where the location of the aortic dissection can be clearly seen.

Aortic dissection is neither a true aneurysm nor a false aneurysm, but rather due to various reasons leading to damage between the arterial inner lining and the middle layer, with blood flowing along the torn inner lining, forming a hematoma in the middle layer!

And it splits the aortic wall into two layers, with the dissected part gradually extending and expanding towards the proximal and distal ends of the aorta under the impact of blood flow, forming a separation and expansion of the middle layer within different ranges, known as aortic dissection. Some also prefer to call it aortic layer separation.

Xu Ziming hurriedly came out holding imaging films, his face visibly solemn.

Seeing this, Chen Cang quickly asked, "What's going on?"

Xu Ziming couldn't help but say, "The situation is a bit special!"

His words made Chen Cang's heart miss a beat: "In the ascending aorta?"

Xu Ziming nodded!

At that time, Chen Cang's participation in the cardiovascular surgery skills competition mainly involved anastomosis of the thoracic great vessels.

Among the thoracic great vessel anastomoses, the most technically difficult and dangerous is the one involving the ascending aorta.

Now that the aortic dissection has occurred in the ascending aorta, this was obviously not good news!

Chen Cang hurriedly took the films for a careful look and immediately saw the location of the aortic dissection!

Moreover, it was clear that the start of the aortic wall dissection originated from the root of the ascending aorta, the inner lining's tear starting from the anterior wall of the proximal ascending aorta, extending to the descending aorta!

After seeing this, Chen Cang couldn't help but ponder over the situation... it was indeed complicated.

Because it had already involved dissection of the arch artery branches, as well as aortic valve insufficiency.

Looking at the films, the three of them fell silent.

Ma Yuehui said directly, "Let's go back to emergency first, and figure out a plan there!" "There is still one issue that needs clarification; what exactly is causing the patient's condition?"

During their conversation, they wheeled the patient into emergency, and at this moment, the test results were also coming out!

The attending physician had just finished collecting the patient's medical history from the family.

Seeing Chen Cang and the others return, they hurried over.

"Doctor Chen, we communicated with the family, and here's the medical history: the patient has a clean past medical examination, no trauma or surgery history, no hypertension, diabetes... the patient's parents have not found any familial hereditary diseases either!"

The attending physician's words startled Xu Ziming and the others!

Then what was the cause?

Although the etiology of aortic dissection has not been clearly defined to date, there must be some precipitating factors, right?

At that moment, Chen Cang suddenly thought of something and turned to enter the resuscitation room.

After entering, Chen Cang lifted the patient's hands to take a closer look!

Tian Zhengkai is a basketball star, tall with long arms and large hands; Chen Cang also suddenly remembered such a thing.

He saw that the fingers on both hands were very long!

Chen Cang carefully compared and found that his hands were about 25cm long, with a height of 220cm... the ratio of hand length to height is >11%!

Chen Cang then hurriedly observed the palms.

At this point, Tian Zhengkai's symptoms had eased somewhat after medication.

Chen Cang quickly instructed: "Thumb inwards, the other four fingers clenched into a fist!"

Tian Zhengkai nodded and did as told.

Chen Cang immediately noticed that the tip of Tian Zhengkai's thumb extended beyond the lower edge of the palm!

This was a sign of the thumb sign!

With the special skeletal changes and abnormal cardiovascular manifestations, although there were no ocular symptoms, Chen Cang was now only one step away from a definitive diagnosis - family history!

At this moment, Xu Ziming and Ma Yuehui also clearly understood Chen Cang's series of examinations and quickly realized what the situation was.

Chen Cang urgently said to the attending doctor, "Take me to see the family members!"

The young doctor nodded and immediately took Chen Cang to the emergency hall, where Chen Cang saw the patient's wife and parents.

Seeing his father, Chen Cang suddenly understood - the height was truly inherited.

"Hello, I am Chen Cang, Tian Zhengkai's doctor. I have a few questions that I would like to consult with you." Chen Cang did not beat around the bush and got straight to the point.

By this time, the family members of Tian Zhengkai were already in a state of confusion.

Tian Zhengkai's child was only two years old, held in his wife's arms.

His parents, who were not yet sixty, with the father being very tall.

"Dr. Chen, hello. What is the condition of my son right now?" Tian's father asked with some concern.

Chen Cang said directly: "The situation is not optimistic. We are preparing for surgery. We are speaking to you now to understand some details and to sign the consent form for the surgery!"

After speaking, Chen Cang instructed the young doctor, "Prepare the informed consent form, the critical condition notice..."

Upon hearing this, the attending doctor quickly got up.

The family of Tian was suddenly taken aback, urgently asking, "Critical condition notice? Dr. Chen, what's going on? How did it become a critical condition?!"

Tian Zhengkai's parents were ordinary people; his father a PE teacher at a middle school, his mother a math teacher. Both had retired and were living in the capital, taking care of their grandchild, originally from Beihe Province.

And his wife, now 28, with a child only two years old!

For such a family, if anything were to happen to Tian Zhengkai, the outcome was unspeakable.

As the pillar of the family, this disaster could be devastating.

To put it into perspective, Tian Zhengkai, even at 33, was earning an annual salary of several million, which, even in the capital, categorized him in the high-income group.

If something were to happen to Tian Zhengkai...

Upon hearing this news, all three of them turned pale.

Seeing this, Chen Cang explained the risk involved with the patient and even detailed the mortality rate of the operation.

After listening, the whole family fell silent.

The wife, with tears in her eyes, looked at Chen Cang, her hands trembling as she held her child: "Doctor, you must save him!"

"The child is not even two years old, he just learned to call daddy..."

The voice of Tian Zhengkai's wife trailed off as she began to choke up.

Chen Cang reassured, "We will do our utmost."

After speaking, Chen Cang looked at Tian Zhengkai's father, "May I ask, does your family have a history of Marfan syndrome?"

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