------Program code: NS-080911-01927 (what's this?)
Source: CCTV.com
09-11-2008 10:21
Some doctors suggested performing the heart operation first to save the pregnant woman from heart failure. However, a heart operation usually requires that the heart stop beating for a time, but if the mother heart beat was stopped the baby would die.
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Another idea was to carry out both operations simultaneously. However, this would still require that the mother’s heart beat be stopped, and, again, the chances of the baby surviving would be slim. Li Tong suggested that they carry out the Cesarean section first and then perform the heart operation. This proposal was highly risky, because there was a chance that neither the mother nor the baby would pull through.
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The unborn baby was being provided with 1000 mls of blood while in the uterus, but as soon as the baby is removed, blood would suddenly rush back to the mother’s heart in a flash. As Gao was suffering from serious heart abnormalities, this rapid rush of blood could cause sudden death. Moreover, there were three clusters of bacteria on her heart, and such a rush of blood could easily cause the bacteria clusters to clog her veins. If this were to occur, Gao would not leave the operation table alive.
After discussions, most of the doctors agreed that the safest plan was to perform the heart operation first to save Gao’s life at the cost of the baby, but this would mean that Gao would lose the baby she had already risked her life for. Li Tong didn’t want to give up on the baby like this.
Li Tong undertook a thorough study of Gao’s case, and after taking every possible risk factor into account, he decided that he should try to save both the mother and the baby.
According to Li Tong’s plan, the doctors would carry out the Cesarean section on the pregnant patient first. Then with the baby removed from the uterus, they would carry out the heart operation that would save the mother’s life.
The day for Gao’s operations arrived, and all the departments of No. 3 Central Hospital of Tianjin City were to be involved in this special case.
The first step in the operation was administering anesthesia. Because Gao already showed symptoms of heart failure, it was possible that the baby would not pull through if the mother were given full body anesthesia, and so after discussion, Li Tong and the anesthesiologist decided to administer wrist anesthesia for the Cesarean section. Then as soon as the Cesarean section was over, they would administer full body anesthesia for the heart operation.
Bao Yueru, director of Naecology & Obstetrics Department, was to perform the Cesarean section. To prevent the bacteria clusters from falling into the blood flow, Li Tong told Bao that her moves had to be extremely gentle.
Bao Yueru opened up Gao’s uterus, and within just a few second a healthy baby girl was born.
Immediately after that, Bao Yueru began to stitch up Gao’s uterus. To prevent Gao from serious blood loss after the operation, Li Tong asked the nurses to prepare hemostatic gauze and press it against the wound to stop the bleeding.
It took Bao Yueru only 40 minutes to finish the Cesarean section. Now it was time for Li Tong to perform the operation to repair her heart defects. But would Gao be able to pull through such a dangerous operation?
During the Cesarean section, a great quantity of blood would rush back to the patient’s heart, and this would not only place a heavy burden on the heart but also cause the bacteria clusters in her heart to move and clog her blood vessels. Either way, Gao’s life would be in danger. However, due to Li Tong’s precautionary approach, Gao’s heartbeat and blood pressure remained steady, and this made it possible for the operation to continue smoothly.
First, Li Tong found the bacteria clusters in Gao’s heart and removed them. Such clusters of bacteria absorb nutrition by eating off human tissue, and Li Tong found that they had already eaten up half of Gao’s cardiac valve. Li Tong began by repairing the cardiac valve defect.
As Li Tong was repairing Gao’s heart, it suddenly occurred to him that Gao was so weak physically that she could easily be attacked by bacteria at this time. The question was: could there be bacteria clusters in other parts of Gao’s heart?
Li Tong immediately searched the other parts of Gao’s heart, and found out there were indeed more…two bacteria clusters were found embedded in the wall of the pulmonary artery. He immediately removed them.
After Li Tong repaired the holes in the wall of Gao’s heart, the surgical repair part of the operation was over. However, this didn’t mean that the operation was could yet be called a success. For Li Tong, the final stage was critical – he had to see whether Gao’s heart could resume beating by itself.
During the operation, an extracorporeal circulation apparatus was used to assist the circulation of blood, and during this time phase there was no blood flow in the heart. Now Li Tong had to cause the blood to rush back to the heart. However, at the moment the blood rushed back to the heart, it might cause considerable harm. Would the heart be able to deal with this after having just been repaired?
As the blood rushed into the heart, the heart began to beat again and its color began to turn red. The Electrocardiogram monitor showed that the patient had resumed all signs of life. The operation was a success.
But after the operation Gao had to face yet another dangerous stage as she was still not able to expel the water in her body. Li Tong controlled the level of blood transfusion and liquid delivery to the patient, making sure it was exactly right. And there was another problem. Gao would also begin lactation, but as she was on heavy medication in order to control her condition, her milk would contain various poisonous elements, making it unsuitable for breastfeeding the baby. As the open- heart operation had left a wound somewhere near Gao’s breasts, if she lactated too much milk it would affect the wound’s ability to heal. So Li Tong took certain approaches to adjust Gao’s endocrine system to stop her lactation to avoid the wound becoming infected.
Seven days after the operation, Gao finally saw the baby she had risked her life for.
Editor:Yang
