Source:
11-14-2008 11:45
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Wan Feng began to cut open the baby’s chest. Six months before, as a result of a similar operation, the heart had adhered to the breastbone. Wan Feng had to cut apart the breastbone. But the slightest slip could cause irreversible damage to the heart.
The traditional way of performing a thoracotomy involves cutting open the chest with a saw along a straight line. The advantage of a swing saw is that it doesn’t injure soft tissues, so after the breastbone is cut apart, the heart won’t be injured.
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Given that Lele weighed only six kilos, if he lost more than 10 millilitres of blood during the operation, his blood pressure would fall dangerously low. Controlling the loss of blood after the chest was cut open, was another difficulty facing Wan Feng.
Wan Feng succeeded in cutting open the baby’s chest and exposing his tiny heart.
The operation was very complicated, but Doctor Wan made an excellent beginning. The medical team in the operating theatre were greatly encouraged.
Wan Feng examined the baby’s pulmonary arteries. He found that the artificial blood vessel inserted during the first operation had supplied sufficient blood, so that the left and right pulmonary arteries were developing quite well.
However, the artificial blood vessel had only helped the left and right pulmonary arteries grow; the pulmonary arterial trunk had failed to grow properly. This was a latent threat to the baby’s life.
After further examination, Doctor Wan found that the baby’s pulmonary arterial valve was scarcely functioning.
The pulmonary arteries are some of the most important blood vessels in the human body. From them the blood flows into the lungs to acquire oxygen. On the pulmonary artery is a valve, which opens and closes with the systole and diastole of the heart. But Lele’s pulmonary arterial valve was failing to function properly. This meant his pulmonary arteries weren’t working and blood wasn’t flowing into his lungs.
Under the circumstances, it was extremely difficult to carry out major surgery to correct Lele’s heart abnormalities. One doctor suggested reducing the risk by performing an operation just to expand the pulmonary arterial trunk; a second operation could then be carried out after it had developed for a certain period. It was up to Wan Feng to make the decision.
But performing an operation on the baby with his heart artificially stopped, would damage the heart. So the operation had to be performed in low temperature conditions, at which the heart’s metabolism would be slowed.
Wan Feng lowered Lele’s temperature to between 28 and 30 degrees. He also placed ice cubes on the baby’s heart to reduce its temperature to 4 degrees. In a traditional operation, the supply of blood to the heart would be cut. Protective solution would be infused into the heart at 20-minute intervals to keep the heart soft enough for the operation to proceed. However, the technique was not conducive to the recovery of the baby’s heart.
The best way to protect the heart was to keep blood flowing through it throughout the operation.
Wan Feng tied up the artificial blood vessel inserted during the first operation, remedied the ventricular septa defect, removed the hypertrophic part of the right ventricle and widened the narrow pulmonary arteries.
Widening the pulmonary arteries is not normally a complicated technique. But while Doctor Wan was performing this part of the operation, a crisis suddenly occurred. Cutting open the pulmonary artery vessels affected the functioning of the aortic valve.
If the aorta in the human body is likened to a river, the aortic valve is a dam across it. It seemed that in the baby’s case, the dam had been breached, with blood gushing out of his aorta.
Wan Feng immediately halted the flow of blood from the aorta. At the same time, he ordered his assistants to attach an aspirator to move the blood back into the baby’s circulation system.
Eventually, all the abnormalities in the baby’s heart were corrected. The main problem now was to restore the heart’s function.
Wan Feng raised the baby’s temperature, and his heart began to beat regularly.
But the operation was only the first step in Lele recovering full health. He remained in a lethargic state and needed a period of intensive postoperative care.
Lele was so weak after the operation that he couldn’t even cough up phlegm.
Wan Feng ordered the nurses to clear away the phlegm and put the baby on a respirator. This improved his breathing and reduced his oxygen deficiency. Doctor Wan also prescribed a special nutritious diet to strength him physically.
Lele made a rapid recovery after the operation. There is now every chance that he will lead a normal life.
Editor:Yang
