Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 212

#212 Hawk Eyes, Woman’s Hands, Lion’s Heart (15)

Thump, thump—

A heart, no bigger than a plum, smaller than a small apple, reveals itself.

Approximately 140 beats per minute.

Atrium once, ventricle once…

The heart muscles contract rhythmically, alternating in that manner.

Even though the positions of the aorta and pulmonary artery are reversed, it was beating vigorously like any other baby’s heart.

The vitality felt from that heartbeat was palpable even beyond the screen.

‘…That’s a child’s heart.’

I felt a sense of awe.

A completely different feeling from when I see an adult heart.

It was amazing to think that such a small thing contained all the same structures as an adult heart.

However, unlike adults, there wasn’t much yellow fat visible.

“Adult and pediatric hearts are different in many ways. From the appearance to the surgical procedure.”

We, the soon-to-be first-year residents, were momentarily lost in admiration.

I could understand why Dr. Ma Dongseop described it as a ‘new world’.

“Hehe. Don’t be too surprised yet. The surgery is just beginning. If you look there…”

Dr. Ma Dongseop pointed at the screen and was about to explain something, but suddenly stopped.

“Shhh.”

Dr. Ma Dongseop put his finger to his lips.

Soon, Professor Baek Euishin’s face was zoomed in on one side of the screen.

Beyond the protruding 3.5x magnifying glasses, his gaze was even colder than in the lecture hall.

Upon closer inspection, there was a small microphone attached to the side of his neck.

Soon, his voice was heard.

On the surgery field screen right next to him, the pericardium [the membrane enclosing the heart] fixation was already complete, and the structures of the heart were clearly visible.

Roughly, it meant that the course of the coronary artery was as expected.

In TGA [Transposition of the Great Arteries] surgery, it is important not to damage the coronary arteries that supply oxygen to the heart itself, so this was a scene to check the location in advance.

As the name of the surgery suggests, this surgery involves moving the root of the pulmonary artery.

Therefore, it was important to sufficiently dissect the surrounding area to free it up so that the pulmonary artery could be moved.

Soon, the forceps in Baek Euishin’s left hand and the Bovie [electrocautery device] in his right hand began to move.

But at that moment.

Pause-

Professor Baek Euishin’s hand stops.

He raises his head and glares at Professor Heo Junim in front of him.

I wonder if he even knows the microphone is on.

He began to spit out sharp words.

It was a moment where you could feel that ‘even a promising professor is just the first assistant to Baek Euishin’.

Professor Heo Junim bowed his head and concentrated on the surgery again.

It was completely different from his usual cheerful and talkative self.

Sweat was dripping from our temples as we watched.

“Wow……”

“I’ve never seen that professor get scolded before.”

“Well, Professor Heo Junim used to be on Professor Baek Euishin’s team.”

“I heard he was the one who got chewed out the most by Professor Baek back in the day?”

Whisper, whisper.

The residents suppressed their emotions and held their breath.

I never thought the day would come when I would feel sympathy for a professor.

That’s how tense the atmosphere was.

Tension was slowly building in the operating room, and the people in the auditorium watching it also focused more on the surgery.

‘Finally, it’s starting.’

Zzzzzz-

Baek Euishin’s Bovie moves.

The structures of the heart revealed clear shapes along the path of his electric scalpel.

Like magic, the aorta, pulmonary artery, and their branches accurately showed their shapes where he touched.

Almost without micro-bleeding, the tangled tissues were separated from each other in an instant.

“Hmm……”

“Neat.”

The audience in the auditorium briefly murmured and nodded.

Of course, only a few did.

Most of the professors were still looking at Baek Euishin’s every move as if evaluating him, with their arms crossed.

“As expected, Professor Baek Euishin’s fingertips are alive. Even if it looks easy, it’s not easy to dissect like that in an instant.”

Dr. Ma Dongseop stroked his chin and said.

“Wow, I couldn’t see it well before, but now I can see the pulmonary artery branches and other structures well… Amazing.”

Shin Sangmi also stared intently at the screen and exclaimed.

I wondered if she was the same person who used to hate heart surgery so much.

Meanwhile, Ryu Myungin next to me mumbled in a voice as small as a mosquito.

“Hey, I think I could do that much if I did it a few times……”

Cocky bastard.

But it wasn’t entirely unfounded.

In fact, I heard that even residents can become somewhat proficient in peripheral dissection.

“Hey, you have to watch until the end. The main surgery hasn’t even started yet.”

Behind Dr. Ma Dongseop’s whisper, Professor Baek Euishin’s voice was heard again.

Immediately, Ma Dongseop added an explanation.

“The fact that he’s giving heparin means he’s about to start CPB.”

CPB (Cardio-Pulmonary Bypass).

In order to operate on the inside of the heart, the heart must be stopped and empty.

If the heart is stopped and empty, doesn’t that mean the person is dead?

So, the method created to perform heart surgery without killing the person is .

Simply put, it is ‘the process of drawing blood from the person’s great veins, instead of the heart and lungs, and putting oxygenated blood back into the aorta’.

The machine needed for this is called an artificial heart-lung machine, and heart surgery is impossible without this machine.

“Everyone knows what it is, right? It’s made to allow the heart to not work for a while.”

The idea of stopping and emptying the heart to perform heart surgery.

Who could easily think of this?

This machine was first used in 1953.

In other words, the history of heart surgery is less than 70 years old.

Simplifying this artificial heart-lung machine and taking it out of the operating room is what we commonly call ECMO [Extracorporeal Membrane Oxygenation].

Historically, the starting point of ECMO was heart surgery.

‘Isn’t that the most amazing thing among the countless medical techniques that mankind has built up?’

So, for ?

As the name suggests, it is necessary to create a bypass.

For heart surgery, tubes are inserted into the superior vena cava, inferior vena cava, and aorta, respectively, and this process is called cannulation.

However, a point to note here.

When these tubes are inserted, our body considers them foreign substances, so there is a risk of blood clots.

To prevent this risk, the blood must be thinned.

Therefore, the process of inserting heparin is the starting signal for CPB.

“Watch closely. He’ll start suturing soon.”

Ma Dongseop said to us as if foreshadowing.

I felt like people were admiring a work of art with the guidance of a docent.

Soon, Professor Baek Euishin picked up the needle holder and began to suture the great vessels.

Swoosh, swoosh-

Double purse-string sutures (sutures performed to fix thick tubes) are performed on the aorta.

There is no hesitation in Baek Euishin’s hand movements.

Then, the people in the auditorium began to stir little by little.

“Oh……”

“Hasn’t he done heart surgery in a while?”

“Wow, there’s no hesitation. As if he had surgery last week.”

“Is that the purse-string suture he’s doing after several years?”

Everyone is surprised.

In particular, Dr. Ma Dongseop was becoming more and more surprised as the surgery progressed.

It seemed that he also had doubts about Professor Baek Euishin’s surgical skills.

That’s why he couldn’t help but be surprised by the needling he was showing.

‘As expected, he’s amazing.’

.

I was experiencing those words.

Anyone who has done suturing will know.

How much skill is embedded in that seemingly ordinary touch.

‘Even if it’s not flashy, it’s different if it’s embedded with skill.’

I stared at the screen as if I wouldn’t miss a single scene.

I felt like even blinking was a waste.

Watching Professor Baek Euishin’s surgery from beginning to end was a valuable experience.

Of course, even documentaries didn’t show such detailed surgical procedures.

Although I wasn’t in the operating room, I was immersed as if I was performing surgery with Professor Baek Euishin.

“Hey, isn’t he just suturing blood vessels? I think everyone is overreacting too much……”

Ryu Myungin once again broke the atmosphere and mumbled.

Then, Ma Dongseop poked the guy’s side with his elbow.

It was an elbow, but Ma Dongseop’s thick arm was almost like a siege ram breaking down a castle gate.

“Hey, shut up and watch.”

“Agh.”

“When inserting a needle into the aorta like that, both the depth and angle are important. The cannula [a tube for insertion into a vessel], must be well fixed after cannulation, and dissection (aortic dissection) can occur.”

The basic routine of heart surgery.

But it was also an important process.

After finishing suturing the aorta, Baek Euishin immediately finished suturing the superior and inferior vena cava.

At that time, the perfusionist [specialist who operates the heart-lung machine] sitting in front of the heart-lung machine shouted.

“Baseline passed!”

This meant that Lee Seulgi’s blood had become sufficiently thin after heparin administration.

In other words, it meant that cannulation could now be performed.

This time, Baek Euishin picked up the scalpel.

Now, the next step is to make an incision in the circle of the purse-string suture and insert the tube there.

Immediately after, First Assistant Professor Heo Junim is preparing to fix the tube.

Second Assistant Song Yuju is holding a part of the aortic wall with an instrument so that the aorta, which is shaking according to the heart rate, can be fixed.

Dr. Ma Dongseop’s explanation continues.

“If you poke the aorta too deeply, you can poke the back wall. I can talk vividly about this because I’ve done it before.”

Having finished preparing, Baek Euishin brings the scalpel to the aorta without hesitation.

He first slightly peels off the skin of the aorta with a scalpel.

Then, with his left hand preparing to block the place where the scalpel enters and exits so that blood does not spurt from the aorta, he slightly inserts the scalpel held in his right hand into the aorta.

And then.

“!”

Pssst-

Blood spurts shallowly from Lee Seulgi’s aorta.

A few drops of red and clear blood splatter on Professor Heo Junim’s glasses across from him.