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Chapter 423 Top-Level Difficulty Surgery! Zhang Sang's Undefeated Legend Ends on Sakura Island?! [Requesting Monthly Tickets]

"Hey, Ilotti, what's up?"

Zhang Lingchuan answered the phone quickly, because the call was from Ilotti, who had just left.

He asked curiously, after all, it had only been a little over ten minutes since he left.

Could it be that Cameron is experiencing some symptoms?
However, this shouldn't be happening. It's unlikely that his perfect acupuncture technique would have any problems, and Cameron felt quite good overall.

"Dr. Zhang Lingchuan, it's like this, I just saw a voice call option on WeChat on my phone, so I tried to make it, and I didn't expect it to actually go through! I can use this to contact you from now on!"

On the other end of the phone was Ilotti's voice, filled with a little bit of excitement.

With this, you don't need a phone number; you can just call via WeChat voice message if you want to contact them by phone.

It's quite convenient!

"Uh... I thought you had something to say, Ilotti, but it turns out it's just this!"

Zhang Lingchuan hesitated, as if he wanted to say something but then stopped.

"Haha, it's just a trial. By the way, I just found out that Professor Tanaka Nagayama has experienced severe ventricular fibrillation and experts have been invited to assist him, including Professor Jones from the Mayo Clinic. It seems the situation is quite serious, mainly because he had heart stent surgery before and didn't take good care of his body."

Ilotti was somewhat moved.

Even with a successful career, one can still be considered a top-tier doctor, attracting widespread attention.

But diseases treat everyone equally.

Even if you are a top doctor, you can't escape it.

The correct approach for top-tier doctors is to prioritize prevention from the outset.

"Well, it's not that easy to climb up the ladder. Professor Tanaka was already at his limit, but he was so overwhelmed by joy that he didn't pay attention to his health for a long time and didn't even know that a huge change had taken place inside him."

Zhang Lingchuan's expression was somewhat helpless at this moment.

He could understand Tanaka Nagayama's mindset: "I, Zhao Gao, will climb up step by step to the highest point!"

"I wonder if they'll invite us over later. After all, we're both the youngest experts, and we're both technically oriented."

Ilotti spoke of this with a hint of anticipation.

She was very interested in participating in the treatment efforts with fellow top experts.

"Huh? What's going on??"

Suddenly, the next second, Ilotti noticed that the dialing screen on her phone had changed; it turned out that a call had come in.

After that phone call, the WeChat conversation with Dr. Zhang Lingchuan automatically disappeared.

It seems that mobile phone calls still take priority over WeChat calls.

"What? Okay, okay! I understand!"

Ilotti nodded after answering the phone.

At that moment, she received a call from the organizers, asking her to go to the University of Tokyo Hospital to participate in Tanaka Nagayama's surgical treatment.

I was just talking to Dr. Zhang Lingchuan about this.

The next second, I received a call from the organizer.

I don't know if Dr. Zhang Lingchuan received it or not.

"Dududu-"

Room A2122 on the other side.

"That's strange! The phone's ringing again!"

Zhang Lingchuan had just hung up the phone with Ilotti when, to his utter surprise, another one arrived.

And this one turned out to be a call from the teacher's wife.

He was shocked.

What is the teacher's wife trying to do?

The other person had just left!
"Xiao Chuan, are you still in your room?"

Huang Xiangning's voice on the other end of the phone was full of excitement.

She returned to her room and just opened the group chat for "We Are a Loving Family".

Shen Xuanqin: Ru Jiming, that scoundrel! He's utterly despicable and shameless! This is his Six Needles of Divine Sleep, one of his signature techniques, and I never expected he would pass it on to Xiao Chuan! If I weren't so old, I would have gone to the capital to strangle him!

Scrolling up reveals a passage from the old man's own reply.

You can tell the old man is a very explosive person.

Then her son started calling her Ilotti, calling her goddess, and so on.

Then he got scolded by the old man who was in a bad mood.

Huang Xiangning had just opened the chat box, intending to join in cursing this good-for-nothing kid.

Then a phone call came in.

It belongs to the organizer.

They were in a great hurry.

They said that Professor Tanaka's current rescue efforts have encountered difficulties, and they hope that they can come over for a joint consultation, and that Dr. Zhang Lingchuan will definitely be brought along.

A car will arrive at the hotel downstairs in two minutes to wait for them.

Try to get downstairs within five minutes.

Huang Xiangning immediately called Zhang Lingchuan.

"Yes, madam, what's wrong? Why are you in such a hurry?"

Zhang Lingchuan looked a little puzzled.

Even through the phone, I could sense that my teacher's wife was extremely anxious.

But he had absolutely no idea what had happened.

It's impossible that the professor was in critical condition and called for outside help to get to them!
"That's right, the organizers and some officials from Sakurajima Island want us to go to the event to participate in Professor Tanaka Nagayama's medical discussion! And even participate in the surgery!"

Huang Xiangning relayed all the information she had received during the phone call to Xiao Chuan.

Because the phone number Ogawa left was on her side; she was the communications manager.

The organizers don't have Xiaochuan's phone number yet.

"Is that so? Should we go there immediately?"

Zhang Lingchuan asked curiously.

"Yes, we'll go right now. The car is waiting for us downstairs! We'd better be there within five minutes!"

Huang Xiangning nodded.

"Okay! I'll come downstairs right now!"

Since the organizers had extended an invitation, Zhang Lingchuan naturally didn't hesitate.

Saving lives is the priority right now.

It's quite interesting, though. Ilotti had just finished speaking and wasn't even sure if they were there when her call suddenly ended.

Next came the invitation from the organizers.

He quickly put on his shoes and went out.

The University of Tokyo Medical School is right next door.

After they quickly went downstairs, a car was waiting at the door.

Walking there is too slow; taking a car would be much faster. The organizers have been quite thoughtful.

"Hey! Dr. Zhang Lingchuan! You really are here!"

No sooner had Zhang Lingchuan and his group arrived than they saw a blonde beauty get into the car.

This person was none other than Irodi.

However, Dr. Cameron was not by her side.

Of course, Minna was not next to Huang Xiangning.

Because Cameron and Mina are similar, their research is somewhat theoretical.

This time, the organizers mainly invited leading technical experts.

For example, Ilotti.

Although she is a pediatric specialist, in addition to her judgment, coordination, and diagnostic abilities, she is also a top pediatric cardiologist and an expert in interventional therapy.

These judgments, coordination, and diagnoses alone are far from sufficient to make someone a future star in the medical field.

Xiao Chuan and Huang Xiangning are both outpatient emergency care experts.

Huang Xiangning's expertise leans towards surgical procedures involving the limbs.

But their CPR and similar skills are also top-notch.

Needless to say, Ogawa is the founder of the One-Five Cycle Method.

In the morning, during an academic presentation, I received an hour and forty minutes of emergency care. My heart had stopped, but I was miraculously brought back to life.

Finally, it was restored to its original condition.

With just this one skill, he's naturally indispensable for consultations in cases like this!
"Ilotti's phone call was abruptly disconnected earlier, so she must have received a call, right?"

Zhang Lingchuan smiled and said.

He just said it!

Why did the call suddenly disconnect?

"Dr. Zhang Lingchuan is right. WeChat calls are still lower in priority than regular phone calls. They are hung up immediately as soon as a call comes in."

Ilotti nodded, and then shrugged helplessly.

"???"

Huang Xiangning listened from the side with a face full of question marks.

What's going on? The two even made a WeChat call.

What is Xiaochuan trying to do? When did their relationship become so hot?

Next to the operating room at the University of Tokyo Hospital.

All the technical experts came.

They even changed into sterile suits.

The above is describing the current situation of Professor Nagayama Tanaka.

"The patient has experienced four episodes of ventricular fibrillation, but fortunately, the heart rate has returned to normal. We have also put the patient on ECMO. However, the culprit vessel is still not open. There are two reasons for the PCI failure: 1. The vessel is twisted or has abnormal movement, making it difficult for the guidewire to pass or for the instruments to reach it. 2. The patient experienced cardiac arrest and ventricular fibrillation during the procedure, forcing the termination of the surgery."

Dr. Shizuo Ebe, the president of the University of Tokyo Hospital, was giving a report, his expression extremely solemn.

After all, he was under a lot of pressure from above.

Public opinion surrounding the matter is also growing.

After all, the live stream was started in the morning, and the conversation between Professor Tanaka Nagayama and Zhang Lingchuan was broadcast.

It even has a very high level of popularity.

"Therefore, after the third ventricular fibrillation, we changed the guidewire with Jones, choosing the more flexible stiff wire, and used catheter-assisted technique, changing from the radial artery to the femoral artery. Then came the fourth ventricular fibrillation. The PCI team immediately started ACLS, immediately defibrillated and continued cardiopulmonary resuscitation and intravenous administration of adrenaline and amiodarone, while providing circulatory support and using ECMO."

Ebe no Shizuo described the scene during the surgery.

Everyone was shocked after hearing this.

It was extremely dangerous.

"So, in other words, the criminal's blood vessels haven't been opened since Professor Tanaka entered the hospital?"

Ilotti sensed something amiss.

"Dr. Ilodi, although I am reluctant to admit this fact, it is true. Professor Tanaka Nagayama's vascular twisting operation is extremely difficult, and coupled with the material problem, we have not yet been able to open the blood vessel."

Jiang Bianjingfu looked somewhat helpless.

The higher-ups demanded that they protect Professor Tanaka.

But now they're on ECMO.

If the culprit's blood vessel cannot be opened, abnormal heart rate and ventricular fibrillation may occur, and the only subsequent option is CABG, or bypass surgery.

However, Professor Tanaka was in the acute myocardial infarction stage, with a large area of ​​myocardial ischemia and necrosis, a significant decrease in cardiac function EF value, and extreme intolerance to anesthesia and surgical trauma to the heart, resulting in an extremely high perioperative mortality rate.

Furthermore, the surgery is time-consuming and invasive. Compared to PCI, CABG is a major open-chest surgery that requires cardiopulmonary bypass. In the context of myocardial infarction, it is more difficult for a stopped heart to recover.

Most importantly, the risk of bleeding is extremely high.

Because the PCI team in the catheterization lab has already used antiplatelet drugs such as aspirin, clopidogrel, or ticagrelor, and anticoagulants such as heparin and bivalirudin, the patient's coagulation function is suppressed, making it extremely easy for the patient to experience massive bleeding during the procedure.

The mortality rate for a normal bypass surgery is approximately 1–3%.

Emergency bypass surgery, especially after failed PCI culprit vessel recanalization, can have a mortality rate as high as 15–30%.

If the patient is already on ECMO/IABP support before surgery, the mortality rate will reach over 80%.

It is the only possible way to save one's life when there is no other way out.

Even if they survive, the subsequent complications will be a major hurdle.

Prolonged hypoperfusion combined with cardiopulmonary bypass causes significant damage to the kidneys, brain, and lungs.

In summary.

As long as PCI surgery to open the criminal's blood vessels can still be performed, Sakura, represented by Shizuo Ebe, does not want to reach this point.

Because the former still has a chance to recover to a normal state.

As for the latter... we can only say that there is a certain probability of becoming a normal person.

It's almost impossible for him to continue standing on the operating table and shining brightly in the medical field.

“Ilotti, you are a pediatric emergency cardiology specialist with experience in successfully opening up blood vessels in emergency situations, such as twisted blood vessels, abnormal walking patterns, and severe calcification. I would like to ask you to perform the procedure and see if you can open up Professor Tanaka’s blood vessels.”

Jones then looked at Ilotti.

For someone so young to be invited to a world-class emergency medicine forum, they must have some real skills.

This is why Jones insisted on calling her personally to make sure she came over.

Because the other party performed the percutaneous coronary intervention very well.

If he agrees, Professor Tanaka's surgery has a very high success rate.

"I can give it a try."

As a doctor.

When assigned a rescue mission, she certainly couldn't refuse.

Moreover, she herself was very interested in this surgery.

“Thank you very much, Dr. Ilotti, for your help.”

Jiang Bianjingfu bowed in gratitude.

He had investigated all of these experts.

Despite her specialization in pediatrics, Ilotti is undoubtedly a national-level genius in the United States!

"It's a doctor's responsibility, no need to thank me. But how do you plan to deal with the ventricular fibrillation now? The patient's circulatory stability is crucial to the success of the interventional procedure."

ECMO can temporarily replace the heart's pumping action to maintain systemic perfusion.

However, the other party cannot "correct" ventricular fibrillation.

At most, it's just buying time for further treatment, opening up the criminal's blood vessels, and adjusting the arrhythmia.

In short, ECMO is only a "temporary maintenance" method. The ultimate goal is to restore spontaneous circulation. If the heart remains in ventricular fibrillation and the myocardium does not contract effectively, the patient will lose its own pumping function and will eventually be unable to wean off the machine. The prognosis is extremely poor, almost equivalent to being a living dead.

"Dr. Zhang Lingchuan is an expert in treating ventricular fibrillation. He has published several papers on the subject and has also created the 'One-Five Cycle Method.' I hope Dr. Zhang Lingchuan can help us solve the problem of ventricular fibrillation."

At that moment, Jones's gaze was fixed on Zhang Lingchuan.

His eyes held a hint of pleading.

“Mr. Lingchuan, I know that Professor Tanaka Nagayama offended you at the previous meeting, but Professor Tanaka Nagayama is a top doctor in our country’s emergency department and is extremely important to the country and its people. I hope you can assist in his treatment so that he can have the opportunity to help more people and save more lives.”

Jiang Bianjingfu bowed to Zhang Lingchuan.

This is the second person he hopes to join!
"Zhang-san, I had some misunderstandings about you before. I sincerely apologize, and I also apologize on behalf of Tanaka Nagayama-kun. If possible, please protect him in case of possible ventricular fibrillation!"

Dr. Gao Shan is here too.

The contempt he had shown Zhang Lingchuan was gone from his eyes.

After hearing about Zhang Sang's deeds from Koji, he felt deeply remorseful for his previous doubts and was completely convinced of Zhang Sang's character.

Therefore, even highly respected emergency room specialists...

But he was still apologizing.

“Professor Takayama, you don’t need to apologize. I didn’t take the previous matter to heart, and I’m not the kind of person who hides things. But I don’t know the specifics of Professor Tanaka Nagayama’s situation either. I can only say that I will do my best.”

Zhang Lingchuan looked at the dean and Professor Gao Shan, who was also an emergency medicine expert, and said earnestly.

He didn't dare to agree immediately.

We'll need to scan it to find out the exact result.

"Thank you, Zhang! You only need to do your best!"

Dr. Gao bowed at a ninety-degree angle.

Huang Xiangning stood to the side, feeling a surge of pride.

Professor Jones specifically invited Ilotti and Ogawa to help.

This demonstrates the importance of Ogawa in his heart and further proves the crucial role of the five-cycle method.

such a pity.

Ultimately, my talent just can't keep up.

The path that Xiaochuan completed in a few months is something I haven't reached even after more than thirty years.

The difference between a person and a genius is truly vast.

Jones probably felt the same way.

If I'm not mistaken, he must have just undergone percutaneous coronary intervention himself.

But the criminals' blood vessels still haven't been opened.

This clearly demonstrates just how difficult it is to operate.

Professor Jones actually recommended that Ilotti give it a try.

So at least in his mind, the other party believed that Ilotti had the ability to deal with such a difficult intervention technique.

What a freak!

If she hadn't attended this academic conference, she wouldn't have known that such a person existed in America.

"Ding! Ding! Ding ding ding—"

At that very moment, the alarm rang.

"Something's wrong! Professor Takayama! Dean Ebe! Professor Tanaka has experienced his fifth ventricular fibrillation!!"

At that moment, the monitor displayed a VF waveform.

The surgical team immediately stopped what they were doing because the waveform indicated that ventricular fibrillation was occurring.

"Damn it! Ventricular fibrillation again! Quick!!!"

The group immediately entered the interventional operating room.

The interventional procedure is currently suspended.

[Ding! The host has detected ventricular fibrillation in a patient using ECMO, one of the most dangerous scenarios in clinical practice. Please provide immediate assistance!]

Upon first glance.

He saw Professor Tanaka, who had already been fitted with the equipment.

There was a red tag above the other person's head.

It hasn't turned gray yet.

This means that although his current situation is urgent, thanks to the assistance of modern instruments, his vital signs have been temporarily maintained.

System scan complete.

He naturally activated the system scan.

[Patient name: Tanaka Nagayama. 】

[Patient's gender: Male.]

[Patient's age: 57 years old.]

[Patient Status: Currently on ECMO to maintain vital signs.]

[Patient Diagnosis: Acute myocardial infarction.]

[System notification: The patient is currently suffering from acute myocardial infarction. During resuscitation, the culprit vessel is difficult to open, and refractory ventricular fibrillation has occurred. Even with ECMO, ventricular fibrillation continues.]

If ventricular fibrillation persists and cannot be stopped, the heart is in a state of "electrical chaos" and cannot contract effectively. Even if ECMO temporarily maintains perfusion, the heart itself will gradually suffer severe damage such as myocardial necrosis and dilation, making it impossible to wean off ECMO. This means the patient will never regain spontaneous circulation, will remain dependent on ECMO, and will ultimately progress to end-stage heart failure.

This is the result of his scan.

[Mission Category: Active Rescue Mission]

[Mission Overview: The current environment is foreign. As a prospective host for the Perfect Physician, enhancing international reputation is essential. You are currently at the University of Tokyo Hospital and have been invited to join emergency specialist Tanaka Nagayama in his treatment efforts. Please immediately utilize your skills to participate in the rescue.]

[Mission Reward: Successfully treating the host will grant you 1 Common Treasure Chest and 2000 Professional Reputation.]

[Failure penalty: None. 】

[Mission Duration: 24 hours.]

And it also activated a new task.

However, if even treating Cameron just now activated a regular treasure chest, it would be too stingy not to get one in this dangerous situation.

"Please make way, this is Mr. Lingchuan from China, and one of the youngest doctors participating in this World Emergency Medicine Congress."

"That's what Jiang Bianjingfu said at this moment."

And ask everyone to make room for Zhang Lingchuan.

"Zhang Lingchuan? China??"

Everyone was stunned for a moment.

So young?
What's the meaning!
Surely we can't expect this Mr. Lingchuan to be the one to rescue Professor Tanaka Nagayama next!
And the truth was just as unbelievable as they thought.

Zhang Lingchuan did indeed join the rescue team.

The most crucial person is still that pillar of support. "Zhang Sang, what should we do next?"

Dr. Gao asked Zhang Lingchuan.

All eyes were now on him.

“I have little experience in this kind of resuscitation. Since ventricular fibrillation has occurred, I think the most important thing is to deal with the VF wave and continue defibrillation. Next, according to the ACLS procedure, I need someone to assist me with defibrillation. You can arrange the rest of the intervention if you have experience.”

Zhang Lingchuan immediately replied.

The patient is experiencing ventricular fibrillation.

While ECMO can prevent patients from dying from cardiac arrest, if ventricular fibrillation is not treated promptly, the heart will fail. This artificial heart-lung machine is only for emergency use.

It's like an oxygen tank when you're diving.

Wearing it allows you to stay underwater for a period of time without having to come ashore to breathe.

But this oxygen tank certainly can't guarantee you'll stay underwater forever.

Therefore, the real purpose of humans is still to emerge from underwater.

Oxygen cylinders can never replace real oxygen.

"I'll assist you with defibrillation! Then, Ilotti, you prepare for interventional surgery to try and open the criminal's blood vessel!"

Before Dr. Gao could speak...

The renowned Professor Jones was already standing to the side.

If ventricular fibrillation occurs while using ECMO, follow the ACLS procedure: perform chest compressions every 2 minutes and intermittent defibrillation.

someone will ask.

ECMO pumps blood, right? Yes, even though ECMO is pumping blood, you still need to press to help perfuse the heart.

This process requires repeated defibrillation, usually involving multiple attempts to initiate a 200J biphasic wave.

"it is good!"

Zhang Lingchuan nodded.

Immediately begin high-quality CPR, also known as cardiopulmonary resuscitation.

And when he got the hang of it.

Many eyes were fixed on him, and some were even in a dedicated monitoring room.

"Can Zhang Lingchuan from China really save Professor Tanaka?"

"I feel that the dean is being a bit too trusting by directly entrusting this Chinese person with solving the difficult problem of ventricular fibrillation."

"Let's wait and see. Maybe this Chinese man really is capable."

Some of them were chatting.

In particular, specialists at the University of Tokyo Hospital in the island nation harbored deep distrust of him.

They mainly believe that technology is built up over time.

How good can someone be at such a young age?

Operating room scene.

"Understood, I will take responsibility for correcting reversible causes."

Ilotti also followed the arrangements.

The so-called reversible cause, currently in the catheterization lab, is that the blocked blood vessel has not been opened, and she needs to open the blocked blood vessel, which is the culprit's blood vessel.

"Then I will administer medication and assist in correcting the reversible underlying cause."

Dr. Gao Shan took on the task of administering the medication.

In such cases, it is necessary to administer antiarrhythmic drugs, such as amiodarone, with an initial intravenous push of 300 mg, followed by an additional 150 mg.

now.

Just like today's top academic summits.

The strongest lineup in history was also seen in the emergency PCI surgery performed at the University of Tokyo Hospital.

Dr. Takayama, ranked fourth in the entire Sakura Island Emergency Department, administered the medication; Jones, a world-class emergency medicine expert from the Mayo Clinic, performed defibrillation; and Dr. Ilotti, the youngest expert in the history of the World Emergency Medicine Conference and the top academic forum in emergency medicine, led the interventional surgery. Similarly, another 26-year-old Chinese genius, Dr. Zhang Lingchuan, was responsible for high-quality CPR.

When his hand was placed on Tanaka Nagayama's chest.

The scene was so realistic it felt like a real heart was beating.

"This……"

Jones was completely stunned.

This was the first time he had ever seen the founder of the One-Five Cycle Method, a 26-year-old Chinese doctor, performing CPR in real life, and this CPR was so wonderful!

"Perfect."

When Ilodi saw Zhang Lingchuan pressing down, only this one word came to mind.

too strong.

It's so fascinating.

She admitted that she couldn't do that at all, not even a little bit.

Some people, you can tell just by watching them move, it's a feeling of natural talent.

That feeling, in Ilotti's mind, seemed like something that could only be achieved after a long period of time.

"Hammer, hammering technique?"

Immediately after Zhang Lingchuan pressed down, he began to use the hammering technique.

"What? Shouldn't this be defibrillation under normal circumstances? Why did they just use a hammer?"

In the operating room, the other doctors looked at him with an unprecedented doubt, and even more suspicion.

"So that's how the striking technique works."

Jones watched very intently.

Is the landing point in this area?

As the saying goes, laymen watch the show while experts see the details; Ilotti was observing Zhang Lingchuan's strength and landing point.

"Professor Jones! Defibrillate!"

Zhang Lingchuan immediately called for a doctor!

"it is good!"

The defibrillator stored energy and delivered a direct electric shock to Professor Tanaka.

In an instant, the monitor showed a change from ventricular fibrillation VF waves to a wide, complex, and regular sinus rhythm.

"Hiss—, you're back so soon!!"

Under supervision.

They were all dumbfounded.

You should know that when they faced ventricular fibrillation, it took them a long time to recover.

It's completely impossible to restore a convulsing heart to normal with a single blow like that.

"Look, ETCO is up here too!!"

At that very moment, an anesthesiologist shouted excitedly.

A sudden increase in ETCO is usually the first sign that the autocirculation is recovering!

In other words, Dr. Zhang Lingchuan from China, through a single combination of methods, directly gave Professor Tanaka, who initially had little hope, a new lease on life.

That's fucking awesome!!
It has to be the dean.

That insight was truly incredibly sharp.

Monitoring room.

Many of the newly emerged, arrogant veterans were also dumbfounded.

"Dr. Zhang Lingchuan, it's my turn now!"

Then, something else happened that shocked everyone.

This blonde beauty led the entire interventional surgery and entered the blocked blood vessel of the criminal with utmost precision.

The cardiologists had already been unhappy with Jones's arrangements.

But now I'm completely convinced.

"Gulu——"

Everyone swallowed hard.

Even laymen might not realize how dangerous this situation is.

The blood vessels were twisted, making it impossible to access and open the criminal's blood vessels, which was extremely dangerous.

But if a highly skilled doctor manages to get through the twisted part, the danger at that moment is immense!
Even the slightest mishandling could cause blood vessel damage and death in the patient.

Confidence was always written on the face of this gifted young girl.

But even now, you can still see that the other person's forehead is covered in sweat.

However, unless the other party takes the initiative to remind her, no one dares to touch her, for fear that one touch might affect the other party's concentration and thus lead to a complete loss.

Zhang Lingchuan was also watching intently.

I was filled with admiration.

So cool.

Compared to the other person, I really am a cheat.

Looks like I need to work harder.

Some things only become your own after you practice them yourself. I learned a lot during this trip abroad.

"call--"

Throughout the entire operating room, everyone's breathing could be heard.

"Drip-drip-"

At the crucial moment of opening up the channels of crime.

The alarm on the instrument sounded again.

Yes.

It seems that Professor Tanaka Nagayama was preordained by death, as his heart began to fibrillate again.

He seemed to be saying, "If you dare to save someone, I'll cause trouble."

"This……"

Ilotti was completely stunned.

"Professor Jones, defibrillate immediately!"

Zhang Lingchuan is in charge of ventricular fibrillation, so he naturally took immediate action to make arrangements now that ventricular fibrillation has occurred!
"Clear!!"

Jones, holding the defibrillator, shouted the next second!
In an instant.

Everyone who was nearby left the operating table, including Ilotti.

Because anyone who gets close during defibrillation could be electrocuted.

Furthermore, defibrillation and interventional surgery cannot be performed simultaneously under normal circumstances, but this is an emergency, and opening the culprit's blood vessel is the fundamental way to resolve ventricular fibrillation.

Since the root cause of ventricular fibrillation is acute ischemia or reperfusion injury, if defibrillation is repeated but the blood vessels are not opened, the patient is very likely to develop refractory ventricular fibrillation or cardiac death.

Therefore, Ilotti had to maneuver the guidewire to the designated location and try to reopen the criminal's blood vessel as soon as possible.

Furthermore, she had already spent a lot of time navigating the winding area.

This surgery was incredibly difficult.

But for some reason, I have an urge to conquer it!

"If the ventricular fibrillation does not resolve, start CPR immediately."

Jones checked and found that the ventricular fibrillation had not subsided, so cardiopulmonary resuscitation (CPR) was necessary.

"it is good!"

Zhang Lingchuan began the percussion technique and initiated the cardiopulmonary resuscitation phase.

Everyone who wasn't involved in the surgery was admiring his CPR.

Some people even think it's as wonderful as playing the piano.

What's truly amazing is that after Zhang Lingchuan's five-cycle procedure, Jones would deliver another electric shock, and the ventricular fibrillation would then switch to sinus rhythm.

"It's my turn!"

Between pressing and waiting for the rhythm to stabilize, Ilotti quickly advanced the guidewire and balloon dilation.

Time passes minute by minute.

The surgery is also proceeding intensively.

Everyone's hearts were in their throats.

Emergency specialists such as Dr. Takayama and Dr. Shizuo Ebe, as well as hospital executives, were also fully focused on the situation.

If even this lineup can't save Yongshan-kun, then it can only be said that his life ends here.

Because of this surgery.

Two difficulties.

The first step is to open up the criminals' access to resources.

The second is to address malignant heart rate.

Any one of them would be enough to give them a headache and even make them flustered.

But now, Yongshan Jun is enjoying the help of Ilotti, who has the world's top-level skills, to open up the criminal's blood vessels, and Zhang Sang, who has the super-top-level skills of China, to treat malignant arrhythmia.

The two worked together.

Professor Jones also performed defibrillation.

I'll act as the one pushing the medicine.

And there are more than a dozen expert advisors around him.

There were also more than thirty experts observing outside.

I believe you can't find such a surgical team anywhere else in the world.

outside.

[During surgery]

Koji stared at the light that had come on in the operating room.

"Clang-"

Suddenly the operating room doors opened.

Two doctors came out, looking very anxious.

"Doctor, doctor, how is my mentor, Professor Tanaka? Is he getting better? Could you please tell me?!"

A young woman excitedly asked the doctor who had come out.

She herself is a mid-level professional in the emergency department, equivalent to an attending physician.

But the other party is also a person.

I came to a meeting with my teacher, but he suddenly had a heart attack.

She has all the worries that a person should have.

In particular, her teacher had shown her great kindness and support.

"Professor Tanaka's blood vessels are twisted and he walks abnormally, making it very difficult to open the ventricle. He has experienced seven episodes of ventricular fibrillation so far."

After leaving those words, the two doctors hurriedly departed.

Clearly, the girl was anxious, but they were even more anxious.

"Seven...seven ventricular fibrillation episodes!!"

Trance.

The girl looked completely dazed.

As a doctor, she knew all too well what seven ventricular fibrillations meant.

"This……"

So many top experts have gone in.

Ilotti, Zhang Sang, Professor Jones, and their own teachers.

But after such a long period of silence, Koji felt something was amiss.

Now, when he hears about twisted blood vessels, abnormal walking, difficulty opening the ventricles, and seven episodes of ventricular fibrillation, his mind goes blank!

Could it be that Zhang Sang's undefeated myth is about to end on their Sakura Island?
Southern Medical University.

Clinical Medicine Class A1

"A-Gang: This is tough, guys... Professor Tanaka Nagayama might be in trouble this time."

Class group chat.

The message, which already had 99+ views, started scrolling again.

And all these messages with 99+ replies are discussing the same topic.

World Society of Emergency Medicine Annual Meeting, Dr. Nagayama Tanaka, Dr. Ogawa.

"Gangzi! What's going on! Tell me quickly!"

"Oh dear, you're driving me crazy! I should have pursued a PhD myself! Otherwise, I wouldn't have let you keep me in suspense like this!"

"Professor Tanaka Nagayama couldn't be saved? My God! Why didn't they call Dr. Ogawa? If they had, things would have been much better!"

"Indeed, it's probably because they couldn't bring themselves to ask. Even if they had asked Dr. Ogawa to come and assist, with so many emergency room specialists, it shouldn't have been possible for such a top professor to lose his life."

After Ah Gang appeared, everyone jumped out.

At the same time, inquire about the progress.

Some people said they would have been more eager to pursue graduate studies if they had known earlier.

But the discussion mostly revolved around whether Dr. Ogawa participated in the surgery.

After all, in the eyes of everyone.

There are so many resources available, but people just don't use them in their daily lives.

That's really incredibly foolish.

Especially since Dr. Ogawa is so capable.

"A-Gang: According to the latest news, Koji said that the University of Tokyo Hospital has invited all the technical emergency department experts to the site for guidance, and even Dr. Ogawa participated in the treatment. But the situation is not good now. His blood vessels are twisted, he walks abnormally, and it is difficult to open the criminal's blood vessels. He has already experienced seven ventricular fibrillations."

The group chat that this guy, A-Gang, is currently in is the former undergraduate and graduate student group.

Five years after their undergraduate studies, about half of them went on to pursue a doctorate, while the majority went on to enter the workforce.

And A-Gang is the one who is pursuing a doctorate at this university.

The other party's senior fellow doctoral student was Koji.

The two got along very well during their doctoral studies and became like brothers.

Koji first mentioned this in their doctoral group's chat group.

"Seven, seven ventricular fibrillation episodes??"

"My God! Even Dr. Ogawa hasn't dealt with seven ventricular fibrillation episodes before!!"

"Old Deng's heart is truly incredible. For a moment, I'm a little confused. Does the other side want him dead or alive?"

"That's really going to be a close call."

"Exactly! Two major problems: tortuous blood vessels, abnormal gait, and ventricular fibrillation. Seven times, they must have needed an artificial heart-lung machine, right? But even then, the ventricular fibrillation problem still needs to be addressed, otherwise the heart will fail!"

"I suddenly have a feeling that Dr. Ogawa might be in for a disaster. How can he possibly win a battle that starts in hell? There's absolutely no way to win!!"

Everyone felt a sudden tightness in their chest.

"Let's hope that Dr. Ogawa can create another miracle."

Chatting and chatting.

Everyone hopes for a miracle.

the other side.

Tanaka Nagayama's family also rushed to the scene.

They prayed with their hands clasped together.

In the catheterization lab, the eighth ventricular fibrillation ended.

ECG: Sinus rhythm, ST segment elevation.

Angiography showed complete occlusion of the proximal segment of the right coronary artery. The guidewire had successfully passed through the occluded segment and was located distally.

Ilotti raced against time, maneuvering swiftly; success or failure hinged on this moment.

Zhang Lingchuan was also covered in sweat, staring intently at Ilotti.

Everyone held their breath.

Once the balloon inflates and the stent is successfully inserted, the culprit's blood vessel will be successfully opened!

"this--"

But the next second.

Everyone felt like they'd been doused with a bucket of cold water!

The images show that the blood vessels are severely calcified, and the balloon cannot expand to the lesion site, turning the whole thing into the shape of a dog bone!
In other words, the stent cannot pass through!
The criminal's blood vessels still cannot be opened!
"Drip-drip-"

The monitor suddenly sounded an alarm!
My blood pressure plummeted!
Heart rate drops sharply!

The ninth ventricular fibrillation has arrived!

However, at this moment, everyone looked ashen-faced.

It was as if death was already a foregone conclusion.

……

(End of this chapter)