After being separated from my family, I became a darling of the military region thanks to my medical

Mayo Clinic 1.

The operating lights were blindingly white.

In this enormous catheterization lab, which houses some of the most complex interventional procedures in North America, you could hear a pin drop.

Ye Zhen stood at the surgeon's position. Harrison served as the first assistant on the opposite side, while Whitman, the head of pediatric cardiac surgery, served as the second assistant.

Former Cleveland director Cohen didn't go to the observation room. He moved a chair, sat at the recording table in the corner of the catheterization lab, and opened his notebook.

Outside the radiation-shielding lead glass, a large crowd had gathered.

Harvard Medical School professors, directors of major heart centers, and cardiac surgeons from all over the United States surrounded the closed-circuit television and glass walls.

No one spoke. Only the monitor emitted a monotonous "beep-beep" sound.

Ye Zhen raised her right hand.

"Puncture needle".

The scrub nurse immediately slapped the needle handle into her palm.

Without any unnecessary movements, Ye Zhen accurately felt the pulse of the right femoral vein, inserted the needle, and the blood return was smooth.

"Guide wire".

The soft-tipped guidewire was inserted into the blood vessel along the puncture needle. Ye Zhen looked up at the angiography screen above her head.

The guidewire travels through the blood vessel, passes through the inferior vena cava, and enters the right atrium.

"Through the oval aperture".

Ye Zhen slightly turned her wrist, and the guidewire drew an arc on the screen, passing through the interatrial septum, entering the left atrium, and sliding into the left ventricle.

Track established.

"Angiography"

The contrast agent was injected. The screen immediately displayed the actual blood flow inside the heart.

The massive ventricular septal defect is like a funnel. Blood is rushing wildly between the left and right ventricles.

Ye Zhen glanced at the imaging screen.

"Seven-millimeter asymmetric occluder".

Whitman paused, then lowered his voice: "The defect is nine point three millimeters in diameter; normally you should choose a model with a diameter of ten to twelve millimeters."

Ye Zhen didn't stop and began pushing the delivery sheath.

"The aortic valve margin is only 0.9 millimeters."

"The left disc of the 10mm occluder has a diameter of 14mm. Once deployed, it directly crushes the aortic valve leaflets, leading to acute regurgitation."

"Seven millimeters asymmetrical design, left disc diameter eleven millimeters. Those extra three millimeters are her lifeline."

Whitman shut her mouth. The experts in the observation area took out their pens and quickly jotted down the logic behind this parameter selection.

The delivery sheath reaches the left ventricle.

"Balloon test sealing".

The test balloon is inserted into the defect along the track.

Ye Zhen slowly injected saline solution, and the balloon gradually expanded on the screen, eventually fitting into the defect.

"Report the indicators: left ventricular pressure, aortic regurgitation, and electrocardiogram."

Harrison glanced at the monitor on the left: "Left ventricular pressure 85, within the threshold."

"The ultrasound showed no aortic regurgitation."

Both are qualified.

Before anyone could breathe a sigh of relief, Whitman's expression changed.

"Abnormal electrocardiogram!"

"PR period extended!"

"One hundred and sixty...one hundred and eighty...two hundred!"

A collective gasp rippled through the observation area. Several experts instinctively pressed themselves closer to the glass.

A prolonged PR interval indicates mechanical compression of the conduction bundle. Increased compression can lead to complete atrioventricular block, causing cardiac arrest.

This is a red line in interventional surgery.

The standard procedure has only one path: remove the balloon, abandon intervention, and turn to open the chest.

Whitman broke out in a cold sweat: "Dr. Ye, should we retreat?"

Ye Zhen stood in front of the operating table, not taking a single step back.

"We will not withdraw."

She gripped the end of the sheath with both hands and stared at the imaging screen.

"Keep a close eye on the PR period."

As soon as she finished speaking, Ye Zhen's fingers moved.

Instead of pulling the sheath back, she kept it in place and rotated the tube counterclockwise very slowly.

Five degrees.

Ten degrees.

Fifteen degrees.

On the angiography screen, the long axis of the balloon was deflected by an extremely small amount, the angle shifted, and it left the muscle of the conduction bundle.

"Electrocardiogram!"

Whitman shouted it out.

"One hundred and eighty...one hundred and sixty...one hundred and forty!"

"PR interval has returned to normal!"

The crisis is over.

The whole process took less than twenty seconds.

Outside the observation room, several directors of the cardiology center looked at each other in bewilderment. Instead of evacuating, they were directly performing rotational fine-tuning within the fragile heart chambers?

This tactile experience of three-dimensional perception of anatomical structures broke through their cognitive boundaries.

"Inflate the balloon and release the occluder."

The scrub nurse handed over the push rod loaded with the 7mm occluder.

Ye Zhen pushed the occluder into the sheath and delivered it to the left ventricle.

"Release the left wheel."

Push the lever forward. The left half of the occluder expands in the left ventricle, like a miniature umbrella.

Ye Zhen pulled back slightly, pressing her left disc tightly against the left side of the interventricular septum.

"Release the right wheel."

The sheath retracts. The right half of the occluder expands in the right ventricle. The alloy mesh discs at both ends clamp tightly around the edge of the defect.

It takes shape in the very instant.

"Beep beep beep beep—!"

The high-frequency alarm sounded shrilly.

On the monitor, the blood pressure readings plummeted.

"One hundred, ninety, eighty-five!"

Blood oxygen saturation plummeted from 75 to below 70.

"Insufficient left ventricular volume!" Whitman roared.

The left ventricular outflow tract is only 4.6 mm in diameter, and the left ventricle itself is underdeveloped. After the occluder is deployed, its large size occupies the remaining intracardiac space.

The blood returning from the pulmonary veins is blocked and cannot reach the aorta.

Acute left heart failure.

Whitman turned to look at the backup passage.

"Surgical team! Bring the cardiopulmonary bypass machine over!"

"Open her chest immediately!"

The experts in the observation room were ashen-faced. Physical volume limitations were an ironclad rule; no technique could compensate for insufficient cavity space.

Ye Zhen's voice drowned out the alarm.

"Don't move!"

She reached out to stop Whitman, who was about to turn around to get her open-chest bag.

Give me thirty seconds.

Ye Zhen gripped the delivery sheath with both hands, her thumbs pressing against the push rod.

She neither retrieved the occluder nor allowed the surgeons to take over.

Amidst everyone's shocked gazes, Ye Zhen exerted force with her wrist, pushing the delivery sheath forward two millimeters.

Only two millimeters.

The end of the sheath slightly presses against the center of the left disc of the occluder.

The alloy mesh, which was originally perfectly round, underwent a slight deformation under this extremely small physical force.

It changed from a circle to an elongated ellipse.

The major axis of the ellipse follows the direction of blood flow, while the minor axis avoids the narrowest part of the outflow channel.

The previously blocked space was forcibly squeezed out to create a two-millimeter-wide blood flow channel at this moment.

The monitor's alarm was still blaring.

But the numbers scrolling on the screen stopped.

Whitman's mouth was open.

"Blood pressure...55, 60, 70."

"Blood pressure is rising!"

Harrison looked at the blood oxygen saturation: "Seventy-one...seventy-five...seventy-eight...eighty-two."

Thirty seconds.

The high-frequency alarm stopped abruptly. The catheterization lab returned to a steady "beep-beep" sound.

Ye Zhen gripped the sheath firmly, looking at the occluder on the imaging screen whose shape had changed, preparing to issue the locking command.

The observation area was deathly silent.

Old Cohen sat at the record table in the corner of the catheterization lab, his pen hovering in mid-air, a drop of ink spreading across the paper. He had even forgotten to take notes.

Several professors of cardiac surgery from Harvard Medical School looked at each other.

No textbook has ever described how, after the occluder has been released, the physical compression at the end of the sheath can be used to forcibly change the geometry of the shape memory alloy, thereby creating a life-saving blood flow channel out of thin air within the narrow ventricular cavity.

This requires not only a terrifying understanding of anatomy, but also the control of hand strength down to the micrometer level. Pushing too much will cause the occluder to shift; pushing too little will cause the patient to die of heart failure.