I, Tomoya Aki, am not a bootlicker

The aortic curtain, also called the aortic-mitral intervalvular fibrous body, is less than 1 cm high and is located between the anterior leaflet of the mitral valve and the root of the non-coronary valve, close to the roof of the left atrium.

Infective endocarditis, degenerative calcification, and previous mitral valve replacement surgery can damage this structure, making aortic and mitral valve replacement very difficult.

In these cases, surgical reconstruction of the aortic curtain may be the only option.

Chapter 483 Psychological preparation

The aortic curtain was reconstructed and expanded. This was the answer given by Tomoya Aki.

The patient has been carrying on a normal daily life due to the deterioration of the bioprosthetic valve function from the previous surgery, which resulted in severe heart failure symptoms.

Regardless of whether she is a VIP or not, surgery for such patients must be arranged as soon as possible, otherwise their lives may be in danger at any time.

Consider performing curtain reconstruction to implant a larger artificial valve and avoid postoperative complications.

One of the main reasons for this consideration is that it has been found that the peak pressure gradient of the aortic valve increases year by year.

At that time, only size 19 biological valves could be implanted. If a larger size biological valve was to be implanted, the only option was to enlarge it.

In clinical practice, it is uncommon for patients to undergo aortic curtain reconstruction surgery.

At the same time, this also poses a great challenge to the surgical team.

The surgery requires replacement of both valves and reconstruction of the aortic curtain, which further increases the difficulty of the operation.

When it came to the aortic curtain reconstruction, Akitomo Tomoya was mentally prepared, guessing that he might not be the one to perform the surgery this time.

To be on the safe side, if this operation is to be performed, it would most likely be Sasaki Kazuru or Yoshida Aoba who would lead the team.

"In the United States, they call this type of surgery a commando operation. You've probably only seen it in papers."

Yoshida Aoba frowned slightly.

There is a set of data that shows more than five hundred patients with valvular heart disease underwent surgery, among which only a few patients with aortic valve and mitral valve disease had damage to the valvular structure and required valvular reconstruction.

It's not like he hasn't encountered patients who needed this kind of surgery before, but it's also because of this that it would be worrying if such an operation was handed over to Tomoya Aki to perform.

Because even if he guaranteed that Aki Tomoya already had the ability to perform surgery, Aki Tomoya had never performed surgery as a lead surgeon before.

"On one side is the department, and on the other side is the patient. In addition to getting the consent of the people in the department to let you perform the surgery, you also need the consent of the patient."

Yoshida Qingyun was also worried, although he was willing to talk to Aki Tomoya.

But at the same time, there will be worries in my heart.

Not everyone can perform this operation.

And, that’s VIP.

Whether they are ordinary patients or VIPs, they all hope that the person who performs surgery on them is an expert, a famous doctor.

It is also because they are VIPs that they are willing to pay so much money so that experts can provide them with special medical care.

If you tell them that the surgeon is performing the surgery for the first time, both ordinary patients and VIPs will feel dissatisfied.

Of course, Aki Tomoya was aware of these things, so he did not force Yoshida Aoba to let him perform the surgery.

The suggestions just made were also based on considerations of the specific situation.

Akitomo believes that curtain reconstruction is necessary, or must be performed during this double valve replacement surgery.

The small biological valve is no longer suitable for the patient, and a larger biological valve needs to be implanted. In order to eliminate the mismatch, it is naturally necessary to reconstruct and expand the aortic curtain.

"I'll go talk to Sasaki. There will be a consultation in the afternoon. Come with me then."

Yoshida Aoba is still prepared to fight for Aki Tomoya.

Because if we talk about aortic curtain reconstruction, since it is rare, everyone is actually similar.

He is Mrs. Omi's attending physician. If the surgeon is to be the lead surgeon, it would be Yoshida Aoba, even if it is not Aki Tomoya's turn.

But there is one thing that is the difference between Yoshida Aoba and Aki Tomoya.

The former has extensive experience in heart surgery, while Tomoya Aki, in the eyes of most people, is just a rookie.

So Yoshida Aoba also reminded Aki Tomoya that if it doesn’t work this time, then try next time and don’t be disappointed.

In this regard, Akitomo expressed his understanding. When he thought about aortic curtain reconstruction, he knew there was little hope.

It would be more reassuring to leave it to a more reputable doctor rather than a novice doctor.

So, if I have to say I am disappointed, it is not too big.

After calming down, Akitomo decided that he would not be the main surgeon this time and that the next time would be enough.

The surgery that needed to be performed was very complicated and the patient was a VIP, so it wasn't something that could be easily handed over to him.

……

"It appears that a curtain reconstruction is needed to allow for the implantation of a larger bioprosthesis."

After learning about the matter from Yoshida Aoba, Sasaki Ichiru agreed with Aki Tomoya's point of view.

According to the current situation, it is imperative to choose curtain reconstruction to allow patients to implant larger bioprostheses and improve the aortic valve pressure gradient.

"But you came to me because you want me to be the surgeon?"

Sasaki Ichiru looked at Yoshida Aoba with a scrutinizing gaze.

It’s not that he couldn’t see Yoshida Aoba’s purpose in coming to see him, but it’s hard for him to say anything about things like this.

Therefore, it would be better to make Yoshida Aoba shut up by pretending that he wanted to snatch the surgery away from him.

However, Yoshida Aoba's understanding of him is unmatched by anyone else.

Seeing that Sasaki was perfunctory at this time and wanted to avoid the topic, he replied a little unhappily: "Doctor Sasaki, you should know why I came to see you."

"...But you should also know that for an operation like this, the first time the surgeon is Dr. Aki, even if you feel assured, will others feel assured?"

“He proposed the plan.”

"But you and I can both think of this plan."

Sasaki's momentum was undiminished once he entered the game, and this matter also gave him a bit of a headache.

Although he also believed that Akitomo was capable of performing the surgery, it was inappropriate to perform such an operation at the beginning.

"You know it yourself, isn't it too soon to let Dr. An Yi perform such a complicated surgery for the first time?"

“I think he has the ability.”

Yoshida Aoba said this stubbornly, but how could he not be worried in his heart?

Besides, he didn't know what to say to the patient.

Even if Sasaki Ichiru nodded, if the patient could not be convinced, he would have to do it himself in the end.

"Even if I agree, Mrs. Omi will be scared. Let's put this matter aside for now and arrange the surgery first."

Sasaki Ichiru shook his head.

"I will be there by then, and if there is any situation, I will take action."

Yoshida Aoba's greatest confidence is that he also follows the review, which is a point that cannot be ignored.

"If it really doesn't work, you can come along too. With the two of us here to check, if anything goes wrong, you and I can take over at any time."

"Do you need to worry so much?"

Sasaki Ichiru widened his eyes and looked at Yoshida Aoba who was speaking to him in a pleading tone in disbelief.

The other party is too nice to Aki Tomoya.

"I only have this one disciple, unlike you."

Chapter 484 This is Doctor An Yi

"You really scared me..."

Sasaki Ichiru looked at Yoshida Aoba in front of him in surprise.

Although he could understand Yoshida Aoba's feelings, this matter could not be decided by emotions.

Besides, he was too nice to Akitomo.

When our relationship was good before, even when we were at the university hospital, I had never seen him take such good care of me.

If he could perform this operation and it was successful, it would mean that Tomoya Aki's first operation would not only be perfect, but if it got out, he would also become famous.

The young and outstanding cardiac surgeon successfully completed the "commando" or curtain reconstruction surgery on his first performance.

After the news gets out, looking back at Tomoya Aki's age, there will definitely be a lot of people who are amazed and envious.

The first operation was such a challenging thing that it could be said that a big stage had been set up.

However, this is surgery to save lives, not a show.

Patients are VIPs of the hospital, and even if they are ordinary patients, we have to consider more secure methods.

But just like Yoshida Aoba said, let him and the other party work together as assistants of Aki Tomoya. If Aki Tomoya has any problems along the way, either of them can take over before any problems arise.

"Do you want me to ask Dr. Nakagawa and Dr. Moriyama to come along as well?"

"You can call Dr. Nakagawa over, but forget about Dr. Moriyama. He's too withdrawn and I don't like him. And don't forget why Amami-kun came to my side in the first place."

"Haha, you really wish for it!"

Sasaki was just talking casually, but he didn't expect the other party to bargain with him.

"Even if it's not Aki Munjitō, the staffing is still the same."

"But if you rashly give this surgery to Aki Junji, even if the department agrees, do you think the patient will agree?"

Although there is no problem with staffing, who will perform the surgery requires more than just approval from the department.

If the patient does not agree, it will be in vain.

Therefore, the key point is not whether Sasaki nods, but whether the VIP will agree.

"I owe you a favor. No matter whether it succeeds or not, as long as you nod your head, I will convince Mrs. Omi."

"...You can't lie, you can't hide anything from the patient, and you can't tell anyone anything that's not true!"

Sasaki Ichiru looked at Yoshida Aoba warily.

He didn't want to see Yoshida Aoba running to the patient and talking nonsense about this matter. If something happened then, it would be troublesome.

"I won't say anything nonsense. I'm just trying it out. Whatever the facts are, we'll do what we have to do. After all, the plan was proposed by Ami-kun. Let the person who proposed the plan perform the surgery, and the patient will feel at ease."

"Don't play word games with me!"

Sasaki Ichiru shook his head in warning.

He seemed to feel how persistent Yoshida Aoba was about this matter.

But it’s the same problem, we have to convince the patient first.

If the other party is unwilling, there is no point in saying anything.

"You can try. No matter what the result is, Aki-kun is still in the surgery team."

"That's it, I'll take the first step."

Yoshida Aoba turned and left.

Watching his back as he left, Sasaki couldn't help but sigh, "After letting this guy go, he's slowly getting better, right?"

This is a good thing. He doesn't have to dwell on the failed marriage in the past. Now Yoshida Aoba has a new direction.

Yoshida Aoba is now a good teacher, which is better than the time when he was always worried about his failed marriage.

But he is too good a teacher.

The first operation was to perform the challenging aortic curtain reconstruction.

"But it's hard to say what happened to Director Monobu..."

Although he was responsible for arranging most matters in the department, an operation like this one could not be carried out without informing the director of the logistics department in advance.

Not to mention, Director Monobe might also be interested in this operation.

It is also a troublesome task to convince Director Mononobe to agree to let Tomoya Aki perform the surgery.

"Yoshida, you really caused me trouble..."