Operating Room.

At this moment, the atmosphere in the operating room was extremely tense. Everyone present was on edge, as if facing a formidable enemy.

Zhao Heng over here had already completed the pre-operative anesthesia preparations.

But looking at the patient's fluctuating heart rate and blood pressure, Zhao Heng felt as if his emotions were riding a roller coaster.

"The patient's vital signs are stable, we can begin the surgery."

Zhao Heng steadied his mind, looked again at the patient's heart rate and blood pressure, and said to the chief surgeons Liu Ziang and Jiang Rui.

"Okay, let's begin."

Liu Ziang nodded, marking the start of the surgery.

The first task was extracorporeal circulation, performing it on such a critically ill patient was like dancing on a knife's edge; a slight mistake could mean the patient's heart might cease to recover its beat.

"Dr. Zhao, the heart-lung machine, temperature control water tank, and oxygenator are ready."

Over here, Tian Zhen also reported to Zhao Heng.

She and Sun Li had prepared all the equipment needed for the extracorporeal circulation.

"Good."

Zhao Heng nodded.

Next, together with cardiac surgeon Jiang Rui, Zhao Heng would complete the extracorporeal circulation, while Liu Ziang was preparing to open the skull.

All these tasks proceeded methodically, the whole operating room was like a complex, large battlefield, with each person charging forward at different times.

This is the common multi-threaded working model in the operating room, and as a surgeon, one must be extremely adept at this working mode.

Normally, when performing extracorporeal circulation open heart surgery, a median sternotomy is used, with most of the supply cannulae inserted through the ascending aorta, and venous drainage cannulae inserted through the right atrium.

A median sternotomy, simply put, means the patient's chest must be completely opened from the middle, directly exposing the heart.

This is similar to craniotomy operations.

Zhao Heng held the sternum retractor, while Jiang Rui held the electric scalpel; under their collaboration, the patient's chest was quickly opened.

With the chest opened, the heart was directly visible.

Seeing the heartbeat of a human heart at such close proximity, this vivid lively experience was truly awe-inspiring.

No matter how many times he had seen it, every time he saw such a scene, Zhao Heng always felt a shiver in his core.

This was a very vivid life, and the life and death were in the hands of the chief surgeon, a feeling that if one has never been a surgeon, they simply cannot comprehend.

Hiss!

Upon seeing the patient's heart, Zhao Heng drew in a sharp breath.

Because, on the surface of the heart, he saw scars caused by electric shocks. These scars radiated across the heart's surface, a very typical electric shock display.

Seeing this sight before him, Zhao Heng again felt that it was a miracle this patient was alive and on the operating table.

Next, let's see if another miracle can occur.

"Proceed with the cannulation of the ascending aorta."

Zhao Heng said in a deep voice.

Being the anesthesiologist, the array of procedures involved in extracorporeal circulation naturally fell under his leadership.

"Alright."

Jiang Rui nodded.

At this moment, his respect for Zhao Heng, already substantial, deepened further.

Even at Hopkins, performing extracorporeal circulation on such critically ill patients was enough to write a paper and publish it in an SCI main journal.

This was a race against death.

To put it simply, performing heart surgery is like an engine encountering an issue that needs fixing without turning off the vehicle.

This undertaking of heart surgery and extracorporeal circulation is that kind of procedure.

Extracorporeal circulation essentially involves temporarily establishing a circulation system outside the heart to replace it, during which the heart must be in a non-beating state.

Only after the surgery on the heart is complete can its beat be restored.

When inserting the cannula, Zhao Heng's heart was in his throat; if the extracorporeal circulation was not complete and the patient's heart ceased to beat, it would mean all subsequent procedures were unnecessary.

But fortunately, in regards to this patient, Zhao Heng had prepared thoroughly, so the arterial supply cannulation through the ascending aorta, venous drainage cannula via a single right atrium cannula, superior and inferior vena cava cannulation, left heart drainage tube—all were smoothly completed.

Watching the continuously changing numbers on the fluorescent digital display, Zhao Heng let out a sigh of relief.

The blood pressure, flow rate, and oxygen concentration were all normal, the subsequent surgery could proceed as planned.

"Dr. Jiang, you can begin."

Zhao Heng nodded at Jiang Rui.

"Alright."

Jiang Rui, who had been waiting, proceeded with a resident doctor from the cardiothoracic department to commence the repair of the heart valve.

At the same time, Liu Ziang was also performing the craniotomy, removing the intracranial hematoma.

Seated next to a pile of monitors, Zhao Heng sat upright, attentively monitoring the real-time data displayed on the screens.

The data continuously reflected the condition of the patient's body.

Time ticked away, minute by minute.

After three hours, Liu Ziang first completed the removal of the intracranial hematoma and proceeded with cranioplasty.

Having completed the hematoma removal, Liu Ziang looked at Zhao Heng, who had been under high tension without a moment's relaxation, and felt even more admiration.

Today's young doctors are seldom like Zhao Heng.

At this moment, Jiang Rui suddenly frowned, appearing to encounter some issue.

"Dr. Jiang?"

Seeing Jiang Rui frown, Zhao Heng couldn't help but stand up and ask.

"Dr. Zhao, Director Liu, come and see."

Jiang Rui called out to Zhao Heng and Liu Ziang.

Upon Jiang Rui's words, Zhao Heng and Liu Ziang walked over to the operating table and looked over at where Jiang Rui was pointing.

Upon seeing, Zhao Heng's scalp tingled, and Liu Ziang felt no better.

They saw that the patient's heart surface seemed beyond repair, the heart looked like a rotten peach.

Truly it was hard to fathom how the patient had managed to make it onto the operating table until now.

"These are electrical injury sequelae, rhabdomyolysis, likely due to the patient's unique constitution that it only manifested now."

Jiang Rui explained to Zhao Heng and Liu Ziang.

Rhabdomyolysis is a syndrome caused by substances within cells entering the extracellular fluid, usually resulting from trauma, strenuous exercise, high fever, electrical injury, and electrolyte imbalances.

The biggest issue with rhabdomyolysis is that an excessive amount of broken cell products enter the renal vasculature, potentially leading to acute renal failure and disseminated intravascular coagulation (DIC) as severe complications.

"The heart is only one locus; there must be others."

Zhao Heng said solemnly.

"Let's complete the surgery first, and post-operatively, we must vigilantly prevent the onset of acute renal failure and DIC in the patient."

Liu Ziang thought for a while and made a decision.

"Alright."

Jiang Rui nodded.

This patient seemed to be doomed with misfortunes. Even if they survived the surgery, they still had to get through the acute renal failure and disseminated intravascular coagulation caused by rhabdomyolysis post-operatively.

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