Chapter 432: Chapter 431: Preliminary Procedure

At 9:10 AM, in Operating Room 5 of the cardiac surgery department, the unconscious patient had already been moved onto the operating table, fully prepped for surgery.

Liang Zhaokui and his surgical team were standing by, ready for action.

"Mr. Liang, the vehicle transporting the blood is still stuck on the overpass. It’s not moving at all."

Upon hearing his assistant’s latest report, Liang Zhaokui’s gaze shifted to the blood salvage machine at the side. He instructed, "Go check it again. Make sure there are absolutely no problems with it."

"If we have a massive hemorrhage during the operation, that machine will be our last hope."

This imported blood salvage machine could collect the blood lost by the patient during surgery.

It would then undergo a multi-step process including filtration, washing, and concentration to produce standard-compliant plasma to be reinfused into the patient.

Intraoperative autotransfusion was already a common method used by many major hospitals for transfusions during major surgeries.

It offered numerous advantages.

For instance, it alleviated blood supply shortages, reduced medical costs, eliminated the need for blood typing and cross-matching, and decreased transfusion reactions and complications.

However, for surgeries with massive blood loss, this autotransfusion method could only be considered an effective supplement. Preparing an adequate supply of allogeneic blood was still essential.

The collection and processing of autologous blood had issues with recovery efficiency.

Not all the blood a patient lost could be collected and reused; some loss was inevitable.

A recovery rate of fifty to sixty percent was considered quite good.

A patient bleeds continuously during surgery, and in some operations with massive hemorrhaging, the amount of blood transfused can sometimes be two to three times the patient’s total blood volume.

Due to this efficiency rate and the inevitable loss, autotransfusion alone could not meet the patient’s blood requirements, especially in surgeries with massive hemorrhaging.

There was also the issue of a time delay.

From the moment a patient began to hemorrhage, to the collection of blood, its processing into transfusable plasma, and its reinfusion back into the body, there was a time lag of fifteen to thirty minutes.

During this period, the patient’s body would not receive a timely blood supply, which was long enough to cause fatal complications.

Seeing his assistant confirm once more that the blood salvage machine was functioning normally, Liang Zhaokui turned his gaze to Yan Feifan, who was standing in the lead surgeon’s position.

He glanced again at the patient’s vital signs displayed on the various monitors, took a deep breath, and nodded. "Mr. Yan, let’s begin."

Having received the go-ahead, Yan Feifan didn’t hesitate for a second, immediately starting the procedure.

To minimize the incision and reduce blood loss, Yan Feifan didn’t use the conventional open-chest approach. Instead, he used a scalpel to cut directly through the skin, muscle, and thoracic diaphragm between the patient’s third and fourth left ribs, straight to the heart.

Then, Yan Feifan used a retractor to spread the third and fourth left ribs as wide as possible to facilitate the next step of the surgery.

Through the surgical window created by the retractor, Yan Feifan, Liang Zhaokui, and the others standing on either side of the operating table could clearly see most of the deep red heart, endlessly expanding, contracting, and beating.

The sight before them made Liang Zhaokui and the others’ hearts pound with anxiety.

On the right atrium, a glossy, oval-shaped hematoma, nearly two centimeters at its widest point, was bulging out.

It was a ticking time bomb, ready to burst at any moment.

If it burst, the myocardium would rapidly lose blood, leading to fatal consequences like cardiac arrest.

Liang Zhaokui once again turned his gaze to Yan Feifan.

He saw him steadily take a puncture syringe filled with an embolic agent from the nurse and move it toward the surgical window.

Liang Zhaokui paid special attention, noting that Yan Feifan’s gaze was focused and steady, showing no trace of hesitation or panic.

This made him nod to himself in approval.

’This kid’s skills are the real deal.’

’Just look at that mountain-like composure. It’s terrifyingly steady. He has the air of a great general who wouldn’t flinch if a mountain crumbled before him.’

’This is a surgeon who can dominate the operating room, one who inspires trust and calm in his colleagues.’

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’A natural-born king of surgery...’

Liang Zhaokui had just finished praising Yan Feifan in his mind when Yan Feifan’s next move nearly made him cry out in shock.

Liang Zhaokui had assumed Yan Feifan would pause. He expected him to observe with intense focus for a moment, compose himself, regulate his breathing and heart rate, and then, seizing the perfect opportunity, perform a swift, precise, and decisive puncture into the proximal branch of the coronary artery at the base of the cardiac hematoma to inject the embolic agent.

He never imagined that the guy would move his hand, holding the puncture syringe, toward the surgical window and, without any pause, thrust it straight in.

Immediately after, Liang Zhaokui saw the man’s hand jab twice, as quick and simple as a chicken pecking at rice.

Then, Yan Feifan withdrew the puncture syringe.

’That’s it?’

’I wasn’t prepared for that at all!’

Yan Feifan’s movements were so simple and casual, truly like a chicken pecking at rice—effortless and arbitrary.

"Is that... it?" Liang Zhaokui couldn’t help but ask for confirmation.

Yan Feifan didn’t even bother to reply, simply giving a slight nod as he handed the puncture syringe to a nearby nurse.

He then held out his hand and ordered the nurse, "Shunt tube!"

Having finally gotten a response, Liang Zhaokui felt a flicker of anger flare up inside him, the result of the huge gap between his expectations and reality.

’You damn kid, this is a life-or-death procedure!’

’Can’t you be a little more solemn, a little more serious? Add some ritualistic preamble, show some respect for us... for the patient’s life?’

Liang Zhaokui looked back toward the surgical window.

He saw that the bloody bulge had clearly shrunk by a third and knew the embolic agent was taking effect.

Just then, Yan Feifan’s hand, holding the shunt tube with surgical forceps, once again entered the surgical window.

The shunt tube was a ten-centimeter-long flexible tube with thick puncture needles on both ends. The ends were clamped shut with small clips, and the air had been purged from it.

The next step was performed in Yan Feifan’s typical style.

No pause, no preamble. With a motion that seemed casual yet was lightning-fast, he swiftly and accurately inserted the needles on either end of the shunt tube into the proximal and distal sides of the cardiac hematoma.

As Yan Feifan released the two small clips on the shunt tube, red blood began to flow rapidly through it.

The pressure of the blood flow caused the tube to stand erect over the heart like a quivering arch bridge.

Meanwhile, a large, previously pale area on the heart’s surface began to rapidly turn blood-red, as if being painted with splashed ink...

"Mr. Liang, the temporary external cardiac bypass is complete. Now we just need to wait for the blood products to arrive."

Liang Zhaokui composed himself and put on what he believed to be his most amicable smile.

"Mr. Yan, excellent work. You can leave the rest to us."

"And, uh... like I said before, my door will always be open to you. Unconditionally open..."

「When Yan Feifan returned to the Plastic Surgery Center, it was already past ten in the morning.」

This earned him quite a bit of grief from Wang Chuan.

"Feifan, I know we’re close, but you can’t be this casual. You said half an hour, but it’s been over an hour."

Wang Chuan complained again, "Ah Yimu just video called. She wants you to give her a detailed check-up."

"I told her that her nose has healed perfectly and doesn’t need any further adjustments. But that girl doesn’t believe me. She insists on hearing it from you before she can relax..."

Yan Feifan chuckled and explained, "Director, something unexpected came up. I was helping Mr. Liang with a cardiac bypass surgery."

Wang Chuan let out a soft "Oh," then his eyes suddenly widened.

"What? A cardiac bypass surgery?"

"You did it?"

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