Chapter 488: Chapter 279: He Guangzong’s Amazement

"First, I agree with the diagnostic approach proposed by Director Liu and the other directors, but I believe it’s not comprehensive enough."

"I believe the patient’s true condition is the rare Berry syndrome, an uncommon combined cardiac malformation characterized primarily by aortic arch hypoplasia, coarctation or interruption, and ventricular septal defect... It is also often accompanied by complications such as patent ductus arteriosus and pulmonary hypertension..."

Hearing Jiang Ming’s analysis, many of the junior doctors were completely baffled; they had never even heard of this condition.

Gan Qi, the director of cardiac surgery, was suddenly startled, as if he had just remembered something.

Only He Guangzong’s eyes lit up. He truly hadn’t expected this Jiang Ming to so incisively pinpoint the condition.

He Guangzong followed up with great interest:

"Dr. Jiang, could you tell us how you reached this conclusion? What features led you to this judgment?"

Seeing He Guangzong’s pleasantly surprised expression, the other veteran directors could tell that Jiang Ming was most likely correct.

They were also curious as to how Jiang Ming had thought of such a rare syndrome.

Although Jiang Ming had braced himself, seeing the renowned He Guangzong and his own department director looking at him with such anticipation still made him feel a thrill of excitement.

For some time now at Xingke University Hospital, he had been just another ordinary face among the elite young doctors. It had been a long time since he had received this kind of attention and recognition.

Jiang Ming felt a pang of gratitude toward Wu Ting for giving him this opportunity, but also a hint of envy, knowing this was just a normal day for Wu Ting.

"Berry syndrome is indeed very rare. Although it’s difficult to diagnose, it does have certain characteristics. The most important one, which is very easily overlooked, is the ’butterfly sign’..."

"...In the parasternal short-axis view of the great arteries, you can detect the typical ’butterfly sign’ of Berry syndrome. This is when the aorta and pulmonary artery are displayed simultaneously, clearly showing the left pulmonary artery continuing from the main pulmonary artery, and the right pulmonary artery continuing from the ascending aorta..."

"Director He, that is my diagnostic reasoning."

After Jiang Ming finished his explanation, many of the junior doctors were completely lost; they couldn’t follow what they couldn’t even understand. Only a few of the attending physicians were able to keep up with Jiang Ming’s line of thought.

Listening to Jiang Ming’s analysis, He Guangzong was quite surprised. The young man’s judgment was almost identical to his own.

’I only managed to summarize these diagnostic techniques after decades of clinical experience at a top-tier institution like Fuwai, especially the easily overlooked yet classic "butterfly sign." I never expected Dr. Jiang to have achieved such a level of expertise at such a young age.’

He Guangzong did not hold back his praise and admiration:

"Director Liu, I didn’t realize your department had a doctor with such a deep understanding of Berry syndrome."

"Dr. Jiang, your judgment is identical to my own. I also believe the patient has the rare Berry syndrome. For this condition, we need to redesign the surgical plan. Besides the aortic arch lesion, there are many other complications we need to factor in..."

Hearing He Guangzong’s assessment, everyone was rather surprised.

Director Liu hadn’t expected Jiang Ming to perform so brilliantly either. He began to wonder, ’Have I been overlooking Jiang Ming all this time? It seems I’ll have to give Jiang Ming more opportunities and training from now on.’

The junior doctors all looked at Jiang Ming with envy. To be able to shine in an external consultation like this was a great honor for their team. With such an outstanding performance, he was sure to get more opportunities in the future.

Director Liu had always been a man who rewarded merit and punished failure, never stingy with praise for his subordinates.

With a diagnostic approach established, the next step was to gather more comprehensive test results.

They ordered a new series of enhanced scans for the patient, based on the Berry syndrome diagnosis.

During this interval, everyone took a short break.

Jiang Ming took the opportunity to go to the restroom and immediately sent a message to Wu Ting.

"Wu Ting, you’re incredible!"

"Your diagnosis was exactly the same as Director He Guangzong’s. That’s amazing."

After expressing his awe and admiration, Jiang Ming continued to ask for guidance:

"Boss, could you teach me the specific treatment plan too? The discussion on the surgical plan is about to start."

Just as Jiang Ming had hoped, Wu Ting quickly sent over the surgical plan.

"Hybrid Technology, using TEVAR combined with ascending aorta replacement and vascular bypass grafting..."

"This includes the aortic replacement using the bioresorbable polymer vascular stent that I developed... A one-stop, single-session Hybrid procedure..."

Looking at Wu Ting’s answer, Jiang Ming was filled with reverence. ’No wonder he won the national cardiac surgery skills competition.’

After memorizing the treatment plan, Jiang Ming returned to the consultation room.

A short while later, the results of the new enhanced scans, ordered by Director He, came back.

As expected, the patient’s complex vascular malformation was far more dangerous than the previous scans had shown. If they hadn’t had a clear direction, it would have been very easy to miss the remaining complications.

Seeing the latest supplementary results, Director Liu and Director Gan were both impressed by Jiang Ming’s sharp insight, and even more grateful that they had invited Director He Guangzong.

’He really is the top surgeon of Fuwai Hospital’s cardiovascular center!’

Having him oversee things was truly reassuring.

With the diagnosis confirmed, the next step was to design the surgical plan.

Cherishing this rare consultation, Director Liu had his subordinate doctors propose their own plans, hoping Director He would offer some guidance and evaluation.

The other doctors were eager to prove themselves and began to present their treatment plans. Jiang Ming’s home run with the diagnosis had ignited their competitive spirit.

Diagnosing a condition involved a certain degree of chance and theoretical knowledge, but a surgical plan was the real deal. One needed to be thoroughly familiar with clinical procedures to propose an appropriate solution.

One of the doctors was the first to present his surgical plan:

"First, given the patient’s highly complex condition, I recommend a two-stage surgical procedure..."

"In the first stage, we would perform an aortic arch reconstruction for the lesion, using a median sternotomy. The reconstruction would be completed with an extended end-to-side anastomosis... using an autologous pericardial patch..."

"The second stage would involve a traditional surgical correction of the intracardiac malformation..."

After he finished, He Guangzong offered a brief evaluation. It was clear the doctor’s fundamentals were solid, and the proposal was for a very traditional open-heart surgery.

’However, this traditional surgical approach is somewhat outdated. The probability of sequelae and complications would be high, and the prognosis wouldn’t be optimal.’

Next, another doctor proposed a plan to address the aortic arch lesion under deep hypothermic circulatory arrest:

Intraoperatively, they would first clamp the brachiocephalic trunk, left common carotid artery, and left subclavian artery. After completely resecting the coarctation segment, they would perform an extended end-to-side anastomosis to reconstruct the aortic arch. The anastomosis would be extended to the origin of the aortic arch, with the posterior wall sutured continuously and the anterior wall widened with an autologous or bovine pericardial patch...

’This plan is a significant improvement over the previous one, but it still carries the risks associated with deep hypothermic circulation.’

As He Guangzong listened to the plans from the doctors of Xingke University Hospital, he felt a bit disappointed. ’It seems the development and promotion of Hybrid Technology still have a long way to go!’

He Guangzong looked toward Jiang Ming with a hint of expectation:

"Dr. Jiang, what are your thoughts?"

This was the moment Jiang Ming had been waiting for. He stood up and said calmly:

"I believe the optimal plan for this surgery is to use the new Hybrid Technology pioneered and led by Fuwai Hospital. Specifically, through TEVAR combined with ascending aorta replacement and vascular bypass grafting..."

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