Pulmonary hypertension is particularly susceptible to this hypercoagulable state. When it becomes hypercoagulable, pulmonary embolism is likely, which will further worsen right heart failure.

In clinical practice, this condition is sometimes treated with anticoagulant injections, most commonly low molecular weight heparin sodium injected into the abdomen.

Pregnant women require special consideration. In cases like this surgical patient, it is precisely the hypercoagulable state of pregnancy that has caused thrombosis in the existing mechanical valve, necessitating urgent heart surgery.

How to address these conflicting issues? It’s best to avoid massive bleeding during surgery for pregnant women. As Doctor Du mentioned, on one hand, obstetricians should try to shorten the time of the Cesarean Section, allowing the cardiac surgery team to take over. On the other hand, anesthesiologists must play a role in safeguarding the pregnant woman during surgery, striving to help her endure the Cesarean Section procedure.

After receiving a call from Du Yeqing, Anesthesiologist Doctor Mo arrived on the scene.

Doctor Mo first introduced to the obstetricians: "The anesthesia plan should be based on already mature and effective plans to schedule the patient. General anesthesia is used for heart surgery, while the Cesarean Section can use either continuous epidural anesthesia or continuous epidural anesthesia."

Why not use general anesthesia for the Cesarean Section?

Traditionally, anesthesiology has considered general anesthesia to present many disadvantages for Cesarean Sections, with the biggest being that many general anesthetics can easily enter the fetus and cause fetal respiratory depression. Unfortunately, these drugs are the ones most commonly used and familiar to anesthesiologists during general anesthesia. If these common drugs are replaced with less frequently used special drugs, there is a risk of unforeseen complications.

In the current case, this patient is risking her own life just to have a child, and neither she nor her family is willing to put the child at risk at such a critical moment. Fetal respiratory depression could result in the newborn being asphyxiated, potentially leading to brain damage if the baby survives. Therefore, the patient and her family, having researched medical information, refuse general anesthesia.

Is it possible to use continuous epidural anesthesia instead of general anesthesia?

The anesthesiologists and cardiac surgeons cannot guarantee 100% certainty about this; they might urgently switch to general anesthesia depending on the situation during surgery. The patient’s current cardiac function is not good, and it may require additional circulatory support during the operation.

Du Yeqing said, "If the patient’s condition worsens, we might provide her with pre-emptive IABP support."

(The meaning of IABP was explained in previous Chapters and will not be repeated here.)

Given these circumstances, how can we ensure the feasibility of the current plan?

"Director Zhang led the morning rounds discussion, and today he will prescribe a different combination of medications to be used. It’s anticipated that the patient’s condition will improve by tomorrow," Du Yeqing said.

It turns out the big boss made a move.

"Of course, according to our Director Zhang’s prediction, the medication can only sustain her until about the day after tomorrow," Du Yeqing added. It’s not that it wasn’t used before, but it needs to be applied at the critical moment. Some drugs show immediate effects but don’t fundamentally solve the issue, and their effectiveness quickly diminishes.

After listening, Du Haiwei knew that cardiac and interventional cardiology doctors would be there to guard the Cesarean Section, which relieved some of the obstetricians’ anxiety.

During the meeting, someone quietly arrived and sat next to Zhang Huayao, secretly gesturing to Student Xie.

Xie Wanying turned her head and saw Senior Brother Shim’s charmingly raised eyebrows smiling at her.

On site, except for the neonatal specialist, most of the surgical team doctors were present, allowing open discussions about any issues.

Du Haiwei turned to the young doctors in the group, seeking a collective brainstorming: "Share your thoughts on this surgery, and bring forth any good suggestions for discussion."