Surgery Godfather-Chapter 450 - 411 Lets Get to Work
Chapter 450: Chapter 411: Let’s Get to Work
Chapter 450: Chapter 411: Let’s Get to Work
Under the guidance of fighter jets, the plane entered Alaskan airspace, established contact with Fairbanks airport tower, and landed smoothly.
The airport manager, accompanied by several staff members, boarded the plane to express his intentions to Dr. Yang, and led him to the specially prepared private jet that would fly directly to Houston.
They were very warm and considerate. Knowing there were three people, they prepared three coats to temporarily fend off the cold. There was some distance from one plane to another, and having the coats for warmth during the journey would prevent them from suddenly feeling too cold.
As Fairbanks is near the North Pole, the average annual temperature is quite low. Upon disembarking, it was indeed chilly.
The emergency situation on the International Space Station is now the hottest news in the United States, leaving no one uninformed even in the remote town of Fairbanks.
Upon learning that Dr. Yang was rushing to Houston to take part in the rescue of astronaut Steven from the International Space Station, the African-American manager told Dr. Yang that after accomplishing his mission, he must visit Fairbanks. He offered to show everyone the Northern Lights, treat them to reindeer meat and king crab, and enthusiastically left his phone number with Dr. Yang.
As day began to darken, everyone raced against time, not daring to waste any second. They immediately boarded the private jet to Houston.
By the time they arrived in Houston, it was already late at night. Jim Basa, accompanied by John Ansen and several officials, were waiting at the airport.
This was a world-leading expert recommended by John Ansen from Mayo Clinic. Famous for being even more prestigious than Ansen, considered Ansen’s teacher in medicine, his unique charisma was evident at first sight.
Given John Ansen’s prominent position in the United States’ neurosurgery field, it was a gamble for Jim Basa to rely heavily on Dr. Yang.
A business vehicle rapidly transported them to Space City, the ground control center at the Johnson Space Center, where lights were on all night.
The Emergency Rescue Team had already laid floor bedding here, allowing anyone who needed rest to lie down at any time. Everyone was working in shifts to maintain a continuous 24-hour operation.
When Dr. Yang entered the main hall of the Ground Control Center, the myriad of screens, busy staff, and clicking of keyboards all signaled that this was the communication center between the United States and the International Space Station.
Upon hearing of Dr. Yang’s arrival, over a hundred people, including doctors, engineers, and ground control center staff, gathered to finally meet the expert highly praised by John Ansen. He was much younger than they had imagined.
In such an emergency, no time was wasted on extraneous introductions. The patient’s condition had already been communicated back and forth several times. John Ansen brought Dr. Yang straight to a screen, and the doctors gathered around.
“Blood pressure 85/40mmHg, heart rate 38 beats/minute. We’re currently using nifedipine for controlled blood pressure lowering, and applying an ice cap to lower the temperature of the head.” Ansen said, choosing only the most vital points.
As soon as Dr. Yang sat down, he got into the swing of things. He had already gone through Steven’s medical records on the plane and was simply revisiting the case now.
On the private jet to Houston, Dr. Yang had already cloned Steven’s experimental body in system space and performed a simulated surgery. The formidable capabilities of the system space not only allowed for the cloning of cases but also for the cloning of surgical equipment and environments.
He simulated two methods: one using remote medical surgical equipment and the other performing the surgery directly on the space station.
This was the first time Dr. Yang had encountered such a peculiar case. In human history, Steven would probably be the first astronaut in space who required surgery, and many aspects of the situation had to be explored.
“This is a full-brain DSA that the astronaut Dr. Susan carried out for Steven at the space station. The image quality is not very good,” Ansen revealed as he pulled up the DSA image.
“The image quality is bad, but sufficient for diagnosis. He has a small cerebral aneurysm. The artery it’s on is very risky. It impinges upon the medulla oblongata’s circulatory system – fatal if it ruptures. Immediately proceed with endovascular surgery to embolize the aneurysm.” All the onlookers were first-class doctors, so Dr. Yang decided to be straightforward and not beat around the bush.
“Routine MRI and CT angiography of the cerebral vessels conducted on the ground showed no abnormalities. It’s likely a cryptic cerebral aneurysm with the initial symptoms of a slowing heart rate. Several days ago, Steven had started to display headache, dizziness, and feelings of suffocation from lack of oxygen,” Ansen continued to introduce the case.
“Correct, cryptic cerebral aneurysm. In a microgravity environment, without normal gravity on earth, venous drainage from the head becomes difficult, resulting in relative venous congestion and arterial congestion. The concealed aneurysm appeared under higher blood pressure, it disrupts the circulatory system, leading to myocardial inhibition. This is a case of central myocardial inhibition. Surgery must be arranged as soon as possible. What medications, equipment, and medical conditions do you have on the space station? Give me a detailed list and be quick about it!” Dr. Yang did not have the time to lecture them, as Steven’s condition could not afford the wait.
An intervention surgery had to be performed. If there was access to drug-loaded microspheres, it would be even better, especially flexible stent drug-loaded microspheres that absorb coagulation drugs, which could then be transported to the location of the aneurysm. The coagulation drugs carried by the microspheres would gradually initiate the coagulation process at that local area to form a thrombus. With no blood flow to pass through, the aneurysm naturally wouldn’t experience any pressure of blood flow, eliminating the risk of rupture. After two weeks, the thrombus would become an old one with added stability, which could withstand the shock brought by a swift plummet when returning to Earth.
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Companies that have more mature microsphere technology include Biocompatibles in the UK, BioSphere in the United States, and Hengrui in China. Their embolic microspheres – DC Bead, HepaSphere, and CalliSpheres – are mainly used to treat liver cancer, by binding with anthracene through ionic (mainly) and hydrogen bonds. They can precisely control the dosage of medications, which are then slowly released through an ionic exchange mechanism following arrival at the lesion.
If the microspheres could be loaded with coagulation drugs like thrombin, there would be no need for release, simply let it act locally at the target area.
Laboratories of some companies are currently researching this type of microsphere. Dr. Yang was not sure about its progress towards clinical usage.
If there isn’t such microsphere product, traditional coil embolization has to be used.
However, with subsequent risks involved with metal coil embolization, after dealing with the aneurysm crisis, Steven would eventually have to return to Earth. He couldn’t possibly stay on the space station for the rest of his life. During the high-speed descent back to Earth, if the coil were to move in his brain, it could pose a life-threatening danger.
Therefore, the second method, coil embolization, would require an additional surgical procedure to ligate the artery after stabilising the condition, so as to withstand the shock caused by a high-speed descent when returning to Earth.
Performing a craniotomy on a space station, let alone a brainstem surgery, is absurdly impossible.
Yang Ping shared his ideas, hoping to make use of the first method; to deal with everything at once, simple, safe, and minimally invasive.
“Regardless of the method, I want to know the success rate?”
Professor Massimo had been silent all this time, he was repulsed by Yang Ping’s self-confidence.
“This is Professor Massimo, the head of the intervention department at Johns Hopkins.” John Ansen took the opportunity to introduce him.
“Hello, Professor Massimo!”
Yang Ping had read many of his classic interventional publications in the system space, and the latest industry-leading micro-spring coils were his design.
But now, Yang Ping had neither the mood nor the time to flatter him.
“Success rate? If I must give a definitive number, above eighty percent.” Yang Ping could only give a rough estimate.
“Eighty percent?” Massimo almost burst into laughter on the spot, not even the most brazen charlatan dares to boast so wildly. What kind of person did John Ansen invite? He was just a charlatan. Massimo would have been willing to listen even if he said thirty or forty percent.
“What’s the matter? Professor, did I say something wrong?” Yang Ping thought his reaction was too exaggerated.
“You didn’t say anything wrong, maybe I heard it wrong, how many of these cases have you, Dr. Yang, operated on before?” Massimo asked in a questioning tone.
At this point, every second was crucial, and the aneurysm up in space could burst at any moment. And he was still debating with me.
“Professor Massimo! Are you doubting my surgical skills? I don’t have time for your questioning, did you invite me to Houston for questioning? Or to help solve a crisis? If it’s the former, I’m not interested, and I believe you aren’t either. Right now, either follow my lead or solve the problem yourselves, and buy me a flight ticket, I will return to China immediately.” Yang Ping got impatient, at the crossroad of life and death, there was no time to waste on small talk.
Jim Basa thought Massimo’s entanglement was reasonable, but meaningless and not suitable for this emergency scenario. With the endorsement of John Ansen and Mayo, there is no room for doubt. Otherwise, they wouldn’t have invited him.
“The implementation of medical rescue technology will be directed by Dr. Yang Ping, and no refutations or debates will be accepted.” Jim Basa stabilized the situation.
“We will contact BioSphere company immediately to enquire about the availability of drug-loaded microspheres for blood coagulation.” Alpha, the Chief Medical Officer of NASA, mobilized immediately.
The emergency rescue team was directly commanded by the president, with Jim Basa as the team leader. In times of crisis, they could allocate all resources.
This type of resource allocation by the rescue team, a flat-style crisis management, is highly efficient.
A few phone calls later, it was confirmed that BioSphere’s research on drug-loaded microspheres for blood coagulation hadn’t been successful yet and didn’t meet clinical requirements. Currently, only microspheres for liver cancer treatment were available.
So, they could only use spring coil embolization to solve the most urgent problem, and further problems would be researched later.
“Professor Massimo has more precise intracranial intervention equipment.” Dr. Eugene reminded everyone.
“If necessary, we can launch another rocket to deliver the equipment, but it will take eight hours.” Richard thought it would be feasible to launch a high-density rocket.
“Eight hours is too long, Steven can’t hold on for that long.” Yang Ping rejected this plan, his simulated surgery and pathological dissection gave him a very accurate assessment of Steven’s condition.
“The Russians can deliver it in three hours.”
“The equipment is in the United States, but their rockets are in Kazakhstan.”
“Let’s get to work! Proceed with the surgery directly, using your existing equipment, and prepare to open the remote surgery system.” Yang Ping was ready to perform the surgery overnight.
By tomorrow morning, Steven would no longer need rescue. His aneurysm would have ruptured.
The eighty percent success rate was in reference to using the remote surgery system.
All the doctors were stunned. The remote surgery system had uncertainty due to communication delays and interruptions, and the stability of the patient on the space station was also a concern due to various reasons.
Under such circumstances, the intervention of the small arteries in the brainstem – regardless of interrupting communication, any delay could pierce a blood vessel, resulting in immediate death.
But now, he was the only one with confidence, and there was no other way.
