How to give first aid to a patient with acute type A aortic coarctation?

   At six o’clock in the morning of May 27, the operating room of Peking Union Medical College Hospital was as calm as usual. In the operating room of cardiac surgery on the third floor, an intense and orderly resuscitation had just finished. Director of Cardiac Surgery Miao Qi walked off the operating table slightly exhausted, but his face showed the joy of success! In the afternoon of May 26, a 76-year-old American female patient visiting China was seen in the emergency room of the International Medical Department. Due to the patient’s age and the complexity of the surgery (requiring simultaneous replacement of the ascending aorta, aortic arch, head and arm vessels and coronary arteries) and the high risk, the elderly American was referred to Union Hospital with a last hope after being transferred to several hospitals. Director Chen Lin and Chief Nurse Qin Ying of the International Medical Department arrived at the scene at the first time and quickly organized a multidisciplinary consultation and discussion among cardiac surgery, anesthesiology, operating room, ICU, vascular surgery and radiology, and formulated a rigorous surgical plan. A strong rescue team was immediately formed and put to work quickly. With the active cooperation of relevant departments in the hospital, a “life” channel was quickly opened for the patient. After more than 10 hours of battle that night, the patient’s aortic valve, coronary artery, ascending aorta, aortic arch and three cephalic vessels involved in the coarctation were successfully replaced with artificial vessels. During the operation, the systemic blood circulation was stopped for 34 minutes and the lowest temperature was 18℃. The operation was successfully completed at 6:00 a.m. the next day, and the patient was safely transferred to the ICU for further treatment, and was finally successfully transferred back to his home country after his body gradually recovered and stabilized, and has now fully recovered. The superb technology, good service and excellent team of Concordia Hospital were fully recognized by the American patient and his family, who sent a letter of thanks.  According to the data, the mortality rate of untreated patients with acute type A aortic coarctation is 33% within 24 hours and up to 50% within 48 hours. However, due to the difficulty of surgery and the number of important organs involved, complications and mortality are very high, until the 1990s, the major medical centers in China could only complete local aortic replacement surgery, and the total number of surgeries was only 300, but the mortality rate was more than 20%. In recent years, the cardiac surgery department of Peking Union Medical College Hospital has completed more than 100 cases of aortic surgery based on the comprehensive advantages of the Union, and the surgical procedures used cover almost all the surgical methods commonly used in the treatment of aortic diseases internationally, and the success rate of the surgery is close to the international advanced level.