The monitors beeped wildly, the numbers flashing red as the patient’s vitals plummeted. You and Ava Bekker stood over the open chest of a man in his mid-forties, his heart exposed, revealing the largest atrial septal defect either of you had ever seen.

“This is massive,” you muttered, sweat beading at your temple beneath your surgical cap.

“No kidding,” Ava snapped, voice sharp with focus. “His heart’s working overtime just trying to compensate. If we don’t close this fast, he’s going to crash.”

The anesthesiologist called out from behind you. “BP’s tanking—he’s getting more unstable!”

Ava cursed under her breath, reaching for a suture. “Alright, we have to patch this, now. We go for the pericardial patch—”

“No,” you cut in, already reaching for a larger graft. “It’s too big. A standard patch won’t hold, we need something stronger.”

Her eyes snapped up to yours, icy blue and intense. “We don’t have time to debate, we need to close it!”

You held firm. “If we use a pericardial patch, the tension will rip it apart. This defect is practically half his atrium. We need a synthetic graft, reinforced.”

Ava hesitated—only for a second—but you caught it. Then, with a sharp nod, she relented. “Fine. Get the graft prepped. Fast.”

The tension in the OR was thick as you worked in sync, every movement precise, the seconds stretching unbearably long. The heart monitor’s erratic beeping filled the room as the patient fought to hold on.

Finally, Ava secured the last suture. “Alright—bypass off.”