-Max chain over 60 - 500
-No mistakes - 800
-Completed with 120 left - 400
-30 COOLs earned - 300
Here you'll be fighting Kyriaki and Paraskevi at the same time. Plus, you'll already be at the heart from the start, so you can't let Paraskevi burrow even once.
Now the way we're going to approach this is that we will deal with the Paraskevi BEFORE the Kyriaki. There are two reasons for this: One, since it can instakill Derek, it's the bigger danger. Two, by letting Kyriaki live longer, it can cause more damage which allows us to get more COOLs on the lacerations and thus more points.
So get inside Derek. You'll see a number of lacerations. Suture them all except for one, then raise vitals all the way to max. When they're at 99 suture the last one. Now Kyriaki and Paraskevi will appear. The Paraskevi are tiny so they can be picked up immediately. Laser them both and pick one up to get rid of it. Now suture the lacerations Kyriaki caused. Raise vitals to 99 again, then pick up the other Paraskevi. As soon as you do this, 3 more Kyriaki will spawn and create 3 lacerations, as well as 2 more Paraskevi. Quickly laser and pick up both Paraskevi. This will free you of them for the time being.
Now at this point there will 5 Kyriaki running around inside the heart. This is not a small number. They will cause a huge amount of lacerations, but this isn't a bad thing. It's actually what we want. Start suturing every one you see, and when there are none in sight, raise vitals. When vitals are at 99 start using the ultrasound and bring some Kyriaki to the surface. Since there are so many of them it might not be a good idea to cut them all up immediately. 3-4 of them is fine. Vitals will go down by a lot when you bring them out, and the others will surely cause even more lacerations. Keep an eye on the vitals. If they go down to critical you may have to inject some stabilizer before proceeding. If there are too many lacerations present very quickly suture some of them in between raising vitals. The reason we're raising vitals and suturing instead of killing the Kyriaki as soon as possible is because 1) vitals might be too low and Derek could die while you're lasering them and 2) we want them to cause a little bit more damage to rack up some more points and they can't do that if they're dead. As soon as vitals are at a reasonably comfortable level start lasering all the Kyriaki on the surface. Remember that these are a bit stronger and require 3 pricks with the laser each before they die. When all of the ones on the surface are dead suture any remaining lacerations. Now bring out the remaining ones and kill them. Before gelling the final incision wound raise vitals to 99 once again.
Remember to get COOLs in as many of these lacerations as possible. You need 30 of these for the special bonus. If you left the Kyriaki alive for as long as possible like I told you though, you should have plenty of opportunities.
Now the boss Kyriaki will make its appearance along with his trademark triple slash. A small kyriaki will also be escorting him, plus a couple of small (but not tiny) Paraskevis. We're going to continue this in the same way. Let the Kyriaki be and concentrate on the Paraskevi. Paralyze them both and cut one with the scalpel, then laser both of the tiny resulting ones and put them on the tray. Then suture all of the lacerations including ones Kyriaki may have caused. Next, do the same thing for the other Paraskevi.
Now you only have Kyriaki to worry about. Suture all the lacerations and raise vitals to a reasonable level, then start fighting them as you always have. By this time you most likely have gotten enough points so you can go ahead and kill the small one first. If you want to let him live until after you kill the boss so you can suture even more it's up to you though.
That'll be it. By now you've probably gotten enough points that getting COOLs on the final suture and bandage isn't imperative. Just make sure you don't get a miss!