So wo duruyɛfo aka sɛ mogya ntini titiriw a ɛde mogya a mframa pa wom fi wo koma mu kɔ wo nipadua nyinaa mu no ayɛ mmerɛw na ayɛ kurukuruwa a ɛte sɛ balloon wɔ ne nnyinaso? Anaasɛ ebia wɔahyɛ nyansa sɛ ebia ebehia sɛ wɔyɛ wo oprehyɛn ma eyi? Ɛyɛ awosu koraa sɛ wobɛte dadwen nka bere a wote eyi no, nanso yɛsrɛ sɛ hu sɛ eyi yɛ adeyɛ a ɛho hia a wɔayɛ sɛ wɔde begye wo nkwa. Ɛnnɛ, yɛbɛka nea Aortic Root Replacement yɛ pɛpɛɛpɛ, sɛnea wɔyɛ, ne biribiara a ɛsɛ sɛ wuhu fa saa adeyɛ yi ho wɔ Nirogi Lanka ho asɛm.
Sɛ yɛbɛka no tiawa a, dɛn ne Aortic Root Replacement?
Aorta yɛ mogya ntini a ɛsõ na ɛho hia sen biara wɔ wo nipadua mu, na ɛne wo koma wɔ abusuabɔ tẽẽ. Ɔfã a edi kan koraa a aorta no bata wo koma ho no, wonim no sɛ "Aortic Root." Ɛtɔ mmere bi a, ɔfã yi fasu yɛ mmerɛw na efi ase bɔ te sɛ balloon. Eyi ne nea yɛfrɛ no "Aneurysm."
Asiane titiriw a ɛwɔ ntini a ɛma mogya tu mu ne sɛ ebetumi atetew (atwitwa) anaasɛ apae (apaapae) bere biara. Sɛ eyi ba a, ebetumi ama mogya atu kɛse wɔ ne mu, na ɛno yɛ tebea a egye ntɛmpɛ a ɛde ne nkwa to asiane mu.
Bere a wɔreyɛ Aortic Root Replacement no, wo oprehyɛn ho ɔbenfo no yi aorta no fã a ayɛ mmerɛw na ayɛ kɛse no na ɔde aduru a wɔde ahyɛ mu no si ananmu. Saa adeyɛ yi siw nsɛnnennen a asiane wom yi ano yiye na ɛboa ma wɔbɔ wo nkwa ho ban.
Dɛn ne oprehyɛn yi ahorow atitiriw?
Akwan titiriw abien na ɛwɔ hɔ a wɔfa so yɛ oprehyɛn yi. Wo oduruyɛfo a ɔyɛ wo oprehyɛn no begyina w’ayaresa tebea pɔtee so akyerɛ ɔkwan a ɛfata sen biara a wobɛfa so ama wo ho atɔ wo.
| Oprehyɛn Su a Wɔyɛ | Nkyerɛmu |
|---|---|
| Aortic Ntini a Wɔde Si ananmu (ARR) / Bentall Adeyɛ | Wɔ saa adeyɛ yi mu no, wɔde aduru a wɔde ayɛ ne valve foforo sesa wo aorta ntini a asɛe no ka aortic valve no ho. Eyi ne sika kɔkɔɔ gyinapɛn sɛ wo aortic valve no retu anaasɛ calcified kɛse a. Sɛ wɔde mfiri a ɛma mogya tu di dwuma a, ɛho behia sɛ wonom nnuru a ekum mogya a ɛtwetwe wo nkwa nna nyinaa na amma mogya antɔ. |
| Valve-Sparing Ntini a Wɔde Si ananmu (VSRR) . | Sɛnea edin no kyerɛ no, saa adeyɛ yi si ntini no fã a ayɛ mmerɛw nkutoo ananmu bere a ɛkora w’ankasa aortic valve a ɛte apɔw so no. Eyi ye ma ayarefo nkumaa anaa wɔn a wɔwɔ ntini a ɛka bom yɛ adwuma (te sɛ Marfan syndrome) a wɔwɔ ntini a ɛyɛ den no. Mfaso titiriw a ɛwɔ so ne sɛ mpɛn pii no wunhia nnuru a ɛma mogya yɛ mmerɛw wɔ wo nkwa nna nyinaa mu. Akwan titiriw abien na ɛwɔ hɔ: Yacoub kwan no ne David kwan no. |
VSRR no mu ahorow nketewa
Wɔde akwan titiriw abien no mu biako na ɛyɛ VSRR: Yacoub ne David akwan horow no.
- Yacoub adeyɛ: Eyi hwehwɛ sɛ wɔsan yɛ aortic ntini no ma ɛne mfitiase valve no hyia. Ɛtaa fata yiye ma ayarefo a wɔn mfe akɔ anim anaa wɔn a ɛnyɛ awosu mu tebea horow na ɛde wɔn ntini mu yare no.
- David kwan a wɔfa so yɛ no: Nea ɛka eyi ho ne sɛ wɔbɛsan de valve no ahyɛ aduru a wɔde ahyɛ nipadua mu no mu. Ɛwom sɛ ɛyɛ den kɛse wɔ mfiridwuma mu de, nanso wɔde di dwuma kɛse na wɔkamfo kyerɛ kɛse ma ayarefo nkumaa a wɔwɔ awosu mu tebea horow te sɛ Marfan yare no.
Henanom na Wohia Oprehyɛn Yi ne Bere Bɛn?
Sɛ wo aorta ntini no yɛ kɛse a, asiane a ebetumi aba sɛ wobɛpaapae anaasɛ wobɛpaapae mu, na ɛno ma oprehyɛn ho hia. Bere a eyi betumi aba esiane mfe a obi asɛe nti no, awosu mu tebea horow te sɛ Marfan syndrome anaa Loeys-Dietz syndrome betumi ama saa ntini a ɛyɛ hu yi aba ntɛm koraa wɔ asetra mu.
Gyinaesi ahorow a ɛfa oprehyɛn ho no gyina ntini a ɛma mogya tu no kɛse ne asiane pɔtee a wowɔ so:
- Sɛ wunni awosu mu asiane biara a ɛda adi a, wɔtaa kamfo kyerɛ sɛ wobɛyɛ oprehyɛn bere a ne kɛse adu sɛntimita 5.5 no .
- Sɛ wowɔ Marfan syndrome a, mpɛn pii no, ahwehwɛde no yɛ 5.0 cm .
- Sɛ wowɔ Marfan syndrome a wɔde abusua abakɔsɛm a ɛfa aortic dissection, nyinsɛn nhyehyɛe, anaa onyin ntɛmntɛm (bɛboro 3mm afe biara) aka ho a, wobetumi akamfo akyerɛ sɛ wɔnyɛ oprehyɛn wɔ 4.5 cm .
- Sɛ wowɔ bicuspid aortic valve ne asiane afoforo te sɛ mogya mmoroso a wontumi nni so a, wɔtaa susuw ho sɛ wode wo ho bɛhyɛ mu wɔ 5.0 cm .
Nea ɛho hia sen biara no, saa gyinaesi ahorow yi yɛ nea ɛfa obiara ho kɛse. Wo Nirogi Lanka oprehyɛn ho ɔbenfo no begyina wo mfe, w’akwahosan nyinaa, ne w’aduruyɛ ho abakɔsɛm so akyerɛ bere a eye sen biara a wode bɛyɛ wo oprehyɛn no.
Sɛnea Wobɛsiesie Wo Ho Ama Wo Oprehyɛn
Esiane sɛ eyi yɛ adeyɛ titiriw nti, ahosiesie a edi mũ ho hia. Wo nnuruyɛfo kuw no bɛyɛ nhwehwɛmu a edi mũ:
- Mogya mu nhwehwɛmu: Sɛnea ɛbɛyɛ a wɔbɛsɔ w’asaabo ne w’ahyehyɛde no nyinaa dwumadi ahwɛ.
- CT anaa Cardiac MRI: Sɛnea ɛbɛyɛ a wubenya wo aorta no nyinaa ho mfonini a ɛkɔ akyiri.
- Coronary angiography: Sɛnea ɛbɛyɛ a ntini ahorow a ɛma wo koma no yɛ yiye.
- Duplex ultrasound: Sɛnea ɛbɛyɛ a wobɛhwɛ sɛnea wo carotid ntini a ɛwɔ kɔn mu no akwahosan te.
Ɛsɛ sɛ wo ne wo duruyɛfo bɔ nkɔmmɔ pefee wɔ:
- Nnuru nyinaa: Nea ɛka eyi ho ne vitamin, nhabannuru a wɔde ma, ne nnuru a wɔtɔn, a ebia ebehia sɛ wogyae emu bi ansa na wɔayɛ oprehyɛn.
- Akwahosan tebea horow a ɛwɔ hɔ dedaw: Ɛsɛ sɛ wɔhwɛ tebea horow te sɛ mogya mmoroso so yiye ansa na wɔayɛ oprehyɛn no.
- Sigaretnom: Anyɛ yiye koraa no, ɛsɛ sɛ wugyae sigaretnom ɔsram biako ansa na wɔayɛ wo oprehyɛn. Yɛsrɛ sɛ bisa wo Nirogi Lanka kuw no sɛ wuhia mmoa wɔ gyae a wubegyae mu anaa.
Bere a Wɔreyɛ Adeyɛ no ne Bere a Wɔreyɛ no Akyi
Bere a wɔreyɛ oprehyɛn no, wɔde wo bɛhyɛ aduru a wɔde kum nipadua no mu. Wɔde wo bɛka afiri bi a wɔde twa koma ne ahurututu mu , a egye wo koma ne w’ahurututu dwumadi bere tiaa bi, na ɛma oduruyɛfo a ɔyɛ oprehyɛn no tumi yɛ koma a ɛyɛ den na ɛyɛ komm ho adwuma.
Oduruyɛfo a ɔyɛ oprehyɛn no bɛtwa wo moma so, ayi aortic fã a ayɛ mmerɛw no, na ɔde aduru a wɔde ayɛ wo koko asi ananmu. Afei wɔsan de ntini a ɛma mogya tu no bata ntini a wɔde ahyɛ nipadua no mu no ho ansa na wɔatoto nea wɔatwa no mu. Mpɛn pii no oprehyɛn no gye nnɔnhwerew 4 kosi 6 .
Wɔ oprehyɛn akyi no, wobɛtra Intensive Care Unit (ICU) ansa na woatu akɔ baabi a wɔhwɛ wɔn a wɔyare nyinaa. Mpɛn pii no, ayaresabea a wobɛtra nyinaa bɛyɛ dapɛn biako, na ɛno mu no wɔbɛhwɛ wo yiye na wɔama wo ɛyaw ano aduru ne nnuru a ɛho hia.
Dɛn ne Bere a Wɔde Yɛ Adwuma?
Mpɛn pii no, sɛ obi ho bɛtɔ no koraa wɔ oprehyɛn kɛse yi akyi a, egye adapɛn 6 kosi 12 , na wɔ tebea horow bi mu no, egye asram pii. Wo nipadua hia bere ne boasetɔ kɛse na ama asa yiye wɔ oprehyɛn a emu yɛ den saa akyi.
- Adapɛn 6 a edi kan no: Kwati sɛ wobɛka kar, wobɛma nneɛma a emu yɛ duru so, anaasɛ wobɛyɛ nneɛma a emu yɛ den.
- Wɔ desk nnwuma ho: Ebia wubetumi asan akɔ adwuma wɔ bɛyɛ adapɛn 6-8 mu.
- Wɔ nnwuma a ɛyɛ den honam fam adwuma ho: Ɛho behia sɛ wotwɛn kyɛ, sɛnea w’akwahosan kuw no de afotu ma no.
Wo duruyɛfo akwankyerɛ a wubedi akyi pɛpɛɛpɛ na wode wo ho ahyɛ nhyehyɛe ahorow a wɔde siesie koma no mu no bɛboa wo kɛse ma wo ho atɔ wo ntɛmntɛm na ɛnyɛ den.
Bere a Ɛsɛ sɛ Wohwehwɛ Aduruyɛ mu Ahwɛyiye Ntɛm ara
Sɛ wosan kɔ fie a, sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi bi a, kɔ wo duruyɛfo nkyɛn ntɛm ara.
| Nsɛnkyerɛnne a Ɛsɛ sɛ Wohwɛ | |
|---|---|
| Oprehyɛn a Wɔde Twitwa Nneɛma Ho Dadwen: | |
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| Nneɛma Afoforo a Ɛhaw Ade: | |
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Sɛnea Wobehu Asɛm a Egye Ntɛmntɛm
Sɛ wowɔ ntini mu yare a wɔansa a, sɛnkyerɛnne ahorow a edidi so yi betumi akyerɛ sɛ ɛrepaapae anaasɛ ɛretetew. Sɛ ɛba saa a, hwehwɛ ayaresa a egye ntɛmpɛ ntɛm ara denam kɔ a wobɛkɔ dwumadibea a ɛbɛn wo a wɔhwɛ ntɛmpɛ so anaasɛ wobɛfrɛ 911 (anaasɛ wo mpɔtam hɔ adwumayɛbea a wɔhwɛ ntɛmpɛ so).
- Ɛyaw a ɛba mpofirim a wontumi nnyina ano wɔ ne moma so anaa n’akyi atifi (wɔtaa ka ho asɛm sɛ ɛyɛ tete a ɛtetew anaasɛ ɛtetew).
- Fifiri a ɛdɔɔso ne honam ani a ɛyɛ nwini na ɛyɛ mmerɛw.
- Ɔhome a ɛyɛ den.
- Adwene a ɛyɛ basaa anaasɛ obi a ɔtotɔ piti.
- Koma a ɛbɔ ntɛmntɛm anaasɛ ɛnteɛ daa.
Nneɛma Titiriw a Wɔde Kɔ (Nirogi Lanka) .
- Aortic Root Replacement yɛ oprehyɛn a egye nkwa a wɔyɛ wɔ aorta no fã a edi kan a ayɛ mmerɛw no so.
- Oprehyɛn yi ahorow atitiriw abien na ɛwɔ hɔ: biako a wɔde si aortic valve (ARR) ananmu ne biako a ɛkora so (VSRR). Wo duruyɛfo a ɔyɛ wo oprehyɛn no na ɔbɛkyerɛ ɔkwan a eye sen biara a wobɛfa so.
- Bere a ahotɔ a edi mũ gye asram pii no, nkonimdi ne nkwa a wonya wɔ saa adeyɛ yi mu no dɔɔso yiye (bɛyɛ 98%-99%).
- Aduruyɛ ho akwankyerɛ a wɔde ma ansa na wɔayɛ oprehyɛn ne oprehyɛn akyi a wobedi so denneennen ho hia na ama obi ho atɔ no yiye.
- Mma ntwentwɛn wo nan ase sɛ wo ne wo duruyɛfo besusuw nsɛmmisa anaa ehu biara ho. Bere a saa adeyɛ yi yɛ ade a nnuruyɛfo yɛ daa no, ɛyɛ osuahu titiriw ma wo, na ɛyɛ ade a ɛfata koraa sɛ wubenya nneɛma bi a ɛhaw wo.
Aortic Root Replacement, Aorta, Koma Oprehyɛn, Aneurysm, Bentall nhyehyɛe, Marfan syndrome, Aortic valve, Koma yare, Koma oprehyɛn
