So wo ba kumaa no wɔ komayare? Momma yɛnka Hypoplastic Aortic Arch ho asɛm!

So ɛtɔ mmere bi a ɛyɛ den ma wo ba kumaa sɛ ɔbɛma nufu? So ɔbrɛ sen sɛnea ɔtaa yɛ bere a ɔrehome no? Anaasɛ ɛte sɛ nea ne ho ayɛ fitaa na ne ho fifiri? Ɛyɛ ade a ɛfata sɛ wo sɛ ɔwofo sɛ wohaw wo ho kɛse bere a saa nneɛma yi to wo ba ketewa no. Ɛtɔ mmere bi a, nea ɛde eyi ba no betumi ayɛ komayare a wɔde awo obi. Ɛnnɛ, yɛrebɛka tebea bi a ɛba nkokoaa koma mu, nanso sɛ wohu ntɛm na wɔsa no yiye a, wobetumi asa ho asɛm.

Dɛn ne Hypoplastic Aortic Arch?

Sɛ yɛbɛka no tiawa a, Hypoplastic Aortic Arch , a ɛtɔ mmere bi a wɔfrɛ no Aortic Arch Hypoplasia (AAH) , yɛ awo mu dɛmdi a ɛba wo ba no koma fã bi , aorta . Susuw ho saa kwan yi so, aorta no te sɛ ntini kɛse bi a ɛde mogya kɔ yɛn nipadua nyinaa mu. Efi ase wɔ koma no mu na ɛde mogya a oxygen wom kɔ nipadua no nyinaa mu. Wɔayɛ no te sɛ poma, na ɛyɛ kurukuruwa kakra. Wɔfrɛ baabi a ɛyɛ kurukuruwa a ɛwɔ poma no atifi no aortic arch , a ɛkyerɛ ‘aorta no anim.’

Asɛmfua ‘hypoplastic’ kyerɛ sɛ ‘ɛnnyaa nkɔsoɔ yie’, ‘ketewa’. Enti, akokoaa a ɔwɔ hypoplastic aortic arch no wɔ aortic arch a ennyaa nkɔso. Ɛne sɛ, bue, anaa ne ntwemu, a ɛwɔ saa ɔfã no mu no yɛ teateaa koraa sen sɛnea ɛsɛ sɛ ɛyɛ. Sɛnea nsu paipu siw no, sɛ aortic arch no yɛ teateaa a, ɛbɛyɛ den sɛ mogya befi koma no mu akɔ nipadua no afã horow a ɛwɔ fam, afa aorta a ɛsiane no mu . Eyi betumi atew mogya dodow a ɛkɔ nipadua no nyinaa mu no so.

Henanom na tebea yi ka no kɛse? So abusuabɔ bi wɔ komayare afoforo ntam?

Aortic arch hypoplasia (AAH) no ankasa betumi aba. Nanso, wɔtaa hu no sɛ ɛwɔ komayare foforo a wɔde awo mu , a wɔfrɛ no coarctation of the aorta . Eyi yɛ tebea a ɛma aorta no fã foforo a mpɛn pii no ɛbɛn ductus arteriosus, mogya ntini titiriw bi a ɛtaa ba awotwaa no mu no mu teateaa.

Enti ebia wo ba no duruyɛfo bɛka sɛ, "Wo ba no wɔ coagulopathy of the aorta with aortic arch hypoplasia." Ɛno kyerɛ sɛ aorta no mu teateaa, ɛnyɛ beae biako pɛ, na mmom ɔfã tenten bi.

Nea ɛka ho no, nkokoaa a wɔwɔ AAH no betumi anya komayare afoforo. Nhwɛsoɔ:

• Atrial Septal Defect (ASD) : Tokuru a ɛwɔ ɔfasu no mu wɔ koma no atifi adan abien no ntam.
• Atrioventricular Septal Defect : Mfomso a ɛyɛ den a ɛwɔ afasu a ɛwɔ koma no adan ntam no mu.
• Bicuspid Aortic Valve ne Aortic Valve Stenosis : Mfomso ne aortic valve no a ɛyɛ teateaa.
• Hypoplastic Left Heart Syndrome (HLHS) : Koma no benkum so ntumi nkɔ yiye.
• Patent Ductus Arteriosus (PDA) : Mogya ntini bi a wɔfrɛ no ductus arteriosus a ɛsɛ sɛ wɔto mu wɔ awo akyi no da so ara bue.
• Shone’s Syndrome : Mfomso ahorow pii a wɔaka abom a ɛmma mogya nkɔ koma no benkum so.
• Ventricular Septal Defect (VSD) : Tokuru a ɛwɔ ɔfasu no mu wɔ koma no ase adan abien no ntam.

Koma mu yare bɛboro biako te sɛ eyi a wubenya no ho hia yiye bere a woreyɛ ayaresa ho nhyehyɛe no. Efisɛ oprehyɛn anaa ayaresa nhyehyɛe a wɔayɛ ama tebea horow a ɛyɛ den, pɔtee a ɛwɔ akokoaa no koma mu no ho hia.

Sɛ abofra bi wɔ saa tebea yi a, dɛn ne sɛnkyerɛnne ahorow?

Nkokoaa a wɔn aorta no ayɛ coarctation ne aortic arch hypoplasia taa fi ase da sɛnkyerɛnne ahorow adi wɔ awo akyi bere tiaa bi . Fa no sɛ wo ba a wɔawo no foforo a wabrɛ bere a wanom nsa kakraa bi akyi no, ɛte sɛ nea ɛyɛ den ma no sɛ ɔbɛhome. Ɛtɔ mmere bi a, wɔn ho fifiri na wɔdan kɔla a ɛyɛ bruu-fitaa. Hwɛ sɛnea ɛyɛ hu sɛ ɛna behu biribi a ɛte sɛɛ, ɛnte saa?

Nsɛnkyerɛnne titiriw a wobetumi ahu ne:

• Fast pulse : Pulse rate no yɛ ntɛmntɛm dodo.
• Ɔbrɛ : Akokoaa no te ɔbrɛ nka ntɛmntɛm, titiriw bere a ɔrema nufu no.
• Wora a ɛyɛ fitaa anaasɛ ɛyɛ mmerɛw : Ɛtɔ mmere bi a, honam ani nso betumi ayɛ bruu.
• Fifiri a emu yɛ duru .
• Su a wɔtaa su, abufuw .
• Ahome a wɔhome ntɛmntɛm anaasɛ ɛyɛ adwumaden .
• Ɔhaw a ɛwɔ aduan a wɔde ma mu: Ɔpow sɛ ɔbɛnom nufusu, anaasɛ ogyae bere a wanom kakra awie no.
• Apɔw-mu-teɛteɛ a ɛyɛ mmerɛw wɔ nipadua no afã horow a ɛwɔ fam : Titiriw wɔ nan no mu no, ntini a ɛwɔ asen no mu no yɛ mmerɛw yiye bere a wɔde wɔn nsa ka no.

Sɛ wo ba no wɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, ɛho hia yiye sɛ wohwehwɛ aduruyɛfo afotu ntɛm ara .

Dɛn nti na eyi rekɔ so? Dɛn ne nea enti a ɛte saa?

AAH yɛ komayare a wɔde awo obi . Ɛyɛ biribi a ɛba bere a akokoaa no da so ara wɔ awotwaa mu. Nhwehwɛmufo da so ara rebɔ mmɔden sɛ wobehu nea ɛde komayare a wɔwo no yi ba ankasa.

Nanso nea wonim ne sɛ sɛ akokoaa no aortic arch no ankɔ so yiye wɔ nyinsɛn no adapɛn kakraa a edi kan no mu a .

Wobɛyɛ dɛn ahu eyi? Dɛn ne sɔhwɛ ahorow no?

Nnuruyɛfo de eyi di dwuma de hu yare no.Mfoninitwa sɔhwɛ ahorow titiriw. Wɔtaa yɛ nhwehwɛmu ahorow yi bere a wɔawo akokoaa no akyi pɛɛ.

Nhwehwɛmu atitiriw a wɔde hu AAH ne:

• Koma mu Kɔmputa so Tomography (CT scan) .
• Magnetic Resonance Angiogram (MRA) a Wɔde Yɛ Adwuma (MRA) .
• Transthoracic Echocardiogram (TTE) : Eyi te sɛ koma no mu mfonini a wɔde ultrasound yɛ.
• Cardiac Catheterization : Ɛtɔ mmere bi a, ɛsɛ sɛ wɔyɛ nhwehwɛmu yi nso.

Saa sɔhwɛ ahorow yi betumi ahwɛ sɛnea akokoaa no koma te, kyerɛ sɛ, sɛnea wɔahyehyɛ emu afã horow no, kɔ akyiri kɛse. Wobetumi ahu nso sɛ akokoaa no wɔ komayare afoforo anaa. Ɛnam saa nsɛm yi nyinaa a wɔboaboa ano so na nnuruyɛfo no yɛ ayaresa a ɛfata sen biara ma akokoaa no ho nhyehyɛe.

Nea ɛbɛyɛ na nnuruyɛfo ahu sɛ ebia AAH bi wɔ hɔ anaa no, wɔhwɛ sɛnea akokoaa no aortic arch no kɛse te. Ne titiriw no, wɔsusuw ne kɛse , a ɛyɛ ɔkwan a wɔabue mu no tɛtrɛtɛ. Wɔde saa susudua yi toto akokoaa no aorta no afã afoforo (sɛ nhwɛso no, aorta a ɛforo anaa aorta a ɛsiane) no ntwemu ho. Wɔde saa gyinapɛn ahorow yi di dwuma de kyerɛ sɛ ebia aortic arch no ntwemu yɛ teateaa dodo anaa.

Momma yensua aotic arch no afã horow no ho ade kakra.

Sɛ wo ba no oduruyɛfo ka tebea yi ho asɛm a, ebia ɔbɛka aortic arch no afã horow ho asɛm. Ebia woresusuw ho sɛ, "So aortic arch no mu paapae yɛ no afã afoforo? So ɛnyɛ aorta kɛse no fã?" Yiw, ɛyɛ nokware. Aortic arch yɛ aorta no fã ketewaa bi a "ɛte sɛ poma". Nanso, te sɛ aorta no afã horow nyinaa no, aortic arch no wɔ mogya ntini (ntini) a ɛpue kɔ mmeae ahorow. Te sɛ ɔkwan kɛse bi wɔ akwan a ɛwɔ nkyɛnkyɛn no ara pɛ. Nnuruyɛfo de mogya ntini ahorow yi di dwuma sɛ ahye, na wɔhyɛ baabi a aortic arch no fã pɔtee bi fi ase na ɛba awiei agyirae. Saa "map" yi boa kɛse wɔ AAH a wobehu ne ayaresa ho nhyehyɛe mu.

Aso no afã horow bi a ebia wo ba no duruyɛfo bɛka ho asɛm ni:

• Proximal Transverse Arch : Eyi wɔ akokoaa no Brachiocephalic Artery (ɛtɔ mmere bi a wɔfrɛ no Innominate Artery) ne Left Common Carotid Artery ntam. Eyi ne ɔfã a ɛbɛn koma no paa.
• Distal Transverse Arch : Eyi wɔ benkum so common carotid artery ne benkum subclavian artery ntam .
• Aortic Isthmus : Eyi wɔ benkum so subclavian artery ne mogya ntini a yɛadi kan aka ho asɛm a wɔfrɛ no Ductus Arteriosus no ntam .

Wo ba no duruyɛfo na ɔbɛkyerɛ baabi pɔtee a ɛyɛ teateaa wɔ wo ba no aso mu, ne baabi a teateaa no akodu. Saa nsɛm yi bɛkyerɛ ayaresa nhyehyɛe no kwan.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Nkokoaa a wɔwɔ hypoplastic aortic arch no behia sɛ wɔyɛ wɔn koma oprehyɛn de siesie tebea no. Wo ba no koma ho oprehyɛn bɛkyerɛkyerɛ oprehyɛn ko a wo ba no behia mu akyerɛ wo. Oprehyɛn no betumi ayɛ soronko a egyina sintɔ afoforo ne sɛnea wɔahyehyɛ wo ba no koma so. Ebia ebehia sɛ woyɛ thoracotomy , a ɛyɛ ade ketewaa bi a wɔatwa wɔ wo ba no koko benkum so, anaasɛ sternotomy, a ɛyɛ ntwitwiridii a wɔtwa kɔ fam wɔ koko no mfinimfini.

Wɔfrɛ oprehyɛn a wɔtaa yɛ no resection with extended end-to-end anastomosis . Saa oprehyɛn yi boa kɛse ma nkokoaa a wɔn aorta no ayɛ coarctation ne aortic arch hypoplasia. Wɔ saa adeyɛ yi mu no, oduruyɛfo a ɔyɛ oprehyɛn no yi aorta no fã a ayɛ teateaa no, fa aorta no fã a ɛwɔ fam (aorta a ɛsiane), na ɔde bata baabi a wɔatwa a ɛware kakra wɔ aortic arch no mu.

Anidaso a ɛwɔ oprehyɛn yi mu ne sɛ ɛbɛma mogya afa akokoaa no aorta no mu atu mpɔn, na ahwɛ ahu sɛ akokoaa no akwaa ne ne ntini ahorow no benya mogya a oxygen pii wom a ɛdɔɔso.

Dɛn ne anidaso a ɛbɛma me ba no ho atɔ no?

Asɛmmisa yi ho mmuae a eye sen biara ne wo ba no oduruyɛfo. Efisɛ akokoaa yiyedi gyina nneɛma pii so. Titiriw no, sɛ́ ebia komayare afoforo a wɔde awo obi wɔ hɔ no nya nkɛntɛnso kɛse.

Mpɛn pii no, nkokoaa a wɔasa wɔn yare wɔ tebea bi a wɔfrɛ no aotic arch hypoplasia ho no wɔ hokwan kɛse sɛ wobenya ɔhaw ahorow a edidi so yi akyiri yi:

• Wɔn aorta a ɛyɛ teateaa mpɛn pii .
• Mogya mmoroso (Hypertension) .
• Adidi anaa mene a ɛyɛ den : Eyi betumi asi sɛ ntini bi sɛe bere a wɔreyɛ oprehyɛn no (eyi ntaa nsi koraa).

Wo ne wo ba no duruyɛfo nka asiane ahorow yi ne sɛnea wobedi ho dwuma ho asɛm.

So wobetumi asiw tebea yi ano?

Ebia wontumi nsiw koma mu dɛmdi a wonya fi awo mu te sɛ hypoplastic aortic arch ano koraa . Nanso, afotu a wo duruyɛfo de ma sɛ wubenya nyinsɛn a ɛfata a wubedi akyi no betumi aboa ma asiane a ɛwɔ hɔ sɛ wubenya saa tebea yi anaa sintɔ afoforo no so atew.

Mpɛn pii no, akyinnye biara nni ho sɛ ɛsɛ sɛ wɔkwati saa nneɛma yi bere a wɔyem no:

• Nsaden .
• Kwati sigaretnom, vaping ne tawa nneɛma nyinaa . Afei nso, kwati sigaret a wɔde di dwuma .
• Nnubɔne a mmara mma ho kwan, titiriw cocaine .

Na nso, wo deɛ.Ɛho hia yiye nso sɛ wobɛkɔ nhwehwɛmu a wɔyɛ ansa na wɔawo no daa. Sɛ wowɔ akwahosan ho tebea foforo biara a, hwehwɛ aduruyɛfo afotu na ama woadi saa tebea horow no ho dwuma ansa na woanyinsɛn ne bere a woanyinsɛn no.

Ɔkwan bɛn so na wɔbɛhwɛ akokoaa no bere a wɔayɛ no oprehyɛn awie no?

Ebia ɛsono akokoaa biara ahiade wɔ oprehyɛn akyi, enti ɛbɛyɛ papa sɛ wubebisa wo ba no aduruyɛ kuw no sɛnea wɔbɛhwɛ wo ba no wɔ bere tiaa ne bere tenten mu.

Nsɛmmisa bi a wubetumi abisa wo duruyɛfo ni:

• Sɛ mekɔ fie a, ɛsɛ sɛ mehwɛ me ba no dɛn?
• Aduru bɛn na ɛsɛ sɛ mede ma me ba? Bere tenten ahe na ɛsɛ sɛ mede ma?
• So ayaresa ahorow bi ho hia na aboa abofra no nipadua anaa ne ntini mu dwumadi?
• So anohyeto bi wɔ abofra no dwumadi ahorow ho?
• Bere bɛn na asiane biara nni ho sɛ mede me ba bɛkɔ baabi a wɔhwɛ mmofra? Akwankyerɛ titiriw bɛn na ɛsɛ sɛ mede ma wɔn?
• So me ba no behia ayaresa foforo anaa oprehyɛn?

Ɔwofo a obi bɛyɛ no yɛ den bere nyinaa. Nanso abofra a ɔwɔ komayare te sɛ hypoplastic aortic arch (AAH) a wo ne no bɛtra no betumi de nsɛnnennen foforo aba da biara da. Ebia ɛbɛyɛ te sɛ nea nsɛm a nnuruyɛfo ka ne ayaresa nhyehyɛe ahorow no bi ase. Ɛno yɛ ade a ɛfata, na ɛnyɛ wo nkutoo. Bisa wo ba no oduruyɛfo no nneɛma a wɔde bɛyɛ adwuma ne akuw a wɔboa wo a wobetumi aboa wo ho asɛm. Mpɔtam a wobɛboa wo ne w’abusua no betumi aboa ma adwennwen so atew na ama woanya ahoɔden a wode bɛkɔ w’anim wɔ wo ba no ahiade ahorow ho.

Momma yɛnkae nea yɛkaa ho asɛm no ara kwa (Take-Home Message) .

• Hypoplastic Aortic Arch (AAH) yɛ tebea a ɛma aorta no arch, mogya ntini titiriw a ɛwɔ akokoaa no koma mu no nnyin yiye, na ɛma arch no yɛ teateaa.
• Eyi ma ɛyɛ den sɛ mogya bɛsen afi koma no mu akɔ nipadua no afã afoforo.
• Wɔtaa hu tebea yi ne komayare foforo a wɔfrɛ no Coarctation of the Aorta .
• Nsɛnkyerɛnne te sɛ ɔbrɛ, ahome a ɛyɛ den, ne honam ani a ɛyɛ fitaa betumi ada adi wɔ akokoaa no nkwa nna mfiase.
• Wobetumi de scan soronko ahu tebea yi.
• Ayaresa no ne koma mu oprehyɛn .
• Aduruyɛ ho akwankyerɛ a wobedi akyi pɛpɛɛpɛ ne bere tenten akyi a wobedi akyi wɔ oprehyɛn akyi no ho hia yiye.
• Suban pa a wodi akyi wɔ nyinsɛn mu no betumi atew asiane a ɛwɔ hɔ sɛ obi benya awo mu dɛmdi bi so.
• Ɛnyɛ wo nko ara. Nya mmoa fi nnuruyɛfo ne akuw a wɔboa wɔn hɔ.

Yɛwɔ anidaso sɛ saa nsɛm yi bɛboa wo. Yɛpɛ sɛ wo ba kumaa no ho tɔ no ntɛm!

` Hypoplastic Aortic Arch, Aortic Arch Hypoplasia, koma a wɔde awo wɔn, akokoaa koma oprehyɛn, aorta a ɛyɛ coarctation, nkokoaa komayare, koma oprehyɛn