Ebia woate Atrial Fibrillation (Afib), tebea bi a ɛma wo koma bɔ ntɛmntɛm na ɛbɔ ntɛmntɛm ho asɛm. Ebia wo anaa w’abusua mu obi wɔ saa tebea yi. Asiane kɛse a ɛwɔ Afib mu ne asiane a ɛkɔ soro sɛ obenya ɔyare a ɛma obi hwe ase. Sɛ́ eyi ano aduru no, nnuruyɛfo taa kyerɛw nnuru a ɛma mogya tu. Nanso nnuru yi a wɔbɛnom bere tenten no nyɛ mmerɛw mma obiara. Wɔ nnipa a wɔte saa fam no, yɛreka ayaresa kwan titiriw bi a ebetumi atew asiane a ɛwɔ hɔ sɛ wobenya akisikuru no so ho asɛm.
Sɛ yɛbɛka no tiawa a, dɛn ne Benkum Atrial Appendage Closure (LAA Closure)?
Nea ɛbɛyɛ na yɛate eyi ase no, momma yenni kan nsua yɛn koma fã ketewaa bi ho ade. Wɔ yɛn koma no benkum so dan a ɛwɔ soro a wɔfrɛ no Benkum Atrium no mu no, biribi ketewaa bi a ɛte sɛ kotoku bi apue. Eyi ne nea yɛfrɛ no Left Atrial Appendage (LAA) .
Mpɛn pii no, sɛ koma no bɔ denneennen a, wɔde mogya a ɛwɔ LAA yi mu no kɔ koma no fã a aka no mu. Nanso, wɔ obi a ɔwɔ Atrial Fibrillation (Afib) , koma no bɔ a ɛnteɛ, enti mogya a ɛwɔ kotoku a wɔfrɛ no LAA yi mu no ntumi nkɔ yiye na efi ase boaboa ano. Awiei koraa no mogya a wɔaboaboa ano yi betumi adan mogya a ɛtɔ .
Nea ɛyɛ awerɛhow no, sɛ saa mogya a ɛtɔ gu nipadua no mu yi pae na ɛkɔhyɛ mogya ntini bi a ɛkɔ amemene no mu mu a, ebetumi ama obi anya akisikuru . Bɛyɛ 90% a ɛwɔ nnipa a wɔwɔ Afib mu no fi mogya a ɛtɔ gu LAA no mu.
Enti, wɔ saa ayaresa a wɔfrɛ no LAA Closure yi mu no, wɔto kotoku a wɔfrɛ no LAA a mogya a ɛtɔ wom no mu, denam oprehyɛn so anaasɛ ɛnam ntwitwiridii ketewaa bi so. Sɛ wɔto eyi mu wie a, sɛ mogya tu mpo a, entumi nkɔ mogya no mu. Enti, asiane a ɛwɔ hɔ sɛ obi benya akisikuru no so tew kɛse.
Nea ɛho hia ne sɛ saa ayaresa yi nsa Afib yare, nanso ɛtew asiane a ɛwɔ hɔ sɛ obi benya ɔyare a ɛma obi hwe ase a ɛde ba no so kɛse.
Henanom na saa ayaresa yi ye ma wɔn? Dɛn nti na womfa nnuru a ɛma mogya tu kɛkɛ nni dwuma?
LAA Closure nyɛ ayaresa ma obiara a ɔwɔ asiane kɛse mu sɛ obenya akisikuru esiane Afib nti. Wosusuw ho titiriw ma nnipa a:
- Wɔn a wɔmpɛ sɛ wɔnom nnuru a ekum mogya a ɛtwetwe mogya bere tenten no fam no.
- Nnipa a wɔtaa hwe ase ma enti asiane kɛse wom sɛ mogya bɛtu wɔn (efisɛ opira ketewaa bi mpo betumi ama mogya atɔ kɛse bere a wɔnom nnuru a ɛma mogya tu no).
- Wɔn a wonya nsunsuanso afoforo a efi nnuru a ɛma mogya yɛ mmerɛw mu ba no fam.
- Wɔ wɔn a wontumi ntua nnuru a wɔde ma mogya no ho ka kɛse no fam.
Nnipa pii hyia nsɛnnennen ahorow bere a wɔnom nnuru dedaw a ɛma mogya yɛ mmerɛw te sɛ Warfarin no.
| Ɔhaw ahorow a ɛwɔ nnuru te sɛ Warfarin a wɔnom mu |
|---|
| - hia sɛ wokɔ ayaresabea daa kɔyɛ wo mogya mu nhwehwɛmu de hwɛ sɛ aduru dodow a wɔde ma no teɛ. |
| - nnuan bi a vitamin K wom (te se spinach) hia se woto ano hye. |
| - asiane a ewo ho se mogya tu no ye den paa. |
| - binom nipadua ntumi nnye saa aduru yi ntom. |
Ɛwom sɛ nnuru foforo te sɛ Apixaban ne Rivaroxaban wɔ hɔ de, nanso ne bo a ɛkɔ soro ne asiane a ɛkɔ so sɛ mogya bɛtɔ no yɛ nsɛm ma nnipa binom. Akyinnye biara nni ho sɛ ɛsɛ sɛ wo ne wo koma ho ɔyaresafo kasa na osi ayaresa a eye ma wo ho gyinae.
Akwan bɛn na wɔfa so to saa LAA yi mu?
Akwan ne mfiri ahorow wɔ hɔ a wɔfa so yɛ eyi. Fa no sɛ ɛte sɛ nea wɔreto nsu toa ano, wɔde saa mfiri yi to kotoku a wɔfrɛ no LAA yi ano.
- Mfiri a wɔde siw nipadua no mu: Eyinom te sɛ nkatanim ketewaa bi. Wɔde catheter na ɛde hyɛ koma no mu na wɔde siw LAA no ano fi mu. Mfiri a agye din no bi ne WATCHMANTM ne AmuletTM.
- Mfiri a wɔde to abɔnten: Ɛtɔ mmere bi a, bere a wɔreyɛ koma oprehyɛn afoforo no, wobetumi de afiri a wɔde kyekyere (`AtriClipTM`) anaasɛ wɔde nhama soronko (`LariatTM`) atoto LAA no mu wɔ akyi.
Wɔpaw ɔkwan a ɛfata wo bere a wo ne wo duruyɛfo abɔ nkɔmmɔ awie no.
Ahosiesie a wɔyɛ ma ayaresa ne sɛnea ayaresa no kɔ so
Ansa na wɔbɛsa no yareɛ...
Ansa na wɔbɛyɛ saa adeyɛ yi no, ɛho behia sɛ wo duruyɛfo no susuw wo LAA no kɛse ne ne nsɛso pɛpɛɛpɛ. Ɛnyɛ obiara LAA na ɛyɛ pɛ. Ebinom ka sɛ wɔayɛ no te sɛ akokɔ ntaban, cactus, anaa cauliflower. Eyi bɛhwehwɛ sɛ wɔyɛ Transesophageal Echocardiogram (TEE) (koma no mu nhwehwɛmu a wɔfa afiri bi a wɔfrɛ no larynx mu) anaa Cardiac CT scan. Wɔbɛkyerɛ wo nso sɛ mmuada (ɛnyɛ sɛ wubedi anaa nnom) nnɔnhwerew kakraa bi ansa na wɔayɛ oprehyɛn no.
Bere a wɔreyɛ ayaresa no...
Wobetumi afa akwan titiriw abien so ayɛ eyi:
1. Ne koma oprehyɛn afoforo:Sɛ woreyɛ koma oprehyɛn atitiriw afoforo te sɛ oprehyɛn a wɔde twa ho hyia a, oduruyɛfo no betumi ayi LAA a wɔato mu no nso anaasɛ ɔbɛpam bere koro no ara mu.
2. Minimally Invasive: Eyi ne ɔkwan a wɔtaa fa so yɛ adwuma. Ɛha yi, wɔde afiri teateaa bi a wɔfrɛ no catheter fa w’asen mu hyɛ ntini bi mu na wɔkyerɛ kwan kɔ wo koma mu nyinaa. Afei, wɔde afiri bi a wɔadi kan apaw gu LAA no ano na wɔsɔ ano na amma mogya a ɛbɛtɔ no antumi ankɔ. Wɔnam X-ray (Fluoroscopy) ne scan (TEE/Intracardiac Ultrasound) mfiridwuma titiriw bi akwankyerɛ ase na ɛyɛ saa adeyɛ yi nyinaa.
Wɔ ayaresa akyi...
- Mpɛn pii no, ɛsɛ sɛ wotra ayaresabea hɔ anadwo.
- Wɔbɛyɛ TEE scan bio wɔ bɛyɛ nnafua 45 mu de ahwɛ sɛ ayaresa no dii yiye anaa.
- Wɔbɛma wo aduru a ɛma mogya yɛ mmerɛw ne aspirin a fa kosi sɛ nipadua no ntini benyin atwa saa afiri yi ho ahyia, na egye bɛyɛ ɔsram biako ne fã.
- Ɛno akyi no, ɛsɛ sɛ wugyae mogya a ɛma mogya tu no nom na wonom Clopidogrel ne aspirin bɛyɛ asram 6. Ebia ɛsɛ sɛ wonom aspirin mpo wo nkwa nna nyinaa. Wɔbɛyɛ eyinom nyinaa wɔ wo duruyɛfo afotu so.
Mfaso ne asiane bɛn na ɛwɔ saa ayaresa yi so?
Te sɛ aduruyɛ biara no, eyi wɔ mfaso ne asiane nyinaa.
| Mfasoɔ | Asiane/Nsɛnnennen a Ɛba |
|---|---|
| Asiane a ɛwɔ hɔ sɛ obi benya ɔyare a ɛma obi hwe ase no so tew kɛse. | Ɔhaw bi a ɛwɔ afiri a wɔde si so no ho. |
| Sɛ́ wobetumi de wɔn ho afi nnuru a ɛma mogya yɛ mmerɛw (ancoagulants) a wɔnom bere tenten no ho. | Ade bɔne a ɛba bere a wɔde aduru a wɔde kum nipadua no mu yɛ den. |
| Ne ho tɔ no ntɛmntɛm efisɛ wɔnam ntwitwiridii ketewaa bi so na ɛyɛ. | Mogya a ɛretu. |
| Asetra pa a wɔbɛma atu mpɔn. | Koko mu yaw, ɔyare mmoawa. |
| Nsu a ɛboaboa ano wɔ koma no ho (pericardial effusion). | |
| Tebea a ɛte sɛ akisikuru a ɛntaa nsi koraa. |
Saa ayaresa yi tu mpɔn yiye. Sɛnea nhwehwɛmu ahorow bi kyerɛ no, saa kwan yi betumi atew asiane a ɛwɔ hɔ sɛ obi benya ɔyare a ɛma obi hwe ase no so bɛyɛ 80%. Nanso kae sɛ, ɛho hia sɛ wo ne wo duruyɛfo susuw eyinom nyinaa ho ansa na woasi gyinae sɛ ebia eyi fata wo anaa.
Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?
Wɔ bere a wɔahyɛ sɛ wobɛkɔ akɔhwɛ wo akyi no akyi no, sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi a, bɔ wo duruyɛfo amanneɛ ntɛm ara:
- Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya atiridiinini anaa ɔyare foforo bi
- Koma a ɛbɔ a ɛnteɛ
- Koko mu yaw
- Ɔhome a ɛyɛ den
Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, kɔ ayaresabea a ɛbɛn wo no Dwumadibea a Ɛhwɛ Ntɛmntɛm (ETU) ntɛm ara.
Nkrasɛm a Wɔde Kɔ Fie
- LAA Closure yɛ aduru a wɔde sa nnipa a wɔwɔ Atrial Fibrillation (Afib) de tew asiane a ɛwɔ hɔ sɛ wobenya ɔyare a ɛma obi hwe ase no so.
- Eyi yɛ adwuma denam kotoku ketewaa bi a ɛwɔ koma no mu a wɔto mu a wɔfrɛ no LAA no so, na ɛmma mogya a ɛtɔ wɔ hɔ no ntumi nkɔ nipadua no mu.
- Saa ayaresa yi yɛ ɔkwan pa a wɔfa so si ananmu ma wɔn a wontumi nnom nnuru a ɛma mogya tu bere tenten no.
- Eyi rensa Afib yare, nanso ebetumi asiw asiane kɛse a ɛne ɔyare a ɛma obi hwe ase no ano.
- Si gyinae bere a wo ne wo komayare ho oduruyɛfo akasa akyerɛ sɛ ebia saa ayaresa yi fata wo ne mfaso ne asiane ahorow a ɛwɔ so no akyi.
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