So wunim ‘kotoku’ ketewa yi a ɛwɔ wo koma mu yi ho asɛm? – Benkum Atrial Appendage a ɛwɔ nipadua no mu

Yɛn nyinaa nim sɛ yɛn koma yɛ akwaa a ɛyɛ nwonwa. Nanso yɛnka koma yi afã nketenkete no bi ho asɛm pii, ɛnte saa? Wiɛ, ɛnnɛ yɛrebɛka ɔfã ketewaa bi a ebia woante ho asɛm pii, nanso ebetumi ayɛ nea ɛho hia yiye ho asɛm. Ɛno ne "Left Atrial Appendage" anaa wɔ Borɔfo kasa mu no `(Left Atrial Appendage)`, anaasɛ yɛbɛfrɛ no `(LAA)` tiawa. Mma ɛnhaw wo, eyi yɛ biribi a ɛyɛ mmerɛw yiye sɛ wobɛte ase.

Dɛn ne Benkum Atrial Appendage yi?

Sɛ yɛbɛka no tiawa a, LAA yɛ kotoku ketewaa bi a ntini wom a ɛka wo koma benkum so dan a ɛwɔ soro, benkum so ahurututu no bom. Fa no sɛ kotoku ketewaa bi a ɛwɔ w’atade mu.

Wɔtaa ka LAA ho asɛm, titiriw wɔ nnipa a wɔwɔ komayare ahorow bi te sɛ Atrial Fibrillation (koma a ɛbɔ a ɛnteɛ, a wɔsan frɛ no Afib), bere a nnuruyɛfo kamfo kyerɛ sɛ wɔnto LAA no mu, wonyi fi hɔ, anaasɛ wonsiw ano na ama asiane a ɛwɔ hɔ sɛ wobenya ɔyare a ɛma obi hwe ase no so atew no. Eyi te saa efisɛ mogya a ɛtwetwe a ɛba nnipa a wɔwɔ Afib koma mu no mu dodow no ara ba wɔ kotoku ketewa yi a wɔfrɛ no LAA mu.

Nanso ade a ɛho hia sen biara wɔ ha ne sɛ wunni biribiara a wubegyina so asuro . Efisɛ saa `(LAA)` yi ho nhia mma wo koma sɛ ɛbɛyɛ ne da biara da dwumadi ahorow yiye. Koma no tumi yɛ adwuma yiye bere a enni hɔ.

Dɛn na ɛba benkum so atiridiinini (LAA) no so? Dɛn ne n’adwuma?

Saa LAA ketewa yi nso wɔ n’ankasa dwumadi soronko. Ne dwumadi titiriw ne sɛ ɛbɛboa ma wɔahwɛ mogya dodow a ɛwɔ koma no mu, anaa mogya dodow so. Wobɛyɛ dɛn ahu?

Sɛ mogya dodow a ɛba wo koma mu no kɔ soro, na saa `(LAA)` yi afasu trɛw a, ɛma protein soronko bi a wɔfrɛ no `(Natriuretic Peptides)` kɔ mogya no mu. Fa no sɛ ɛyɛ sɛnkyerɛnne kwan so nhyehyɛe ketewaa bi a ɛwɔ yɛn nipadua mu. Saa nnuru abɔfoɔ a wɔfrɛ wɔn `(Natriuretic Peptides)` yi, sɛ mogya dodoɔ kɔ soro a, wɔkɔ asaaboɔ no mu na wɔka sɛ, "Okay, seesei nipadua no wɔ nkyene ne nsuo kakra dodo, momma yɛmfa nsuo nyi wɔn mu bi mfi adi." Afei nso, eyinom ma mogya ntini no dwo kakra, te sɛ nea wɔsansan paipu a ɛyɛ den kakra. Afei mogya no tumi sen ntɛmntɛm, na mogya no nso so tew.

Afei ebia worebisa wo ho sɛ, sɛ yɛyɛ oprehyɛn yi anaa yɛsiw ano a, dɛn na ɛbɛba saa `(LAA)` yi dodow no so? Mpɛn pii no, bere a woayɛ biribi a ɛte saa akyi no, saa `(Peptide)` dodow yi betumi ayɛ nea ɛnteɛ kakra bɛyɛ asram abiɛsa. Nanso afei wɔsan kɔ wɔn tebea a na ɛte kan no mu.

Ade foforo ne sɛ, sɛ `(Natriuretic Peptides)` dodow a ɛwɔ mogya no mu kɔ soro dodo a, ɛtɔ da bi a ebetumi ayɛ tebea bi te sɛ `(Koma a Ɛnyɛ Yiye)` (ɛnyɛ komayare, na mmom koma no dwumadi a ɛyɛ mmerɛw) ho sɛnkyerɛnne. Efisɛ afei nipadua no bɔ mmɔden sɛ ebeyi nsu a ɛboro so no afi hɔ, efisɛ ɛyɛ den ma koma no sɛ bedi mogya a ɛboro so no ho dwuma.

Ɛhe na saa `(LAA)` yi wɔ? Ɔte sɛn?

Okay, afei momma yɛnhwɛ baabi pɔtee a saa `(LAA)` yi wɔ wɔ koma no mu. Ɛwɔ baabi ketewaa bi a ɛte sɛ asubɔnten a ɛda wo koma benkum atrium (benkum fam dan a ɛwɔ soro) ne benkum so ahurututu (benkum fam dan a ɛwɔ fam) ntam. Mpɛn pii no, ɛwɔ benkum ahurututu no atifi anaasɛ ɛwɔ `(Main Pulmonary Artery)`, ɔkwan titiriw a ɛde mogya fi koma no mu kɔ ahurututu mu no atifi. Afei nso, te sɛ koma no fã a aka no, saa `(LAA)` yi nso wɔ `(Pericardium)` mu, ade a ɛbɔ ho ban a ɛte sɛ kotoku a ɛkata koma no ho.

Wɔ afã horow ho no, LAA no yɛ ɔkwan bi a wɔabue mu a mogya fa mu, ne kotoku a wɔde ntini ahorow a ebetumi atwetwe ayɛ. Mogya sen fa saa bue yi mu kɔ mu na efi mu ba.

Sɛ yɛhwɛ ne kɛse a, LAA no tenten taa yɛ bɛyɛ milimita 46 (a ennu nsateakwaa 2 kakra). Nanso nnipa binom tenten tumi yɛ milimita 27 kosi 60. Fa no sɛ ɛte sɛ wo credit card no fã ketewaa no. Saa kotoku ketewa yi tumi kura mogya bɛyɛ mililita 9 (bɛyɛ teaspoon abien). Mpɛn pii no, LAA no ano anaa nea ɛbue no yɛ kurukuruwa. Nanso nnipa binom tumi yɛ kurukuruwa anaasɛ wonya nsusuwii afoforo.

So `(LAA)` ahorow ahorow wɔ hɔ? So wɔwɔ nkɛntɛnso bi?

Yiw, nea ɛyɛ nwonwa no, ɛnyɛ obiara `(LAA)` na ne nsusuwii yɛ pɛ. Te sɛ yɛn nsateaa nkyerɛwee no, ɛsono sɛnea ɛte. Mpɛn pii no, `(LAA)` wɔ afã nketewa abien anaa abiɛsa, a wɔfrɛ no `(lobes)`. Nanso ebia nnipa binom wɔ abon biako pɛ, bere a afoforo nso wɔ anan anaa nea ɛboro saa. Nneɛma atitiriw kakraa bi na wogye tom:

• Akokɔ ntaban nsusuwii: Eyi ne sɛnea wɔtaa yɛ. Akwansin bi a ɛkɔ fam kakra wɔ lobe titiriw no mfinimfini. Wɔkyerɛ sɛ nnipa a wɔwɔ saa tebea yi no nni asiane a ɛwɔ hɔ sɛ wobenya ɔyare a ɛma obi hwe ase no sua .
• Cactus nsusuwii: Eyi wɔ nhwiren titiriw bi a ɛwɔ mfinimfini, na ɛte sɛ nea nhwiren afoforo no fi mu.
• Mframa a wɔfrɛ no windsock shape: Eyi wɔ lobe tenten biako pɛ a ɛyɛ titiriw.
• Cauliflower nsusuwii: Eyi yɛ nea ɛyɛ den kakra. Ɛte sɛ nea nhwiren pii a ne kɛse yɛ pɛ na wɔaka abom. Eyi ne nea ɛntaa nsi, na wobu no nso sɛ ɛno ne nea asiane kɛse wom sɛ obenya ɔyare a ɛma obi hwe ase .

Afei deɛ wote aseɛ, ɛnte saa? `(LAA)` ketewa yi nsusuwii nso betumi aka yɛn akwahosan akodu baabi.

Dɛn ne nyarewa ne ɔhaw ahorow a ɛtaa ba a ɛka (LAA) no?

Ɛtɔ da bi a saa `(LAA)` yi tumi de ɔhaw ahodoɔ ba. Nhwɛsoɔ:

• Apirakuru a akwanhyia de ba:Sɛ wunya kar akwanhyia anaa adwenemhaw foforo a emu yɛ den a, saa LAA yi betumi asɛe anaasɛ atetew.
• Mitral Valve Stenosis: Sɛ mitral valve a ɛwɔ koma no mu no yɛ teateaa a, mogya a efi benkum atrium no mu no yɛ brɛoo. Ne saa nti, mogya a ɛsen fa LAA no nso betumi abrɛ ase.
• Atrial Fibrillation (Afib): Sɛnea yɛadi kan aka no, tebea yi ma asiane a ɛwɔ hɔ sɛ mogya a ɛbɛtɔ wɔ LAA no mu no yɛ kɛse . Sɛ saa ntini yi mu paapae, fa mogya no mu, na ɛkɔhyɛ ntini bi a ɛwɔ amemene no mu mu a, ebetumi ama obi anya akisikuru. Eyi ne asiane titiriw a ɛbata LAA ho.

Ɔkwan bɛn so na wobɛhwɛ akwahosan tebea a ɛwɔ `(LAA)`?

Nnuruyɛfo wɔ akwan horow a wɔfa so yɛ nhwehwɛmu de hwɛ sɛnea LAA no te. Nea ɛho hia titiriw ne akwan a wɔfa so twa mfonini.

• Transesophageal Echo (TEE): Eyi nso yɛ echocardiogram, nanso wɔ eyi mu no, wɔde afiri ketewaa bi a ɛte sɛ mfoninitwa afiri hyɛ menewa no mu na wofi akyi hwɛ koma no. Afei wobetumi ahu LAA no pefee.
• Ultrasound fa catheter mu: Ɛtɔ mmere bi a, wɔhwehwɛ LAA no mu denam ultrasound asorɔkye a wɔde fa tube ketewaa bi (catheter) a wɔde hyɛ nipadua no mu so.
• Koma MRI (Magnetic Resonance Imaging): Ɛde magnetic field ne radio asorɔkye di dwuma de yɛ koma no ho mfonini a ɛkɔ akyiri.
• Cardiac CT scan (Cardiac CT - Computed Tomography): Eyi de X-ray di dwuma de nya koma no ho mfonini a wɔatwa no tiaa.

Saa nhwehwɛmu ahorow yi betumi ada nneɛma pii adi, te sɛ LAA no kɛse ne ne nsɛso, ne sɛ ebia mogya a ɛtɔ wɔ mu anaasɛ enni mu.

Dɛn ne ayaresa ahorow a wɔde sa ɔhaw ahorow a ɛfa `(LAA)` ho?

Sɛ ɔhaw bi wɔ LAA no ho a, ayaresa ahorow pii wɔ hɔ a wobetumi ayɛ. Ebia eyinom bi ne oprehyɛn bi, anaasɛ ebetumi ayɛ oprehyɛn a ɛnyɛ den pii.

• Sɛ `(LAA)` no apira a, wobetumi asiesie .
• Wobetumi asa Mitral Valve Stenosis yare .
• Wobetumi atoto LAA no mu, ayi afi hɔ, anaasɛ asiw ano na amma mogya a ɛbɛtɔ no ankɔ . Eyi te saa titiriw ma nnipa a wɔwɔ Afib a asiane kɛse wom sɛ wobenya ɔyare a ɛma obi hwe ase no. Wɔde mfiri ahorow di dwuma ma eyi.

Mɛyɛ dɛn ama me `(LAA)` (kyerɛ sɛ, me koma nyinaa) anya apɔwmuden?

Nokwarem no, biribi titiriw biara nni hɔ a wubetumi ayɛ ama `(LAA)` nkutoo. Nanso, sɛ woma wo koma nyinaa yɛ apɔwmuden a, `(LAA)` nso bɛtena apɔwmuden. Enti, nneɛma bi a wubetumi ayɛ na ama wo koma anya apɔwmuden ni:

• Anyɛ yiye koraa no, yɛ apɔw-mu-teɛteɛ simma 150 dapɛn biara.Ɛno kyerɛ sɛ wobɛnantew, atu mmirika, anaa wobɛtra sakre so bɛyɛ simma 30 da biara.
• Di aduan a ɛma koma nya ahoɔden. Fa nhabannuru, nnuaba, atoko, nnuan a ahoɔdennuru wom, ne nam ne mpataa a ɛnyɛ den ka w’aduan ho. Tew nnɔkɔnnɔkɔwade, nkyene, ne nnuan a srade wom a wudi so sɛnea wubetumi biara.
• Gyae tawa nneɛma (sigaret, beedis, ne nea ɛkeka ho) a wode bedi dwuma koraa.
• Di adwennwen ho dwuma wɔ wo da biara da asetra mu. Nneɛma te sɛ adwendwene, yoga, ne anigyede ahorow a wɔde wɔn ho bɛhyɛ mu betumi aboa.
• Sɛ wowɔ ayaresa tebea horow te sɛ mogya mmoroso anaa asikreyare a, di so yiye. Di wo duruyɛfo akwankyerɛ akyi yiye.

Nea etwa to no, nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Ebia nnipa pii nte edin `(Left Atrial Appendage)` no ho asɛm mpo. Nanso seesei wunim sɛ ɛwɔ adwuma ketewaa bi nso wɔ koma no mu. Nanso, sɛ wowɔ asiane mu sɛ wobɛkɔ akisikuru esiane saa `(LAA)` yi nti a, kae sɛ wubetumi atra ase a ahoɔden wom mpo a wunni bi .

Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne ehu nka kakra bere a wɔayɛ biribi wɔ koma no ho, te sɛ oprehyɛn no. Nanso, wɔ obi a ɔwɔ `(Afib)` fam no, saa `(LAA)` yi a wosiw ano no betumi ama wade ne ho afi nkwa nna nyinaa mu ahiade a ɛne sɛ wɔde mogya a ɛyɛ mmerɛw di dwuma de siw ɔyare a ɛma obi hwe ase ano no ho.

Enti, wo ne wo duruyɛfo nkasa pefee mfa nea eye ma wo tebea no ne ayaresa a ɛfata sen biara no ho. Wɔbɛkyerɛkyerɛ biribiara mu akyerɛ wo. Nsuro sɛ wubebisa nsɛm. Wo na wusi gyinae wɔ w’akwahosan ho, enti ɛho hia paa sɛ wuhu biribiara.

` Koma, Benkum Atrial Appendage, Benkum Atrial Appendage, LAA, Stroke, Atrial Fibrillation, Afib, Mogya a Ɛtwetwe, Koma Akwahosan, Koma Yare