So wo ba kumaa no wɔ komayare yi? Momma yensua Pulmonary Artery Stenosis ho ade!

So ɛtɔ mmere bi a wo ba no te nka sɛ ne home yɛ den? Anaasɛ ɔbrɛ ntɛmntɛm paa bere a wabɔ agoru kakra mpo? Mmofra nkumaa bi betumi anya komayare a wɔde awo wɔn. Ɛnnɛ yɛrebɛka komayare biako a ɛte saa, a ɛho yɛ na kakra, nanso ɛho hia yiye a ɛsɛ sɛ yɛma yɛn ani da hɔ ho asɛm. Yɛfrɛ eyi `(Ahurututu mu Ntini a Ɛyɛ Den)`. Sɛ yɛbɛka no tiawa a, ɛyɛ ntini titiriw a ɛde mogya kɔ ahurututu mu no a asiw.

Dɛn ne Ahurututu mu Ntini a Ɛyɛ Den?

Sɛ yɛbɛka no tiawa a, mogya ntini kɛse bi wɔ hɔ a ɛde mogya fi yɛn koma nifa (a yɛfrɛ no ``right ventricle``) kɔ ahurututu mu. Wɔfrɛ eyi ``ahurututu mu ntini``. Sɛ edu ahurututu mu a, mframa yi ma mogya yi, na afei wɔde saa mogya a mframa pa wom no kɔ nipadua no nyinaa mu.

Afei, wɔ saa tebea a wɔfrɛ no `(Pulmonary Artery Stenosis)` yi mu no, mogya ntini a ɛde mogya kɔ ahurututu mu no siw anaasɛ ɛyɛ teateaa wɔ beae bi anaa ne nkorabata biako. Ɛte sɛ nsu afiri bi a ɛresiw wɔ mfinimfini. Dɛn na ɛba saa bere no? Ɛbɛyɛ den sɛ mogya bɛsen akɔ ahurututu no mu. Sɛ mogya no ankɔ yiye a, nipadua no nnya mframa pa dodow a ehia. Esiane eyi nti, abofra no koma ne ne nipadua nyinaa ntumi nyɛ adwuma yiye.

Saa akwanside yi betumi aba wɔ ahurututu mu ntini titiriw no mu (`(ahurututu mu ntini titiriw)`), anaasɛ ne benkum anaa nifa nkorabata (`(benkum anaa nifa nkorabata)`). Sɛ saa akwanside yi ba a, ɛsɛ sɛ koma no fã nifa (`(right ventricle)`) yɛ adwumaden yiye na ama mogya no atwam wɔ akwanside no so. Ɛte sɛ nea ɛsɛ sɛ wode ahoɔden pii pia nsu fa paipu a asiw mu. Bere kɔ so no, mmɔdenbɔ a ɛkɔ so yi betumi asɛe koma ntini no.

Nsɛnnennen bɛn na ebetumi afi tebea yi mu aba?

Sɛ wɔansa eyi yiye a, bere kɔ so no, koma no nifa betumi ayɛ nea entumi nyɛ adwuma yiye. Ɛne sɛ, ɛyɛ yie sɛ wobɛnya tebea bi a wɔfrɛ no ``Right-sided heart failure''. Enti, ɛho hia paa sɛ yɛhwɛ eyi so.

Hena na tebea yi ka no kɛse?

Saa tebea a wɔfrɛ no `(Pulmonary Artery Stenosis)` yi ho yɛ na ankasa . Ɛno kyerɛ sɛ ɛnto obiara. Mmofra binom tumi nya bi ka komayare afoforo ho (`(congenital heart disease)` - kyerɛ sɛ, komayare a ɛwɔ hɔ wɔ awo mu). Ɛtɔ da bi a, ɛno nkutoo na ebetumi ayɛ nea enni komayare foforo biara. Afei nso, saa tebea yi betumi aba bere a wɔayɛ koma oprehyɛn bi akyi.

Dɛn ne eyi ho sɛnkyerɛnne? Hwɛ sɛ wo ba no nso wɔ eyinom anaa.

Saa sɛnkyerɛnne ahorow yi gyina sɛnea afiri no mu teateaa no so. Ɛtɔ da bi a, sɛ stenosis no yɛ mmerɛw koraa (`mild stenosis`) a, ebia sɛnkyerɛnne biara nni hɔ koraa . Nanso bere a stenosis no mu yɛ den no, ebia wo ba no bɛda nneɛma te sɛ:

• Te nka sɛ ɛyɛ den sɛ wobɛhome (`(Shortness of breath)`).
• Ɔbrɛ a wɔte nka bere nyinaa (`(Ɔbrɛ)`).
• Ɛte sɛ nea worehome ntɛmntɛm , anaasɛ ebia worehome denneennen.So ɛte sɛ eyi? (`(Ɔhome a emu yɛ duru anaa ntɛmntɛm)`).
• So wo koma bɔ te sɛ nea ɛrebɔ ntɛmntɛm dodo ? (Koma a ɛbɔ ntɛmntɛm).
• So ahonhon bi wɔ wo nan, wo nansoaa, w’anim, w’aniwa, anaa wo yafunu mu? (`(Ɔhohoro)`).
• So ɛtɔ mmere bi a wote nka sɛ wo ho yɛ wo yaw anaasɛ wototɔ piti ? (`(Adwene a ɛyɛ basaa anaasɛ obi a ɔtotɔ piti)`).
• So w’ano, wo nsateaa, ne wo nansoaa dan bruu ? Eyi ne nea yɛfrɛ no wɔ aduruyɛ mu sɛ ``Cyanosis''.
• Sɛ wo ne mmofra afoforo redi agoru a, wobrɛ ntɛm ? So wuntumi ntu mmirika na wunhuruw te sɛ mmofra afoforo? (`(Apɔw-mu-teɛteɛ a wɔtew so)`).

Kae sɛ, sɛ wunya saa sɛnkyerɛnne ahorow yi mu biako anaa abien kɛkɛ a, ɛnkyerɛ sɛ wowɔ yare no. Nanso sɛ wo ba no wɔ saa nneɛma yi bi a, ɛbɛyɛ papa sɛ wobɛhwehwɛ aduruyɛ mu afotu.

Dɛn nti na ahurututu mu ntini yi siw? Dɛn na ɛde ba?

Wɔwo mmofra binom a wɔwɔ saa tebea yi (Pulmonary Artery Stenosis), na wobetumi nso anya ɔhaw ahorow wɔ koma no ntini, afasu, anaa mmeae afoforo ho. Ebia wɔawo afoforo a wɔwɔ saa tebea yi nanso wonni komayare foforo biara. Nea ɛka ho no, tebea yi betumi aba bere a wɔayɛ koma oprehyɛn akyi anaasɛ esiane tebea afoforo a ɛntaa nsi koraa nti.

Nneɛma a wɔde awosu na ɛde ba

Sɛ yɛka ne nyinaa bom a, wɔwo nnipa bɛyɛ 40% a wɔwɔ saa tebea yi (Pulmonary Artery Stenosis), nanso wonni koma mu haw foforo biara.

Nanso, nnipa a wɔwɔ komayare afoforo a wɔde awo wɔn no mu 2% kosi 3% nso betumi anya saa tebea yi (Pulmonary Artery Stenosis). Koma mu dɛmdi a ɛtaa ba no bi ni:

• (Tetralogy of Fallot): Wɔ eyi mu no, abofra no wɔ ɔhaw anan wɔ koma no ho, na ɛmma mogya ntumi nkɔ.
• (Ahurututu mu atresia): Wɔ eyi mu no, ahurututu (ahurututu mu ntini) a ɛda koma no nifa so ne ahurututu mu ntini (ahurututu mu ntini) ntam no ntumi nyɛ. Enti, mogya nkɔ ahurututu no mu.
• (Truncus arteriosus): Mogya ntini kɛse biako mmom sen abien a wɔtaa de di dwuma no. Eyi ma mogya a oxygen wom frafra mogya a oxygen nni mu.
• Aortic valve stenosis: Ɔhaw a ɛwɔ valve a ɛwɔ ntini kɛse a ɛde mogya fi koma no mu kɔ nipadua no mu no ho, na ɛma mogya dodow a ɛkɔ nipadua no mu no so tew.
• Atrial septal defect: Tokuru a ɛwɔ ɔfasu no mu wɔ koma no atifi adan abien (atria) ntam. Eyi ma mogya a oxygen wom ne nea oxygen nni mu no fra.
• Ventricular septal defect: Tokuru a ɛwɔ ɔfasu no mu a ɛtetew koma no ase adan abien (ventricles) ntam. Eyi betumi ama mogya pii akɔ ahurututu no mu.
• (Transposition of the great vessels): Mogya ntini atitiriw abien a ɛde mogya fi koma no mu no dannan. Eyi sɛe mogya a ɛkɔ nipadua no mu sɛnea ɛsɛ na ɛmma mframa pa dodow a ɛkɔ nipadua no mu nkwammoaa mu no ano brɛ ase.
• (Patent ductus ntini a ɛma mogya tu): .Eyi yɛ abusuabɔ a ɛda akokoaa no ahurututu mu ntini ne ntini titiriw a ɛde mogya kɔ nipadua no mu (aorta) ntam. Ɛsɛ sɛ eyi to mu wɔ awo akyi, nanso sɛ ɛnte saa a, mogya pii bɛsen akɔ ahurututu no mu.

Nneɛma afoforo nti

Sɛ eyi da nkyɛn a, ebia ntease afoforo pii wɔ hɔ:

• Rubella syndrome: Sɛ wunya rubella bere a wonyinsɛn a, ebia wo ba no benya koma ne akwahosan ho haw afoforo.
• (Williams syndrome): Eyi de nneɛma ahorow a ɛnteɛ ba abofra no koma ne ne akwaa afoforo mu.
• (Alagille syndrome): Eyi de mmerɛbo mu haw ne komayare ba.
• Takayasu ntini mu yare: Eyi yɛ ɔfe a ɛsɛe mogya ntini akɛse.
• Nsɛm bi a ɛfa ɔkwan a wɔfa so pia abofra no ahurututu mu ntini no kɔ abɔnten no ho.

Oprehyɛn a wɔde ba

Ebia nnipa binom benya saa tebea yi bere a wɔayɛ wɔn oprehyɛn akyi. Nhwɛsoɔ:

• Ahurututu a wɔde si ananmu.
• Oprehyɛn a wɔyɛ de siesie koma mu dɛmdi bi a wɔde woo abofra, anaasɛ wɔde ma mogya fa koma no mu tu mpɔn.
• Oprehyɛn bi a wɔfrɛ no ``Pulmonary artery banding''. Wɔ eyi mu no, wɔhyɛ da twitwa ntini no mu sɛnea ɛbɛyɛ a mogya dodow a ɛkɔ ahurututu no mu no so tew.

Ɔkwan bɛn so na wobetumi ahu yare yi?

Sɛ oduruyɛfo hwehwɛ wo ba no mu a, ebia ɔbɛte koma nnyigyei a ɛnteɛ (``nwiinwii''). Sɛ saa a, wɔbɛkra sɛ wɔnyɛ nhwehwɛmu pii bio. Eyinom bi ne:

• Electrocardiogram - ECG anaa EKG: Eyi kyerɛw anyinam ahoɔden nsakrae a ɛba bere a koma no bɔ no. Ebetumi ahu koma a ɛbɔ a ɛnteɛ (arrhythmias) ne adwennwen a ɛba koma ntini no so.
• Koko mu X-ray: Eyi betumi akyerɛ sɛnea koma, ahurututu, ne ahurututu mu ntini no kɛse ne sɛnea ɛte.
• Echocardiogram: Eyi te sɛ koma no mfonini a ɛkanyan. Ɛde nnyigyei asorɔkye di dwuma de hwɛ koma no ntini ne ntini ahorow.
• Cardiac magnetic resonance imaging (MRI): Eyi yɛ mfoninitwa mfiri a ɛwɔ afã abiɛsa (3D) a etumi hu sɛnea mogya fa wo ba no koma ne ne mogya ntini mu.
• (CT scan): Eyi nso yɛ `(X-ray)` sɔhwɛ. Kɔmputa de abofra no koma mfonini ahorow a ɛtoatoa so di dwuma de yɛ mfonini ahorow a wɔatwa no tiaa. Wɔde aduru soronko bi (`(IV contrast)`) gu koma no mu de hwɛ sɛnea koma no nhyehyɛe ne mogya a ɛkɔ no.
• Koma mu catheterization: Wɔ saa adeyɛ yi mu no, wɔde afiri teateaa (catheter) hyɛ ntini anaa ntini bi mu na wɔkyerɛ kwan kɔ koma no mu. Eyi ma oduruyɛfo no tumi hwɛ oxygen dodow, nhyɛso a ɛsakra, na ɔyɛ koma no X-ray.
• Pulmonary angiography: Wɔde aduru a wɔde yɛ aduru na ɛyɛ ahurututu mu ntini ne ntini a ɛwɔ koma no mu no X-ray.
• (Perfusion scan): Wɔ eyi mu no, wɔde radioactive nneɛma kakraa bi gu mu. Afei, wɔde afiri titiriw bi di dwuma de hwɛ sɛnea mogya kɔ ahurututu biara mu yiye.

Sɛ wo duruyɛfo hu sɛ wo ba no wɔ Pulmonary Artery Stenosis a, wɔde wo bɛkɔ koma ho ɔbenfo a wɔde wo awo no nkyɛn. Oduruyɛfo a ɔte sɛɛ wɔ ahokokwaw ne ntetee a ɛbɛma wahu wo ba no komayare no pɛpɛɛpɛ, ayɛ nhwehwɛmu biara a ɛho hia, ama no ayaresa, ayɛ koma oprehyɛn, na wayɛ nhwehwɛmu a edi akyi . Ebia wɔbɛyɛ sɔhwɛ pii nso sɛ ɛho hia a.

Sɛ wo duruyɛfo reka tebea yi ho asɛm a, ebia ɔbɛfrɛ no Type I, II, III, anaa IV. Eyi yɛ nkyekyem a egyina ntini no afã horow a asiw ne dodow a asiw so.

Dɛn ne ayaresa ahorow a wɔde sa eyi? (Ayaresa)

Ayaresa a eye sen biara no gyina wo ba no yare no ho sɛnkyerɛnne ne nneɛma afoforo so. Sɛ ahurututu mu ntini no nkorabata biako anaa nea ɛboro saa teateaa kakra kosi nea ɛkɔ fam a, ebia ɛho renhia sɛ wɔsa yare . Nanso, sɛ teateaa no mu yɛ den a, ɛho hia sɛ wɔsa yare .

Ayaresa a wɔde sa `(Pulmonary Artery Stenosis)` ne:

Balloon a wɔtrɛw mu / Angioplasty

Wɔ eyi mu no, oduruyɛfo no yɛ:

• Wɔde afiri bi a ɛte sɛ balloon (balloon dilation catheter) hyɛ ntini a asiw no mu.
• Afei, wɔde ahwɛyiye kɛse ma balloon no fi nhyɛso a ɛba fam so kɔ nhyɛso kɛse so.
• Afei saa duct a asiw no trɛw.
• Afei woyi mframa no fi balloon no mu na woyi fi mu.

Balloon a wɔtrɛw mu ne stent a wɔde si hɔ (wɔtaa yɛ eyi) .

Wɔ eyi mu no, oduruyɛfo no yɛ:

• Wɔde stent a wotumi trɛw mu wɔ balloon mu (stent yɛ afiri ketewaa bi a wɔde ahama ayɛ) na ebue ntini a asiw no.
• Wɔde saa stent yi si balloon angioplasty catheter so na wɔde akataso kata so.
• Wɔde stent no rekɔ baabi a ɛfata.
• Woyi kataso a ɛwɔ stent-balloon no so no fi hɔ.
• Afei wɔma balloon no mframa kɔ nhyɛso a ɛfata mu, na ɛtrɛw stent no mu na ɛma ɛkɔ so bata hɔ.

Balloon soronko bi a wɔfrɛ no ``The Cutting BalloonTM``

Saa balloon yi te sɛ balloon a wɔde di dwuma daa ara pɛ. Nanso, ɛwɔ agyan nketewa pii wɔ ne tenten mu. Sɛ oduruyɛfo no ma balloon no mu ma a, saa nhama yi ma ɛyɛ adwuma na etwitwa baabi a asiw no. Eyi ma ɛyɛ mmerɛw sɛ wɔbɛtrɛw afiri no mu, na ama wɔabue kɛse.

Nnipa dodow no ara a wonni komayare afoforo a wɔde awo wɔn no nya nea eye wɔ saa adeyɛ yi mu. Nanso, nnipa bɛyɛ 21% betumi asan asiw wɔn ntini no bio wɔ asram kakraa bi akyi.

Sɛɛgyiri

Nnuruyɛfo a wɔyɛ oprehyɛn fa akwan horow so sa ahurututu mu ntini a ɛyɛ mmerɛw. Nea wɔpaw no gyina sɛnea asiw no te, mogya ntini a atwa ho ahyia, ne nneɛma afoforo so.

So nsɛnnennen bi wɔ ayaresa no mu?

Balloon a wɔtrɛw mu no ma nnipa dodow no ara siw kwan no so tew. Nanso bere kɔ so no, ntini no betumi asiw bio 15% kosi 20%, na ɛsɛ sɛ wɔsan yɛ saa adeyɛ no bio. Mprempren nhwehwɛmufo reyɛ nhwehwɛmu wɔ balloon ahorow ahorow a ebetumi ama wɔanya nea eye na ɛtra hɔ kyɛ ho.

Nsɛnnennen a ebetumi aba bere a wɔretrɛw balloon mu no:

• Ahurututu mu ntini a ɛma mogya tu.
• Ahurututu mu ntini a wɔtwitwa (Ahurututu mu ntini a wɔtwa).
• Ahurututu mu ntini a ɛpaapae (`(Ahurututu mu ntini a ɛpaapae)`).
• Ahurututu mu akisikuru (`(Ahurututu mu akisikuru)`).
• Ɛntaa mma koraa sɛ nnipa betumi awuwu.

Nsɛnnennen a ebetumi aba wɔ stent a wɔde di dwuma mu:

• Mogya a ɛtwetwe.
• Koma mu nnyigyei a ɛnkɔ so pɛpɛɛpɛ (`(Ventricular arrhythmias)`).
• Ebia wɔde stent no bɛto baabi a ɛnteɛ anaasɛ wɔatu afi hɔ.
• Ɛsɛ sɛ wɔtrɛw ntini no mu bio (eyi ntaa nsi).

Mfaso bɛn na ɛwɔ ayaresa so?

Nnuruyɛfo pɛ sɛ wɔde stent gu Pulmonary Artery Stenosis so esiane nneɛma yi nti:

• Wɔyɛ bɛyɛ 96% a etu mpɔn ntɛm ara .
• Egye bere tenten na ama ntini no abue.
• Wobetumi atrɛw beae a ayɛ teateaa no mu bɛyɛ mmɔho abien .
• Ne bo nyɛ den na etu mpɔn sen sɛ wode balloon bɛhyɛ mu anaasɛ wobɛyɛ oprehyɛn kɛkɛ.
• Edi yiye sen balloon angioplasty.

Nnuruyɛfo betumi apaw balloon angioplasty mmom sen sɛ wɔde stent bedi dwuma wɔ nsɛm a edidi so yi mu:

• Sɛ abofra no tebea no mu yɛ den yiye a .
• Sɛ abofra no nipadua no mu nhyehyɛe yɛ nea ɛyɛ den (`(complex anatomy)`).
• Sɛ abofra no sua koraa a .

Dɛn na ɛba wɔ oprehyɛn no akyi?

Sɛ wo ba no wɔ stent a, ɛho behia sɛ ɔnom nnuru a ekum ɔyare mmoawa ne ebia nnuru a ɛma mogya yɛ mmerɛw kakra. Wɔde nnuru yi ma na amma ɔyare mmoawa ankɔ so na wɔagyae mogya a ɛbɛtɔ.

Ɛrenkyɛ na abofra no ho atɔ no wɔ ayaresa akyi?

Adeyɛ a ɛma wo ba no ahurututu mu ntini trɛw no yɛ adwuma ntɛm ara. Eyi kyerɛ sɛ ɛbɛyɛ mmerɛw kɛse ama wo ba no sɛ mogya bɛkɔ n’ahurututu mu na wanya mframa pa.

Sɛ me ba no wɔ saa tebea yi a, daakye bɛyɛ dɛn? (Nkɔmhyɛ) .

Esiane nnɛyi nnuruyɛ a ɛkɔ akyiri nti, nnipa pii a wɔwɔ saa yare yi tra ase kodu wɔn mpanyin afe so. Nanso, ebia nnipa a wɔwɔ tebea horow te sɛ ``Williams syndrome'' ne ``Alagille syndrome'' no rennyɛ wɔn ade yiye wɔ ayaresa ho.

Bere bɛn na ɛsɛ sɛ wode wo ba kɔ oduruyɛfo nkyɛn?

Ɛho behia sɛ wode wo ba kɔhwɛ no daa na ama woahu sɛnea ne ho te. Ɛho behia nso sɛ woyɛ echocardiograms daa de hwɛ sɛ ebia ɛsɛ sɛ wɔtrɛw ntini no mu bio daakye anaa.

Dɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Wubetumi abisa oduruyɛfo no nsɛm te sɛ eyinom:

• Dɛn nti na me ba no nyaa `(Pulmonary Artery Stenosis)`?
• Dɛn ne ayaresa a eye sen biara ma me ba?
• Hokwan ahorow bɛn na ɛwɔ hɔ sɛ ɛho behia sɛ wɔsa me ba no yare bio wɔ eyi ho?

Sɛ wo ba hia Pulmonary Artery Stenosis ayaresa a, oduruyɛfo no besusuw ayaresa a eye sen biara a wɔde bɛma wo ba no tebea no ho. Mma ntwentwɛn wo nan ase sɛ wubebisa nsɛm afa biribiara a wonte ase wɔ wo ba no ayaresa ho.

Nkrasɛm a Wɔde Kɔ Fie

Sɛ ɛba tebea yi a wɔfrɛ no `(Pulmonary Artery Stenosis)` so a, ade a ɛho hia sen biara ne sɛ wubehu sɛnkyerɛnne ahorow no ntɛm na woahwehwɛ aduruyɛ mu afotu . Ɛho hia sɛ wohwehwɛ afotu fi `(congenital heart specialist)` hɔ, titiriw sɛ mmofra wɔ saa tebea yi a.

Mma ɛnhaw wo, ayaresa ahorow wɔ hɔ a wɔde sa eyi . Wobetumi de nneɛma te sɛ balloon a wɔtrɛw mu, stent a wɔde besisi hɔ, ne sɛ ɛho hia a, oprehyɛn adi tebea yi so. Sɛ wɔsa abofra no yare mpo a, ɛho hia paa sɛ abofra no akwahosan kɔ aduruyɛ mu nhwehwɛmu daa na wodi oduruyɛfo no akwankyerɛ akyi . Wo ne oduruyɛfo no nkasa mfa nsɛmmisa anaa nsɛm biara a ɛhaw wo ho.

` Pulmonary Artery Stenosis, Mmofra Koma Yare, Koma a Wɔde Awo Wɔn, Ɔhome a Ɛyɛ Den, Koma Oprehyɛn, Stent