So wo ba kumaa no wɔ komayare anan a emu yɛ den yi? (Tetralogy of Fallot) - Momma yɛnka eyi ho asɛm!

Tetralogy of Fallot, anaa ToF tiawa no yɛ tebea a nneɛma anan a ɛnteɛ bom ba wo ba no koma mu bere a wɔawo no. Saa ɔhaw ahorow yi ma ɛyɛ den ma akokoaa no koma sɛ ɛbɛtwe mogya a oxygen wom a ɛdɔɔso akɔ nipadua no fã a aka no mu. Wunim sɛnea oxygen ho hia na ama biribiara a ɛwɔ yɛn nipadua mu ayɛ adwuma yiye. Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka bere a wote tebea yi ho asɛm no, nanso momma yɛnka ho asɛm nkɔ akyiri sɛnea ɛbɛyɛ a wubetumi ate ase yiye.

Adɛn nti na `(Tetralogy of Fallot)` yi yɛ soronko saa? Dɛn na ɛkɔ so wɔ koma no mu?

Sɛ yɛbɛka no tiawa a, wɔ koma a ɛte apɔw mu no, mogya tu kwan wɔ ɔkwan pɔtee bi so. Ɛne sɛ, mogya a oxygen nnim no kɔ ahurututu no mu, fa mframa pa, na afei ɛsan kɔ koma no mu ma wɔkyekyɛ wɔ nipadua no nyinaa mu. Nanso esiane saa nhyehyɛe mu haw anan yi a ɛwɔ akokoaa a ɔwɔ ``Tetralogy of Fallot`` koma mu nti, mogya a oxygen nnim no bi kɔ nipadua no mu tẽẽ sen sɛ ɛbɛkɔ ahurututu mu. Eyi ne ɔhaw titiriw no.

Afei ma yɛnhwɛ nea koma mu haw anan yi yɛ:

1. Ventricular Septal Defect (VSD) : Fa no sɛ wo koma wɔ adan atitiriw abien, biako wɔ nifa na biako wɔ benkum. Sɛ VSD ba ɔfasu a ɛda abien no ntam a, mogya a oxygen nni mu (mogya bruu) a ɛwɔ nifa so ahurututu no mu no ne mogya a oxygen wom (mogya kɔkɔɔ) a ɛwɔ benkum ahurututu no mu no fra. Eyi nyɛ papa, efisɛ nipadua no hia mogya a ɛho tew a oxygen wom.

2. Pulmonary Artery Stenosis : Mogya ntini titiriw a ɛde mogya a oxygen nnim fi koma no nifa so kɔ ahurututu mu (ahurututu mu ntini) ne ne valve (valve) no yɛ teateaa. Ɛte sɛ nea nsu afiri bi asiw. Eyi ma mogya dodow a ebetumi akɔ ahurututu no mu bere biara a koma bɔ no so tew. Eyi ma mframa pa dodow a wobetumi de ahyɛ mogya no mu no ano hye.

3. Mogya ntini titiriw a ɛde mogya kɔ nipadua no mu no wɔ beae a ɛnteɛ (`Overriding Aorta`) : `(Aorta)` yɛ mogya ntini kɛse a ɛde mogya a oxygen wom kɔ yɛn nipadua nyinaa mu. Mpɛn pii no, eyi bata koma no benkum fam dan no ho. Nanso ɛne `(VSD)` no, saa `(Aorta)` yi wɔ adan abien no nyinaa atifi, na ɛbue ma wɔn baanu nyinaa. Esiane eyi nti, mogya a oxygen nnim ne mogya a oxygen nnim nyinaa fi ase fa saa `(Aorta)` yi mu kɔ nipadua no mu. Sɛ yɛbɛka no pen a, mogya a ɛsɛ sɛ ɛkɔ ahurututu mu na ama wɔanya mframa pa no bi kɔ nipadua no mu tẽẽ.

4. Koma no nifa fam dan no fasu a ɛtrɛw (`Ventricular Hypertrophy`) : Esiane ɔhaw ahorow a yɛaka ho asɛm wɔ atifi hɔ no nyinaa nti, titiriw mogya ntini a ɛde mogya kɔ ahurututu mu no a ɛyɛ teateaa nti, ɛsɛ sɛ koma no ase dan (`(Right Ventricle)`) yɛ adwumaden de bɔ mogya. Sɛnea ntini bi yɛ kɛse bere a woma adesoa bi so no, saa ara na ntini a ɛwɔ saa dan yi fasu mu no nso yɛ kɛse bere kɔ so. Eyi betumi asiw koma no dwumadi kwan bio.

Sɛ ɔhaw anan yi bom a, tebea a wɔfrɛ no ``Tetralogy of Fallot'' no ba.

Saa tebea yi abu so dɛn? Hena na ɛda adi kɛse sɛ obenya bi?

Tetralogy of Fallot yɛ tebea a ɛntaa nsi ankasa.. Sɛnea Amerika akontaabu kyerɛ no, eyi ba wɔ nkokoaa a wɔwo wɔn bɛyɛ 2,000 biara mu biako mu. Nanso, wɔ komayare a wɔde awo obi (`(Congenital Heart Disorders)`) mu no, eyi yɛ tebea a abu so koraa. Saa tebea yi abu so kakra wɔ nkokoaa mmarima mu. Afei nso, nnuruyɛfo ahu sɛ wobetumi ahu `(ToF)` nso wɔ nkokoaa a wɔwɔ nkwaboaa mu nsɛnnennen afoforo te sɛ `(Down Syndrome)` mu.

Ɛntaa mma koraa sɛ nnipa binom betumi anya ɔhaw ahorow bere a wɔanyinyin sɛ wɔansa wɔn yare wɔ mmofraase a.

Ɔkwan bɛn so na nnuruyɛfo hu Tetralogy of Fallot?

Ebia wo duruyɛfo behu saa tebea yi bere a woanyinsɛn anaa bere a wɔawo akokoaa no akyi . Mpɛn pii no, wohu sɛ ɛwɔ adapɛn anaa asram kakraa bi a edi kan wɔ akokoaa no awo akyi.

Nhwehwɛmu a wɔyɛ ansa na wɔawo

Sɛ ultrasound scan a wɔyɛ no daa bere a wɔyem no kyerɛ sɛ koma no mu nneɛma bi anyɛ yiye a, oduruyɛfo no betumi ayɛ scan titiriw bi a wɔfrɛ no fetal echocardiogram . Wobetumi ayɛ eyi wɔ nyinsɛn no adapɛn 18 kosi 22 ntam na ama wɔahu sɛnea akokoaa no koma te pefee na wɔahu sɛ ɔhaw bi wɔ hɔ anaa.

Sɔhwɛ ahorow a wɔyɛ bere a wɔawo akokoaa no akyi

Sɛ wɔwo akokoaa no wie a, sɛ oduruyɛfo no hwehwɛ akokoaa no mu na otie koma no a, ebia wɔbɛte nnyigyei bi a ɛyɛ soronko (`Heart Murmur`) . Eyi yɛ sɛnkyerɛnne a wɔtaa hu wɔ nkokoaa a wɔwɔ `(ToF)` mu.

Nea ɛka ho no, wɔreyɛ sɔhwɛ afoforo pii de asi tebea yi so dua:

• Pulse Oximetry : Eyi yɛ sɔhwɛ a ɛyɛ mmerɛw yiye a ɛnyɛ yaw. Ansa na wode wo ba no bɛkɔ fie no, wɔde sensor ketewaa bi si wo ba no nsa anaa ne nan so de susuw oxygen dodow a ɛwɔ ne mogya mu. Oxygen dodow a ɛba fam betumi ayɛ tebea bi a wɔfrɛ no (ToF) ho sɛnkyerɛnne.
• Echocardiogram (a wɔsan frɛ no echo) : Eyi te sɛ scan. Ɛde nnyigyei asorɔkye di dwuma ma ehu sɛnea akokoaa no koma te pefee, a ne ntini ne mogya a ɛsen ka ho.
• Chest X-ray anaa Cardiac CT Scan : Ɛtɔ mmere bi a eyi betumi akyerɛ sɛ koma no te sɛ "boot-shaped" a ɛnyɛ ne kwan so. Eyi yɛ ToF su.
• Electrocardiogram (EKG anaa ECG) : Eyi sɔ koma no anyinam ahoɔden dwumadi hwɛ. Ebetumi ahu biribiara a ɛnteɛ wɔ koma no mu anaasɛ sɛ ebia koma no mu adan no reyɛ adwumaden dodo.
• Cardiac Catheterization : Eyi yɛ sɔhwɛ a ɛyɛ den kakra. Sɛ ɛho hia nkutoo a, wɔyɛ. Wɔde afiri ketewaa bi (catheter) fa mogya ntini bi a ɛwɔ nan anaa abasa no mu kɔ koma no mu de susuw nhyɛso a ɛwɔ koma no mu, gye mogya, na wohu sɛnea wɔahyehyɛ no yiye.

Sɛ wɔrehu saa tebea yi wɔ ɔpanyin anaa abofra a wanyin kakra mu a, wobetumi de nhwehwɛmu ahorow a yɛaka ho asɛm wɔ atifi hɔ, te sɛ `(EKG)` ne `(Cardiac Catheterization),` adi dwuma.

Ɔkwan bɛn so na wɔsa saa tebea yi `(Tetralogy of Fallot)`?

Ayaresa atitiriw a wɔde sa akokoaa a ɔwɔ `(ToF)` ne nnuru ne oprehyɛn . Sɛ́ anammɔn a edi kan no, nnuruyɛfo betumi ama akokoaa no nnuru te sɛ `(Beta-blockers)` de adi akokoaa no yare no ho sɛnkyerɛnne so na ama mogya no akɔ yiye. Ebia wɔbɛma oxygen foforo nso.

Wɔtaa yɛ oprehyɛn de siesie komayare anan yi nyinaa wɔ akokoaa no awo akyi asram abiɛsa kosi asia. Wɔ oprehyɛn yi akyi no, ɔkwan a mogya fa koma no mu no san yɛ nea ɛfata.

Dɛn ne oprehyɛn a wobetumi apaw?

Ayaresa a wobetumi apaw no betumi ayɛ soronko a egyina akokoaa no tebea so. Ɛtɔ mmere bi a, sɛ akokoaa no sua koraa anaasɛ ɔyɛ mmerɛw yiye a, ebetumi ayɛ den sɛ wɔbɛyɛ oprehyɛn kɛse prɛko pɛ. Wɔ tebea horow a ɛtete saa mu no, wobetumi ayɛ oprehyɛn a ɛnyɛ den (`(Palliative Surgery)`) de adi sɛnkyerɛnne ahorow no so bere tiaa bi kosi sɛ akokoaa no benyin kakra na ne ho ayɛ den. Ɛno nkutoo na wobetumi ayɛ `(Complete Repair)` no.

Oprehyɛn atitiriw pii wɔ hɔ:

• Siesie Awiei : Wɔ saa adeyɛ yi mu no, oduruyɛfo a ɔyɛ oprehyɛn no trɛw valve a ayɛ teateaa ne ɔkwan a ɛde mogya kɔ ahurututu no mu no mu. Afei nso, wɔde aduru bi to tokuru a ɛda koma no ase adan abien (VSD) ntam no mu.
• BTT Shunt Procedure : Eyi ne bere tiaa mu oprehyɛn a yɛadi kan aka ho asɛm. Wɔde afiri ketewaa bi (Shunt) hyɛ akokoaa no nsa ntini (Subclavian Artery) ne ahurututu mu ntini (Pulmonary Artery) ntam. Eyi ma mogya pii sen kɔ ahurututu no mu.
• Ɔkwan a Wɔfa so De Catheter : Ɛtɔ mmere bi a, wobetumi de stent afa catheter so ahyɛ koma no mu a wɔnyɛ oprehyɛn na ama ventricle nifa no abue. Wobetumi de adi dwuma nso de asiw akokoaa patent ductus arteriosus (afiri a ɛka ahurututu mu ntini ne aorta bom) no ano.

Oprehyɛn a wɔyɛ ma mpanyimfo

Ɛntaa mma koraa sɛ nnipa binom betumi atra ase wɔ mmofraase a wɔnyɛ wɔn oprehyɛn biara na wɔadu mpanyin afe so. Animdefo tu nnipa a wɔte saa fo sɛ wɔnyɛ wɔn oprehyɛn koraa na wɔasiw nsɛnnennen a ɛbɛba daakye ano na wɔatew asiane a ɛwɔ hɔ sɛ wobewu mpofirim no so.

Wɔ saa adeyɛ yi mu no, oprehyɛn ho ɔbenfo a ne ho akokwaw wɔ mpanyimfo awo mu komayare (VSD) mu de aduru bi to sintɔ no mu, bue ahurututu nifa no, na osiesie ahurututu no mu ntini no anaasɛ ɔsesa. Ahurututu mu ntini a ɛde mogya kɔ ahurututu abien no nyinaa mu no ayɛ kɛse. Ɛtɔ mmere bi a, wɔde afiri bi si ahurututu nifa ne ahurututu mu ntini no ntam na ama mogya no akɔ yiye.

Mpanyimfo dodow no ara a wɔyɛ wɔn komayare (ToF) siesie no renhia oprehyɛn foforo, nanso ɛsɛ sɛ wɔkɔ so kɔ mpanyimfo awo mu komayare ho oduruyɛfo nkyɛn kɔhwɛ wɔn daa.

Nsɛnnennen bɛn na ebetumi aba wɔ oprehyɛn akyi?

Wɔ Tetralogy of Fallot oprehyɛn akyi no, ɛtɔ mmere bi a (na ɛtɔ mmere bi mpo wɔ bere tiaa bi akyi) no, nsɛnnennen bi betumi asɔre. Nanso mma ɛnhaw wo, nnuruyɛfo no hwɛ eyi so bere nyinaa.

• Electrical Disturbances: Ɛtɔ mmere bi a, patch a ɛto VSD no betumi asiw anyinam ahoɔden nsɛnkyerɛnne a efi koma no atifi (Atria) kɔ ase (Ventricles) no kwan. Wobetumi de afiri a ɛma koma no bɔ kɛse asiesie eyi. Sɛ wɔsiesie ToF a, asiane wɔ hɔ sɛ koma no bɛbɔ denneennen (koma a ɛbɔ daa) wɔ koma no atifi ne fam adan nyinaa mu. Sɛ wowɔ syncopal episode a, ɛsɛ sɛ wɔhwɛ wo mu hwɛ sɛ eyi te anaa.
• Residual Ventricular Septal Defect : Ɛtɔ da bi a, ebia nsuo ketewaa bi bɛtwa patch a wɔde to VSD no mu no ho.
• Aneurysm : Patch a wɔde siesie valve no betumi ama mmeae a ɛyɛ mmerɛw a ɛwɔ valve no mu no ayɛ kɛse na ayɛ aneurysm (a ɛyɛ kɛse te sɛ balloon wɔ mogya ntini mu). Asiane kɛse nso wɔ hɔ sɛ obenya ntini mu yare wɔ aorta a ɛreforo no mu.
• Shunt Nsɛm : Esiane shunt a wɔde sii hɔ wɔ bere tiaa mu oprehyɛn a edi kan no mu nti, ɔhaw ahorow te sɛ ɛyɛ teateaa (stenosis), mogya mmoroso wɔ ahurututu mu ntini no mu, ne koma no benkum so nhyɛso dodo betumi aba.
• Leaky Valves : Mogya betumi akɔ akyi afa valves a ɛwɔ w’ahurututu, aorta, anaa wo koma nifa so (Tricuspid) no mu. Ɛtɔ mmere bi a, ebia ɛho behia sɛ wɔde ahurututu mu ntini (Valve Replacement) di dwuma.

Dɛn na wubetumi ahwɛ kwan bere a wo ne tebea yi te ase no?

Ɛwom mpo sɛ mogya a ɛkɔ koma no mu no san kɔ sɛnea ɛte bere a wɔayɛ no oprehyɛn ama Tetralogy of Fallot akyi de, nanso nneɛma kakraa bi da so ara wɔ hɔ a ɛsɛ sɛ wo anaa wo ba hu:

• Asiane a Ɛwɔ Koma mu Nyarewa : Asiane a ɛwɔ endocarditis mu no dɔɔso kakra. Enti, ɛsɛ sɛ wohwɛ yiye paa wɔ wo sẽ akwahosan ho. Ebia wo duruyɛfo betu wo fo sɛ fa nnuru a ekum ɔyare mmoawa na asiw ɔyare mmoawa ano bere a woresa wo sẽ no.
• Nkɔso a Ɛyɛ Nkakrankakra : Nkokoaa a wɔwɔ Tetralogy of Fallot no betumi anyin nkakrankakra na wɔn mu duru akɔ soro. Ebia wobehia nipadua, kasa, anaa adwuma mu ayaresa.
• Asiane a Ɛwɔ Nyinsɛn Mu : Ɛsɛ sɛ mmea a wɔn mfe akɔ anim yɛ wɔn koma mu nhwehwɛmu titiriw ansa na wɔanyinsɛn. Ebia asiane a ɛwɔ hɔ sɛ nyinsɛn bɛtu no bɛyɛ kɛse kakra asen sɛnea ɛte daa.
• Nnuru Ho Anohyeto : Sɛ́ ɔpanyin no, ebia wɔbɛhwehwɛ sɛ wode nnuru bi ne akwan a wɔfa so siw awo ano nkutoo di dwuma wɔ wo komayare no ho.

Dɛn ne daakye a ɛbɛba `(ToF)` tebea mu?

Esiane sɛ aduruyɛ ho nyansahu anya nkɔso nti, nkokoaa a wɔwɔ `(Tetralogy of Fallot)` daakye ye sen kan no. Oprehyɛn ayaresa di yiye kɛse wɔ sintɔ ahorow a ɛwɔ koma no nhyehyɛe ne mogya a ɛkɔ mu no mu a wosiesie mu. Oprehyɛn a oprehyɛn a mpanyimfo a ne ho akokwaw yɛ wɔ awo mu koma mu oprehyɛn nso yɛ kɛse yiye.

Ɛnnɛ, nkokoaa dodow no ara a wɔyɛ wɔn oprehyɛn de siesie Tetralogy of Fallot no tra ase denneennen. Nanso, ebia anohyeto ahorow bi wɔ dwumadi ahorow a emu yɛ den te sɛ akansi agumadi ho. Nkwa a wonya bere tenten wɔ ToF oprehyɛn akyi no ye yiye. Nnipa dodow no ara a wɔyɛ wɔn oprehyɛn no te ase kosi wɔn mfe 30 mu. Nanso, sɛ wɔanyɛ oprehyɛn a, nnipa 3 biara mu bɛyɛ 1 pɛ na obenya nkwa mfe 10.

Mpanyimfo binom a wɔayɛ wɔn oprehyɛn ama Tetralogy of Fallot bere a na wɔyɛ mmofra no betumi anya ɔhaw ahorow wɔ wɔn mpanyin afe so a ɛsɛ sɛ wɔyɛ nnuru, ayaresa, anaa oprehyɛn foforo. Enti, ɛho hia sɛ mpanyimfo kɔ wɔn koma ho oduruyɛfo nkyɛn ansa na wɔayɛ wɔn nipadua no fã foforo oprehyɛn.

So biribi wɔ hɔ a metumi ayɛ na ama me ba no ho atɔ no?

Bere a wo ba no retwɛn oprehyɛn no, wubetumi aboa no bere a ɔwɔ "tet spells" (bere a ɔdan bruu na ɛyɛ den ma no sɛ ɔbɛhome). Sɛ ɛyɛ den ma no sɛ ɔbɛhome a, fa no to baabi a ɔbɛbɔ fam a ne nkotodwe abɔ ne moma so . Saa gyinabea yi ma mogya kɔ ahurututu no mu kɛse, na ebetumi aboa wo ba no ma ne ho atɔ no.

Afei nso, ɛho hia paa sɛ wɔma akokoaa no nsu a ɛdɔɔso ma ɔnom na ɔmma ɔmmɔ mmɔden dodo.

Bere bɛn na ɛsɛ sɛ mekɔ me duruyɛfo nkyɛn?

Sɛ wo ba no wɔ "tet spell" a emu yɛ den, a ɛkyerɛ sɛ ɔdan bruu na ɛyɛ den ma ne home a, fa no kɔ ayaresabea dan a ɛbɛn hɔ a wɔhwɛ ntɛmpɛ so ntɛm ara . Sɛ woyɛ ɔpanyin a, sɛ wote nka sɛ wo ho atɔ wo, wo ti ayɛ wo yaw, wo home mu yɛ wo den, anaasɛ wo koko yɛ wo yaw a, ɛsɛ sɛ wokɔ baabi a wɔhwɛ wɔn a wɔwɔ ayaresa a egye ntɛmpɛ nso.

Ɛsɛ sɛ wɔyɛ mpanyimfo a wɔyɛɛ wɔn oprehyɛn a edi kan de hwehwɛɛ koma mu ntini (ToF) wɔ wɔn mmofraase no koma mu nhwehwɛmu a edi mũ afe anaa abien biara . Wobetumi ayɛ sɔhwɛ ahorow de ahwɛ sɛnea koma no yɛ adwuma, sɛ nhwɛso no:

• `(Holter Monitor)` (Afiri a ɛkyerɛw `ECG` da mũ no nyinaa)
• Electrocardiogram (EKG) a wɔde kyerɛw koma no .
• Apɔw-mu-teɛteɛ mu Adwennwen Sɔhwɛ
• Echocardiogram (koma mu nhwehwɛmu) .
• Koma mu MRI

Afei nso, wo duruyɛfo no bɛhwɛ wo koma nifa no kɛse ne sɛnea ɛyɛ adwuma daa.

Sɛ wosiesie Tetralogy of Fallot wie a, ɛho behia sɛ wo ba no kɔhwɛ mmofra koma ho ɔyaresafo daa. Saa ɔhwɛ a wɔyɛ no daa yi bɛkɔ so akosi mpanyin afe so.

Nsɛm bi a wubetumi abisa wo duruyɛfo:

• So ɛho behia sɛ me ba no to n’agumadi dwumadi ano hye bere a wɔayɛ no oprehyɛn awie no?
• So ɛho behia sɛ wɔyɛ me ba no oprehyɛn pii?
• Nnuru afoforo bɛn na ɛsɛ sɛ me ba nom (sɛ ɛwɔ hɔ a)?

Awiei koraa no, ɛsɛ sɛ meka sɛ... (Take-Home Message)

Ɛyɛ ade a ɛfata sɛ wobɛte nka sɛ woayɛ basaa na woadi awerɛhow bere a wuhu sɛ wo ba a wɔawo no foforo no wɔ komayare bi no. Nanso kae sɛ, w’aduruyɛfo kuw no aboa awofo afoforo pii a wɔahyia tebea a ɛte saa ara, na wɔn nso betumi aboa wo. Sɛ wote nka sɛ woayɛ basaa wɔ abofra a ɔwɔ Tetralogy of Fallot a wobɛhwɛ no ho a, nsuro sɛ wo ne ɔyaresafo bɛkasa. Afei nso, ɔyaresafo betumi aboa mmofra ne mmerante ne mmabaa a wɔte nka sɛ wodi wɔn atipɛnfo anim wɔ nkɔso mu. Nya ahotoso sɛ sɛ wɔde ayaresa a ɛfata ne ɔdɔ hwɛ mmofra yi a, wobetumi anya asetra pa nso.

` Tetralogy of Fallot, Mmofra Koma Yare, Koma a Wɔde Awo Wɔn, Koma mu Tokuru, Blue Baby Syndrome, Koma Oprehyɛn, Koma Nhyehyɛe