So wɔadan wo ba no koma ntini akɛse no? (Transposition of the Great Arteries) - Momma yɛnka eyi ho asɛm!

Ɛyɛ den sɛ wobɛka ehu ne awerɛhow a wunya bere a wote sɛ wo ba a wɔawo no foforo no wɔ komayare no ho asɛm, ɛnte saa? Nanso mma ɛnhaw wo. Ɛtɔ mmere bi a, nkokoaa tumi ma mogya ntini atitiriw abien a ɛwɔ wɔn koma mu no sesa bere a wɔawo wɔn no. Ɛnnɛ yɛreka tebea biako a ɛte saa ho asɛm, a wɔfrɛ no `(Transposition of the Great Arteries)`. Ebia eyi bɛyɛ te sɛ nea ɛyɛ den kakra, nanso momma yɛmma ɛnyɛ mmerɛw.

Dɛn ne Ntini Kɛse no Transposition?

Sɛ yɛbɛka no tiawa a, eyi yɛ ``congenital`` tebea a ɛba bere a wɔwo akokoaa. Ɛne sɛ, ɔhaw yi ba bere a akokoaa no da so ara wɔ ɛna no awotwaa mu no. Yɛwɔ mogya ntini atitiriw abien a ɛde mogya fi yɛn koma mu kɔ yɛn nipadua no fã a aka no. Baako ne ahurututu mu ntini a ɛde mogya kɔ ahurututu mu , na biako nso ne aorta a ɛde mogya kɔ yɛn nipadua no fã a aka no . Nea ɛba wɔ tebea yi mu ne sɛ mogya ntini akɛse abien yi bata koma no ho wɔ mmeae a ɛnteɛ, na ɛnyɛ mmeae a ɛfata. Ɛte sɛ nea wɔasesa paipu a ɛkɔ nsukorabea abien mu no.

Ɔkwan bɛn so na mogya taa tu kwan? Dɛn na ɛba wɔ tebea yi mu?

Mpɛn pii no, eyi ne nea ɛba: nipadua no mogya a oxygen nnim (mogya bruu) no kɔ koma no mu, fi hɔ kɔ ahurututu mu kɔfa mframa pa. Afei mogya foforo a oxygen pii wom (mogya kɔkɔɔ) no san kɔ koma no mu, na efi hɔ kɔ nipadua no nyinaa mu fa ntini akɛse no mu. Nanso wɔ saa ``Transposition of the Great Arteries'' tebea yi mu no, esiane sɛ wɔsesa mogya ntini abien no nti, mogya a oxygen nnim no san kɔ nipadua no mu sen sɛ ɛbɛkɔ ahurututu mu. Saa ara na mogya a oxygen pii wom a efi ahurututu mu ba no san kɔ ahurututu no mu mmom sen sɛ ɛbɛkɔ nipadua no mu. Wo de susuw sɛnea mframa pa a eyi bɛkɔ akokoaa no akwaa mu no sua koraa ho hwɛ.

So eyi ahorow bi wɔ hɔ?

Yiw, eyi ahorow atitiriw abien na ɛwɔ hɔ: 1. Levo-transposition (Levo-transposition anaa l-TGA): Wɔ eyi mu no, akokoaa no aorta no wɔ ahurututu mu ntini no benkum so. Wɔ eyi mu no, ɛnyɛ mogya ntini abien no nko na wɔsesa, na mmom koma no ase adan nso. Nanso, wɔ saa su yi mu no, mogya a oxygen nnim kɔ ahurututu mu na mogya a oxygen wom kɔ nipadua no mu, enti ɛnsɛe pii. Eyi nyɛ nea abu so kakra. 2. Dextro-transposition (Dextro-transposition anaa d-TGA): Wɔ eyi mu no, akokoaa no aorta no wɔ ahurututu mu ntini no nifa so. Eyi ne nea abu so sen biara, na ɛno nso ne nea ɛsɛ sɛ wɔde adwene si so kɛse. Yɛbɛka saa `(d-TGA)` yi ho asɛm pii wɔ saa asɛm yi mu.

Dɛn nti na wɔfrɛ tebea yi d-TGA yɛ asiane ma nkokoaa?

Sɛnea madi kan aka no, wɔ `(d-TGA)` fam no, mogya a oxygen nnim ahyɛ akokoaa no nipadua mu ma. Eyi kyerɛ sɛ akokoaa no akwaa a ɛho hia nyinaa, te sɛ amemene, asaabo, ne mmerɛbo, nnya mframa pa dodow a wɔhwehwɛ. Eyi yɛ asiane kɛse ma akokoaa no nkwa. Ɛtɔ da bi a, sɛ wɔwo saa nkokoaa yi a, ebia tokuru bi bɛda koma no atifi adan `(Atrial Septal Defect anaa ASD)` ntam anaasɛ tokuru bi bɛda koma no ase adan `(Ventricular Septal Defect anaa VSD)` ntam. Ɛwom sɛ saa ntokuru yi yɛ tebea horow a ɛyɛ soronko ankasa de, nanso wɔ nsɛm a ɛtete saa mu no, saa ntokuru yi ntumi mmoa kɛse. Ɛne sɛ, saa ntokuru yi ma mogya bi a oxygen wom frafra mogya a enni oxygen no mu. Nanso, mframa pa dodow a wonya no nnɔɔso koraa. Enti, akyinnye biara nni ho sɛ akokoaa no hia ayaresa.

Mma ɛnhaw wo, oprehyɛn ahorow wɔ hɔ ma tebea yi. Nnuruyɛfo de mfe pii ayɛ oprehyɛn ahorow yi yiye.

Sɛ wo ba no wɔ saa tebea yi a, dɛn ne sɛnkyerɛnne ne sɛnkyerɛnne ahorow? (Mpopoeɛ)

Nkokoaa a wɔawo wɔn foforo a wɔwɔ `(d-TGA)` betumi anya tebea bi a wɔfrɛ no `(cyanosis),` a ɛyɛ honam ani kɔla bruu/akuturuku esiane oxygen a wonni nti. Ebia wɔwɔ koma a ɛyɛ mmerɛw nso. Nsɛnkyerɛnne titiriw a ɛkyerɛ ne sɛ:

• Ɔhome a ɛyɛ den .
• Pulse no yɛ mmerɛw yiye.
• Kyerɛ sɛ ɔmpɛ na ɛyɛ den sɛ ɔbɛnom nufusu.
• Me koma te sɛ nea ɛrebɔ denneennen dodo, te sɛ nea ɛrebɔ ntɛmntɛm dodo.
• Aniwa no were ne fitaa betumi ayɛ bruu (wɔ nkokoaa a wɔn honam ani yɛ fitaa mu) anaasɛ ɛyɛ fitaa (wɔ nkokoaa a wɔn honam ani yɛ tuntum mu).

Bere bɛn na saa sɛnkyerɛnne ahorow yi fi ase?

Akokoaa a ɔwɔ `(d-TGA)` befi ase ada saa sɛnkyerɛnne ahorow yi adi wɔ awo mu. Nanso ɛtɔ da bi a, ɛnam nneɛma te sɛ `(ASD)` nti, ntokuru nketewa a ɛwɔ akokoaa no koma mu no tumi ma mogya bi a oxygen wom kɔ nipadua no mu, enti sɛnkyerɛnne ahorow no ntumi nhu kɛse. Afei nso, `(patent ductus arteriosus)`, mogya ntini bi a akokoaa no de di dwuma bere a ɔwɔ awotwaa mu no tumi bue nna kakraa bi wɔ awo akyi, na ɛma mogya fra. Nanso, sɛ bere tiaa mu ntokuru ne nsukorade yi to mu pɛ a, sɛnkyerɛnne ahorow no betumi ayɛ kɛse mpofirim. Sɛ ɛba saa a, akokoaa no hia ayaresa ntɛm ara.

Dɛn nti na eyi rekɔ so? (Ntease ahorow) .

Nnuruyɛfo da so ara nnim nea ɛde Transposition of the Great Arteries ba ankasa. Te sɛ komayare afoforo a wonya fi awo mu no, wosusuw sɛ awosu mu nsakrae anaa awuduru a wɔde wɔn ho hyɛ mu bere a wɔyem no na ɛde ba. Nneɛma a ebetumi ama tebea no aba no bi ne:

• Sɛ na wowɔ nyinsɛn mu asikreyare bere a na wonyinsɛn a .
• Sɛ wo nya yareɛ te sɛ rubella wɔ nyinsɛn mu a.
• Sɛ woanya nnuru bi a ekum mmoawa anaa nnuru a ekum wura a.
• Sɛ woanom nnuru bi a wɔde sa akisikuru a.

Mma saa nneɛma yi nnyɛ wo hu. Ɛnyɛ obiara a wanya saa nneɛma yi mu biako na obehu eyi.

Ɔkwan bɛn so na nnuruyɛfo hu eyi? (Nyare a Wɔahu) .

Ɛtɔ da bi a, nnuruyɛfo tumi hu saa tebea yi bere a woda so ara nyinsɛn no. Wɔnam nhwehwɛmu a wɔyɛ ansa na wɔawo so na ɛyɛ eyi. Sɛ wo duruyɛfo susuw sɛ biribi asɛe bere a wɔreyɛ wo ba no ultrasound scan a, ebia ɔbɛka akyerɛ wo sɛ wɔnyɛ awotwaa mu echocardiogram. Eyi te sɛ ultrasound, nanso ɛhwɛ akokoaa no koma kɔ akyiri yiye. Eyi betumi asi so dua sɛ ebia wowɔ d-TGA anaa. Sɛ wɔanhu bere a wɔyem a, wɔtaa hu wɔ awo akyi dapɛn a edi kan no mu.

Sɔhwɛ ahorow bɛn na wɔyɛ ma eyi?

Nhwehwɛmu ahorow a nnuruyɛfo de si tebea yi so dua ne:

• Echocardiogram (Echo): Eyi nso yɛ koma no mu ultrasound scan.
• Electrocardiogram (EKG): Sɔhwɛ a wɔde hwɛ sɛnea koma no mu anyinam ahoɔden yɛ adwuma.
• Nkokoaa a wɔawo wɔn foforo pulse oximetry screening: Wɔtaa yɛ eyi wɔ mmofra a wɔawo wɔn foforo nyinaa so.
• Chest X-ray nhwehwɛmu.
• Koma mu catheterization: Eyi yɛ sɔhwɛ a ɛyɛ den kɛse. Wɔde afiri a ɛyɛ tratraa ( catheter ) fa nan anaa abasa no mu hyɛ koma no mu. Sɛ sɔhwɛ afoforo mu nna hɔ a, wɔyɛ eyi.
• CT scan yɛ nhwehwɛmu.

Ɔkwan bɛn so na wɔbɛsa eyi? Wo ba hia mmoa ntɛmntɛm!

Ɛsɛ sɛ wɔyɛ akokoaa a wɔwoo no a ɔwɔ `(d-TGA)` oprehyɛn na ama wanya nkwa. Mpɛn pii no, wɔyɛ oprehyɛn yi wɔ awo akyi dapɛn a edi kan no mu . Wɔfrɛ saa oprehyɛn yi arterial switch procedure . Sɛ yɛbɛka no tiawa a, eyi hwehwɛ sɛ wɔsan de mogya ntini abien a wɔasesa no (aorta ne ahurututu mu ntini) no bom san kɔ ne gyinabea a ɛfata. Eyi ma mogya tumi sen yiye. Sɛ wo ba no wɔ tokuru bi wɔ wɔn koma mu, te sɛ `(VSD)` a, ɛno nso wobesiesie wɔ oprehyɛn yi mu.

Bere tiaa mu nneɛma a ɛsɛ sɛ wɔyɛ ansa na wɔayɛ oprehyɛn

Nnuruyɛfo de bere tiaa mu ayaresa ahorow pii di dwuma de ma akokoaa no tebea no gyina kosi sɛ wobetumi ayɛ oprehyɛn kɛse. Eyinom bi ne:

• Prostaglandin: Wɔde saa aduru yi bue ductus arteriosus, mogya ntini bi a kan no na akokoaa no wɔ wɔ awotwaa mu nanso ɛto mu wɔ awo akyi. Sɛ eyi bue wie a, mogya bi a oxygen wom fi ase sen kɔ nipadua no mu.
• Adeyɛ a wɔfrɛ no Balloon atrial septostomy:Wɔ eyi mu no, wɔde afiri a ɛyɛ tratraa (catheter) di dwuma de ma abɔde mu kwan a ɛda koma no atifi adan abien no ntam no yɛ kɛse. Eyi ma mogya a oxygen wom ne nea oxygen nni mu no frafra, na ɛma nipadua no nya oxygen kakra.

So wobetumi asiw tebea yi ano?

Ɔkwan biara nni hɔ a wonim a wɔbɛfa so asiw Transposition of the Great Arteries ano. Nanso, ɛho hia sɛ wudi akwahosan ho nhyehyɛe pa akyi bere a wonyinsɛn no. Fa wo nnuru nyinaa di dwuma bere ano, fa wo multivitamin no, na kɔ wo duruyɛfo nkyɛn. Sɛ obi wɔ w’abusua mu a ɔwɔ komayare a wɔde wo awo mu a, wo ne wo duruyɛfo nka ho asɛm. Ebia ɔbɛkamfo awosu ho afotu akyerɛ.

Dɛn na ɛba wɔ oprehyɛn akyi? Sɛnea wo ne TGA bɛtra

Ɛwom sɛ oprehyɛn "nsa" tebea no koraa de, nanso nnipa pii a wɔwɔ `(d-TGA)` tra ase a edi mũ, apɔwmuden. Nanso, wɔn a wɔwɔ saa `(congenital)` tebea yi hwehwɛ sɛ wɔhwɛ wɔn wɔ aduruyɛ mu wɔ wɔn nkwa nna nyinaa mu. Koma ho ɔyaresafo bɛhwɛ wo ba no tebea so daa na ɔde afotu biara a ɛho hia ama no. Nkwa dodow a wonya wɔ `(arterial switch)` oprehyɛn akyi no boro 95%. Wɔkyerɛ sɛ saa dodow yi da so ara te saa ara wɔ mfe 25 akyi mpo.

So wo ba betumi ne TGA atra ase yiye?

Yiw, koraa. Sɛ wɔsa tebea `(Transposition of the Great Arteries)` wie a, wo ba no betumi atra ase sɛnea ɛsɛ. Nanso, ehia sɛ wɔhwɛ koma no so wɔ nkwa nna nyinaa mu. Ɛno kyerɛ sɛ:

• Ɛsɛ sɛ wo ne komayare ho oduruyɛfo a ne ho akokwaw wɔ tebea horow yi mu di nkitaho daa.
• Ɛsɛ sɛ wonom nnuru a wɔakyerɛw ama wo no pɛpɛɛpɛ.
• Ɛho behia sɛ wɔyɛ sɔhwɛ ahorow a ɛhwɛ sɛnea koma no yɛ adwuma, te sɛ `(EKG), `(Holter monitor), `(apɔw-mu-teɛteɛ mu adwennwen ho sɔhwɛ ahorow), ne `(echocardiogram),' daa.

Koma ho animdefo pii nkamfo nkyerɛ sɛ wonni akansi agumadi wɔ `(d-TGA)` oprehyɛn akyi. Enti, ɛsɛ sɛ wo ne wo ba, wo mmofra oduruyɛfo, ne wo koma ho ɔyaresafo bom si gyinae a eye sen biara ma wo ba no akwahosan. Mmea pii a wɔayɛ `(d-TGA)` oprehyɛn no awo mma yiye. Nanso, akyinnye biara nni ho sɛ ɛsɛ sɛ wo ne wo duruyɛfo ne komayare ho ɔyaresafo kasa ansa na woanyinsɛn.

So ɛho behia sɛ wɔyɛ koma mu oprehyɛn pii daakye?

Yiw, ebia ɛho behia sɛ wɔyɛ oprehyɛn pii akyiri yi. Mpɛn pii no, ɛsɛ sɛ wosiesie koma no nnyigyei ho haw bi anaasɛ wosiesie koma no mu ntini ahorow.

So asiane wɔ hɔ sɛ obi benya endocarditis?

Endocarditis yɛ tebea a ɛba bere a ɔyare mmoawa bi hyɛn koma no mu no. Nnipa a wɔwɔ komayare te sɛ TGA no taa nya eyi. Enti, ebia ɛho behia sɛ nnipa a wɔayɛ wɔn oprehyɛn a wɔde si nipadua no mu no nom nnuru a ekum ɔyare mmoawa ansa na wɔayɛ wɔn sẽ aduru.

So ebetumi aka amemene no nkɔso?

Mmofra binom a wɔanya ntini mu nsakrae betumi anya ADHD (attention deficit hyperactivity disorder). Anaasɛ ebia wobehia mmoa titiriw wɔ sukuu dwumadi mu. Hu eyi nso.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wo ba no wɔ saa sɛnkyerɛnne ahorow yi a...

• Sɛ wote nka sɛ worehyia ɔhaw wɔ ahome mu a.
• Sɛ pulse no yɛ mmerɛw yiye a.
• Sɛ were a atwa ano no ho ahyia no adan bruu/fitaa a.

Sɛ wuhu biribi te sɛ eyi a, kɔ oduruyɛfo nkyɛn ntɛm ara.

Sɛ woyɛɛ saa oprehyɛn yi bere a na woyɛ abofra a...

Ɛho behia sɛ wɔyɛ wo aduruyɛ mu nhwehwɛmu daa na wɔhwɛ wo so wɔ w’asetra nyinaa mu. Hwɛ komayare ho oduruyɛfo a ne ho akokwaw wɔ mpanyimfo (awo mu) komayare mu.

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Sɛ wo ba no wɔ Transposition of the Great Arteries a, wubetumi abisa oduruyɛfo no nsɛm yi:

• So ɛsɛ sɛ wɔyɛ me ba no oprehyɛn ntɛm?
• Dɛn ne ayaresa a eye sen biara?
• Ɔhwɛ bɛn na me ba no di akyi?
• So ɛho behia sɛ wɔyɛ no oprehyɛn foforo?
• So anohyeto bi wɔ ne dwumadi ahorow ho?
• Ɔkwan bɛn so na ɛsɛ sɛ mehwɛ me ba no wɔ oprehyɛn no akyi?

Sɛ wɔyɛɛ wo oprehyɛn maa tebea yi bere a na woyɛ abofra a, wubetumi abisa wo duruyɛfo sɛ:

• So ɛho behia sɛ wɔyɛ me oprehyɛn foforo?
• Aduruyɛfo hwɛbea bɛn na mihia?
• So anohyeto bi wɔ me dwumadi ahorow ho?
• So metumi awo ba?

Awiei koraa no, ade a ɛho hia sen biara (Take-Home Message) .

Sɛ wuhu sɛ wo ba a wɔawo no foforo no wɔ komayare bi a wofi awo mu a, ɛnyɛ biribi a ɔwofo biara hwɛ kwan. Ebetumi ayɛ awerɛhow. Nanso, ɛnyɛ wo nkutoo na wowɔ. Wo ba no nnuruyɛfo betumi aboa wo wɔ akwantu yi mu na wɔakyerɛ wo kwan wɔ gyinaesi ahorow a wusi no mu.

Kae sɛ nnuruyɛfo de TGA ayɛ nkokoaa yare mfe pii, na nea efi mu ba no di yiye paa. Yɛ den ma wo ba. Nsuro sɛ wubebisa wo duruyɛfo nsɛm wɔ biribiara a wonte ase anaasɛ wunnim ho yiye ho. Wo nhumu yɛ wo ba no ahoɔden kɛse ma daakye a ahoɔden wom.

Koma mu shunting, komayare a wɔde awo obi, oprehyɛn a wɔde sesa ntini mu, cyanosis, nkokoaa komayare, d-TGA, koma mu oprehyɛn