Momma yensua Valve-Sparing Aortic Root Replacement ho ade wɔ nsɛm a ɛnyɛ den mu.

So wo duruyɛfo aka akyerɛ wo sɛ wo aortic ntini no ayɛ kɛse kakra na ɛsɛ sɛ wɔyɛ wo oprehyɛn? Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne dadwen kakra nka bere a wote saa no. Hena na n'ani nnye asɛmfua "koma oprehyɛn" ho? Nanso mma ɛnhaw wo. Mfiridwuma anya nkɔso kɛse nnɛ. Ɛnnɛ, yɛrebɛka oprehyɛn soronko bi a ɛdi mu paa, a ɛdi ɔhaw yi ho dwuma a ɛnyi wo koma fã a ɛsom boɔ paa, a ɛyɛ w’ankasa wo abɔdeɛ mu ‘valve’ no mfi hɔ ho asɛm.

Dɛn ne Valve-Sparing Aortic Ntini a Wɔde Si ananmu?

Nea ɛbɛyɛ na yɛate eyi ase no, momma yenni kan nhwɛ sɛnea koma no yɛ adwuma no tiawa. Fa wo koma sɛ nsu pɔmpɛ wɔ wo fie. Saa pɔmpɛ yi de mogya kɔ wo nipadua nyinaa mu.

• Aorta: Eyi ne afiri titiriw a ɛsõ sen biara a efi koma no mu. Ɛde mogya kɔ nipadua no nyinaa mu.
• Aortic Root: Eyi ne ntini titiriw a ɛne koma no di nkitaho no fã a edi kan. Ɛte sɛ baabi a wode tube bi bata motor ho.
• Aortic Valve: Eyi ne asɛm no fã a ɛho hia sen biara. Baabi a ɛne koma no di nkitaho no, ɔfã bi wɔ hɔ a ɛyɛ adwuma te sɛ ɔpon. Sɛ koma no bɔ mogya a, ɔpon yi bue, na ɛma mogya fi mu. Afei ɔpon yi to mu na ama mogya ansan ankɔ koma no mu. Eyi ne nea yɛfrɛ no `(Aortic Valve)`.

Afei, wɔ nnipa binom mu no, saa ntini kɛse yi ntini a ɛka koma no, `(Aortic Root),` no yɛ mmerɛw kakra na efi ase bɔ na ɛyɛ kɛse te sɛ balloon. Yɛfrɛ eyi `(Aortic Root Aneurysm)`. Sɛ ɛyɛ kɛse saa a, saa ɔpon no, saa valve no, nto mu yiye. Afei mogya no fi ase tu kɔ akyi, `(Aortic Regurgitation)`.

Bere bi a atwam no, bere a ɔhaw a ɛte sɛɛ sɔre no, nnuruyɛfo a wɔyɛ oprehyɛn yi aortic ntini ne aortic valve no nyinaa, na wɔde aortic ntini ne valve a wɔayɛ si ananmu. Wɔfrɛ saa oprehyɛn yi Bentall oprehyɛn .

Tebea bɛn na wɔde oprehyɛn yi sa?

Wɔyɛ saa oprehyɛn yi titiriw ma tebea bi a wɔfrɛ no `(Aortic Root Aneurysm)`. Eyi kyerɛ bere a aorta no ntini ahonhon te sɛ balloon. Eyi betumi ayɛ asiane, efisɛ sɛ ɛyɛ kɛse sen anohyeto pɔtee bi a, ebetumi apae (apaapae) anaasɛ atetew (aortic dissection).

Nnipa binom wɔ awosu mu ntini a ɛka bom yɛ adwuma, te sɛ Marfan syndrome. Nnipa a wɔwɔ saa tebea horow yi wɔ asiane kɛse mu sɛ wobenya aortic root aneurysm.

Hena na ɔfata ma oprehyɛn yi?

Wo duruyɛfo bɛyɛ nhwehwɛmu ahorow de ahu sɛ ebia woyɛ obi a ɔfata ma oprehyɛn yi anaa. Mpɛn pii no, ebia wobɛyɛ obi a ɔpɛ sɛ ɔyɛ saa adeyɛ yi, .

• Sɛ wo Aortic Valve no nni calcification kakraa bi pɛ anaasɛ enni bi koraa a.
• Gye sɛ valve no asɛe kɛse.
• Sɛ valve no reyɛ adwuma yiye, anaasɛ wobetumi de asiesie ketewaa bi asiesie.
• Wɔkamfo oprehyɛn yi kyerɛ nnipa a wonnii mfe 75 ne wɔn a wɔwɔ awosu mu nyarewa titiriw.

Ɔkwan bɛn so na wusiesie wo ho ansa na wɔayɛ wo oprehyɛn?

Esiane sɛ eyi yɛ oprehyɛn kɛse nti, ɛho hia paa sɛ wosiesie wo ho yiye ma no. Wo duruyɛfo a ɔyɛ wo oprehyɛn no bɛma wo akwankyerɛ a emu da hɔ a ɛfa eyi ho.

• Nnuru: Ɛsɛ sɛ woka nnuru biara a worenom mprempren ho asɛm kyerɛ wo duruyɛfo. Ebia ɔbɛka akyerɛ wo sɛ gyae anaa sesa nnuru bi (titiriw nnuru a ɛma mogya tu) ansa na wɔayɛ wo oprehyɛn.
• Mmuadadi: Wɔbɛka akyerɛ wo sɛ nnidi anaa nnom biribiara anadwo fã akyi anadwo a edi oprehyɛn no anim. Nnom nsu mpo.
• Nsɔhwɛ: Oduruyɛfo no bɛhyɛ sɛ wɔnyɛ nhwehwɛmu pii mfa nyɛ oprehyɛn no ho nhyehyɛe.
• Echocardiogram (koma no mu nhwehwɛmu) .
• Mogya mu nhwehwɛmu
• EKG gated CT scan a wɔde yɛ adwuma
• Koma mu MRI
• Coronary Angiogram a Wɔde Yɛ Adwuma
• Sigaretnom: Sɛ woyɛ obi a ɔnom sigaret a, ɛho hia sɛ anyɛ yiye koraa no, wugyae sigaretnom koraa ɔsram biako ansa na wɔayɛ wo oprehyɛn.
• Bisa nsɛm: Wo ne wo duruyɛfo nkasa pefee wɔ biribiara a ɛhaw wo anaa ehu biara a wowɔ ho. Ɛbɛyɛ ahotɔ kɛse sɛ wubehu biribiara yiye.

Ɔkwan bɛn so na wɔyɛ oprehyɛn no?

Mpɛn pii no, oprehyɛn yi gye nnɔnhwerew 4 kosi 6. Sɛ oduruyɛfo a ne ho akokwaw de nsa yɛ oprehyɛn a, wogyae koma no bere tiaa bi, bɛyɛ dɔnhwerew biako. Anamɔn a wɔfa so yɛ saa adeyɛ yi te sɛ nea edidi so yi ara kwa.

1. Anesthesia: Nea edi kan no, wɔbɛma wo anesthesia na ama woada kɛse. Enti worente ɛyaw biara nka.

2. Koko a wobue: Oduruyɛfo no twa koko no mfinimfini (median sternotomy) na ama wɔatumi akɔ koma no mu.

3. Koma-ahurututu afiri: Afei, wɔde wo bɛka koma-ahurututu afiri (cardiopulmonary bypass machine) ho. Saa afiri yi bɛyɛ wo koma ne w’ahurututu adwuma bere a wɔreyɛ oprehyɛn no. Ɛbɛma wo nnuru nso a ɛbɛma wo koma agyae bere tiaa bi.

4. Valve a wɔpaapae mu: Oduruyɛfo a ɔyɛ oprehyɛn no de ahwɛyiye bɛtetew wo aortic valve no mu afi ntini a atwa ho ahyia no ho.

5. Nsiesiei:Sɛ nneɛma nketenkete bi asɛe wɔ valve no anim a, wosiesie no ntɛm ara.

6. Ɔfã a asɛe no a wobeyi afi hɔ: Wɔtwa `(Aortic Root)` no fã a ahonhon na asɛe no na woyi fi hɔ.

7. Artificial tube implantation: Mmom no, wɔfa artificial tube ``graft`` a wɔde ntama soronko bi ayɛ, yɛ no kɛse a ɛfata ma wo, na wɔde hyɛ saa beae no.

8. Reattaching the valve: Afei , w’ankasa wo abɔde mu valve , a wɔde ahwɛyiye yii no, de gu tube foforo a wɔde ahyɛ mu no mu na wɔpam san bom (reimplant).

9. Hwɛ: Hwɛ sɛ biribiara ye anaa, sɛ ebia valve no bue na ɛto mu yiye, ne sɛ ebia nsu bi retu anaa.

10. Nea Wɔto mu: Afei wɔde ahrawa mu ntini a ɛde mogya kɔ koma no mu no bata ntini foforo a wɔde ahyɛ mu no ho. Woyi wo fi koma-ahurututu afiri no mu na sɛ wo koma fi ase yɛ adwuma bio a, wɔto baabi a wɔatwa wo moma so no mu.

11. Nhwehwɛmu a etwa to: Ansa na wobeyi no afi oprehyɛn dan mu no, wɔyɛ ``transesophageal echocardiogram'' de si oprehyɛn no nkonimdi so dua.

Nnɛyi nkɔso a aba wɔ oprehyɛn mu

Bere kɔ so no, nnuruyɛfo de akwan foforo aka ho na ama oprehyɛn yi ayɛ yiye.

• Annulus a wɔtew so: Sɛ yɛbɛka no tiawa a, wɔahyɛ nnyinaso a ɛkura valve (aortic annulus) no mu ma ɛne wo nipadua no ahyia. Eyi remma mogya ntu mfi valve no mu daakye.
• Aortic Sinus Foforo (Neosinus) a Wɔbɛbɔ): Abɔde mu aorta ntini no wɔ wosow nketenkete. Esiane sɛ graft foforo no yɛ tube a ɛyɛ tẽẽ nti, ɛma wosow nketenkete nso. Eyi ma mogya no sen no yɛ nea ɛyɛ abɔde mu de na ɛtew ɔsɛe a ɛba valve nkrataa no so no so.

Mfaso bɛn na ɛwɔ oprehyɛn yi so?

Saa oprehyɛn yi wɔ mfaso atitiriw pii sen Bentall oprehyɛn a wɔde di dwuma wɔ amanne kwan so (a nea ɛka ho ne sɛ wɔbɛsesa valve no ka valve no ho).

Bere tenten ahe na egye na obi ho atɔ no wɔ oprehyɛn akyi?

Sɛ wɔyɛ oprehyɛn no wie a, wɔde wo bɛto baabi a wɔhwɛ wɔn a wɔyare denneennen (ICU) da koro anaa nnanu, afei wɔde wo bɛkɔ ayaresabea a wɔhwɛ wɔn daa. Mpɛn pii no wubetumi afi ayaresabea akɔ fie wɔ nnafua 4 kosi 7 mu.

Saa bere yi mu no, .

• Koma mu ahosiesie nhyehyɛe bi a wode wo ho bɛhyɛ mu no yɛ adwene pa. Ɛbɛboa wo ma wo ho atɔ wo ntɛmntɛm na woayɛ den.
• Oduruyɛfo no ka sɛ ɛnsɛ sɛ woyɛ biribiara te sɛ nneɛma a emu duru so anaasɛ karka bɛyɛ adapɛn 6.
• Bere a ɛsɛ sɛ wodi akyi: Ebia wunsusuw sɛ ɛho renhia sɛ wokɔ wo duruyɛfo nkyɛn bio bere a wo ho atɔ wo no. Nanso ɛho hia sɛ woyɛ saa . Ɛho hia sɛ wohwɛ wo koma tebea daa.

Bere a ɛsɛ sɛ wofrɛ oduruyɛfo no ntɛm ara

Sɛ wosan kɔ fie a, sɛ wunya sɛnkyerɛnne a edidi so yi mu biara a, frɛ wo duruyɛfo ntɛm ara anaa kɔ ayaresabea a ɛbɛn wo no Emergency Department (ETU).

Ɛyɛ ade a ɛfata sɛ wobɛte ehu nka ansa na wɔayɛ oprehyɛn kɛse biara. Nanso kae sɛ, wɔreyɛ oprehyɛn yi de agye wo nkwa na aboa wo ma woanya apɔwmuden akyɛ. Wo ne w’abusuafo ne wo nnamfo nka eyi ho asɛm. Wɔn mmoa no bɛyɛ ahoɔden kɛse ama wo wɔ saa bere yi mu.