Ke mānoanoa nei anei ka ʻiʻo o ka puʻuwai? E kamaʻilio kākou e pili ana i ka lāʻau lapaʻau ʻo Alcohol Septal Ablation (ASA)!

Ke manaʻo nei ʻoe i kekahi manawa ua pōkole ka hanu, ua paʻa kou umauma, a ua luhi paha i ka wā e luhi iki ai ʻoe? Nui nā kumu no kēia mau hōʻailona. Akā i kekahi manawa ʻo ke kumu he pilikia me ka puʻuwai. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi lāʻau lapaʻau kūikawā no ia mau maʻi puʻuwai ʻaʻole pono ke ʻoki kino nui.

I ka ʻōlelo maʻalahi, he aha ka Alcohol Septal Ablation (ASA)?

He mea paʻakikī paha kēia inoa, akā e maʻalahi kākou. ʻO ka Alcohol Septal Ablation (ASA) kahi lāʻau lapaʻau minimally invasive i hana ʻia e nā kauka cardiologists.

ʻO kēia lāʻau lapaʻau no ka poʻe me ka maʻi puʻuwai i kapa ʻia ʻo Hypertrophic Cardiomyopathy (HCM) . He huikau iki ka inoa, ʻeā? I ka ʻōlelo maʻalahi, hoʻoulu kēia maʻi i ka mānoanoa nui o ka ʻiʻo puʻuwai. ʻOi aku ka pololei, ʻo ka paia e hoʻokaʻawale ana i nā keʻena ʻelua o ka puʻuwai, i kapa ʻia ʻo ka septum , e mānoanoa.

E noʻonoʻo ʻoe he pamu wai kou puʻuwai. ʻO kēia pamu ka mea e hoʻouna i ke koko i ke kino holoʻokoʻa. I kēia manawa, inā mānoanoa loa ka paia o kēia pamu, e lilo ka hakahaka no ke kahe ʻana o ke koko i waho i mea haiki, ʻeā? ʻO ia ka mea e hana ʻia ma HCM. Ke mānoanoa ka paia o ka puʻuwai, ʻaʻole e pamu pono ke koko. ʻO ia ke kumu e kū mai ai nā hōʻailona a mākou i ʻōlelo ai ma mua, e like me ka pōkole o ka hanu a me ka luhi.

No laila, ma kēia lāʻau lapaʻau ASA, hoʻohana ʻia kahi ʻōmole lahilahi a palupalu (catheter) e ʻimi i ke kīʻaha koko e hoʻolako ana i ke koko i kēlā ʻāpana ʻiʻo mānoanoa o ka puʻuwai. A laila, hoʻokomo ʻia kahi waiʻona kūikawā liʻiliʻi ma o kēlā ʻōmole i loko o kēlā ʻāpana ʻiʻo mānoanoa. ʻO kēia waiʻona ke kumu o ka make ʻana o nā ʻāpana i ulu pono ʻole, a emi a emi kēlā ʻāpana. A laila e ākea hou ke ala no ke kahe ʻana o ke koko mai ka puʻuwai mai, a hoʻihoʻi ʻia ke kahe ʻana o ke koko.

No wai kēia lāʻau lapaʻau kūpono loa?

ʻO kēia lāʻau lapaʻau no ka poʻe me ke kūlana a mākou i ʻōlelo ai ma mua i kapa ʻia ʻo Hypertrophic Cardiomyopathy (HCM). He maʻi hoʻoilina kēia. ʻO ia hoʻi, inā loaʻa i kekahi o kou ʻohana, loaʻa iā ʻoe ka manawa e loaʻa ai iā ia.

ʻO ka maʻamau, hāʻawi mua ʻia nā lāʻau lapaʻau i ka poʻe me HCM. Eia nō naʻe, no kekahi poʻe, ʻoiai me nā lāʻau lapaʻau, ʻaʻole i kāohi ʻia nā hōʻailona (e like me ka pōkole o ka hanu a me ka luhi). ʻO ia ke kumu e noʻonoʻo ai nā kauka i ka lāʻau ASA no kēia poʻe.

Aia kekahi koho ʻē aʻe no kēia. ʻO ia ke ʻoki puʻuwai hāmama i kapa ʻia ʻo Septal Myectomy . Ma kēia, ua wehe ʻia ka umauma a ua ʻoki ʻia a wehe ʻia ka ʻiʻo mānoanoa. Eia nō naʻe, no ka mea he ʻoki nui ia, ua lōʻihi ka manawa e ho'ōla ai a ʻoi aku ke kiʻekiʻe o nā pilikia.

I ka ʻōlelo maʻalahi, he lāʻau lapaʻau ʻē aʻe kēia no ka poʻe hiki ʻole ke hana i ke ʻoki kino nui.

Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?

Ke hoʻoholo kāu kauka he kūpono kēia lāʻau lapaʻau iā ʻoe, aia kekahi mau mea e pono ai ʻoe e hana ma mua. E hāʻawi kāu kauka iā ʻoe i nā ʻōlelo aʻoaʻo maopopo no kēia.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

Hana ʻia kēia lāʻau lapaʻau ma kahi lumi kūikawā (Cath Lab) ma ke keʻena cardiology o ka haukapila. ʻO ka maʻamau, he hola a ʻelua paha ka lōʻihi.

• Loaʻa iā ʻoe ka ʻike:Ma kēia, ʻaʻole ʻoe i hoʻopau piha ʻia. ʻO ke ʻano kēia ua ʻike ʻoe. Akā ua hāʻawi ʻia ʻoe i nā lāʻau hoʻomaha e hoʻomaha ai a wiwo ʻole.
• ʻO ka anesthesia nila: Hoʻohana ʻia kahi nila e hoʻopau ai i kahi i hoʻokomo ʻia ai ka catheter, e like me kahi kokoke i kou pulima a i ʻole ka ʻūhā.
• Ke hoʻokomo ʻana i ka catheter: A laila e hoʻokomo ke kauka i ka ʻōmole lahilahi ma o kahi kīʻaha koko mai ka wahi mae a i ka puʻuwai.
• Nānā ʻana i ka X-ray: Hoʻohana nā kauka i nā kiʻi X-ray e nānā i ke ala o ka ʻōmole a inā paha e hele ana i kahi kūpono i loko o ka puʻuwai.
• Hoʻokomo ʻana i ka waiʻona: Ke loaʻa ka ʻaʻa koko kūpono, e hoʻokomo ʻia kahi liʻiliʻi o ka waiʻona kūikawā i kapa ʻia ʻo ka waiʻona isopropyl ma o ka ʻōmole i loko o ka ʻiʻo mānoanoa. Hiki iā ʻoe ke manaʻo i kahi ʻoluʻolu ʻole a ʻeha paha i kou umauma i kēia manawa. He mea maʻamau kēia.
• He pacemaker manawa pōkole: I ka wā o ka mālama ʻana, hoʻokomo ʻia kahi uea mai kahi pacemaker manawa pōkole i loko o kahi aa koko i kou ʻāʻī. Waiho ʻia kēia ma kahi no ʻelua a ʻekolu mau lā ma hope o ka mālama ʻana e nānā i kou puʻuwai.
• Pau: Ke pau ka hana, wehe ʻia ka ʻōmole a pani ʻia ka ʻāpana me nā humuhumu a i ʻole kahi kāʻei paʻa.

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Ma hope o ka mālama ʻana, pono ʻoe e noho i ka haukapila no ʻelua a ʻekolu paha lā (48-72 hola). He mea nui loa kēia manawa.

• Ka nānā ʻana i ka helu o ka puʻuwai: I loko o kēia mau lā, e hoʻomau ka hui lapaʻau i ka nānā ʻana i kou ʻano puʻuwai. ʻO kēia no ka mea, ma ke ʻano he hopena liʻiliʻi o kēia lāʻau lapaʻau, hiki i kekahi poʻe ke loaʻa ka hopena ma nā hōʻailona uila i loko o ko lākou puʻuwai. Ua kapa ʻia kēia he Heart Block . Inā hana ʻia kēia, e lohi paha ka helu o kou puʻuwai. ʻO ia ke kumu e nānā pono ʻia ai ʻoe.
• Hoʻomaha moe: Inā ua hoʻokomo ʻia ka ʻōmole ma kou ʻūhā, e noi ʻia ʻoe e noho ma kahi moe me kou mau wāwae pololei no kekahi mau hola e pale aku ai i ke kahe ʻana o ke koko. Inā ua hoʻokomo ʻia ma kou pulima, ʻaʻole pono ʻoe e noho pēlā.
• Nā lāʻau hoʻopau ʻeha: E hāʻawi ʻia iā ʻoe nā lāʻau hoʻopau ʻeha inā pono.
• Hoʻokolokolo hou: Ma mua o ka haʻalele ʻana i ka haukapila, hiki iā ʻoe ke hana i kahi hoʻokolohua ʻē aʻe, e like me ka echocardiogram , e ʻike ai i ka holomua o ka lāʻau lapaʻau.

He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?

E like me nā lāʻau lapaʻau āpau, aia nā pono a me kekahi mau pilikia liʻiliʻi.

He aha nā pono?

ʻO ka pōmaikaʻi nui, ʻaʻole ia e koi i ke ʻoki puʻuwai hāmama. No laila:

• He pōkole loa ka manawa ho'ōla.
• He kakaikahi nā pilikia e pili ana i ke ʻoki kino.
• ʻAʻole ia e waiho i kahi ʻeha nui.
• ʻO kēia ke koho maikaʻi loa no ka poʻe hiki ʻole ke uku i ke ʻoki kino nui.

He aha nā pilikia?

He mea kākaʻikahi nā pilikia, akā he mea nui e makaʻala iā lākou. E haʻi aku kāu kauka iā ʻoe i nā mea hou aʻe e pili ana i kēia.

ʻEhia ka lōʻihi e ho'ōla ai?

ʻOkoʻa kēia mai kēlā kanaka a kēia kanaka. E hilinaʻi kou manawa hoʻōla i kou olakino laulā. Hiki i ka hapa nui o ka poʻe ke hoʻi i nā hana maʻamau i loko o hoʻokahi pule a i ʻole . Eia nō naʻe, pono ʻoe e nānā mau me kāu kauka ma mua o ka hoʻomaka ʻana i kekahi mea e like me ka hoʻoikaika kino ikaika.

Hoʻomaka ka nui o ka poʻe e ʻike i ka hōʻoluʻolu nui mai kā lākou mau hōʻailona ma hope koke iho o ka mālama ʻana.

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​e ʻike koke i ke kauka!

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o ka hoʻi ʻana i ka home mai ka lāʻau lapaʻau, e kāhea koke aku i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

• He puʻuwai naʻau kūpono ʻole a i ʻole ka manaʻo e like me ke kuʻi ʻana o kou umauma (palpitations).
• ʻEha ka umauma.
• Paʻakikī ka hanu ʻana, ka hanu wikiwiki (dyspnea) .
• Pōniuniu a polū paha nā maka.
• Luhi loa.
• ʻUlaʻula, pehu, kahe koko, a i ʻole ke kuni ma kahi i hoʻokomo ʻia ai ka ʻōmole (he mau hōʻailona kēia o ka maʻi).
• Ka luaʻi a me ka luaʻi.

He lāʻau lapaʻau kūpono loa ka Alcohol Septal Ablation no ka Hypertrophic Cardiomyopathy. Hiki iā ia ke kāohi i nā hōʻailona me ka liʻiliʻi o ka pilikia a me ka hoʻōla wikiwiki ʻana ma mua o ke ʻoki ʻana. Inā he mau nīnau kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu cardiologist no ka ʻike hou aku.