Hopohopo e pili ana i ke pani ʻana o ke aʻa aortic? E kūkākūkā maʻalahi kākou me Nirogi Lanka!

Ua ʻōlelo anei kāu kauka ua nāwaliwali ke kīʻaha koko nui e lawe ana i ke koko oxygenated mai kou puʻuwai ma kou kino a puni a ua hoʻomohala i kahi puʻupuʻu e like me ka pōpō ma kona kumu? A i ʻole ua manaʻo paha lākou e pono ʻoe i ke ʻoki kino no kēia? He mea maoli loa ke hopohopo ke lohe ʻoe i kēia, akā e ʻoluʻolu e ʻike he hana koʻikoʻi kēia i hoʻolālā ʻia e hoʻopakele i kou ola. I kēia lā, e kūkākūkā mākou i ke ʻano o ka Aortic Root Replacement, pehea e hana ʻia ai, a me nā mea āpau e pono ai ʻoe e ʻike e pili ana i kēia kaʻina hana ma Nirogi Lanka.

I ka ʻōlelo maʻalahi, he aha ka hoʻololi ʻana i ke aʻa aortic?

ʻO ka aorta ke kīʻaha koko nui loa a koʻikoʻi loa i loko o kou kino, pili pono i kou puʻuwai. ʻO ka ʻāpana mua loa kahi e pili ai ka aorta i kou puʻuwai ua kapa ʻia ʻo "Aortic Root." I kekahi manawa, nāwaliwali ka paia o kēia ʻāpana a hoʻomaka e puʻupuʻu e like me ka pōpō. ʻO kēia ka mea a mākou e kapa nei he "Aneurysm."

I ka wā o ka hoʻololi ʻana i ke aʻa aortic, wehe ke kauka lapaʻau i ka ʻāpana palupalu a puʻupuʻu o ka aorta a hoʻololi iā ia me kahi graft synthetic. Pale pono kēia kaʻina hana i kēia mau pilikia weliweli a kōkua i ka pale ʻana i kou ola.

He aha nā ʻano nui o kēia ʻoki kino?

ʻElua ala nui e hana ai i kēia ʻoki kino. Ma muli o kou kūlana olakino kikoʻī, e hoʻoholo kāu kauka ʻoki i ke ala kūpono loa no kou hoʻōla ʻana.

Nā ʻano liʻiliʻi o VSRR

Hana ʻia ka VSRR me ka hoʻohana ʻana i kekahi o nā ʻano hana nui ʻelua: nā kaʻina hana ʻo Yacoub lāua ʻo David.

• Ke kaʻina hana ʻo Yacoub: Pili kēia i ka hoʻoponopono hou ʻana i ke aʻa aortic e kūpono i ka valve mua. He kūpono pinepine ia no nā poʻe maʻi ʻelemakule a i ʻole ka poʻe nona ka aneurysm ʻaʻole i hoʻokumu ʻia e nā kūlana genetic.
• Ke kaʻina hana ʻo David: Pili kēia i ke kau hou ʻana i ka valve i loko o kahi graft synthetic. ʻOiai ʻoi aku ka paʻakikī o ka ʻenehana, hoʻohana nui ʻia a paipai nui ʻia no nā poʻe maʻi ʻōpio me nā kūlana genetic e like me Marfan syndrome.

ʻO wai ka mea e pono ai kēia hana ʻoki kino a i ka manawa hea?

Inā hoʻonui ʻia ke aʻa o kou aorta, ke kū nei ʻoe i kahi pilikia o ka haki ʻana a i ʻole ka dissection, ka mea e pono ai ke ʻoki ʻana. ʻOiai hiki ke hana ʻia kēia ma muli o ke komo ʻana o ka makahiki, ʻo nā kūlana genetic e like me ka Marfan syndrome a i ʻole Loeys-Dietz syndrome hiki ke hoʻoulu i kēia mau aneurysms weliweli e ulu ma mua o ke ola.

Hoʻokumu ʻia nā hoʻoholo e pili ana i ke ʻoki ʻana ma ka nui o ka aneurysm a me kāu ʻikepili pilikia kikoʻī:

• Inā ʻaʻohe ou pilikia hoʻoilina, ʻōlelo ʻia ke ʻoki kino ke hiki ke anawaena i 5.5 kenimika .
• Inā loaʻa iā ʻoe ka Marfan syndrome, ʻo ka paepae maʻamau he 5.0 cm .
• Inā loaʻa iā ʻoe ka Marfan syndrome i hui pū ʻia me ka mōʻaukala ʻohana o ka aortic dissection, nā hoʻolālā hāpai, a i ʻole ka ulu wikiwiki ʻana (ma luna o 3mm i kēlā me kēia makahiki), hiki ke ʻōlelo ʻia ke ʻoki ʻana ma 4.5 cm .
• Inā he valve aortic bicuspid kou a me nā kumu pilikia ʻē aʻe e like me ke koko kiʻekiʻe i kāohi ʻole ʻia, manaʻo pinepine ʻia ke komo ʻana ma 5.0 cm .

Pehea e hoʻomākaukau ai no kāu ʻoki kino

No ka mea he hana nui kēia, he mea nui ka hoʻomākaukau pono ʻana. E hana kāu hui lapaʻau i kahi loiloi piha:

• Nā hoʻāʻo koko: No ka loiloi ʻana i kou puʻupaʻa a me ka hana holoʻokoʻa o ke kino.
• CT a i ʻole Cardiac MRI: No ka loaʻa ʻana o kahi palapala ʻāina kikoʻī o kāu aorta holoʻokoʻa.
• ʻO ka angiography coronary: No ka hōʻoia ʻana he olakino nā aʻa e hoʻolako ana i kou puʻuwai.
• ʻO ke ultrasound Duplex: No ka nānā ʻana i ke olakino o kou mau aʻa carotid ma ka ʻāʻī.

Pono ʻoe e kamaʻilio pololei me kāu kauka e pili ana i:

• Nā lāʻau lapaʻau āpau: Hoʻokomo pū kēia me nā huaora, nā mea hoʻohui lāʻau lapaʻau, a me nā lāʻau lapaʻau ma luna o ke kūʻai aku, a pono paha e hoʻōki ʻia kekahi o ia mau mea ma mua o ke ʻoki ʻana.
• Nā kūlana olakino e kū nei: Pono e mālama pono ʻia nā kūlana e like me ke koko kiʻekiʻe ma mua o ke ʻoki ʻana.
• Puhipaka: Pono ʻoe e haʻalele i ka puhipaka ma ka liʻiliʻi hoʻokahi mahina ma mua o ke ʻoki kino. E ʻoluʻolu e nīnau i kāu hui Nirogi Lanka inā makemake ʻoe i ke kākoʻo i ka haʻalele ʻana.

I ka wā a ma hope o ke kaʻina hana

I ka wā o ke ʻoki kino, e kau ʻia ʻoe ma lalo o ka anesthesia laulā. E hoʻopili ʻia ʻoe i kahi mīkini bypass cardiopulmonary , kahi e lawe manawa pōkole i ka hana o kou puʻuwai a me kou mau māmā, e ʻae ana i ke kauka ʻoki kino e hana ma kahi puʻuwai paʻa a mālie.

E hana ke kauka ʻoki i kahi ʻoki ma kou umauma, e wehe i ka ʻāpana aortic nāwaliwali, a hoʻololi iā ia me kahi graft synthetic. A laila e hoʻopili hou ʻia nā aʻa coronary i ka graft ma mua o ka pani ʻia ʻana o ka ʻoki. ʻO ka maʻamau, he 4 a 6 mau hola ka lōʻihi o ke kaʻina hana.

Ma hope o ke ʻoki kino, e hoʻolilo ʻoe i ka manawa ma ka Intensive Care Unit (ICU) ma mua o ka neʻe ʻana i kahi keʻena hoʻōla laulā. ʻO ka noho ʻana ma ka haukapila ma kahi o hoʻokahi pule, kahi e nānā pono ʻia ai ʻoe a hāʻawi ʻia i ka mālama ʻeha a me nā lāʻau lapaʻau e pono ai.

He aha ka Manawa Hoʻōla?

ʻO ka ho'ōla piha ʻana ma hope o kēia kaʻina hana nui e lawe pinepine ʻia he 6 a 12 mau pule , a i kekahi mau hihia, he mau mahina. Pono kou kino i ka manawa nui a me ke ahonui e ho'ōla pono ai ma hope o ia ʻano hana paʻakikī.

• No nā pule 6 mua: Mai hoʻokele kaʻa, hāpai i nā mea kaumaha, a hana paha i nā hana ikaika.
• No nā hana ma ke pākaukau: Hiki paha iā ʻoe ke hoʻi i ka hana ma kahi o 6-8 mau pule.
• No nā hana koi kino: Pono ʻoe e kali lōʻihi, e like me ka ʻōlelo a kāu hui mālama ola.

ʻO ka hahai pono ʻana i nā ʻōlelo a kāu kauka a me ke komo ʻana i nā papahana hoʻoponopono puʻuwai e kōkua nui iā ʻoe e hoʻokō i kahi hoʻōla wikiwiki a me ka laumania.

I ka manawa hea e ʻimi koke ai i ka mālama lapaʻau

Ma hope o kou hoʻi ʻana i ka home, inā ʻike ʻoe i kekahi o nā hōʻailona aʻe, e kelepona koke aku i kāu kauka.

Pehea e ʻike ai i kahi pilikia

Inā loaʻa iā ʻoe kahi aneurysm i mālama ʻole ʻia, hiki i nā hōʻailona ma lalo nei ke hōʻike e haki ana a haehae paha. I kēlā hanana, e ʻimi koke i ka mālama ulia pōpilikia ma ka hele ʻana i ka keʻena ulia pōpilikia kokoke loa a i ʻole ke kelepona ʻana i 911 (a i ʻole kāu mau lawelawe ulia pōpilikia kūloko).

• ʻEha koke a hiki ʻole ke hoʻomanawanui ma ka umauma a i ʻole ke kua o luna (i wehewehe pinepine ʻia he manaʻo haehae a haehae paha).
• Ka hou nui a me ka ʻili anu a palupalu.
• Paʻakikī ka hanu ʻana.
• Ka poniuniu a i ʻole ka māʻule ʻana.
• Ka puʻuwai wikiwiki a ʻano ʻē paha.

Hoʻololi Aʻa Aortic, Aorta, ʻoki puʻuwai, Aneurysm, kaʻina hana Bentall, Marfan syndrome, Aortic valve, Maʻi puʻuwai, ʻoki puʻuwai