Ua ʻike anei ʻoe ua like ke kīʻaha koko nui i loko o ko kākou kino me ka paipu wai nui e hoʻolako ana i ka wai i ke kūlanakauhale? ʻO kēia kīʻaha koko ka mea e lawe ana i ke koko maʻemaʻe a waiwai i ka oxygen mai ka puʻuwai a i ke kino holoʻokoʻa. No laila e noʻonoʻo i ke ʻano o ka pōʻino e hiki mai ana inā e nāwaliwali kēia kīʻaha koko nui ma kahi hoʻokahi a hoʻomaka e puʻupuʻu e like me ka pōpō. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi koʻikoʻi, akā pinepine i ka leo ʻole. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia ʻo 'Ascending Aortic Aneurysm'.
I ka ʻōlelo maʻalahi, he aha kēia Ascending Aortic Aneurysm?
He inoa paʻakikī paha kēia, akā he mea maʻalahi loa ke hoʻomaopopo.
E wehewehe mua kākou i kēia inoa.
- Aorta: ʻO kēia kaʻu i ʻōlelo ai ma mua, ʻo ia ke kīʻaha koko nui loa a koʻikoʻi loa i loko o ko kākou kino. Hoʻomaka ia mai ko kākou puʻuwai.
- ʻO ka Aorta Piʻi: ʻO kēia ka ʻāpana piʻi o ka aorta kokoke loa i ka puʻuwai.
- Aneurysm: ʻO kēia ka moʻolelo maoli . ʻO kēia ka wā e puʻupuʻu ai kahi nāwaliwali ma ka paia o ke kīʻaha koko. Ua like ia me kahi "pehu" e puka mai ana mai kahi huila ma ke kaʻa.
I ka ʻōlelo maʻalahi, ʻo ka Ascending Aortic Aneurysm kahi kūlana kahi e nāwaliwali ai ka paia o ka ʻāpana mua o ka aorta e hoʻomaka ana i loko o ko kākou puʻuwai a puʻupuʻu e like me ka pōpō. I kekahi manawa ua kapa ʻia kēia kūlana he Ascending Thoracic Aortic Aneurysm (ATAA) no ka mea aia ia ma ka ʻāpana umauma.
ʻO ka pōʻino nui loa, hiki i kēia wahi pehu ke haehae a haki paha i kēlā me kēia manawa. Inā hana ʻia kēlā, hiki iā ia ke hoʻoulu i ke kahe koko nui i loko o ke kino, kahi mea hiki ke lilo i mea koʻikoʻi loa a hoʻoweliweli paha i ke ola.
ʻO wai ka mea i pilikia nui i ka loaʻa ʻana o kēia maʻi?
ʻOiai hiki ke loaʻa kēia maʻi i kekahi kanaka, ʻoi aku ka nui o ka pilikia o kekahi poʻe. E nānā kākou iā lākou. E noʻonoʻo inā pili kēia mau ʻoiaʻiʻo iā ʻoe.
| Kumu pilikia | He wehewehe maʻalahi |
|---|---|
| Makahiki a me ke kāne | ʻOi aku ka nui o ka pilikia o nā kāne ma luna o 60 mau makahiki a me nā wahine ma luna o 70 mau makahiki. ʻO kēia no ka mea e emi ana ka ikaika a me ka palupalu o nā paia o ko kākou mau kīʻaha koko i ka hala ʻana o ka manawa. |
| Moʻolelo ʻOhana | Inā ua loaʻa i kekahi o kou ʻohana, ʻoiai he hoahānau pili loa (makuahine, makuakāne, kaikaina), kahi aneurysm e like me kēia, ʻoi aku kou pilikia. He hopena hoʻoilina paha kēia. |
| Kekahi mau maʻi puʻuwai | He kiʻekiʻe loa kēia pilikia no ka poʻe me ke kīnā hānau i kapa ʻia ʻo Bicuspid Aortic Valve (he valve puʻuwai nona nā cusps ʻekolu akā ʻelua wale nō cusps). |
| Nā maʻi pili o nā ʻiʻo | ʻO ka poʻe me nā maʻi hoʻoilina e hoʻopilikia ai i ka ikaika o nā ʻiʻo o ke kino, e like me ka Marfan Syndrome , ua nāwaliwali paha ko lākou mau paia o ke kīʻaha koko. |
| Ke koko kiʻekiʻe | He mea nui loa kēia. ʻO ke koko kiʻekiʻe ke ʻano o ka neʻe mau ʻana o ke koko ma lalo o ke kaomi kiʻekiʻe i loko o nā kīʻaha koko. Hiki i kēia kaomi ke hōʻino i nā paia o nā kīʻaha koko a hoʻonāwaliwali iā lākou i ka hala ʻana o ka manawa. |
| Puhipaka | ʻO ka puhipaka kekahi o nā mea nui e hōʻino ai i nā kīʻaha koko. Hoʻopōʻino pololei nā kemika i loko o nā cigarette i nā paia o nā kīʻaha koko, e hoʻonāwaliwali ana iā lākou a e hoʻonui ai i ko lākou ʻano e pehu. |
Ma kahi o 60% o nā aneurysms aortic thoracic āpau e kū mai ana ma ka aorta ascending. Wahi a nā helu helu, hoʻopilikia kēia ʻano ma kahi o 10 o 100,000 mau kānaka i kēlā me kēia makahiki.
No ke aha lā kēia e hana nei? He aha nā kumu?
ʻO kēlā me kēia mea e hoʻonāwaliwali a hōʻino paha i nā paia o ke kīʻaha koko e hiki ke hana i kēia. I ko kākou ʻelemakule ʻana a me ka maʻi puʻuwai, nalowale ko kākou mau aʻa i ko lākou elasticity. A laila, ʻaʻole hiki iā lākou ke kū i ke kaomi o ke koko e kahe ana ma o lākou, a hoʻomaka lākou e puʻupuʻu ma nā wahi nāwaliwali.
Aia kekahi mau kumu nui e hoʻopilikia ai i kēia kūlana:
- Atherosclerosis: Kāhea wale mākou i kēia "nā waihona momona i loko o nā kīʻaha koko." Ma kēia ʻano, hiki i nā mea e like me ka cholesterol ke kūkulu i loko o nā paia o nā kīʻaha koko, e hoʻopaʻakikī ana iā lākou a hoʻonāwaliwali iā lākou.
- Aortitis: He mumū kēia o ka aorta. Hiki ke hana ʻia e kekahi mau maʻi a i ʻole nā pilikia o ka ʻōnaehana pale.
- ʻO ka maʻi valve aortic bicuspid: E like me ka mea i ʻōlelo ʻia ma mua, he kīnā hānau kēia o ka valve puʻuwai. ʻOi aku ka nui o ka pilikia o ka poʻe me kēia maʻi i ka hoʻomohala ʻana i ka aortic dissection.
- Nā maʻi hoʻoilina:
- ʻO Marfan Syndrome: He maʻi e hoʻonāwaliwali ai i nā ʻiʻo pili o ke kino.
- ʻO Loeys-Dietz Syndrome: ʻO kekahi maʻi genetic ʻē aʻe e hiki ai ke hoʻonui i ka aorta.
- ʻO Turner Syndrome: He maʻi genetic e hoʻopilikia wale ana i nā wahine a hiki ke hoʻopilikia i ka ʻōnaehana cardiovascular.
- Nā ʻeha ʻeha: ʻO kahi ulia koʻikoʻi a i ʻole ka hahau ʻana i ka umauma hiki ke hōʻino a haehae i ka paia o ka aorta.
He aha nā hōʻailona o kēia? Pehea ʻoe e ʻike ai?
ʻO kēia ka ʻaoʻao mālie a weliweli hoʻi o kēia maʻi. ʻAʻohe hōʻailona o ka nui o ka poʻe. Hiki iā ʻoe ke hele a ʻike ʻole ʻia a hiki i ka ulu mālie ʻana o ka aneurysm.
Eia nō naʻe, i ka ulu ʻana o ka aneurysm a i ʻole ke kaomi ʻana i nā ʻōpū kokoke, hiki ke loaʻa kekahi mau hōʻailona. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, he mea nui e kamaʻilio koke me kāu kauka.
- ʻEha umauma a ʻeha paha ma ka ʻaoʻao o luna o ke kua: Hiki i kēia ke lilo i ʻeha hohonu a ʻūmiʻi.
- ʻŪhū a ʻūhū paha: Hiki ke ʻike ʻia kēia mau hōʻailona inā e ʻomi ana ka aneurysm i ke alaea.
- Paʻakikī i ka moni ʻana: Hiki paha kēia ma muli o ke kaomi ʻana o ka aneurysm ma ka esophagus.
- Ka Hūhā: Hiki ke loli ke leo ma muli o ke kaomi ʻana o kahi aʻalolo e kaohi ana i nā kaula leo.
- Pōkole o ka hanu.
Pehea e ʻike pololei ai ke kauka i kēia maʻi?
I ka manawa pinepine, ʻike ʻia kēia ʻano ma ke ʻano ulia i ka wā o ka hoʻāʻo ʻana no kekahi ʻano ʻē aʻe. No ka laʻana, hiki i ke kauka ke ʻike i kahi aorta i hoʻonui ʻia i ka wā e lawe ana i kahi X-ray umauma no kekahi kumu ʻē aʻe.
Inā kānalua ke kauka i kēia, e kauoha ʻo ia i nā hoʻokolohua like ʻole e hōʻoia iā ia a hoʻoholo i ka nui a me kahi kikoʻī o ka aneurysm.
| Hoʻāʻo | He aha ka hana a kēia? |
|---|---|
| X-ray umauma | Hiki i kēia ke hāʻawi i kahi manaʻo paʻakikī inā ua hoʻonui ʻia ka aorta, akā paʻakikī ke ʻike i kahi aneurysm liʻiliʻi. |
| ʻO ka Echocardiogram Transthoracic (TTE) | Ua like kēia me ke scan puʻuwai. Hoʻohana ia i nā nalu kani e ʻike ai pehea e kahe ai ke koko ma o ka puʻuwai a pehea e hana ai nā valves puʻuwai. Hiki iā ia ke nānā i ka hoʻomaka ʻana o ka aorta. |
| Ka Nānā CT Umauma | Hiki i kēia ke hana i nā kiʻi ʻekolu-dimensional (3D) o ka umauma. Hiki iā ia ke hōʻike maopopo i kahi aneurysm liʻiliʻi loa a i ʻole kahi kīʻaha koko i haehae ʻia (dissection). I kekahi manawa hana ʻia kēia scan ma ka hoʻokomo ʻana i kahi wai kūikawā i kapa ʻia ʻo contrast i loko o kahi aa koko ma ka lima. |
| MR Angiography (MRA) | He scan MRI kēia. Kōkua ia i ka loaʻa ʻana o ka ʻike kikoʻī loa e pili ana i ka aorta a me ka hana o ka puʻuwai. |
Pehea e mālama ʻia ai?
Hoʻokumu ʻia ka lāʻau lapaʻau i nā kumu e like me ka nui o ka aneurysm, pehea ka wikiwiki o kona ulu ʻana, a me ke kumu.
No nā aneurysms liʻiliʻi (emi ma lalo o 5.5 cm)
Inā ʻoi aku ka liʻiliʻi o ka aneurysm ma mua o 5.5 kenimika a ʻaʻohe ou kumu pilikia kūikawā ʻē aʻe (e like me Marfan Syndrome), ʻaʻole ʻoe e kuhikuhi koke ʻia no ke ʻoki kino. Akā, hiki i kāu kauka ke ʻōlelo i kēia mau mea:
- Nā lāʻau lapaʻau: Hāʻawi ʻia nā lāʻau lapaʻau, ʻoi aku hoʻi no ka kaohi ʻana i ke koko. Ke hoʻohaʻahaʻa ʻia ke koko, e hoʻemi ʻia hoʻi ke kaomi ma nā paia o nā kīʻaha koko.
- Ka nānā mau ʻana:Hana ʻia kahi scan i kēlā me kēia 6 mahina e ʻike ai inā e nui ana ka aneurysm. Inā ʻaʻole ia e ulu wikiwiki ana, hiki iā ʻoe ke nānā iā ia i kēlā me kēia mau makahiki.
- Nā loli o ke ʻano o ka nohona:
- Inā ʻoe e puhipaka, he mea nui e hoʻōki koke .
- Ka ʻai ʻana i kahi meaʻai olakino.
- E hana i ka hoʻoikaika kino māmā ʻaʻole e kau nui i ke kaomi ma luna o nā kīʻaha koko. Pono ʻoe e kamaʻilio me kāu kauka e pili ana i kēia a e ʻimi i ka ʻōlelo aʻo.
No nā aneurysms nui (ʻoi aku ma mua o 5.5 cm)
Inā ʻoi aku ka nui o ka aneurysm ma mua o 5.5 kenimika, ʻōlelo pinepine ʻia ke ʻoki ʻana, no ka mea, ʻoi aku ka nui o ka pilikia o ka haki ʻana ma hope o kēlā nui.
Eia nō naʻe, no ka poʻe me nā maʻi e like me Marfan Syndrome, kahi Bicuspid Aortic Valve, a i ʻole kahi mōʻaukala ʻohana o nā aneurysms, hiki i nā kauka ke ʻōlelo aku i ke ʻoki ʻana ʻoiai inā he liʻiliʻi ka aneurysm. ʻO kēia no ka mea ʻoi aku ka nui o ko lākou pilikia o ka haki ʻana, ʻoiai inā he liʻiliʻi ka aneurysm.
ʻO ke ʻoki kino e pili ana i ka wehe ʻana i ka umauma a me ka ʻoki ʻana i ka ʻāpana nāwaliwali o ka aorta e puʻupuʻu ana. A laila , hoʻokomo ʻia kahi graft ma kona wahi. Hana ʻia kēia me kahi mea synthetic ikaika. I loko o kēia ʻoki kino, hoʻoili ʻia ka hana o ka puʻuwai a me nā māmā i kahi mīkini i kapa ʻia he "mīkini bypass cardiopulmonary." I kekahi manawa, inā he kīnā valve puʻuwai, hana ʻia kēlā ʻoki kino i ka manawa like.
Pehea ke kūlana ma hope o ka mālama ʻana? (Prognosis)
He pilikia kēia no nā kānaka he nui.
Ua hōʻike ʻia nā noiʻi he 79% o ka poʻe i hana ʻia i ke ʻoki koho, a i ʻole 79 mai loko mai o 100, e ola kino maikaʻi ana no ka liʻiliʻi he 10 mau makahiki ma hope o ka mālama ʻia ʻana.
Eia nō naʻe, inā haki a pahū paha kahi aneurysm, he koʻikoʻi loa ke kūlana. Inā ʻaʻole hana ʻia ke ʻoki ulia pōpilikia i loko o 48 mau hola, ʻaʻole e ola ka hapalua o ia mau maʻi. Hōʻike kēia i ke koʻikoʻi o ka ʻike mua ʻana i kēia kūlana a ʻimi i ka lāʻau kūpono, ʻoiai inā ʻaʻohe hōʻailona.
He aha kā mākou e hana ai e pale aku iā mākou iho mai kēia kūlana?
ʻOiai ʻaʻole hiki iā mākou ke kāohi i kekahi mau kumu genetic, nui nā mea e hiki iā mākou ke hana e hōʻemi i ka pilikia.
- He nohona olakino: ʻAi ʻana i ka meaʻai kaulike a hoʻoikaika kino mau.
- E kāohi i nā kumu pilikia: E mālama i kou kaumaha, ke koko, a me nā pae cholesterol ma lalo o ke kaohi. E lawe i nā lāʻau lapaʻau a kāu kauka i kuhikuhi ai no kēia mau mea e like me ke kauoha.
- E hoʻopau i nā ʻano maikaʻi ʻole: Inā ʻoe e puhipaka, e hoʻōki koke. E pale i ka inu nui ʻana i ka waiʻona.
Inā loaʻa iā ʻoe kēia mau hōʻailona, mai hoʻokaʻulua iki!
He mau hōʻailona paha kēia o ka haki ʻana a i ʻole ka pahū ʻana o kahi aneurysm. He mau pilikia olakino kēia. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona , e hele koke i ka ʻOihana Pilikia o ka haukapila (ETU).
| E ʻimi koke i ke kōkua lapaʻau! | |
|---|---|
| 🚨 | Ka ʻeha koke, hiki ʻole ke hoʻomanawanui, a haehae hoʻi ma ka umauma a i ʻole ke kua luna. |
| 🚨 | Paʻakikī nui ka hanu ʻana. |
| 🚨 | Ke ʻū ʻana i ke koko. |
| 🚨 | Ka nalowale o ka ʻike, ka poniuniu, a i ʻole nā hōʻailona o ka hahau ʻana (e like me ke kūlou ʻana ma kekahi ʻaoʻao o ka maka, ka paʻakikī i ka ʻōlelo ʻana). |
Nā nīnau koʻikoʻi e nīnau aku i kāu kauka
He mea maʻamau ke makaʻu inā ʻike ʻoe ua loaʻa iā ʻoe kēia maʻi. Eia nō naʻe, he mea nui e maopopo e pili ana i kou kūlana. Mai poina e nīnau i kēia mau nīnau ke kipa aku ʻoe i kāu kauka.
- Pehea ka nui o koʻu aneurysm?
- He aha kaʻu e hana ai e hōʻemi i ka pilikia o kēia pahū ʻana?
- Ke nui aʻe nei anei ka aneurysm? Inā pēlā, pehea ka wikiwiki o kona ulu ʻana?
- He aha ka likelika e pahū ai kēia?
- E pono anei iaʻu ke ʻoki kino?
- Inā hana ʻia ke ʻoki kino iaʻu, he aha nā pilikia?
Leka Lawe-Home
- ʻO ka Ascending Aortic Aneurysm ka nāwaliwali a me ka pehu ʻana o ka paia o ke kīʻaha koko nui o ka puʻuwai. He kūlana koʻikoʻi kēia e ulu mālie ana.
- ʻO ka hapa nui o ka manawa, ʻaʻohe hōʻailona, no laila he mea nui i ka poʻe me nā kumu pilikia (ke koko kiʻekiʻe, ka puhipaka, ka mōʻaukala ʻohana) e hana i nā nānā olakino maʻamau.
- ʻO ka pōʻino nui loa me kēia, ʻo ia ka hiki ke pahū a lilo ke ola.
- Pono nā aneurysms liʻiliʻi i ka lāʻau lapaʻau a me ka nānā mau ʻana i nā lāʻau lapaʻau, ʻoiai ua mālama ʻia nā mea nui me ke ʻoki ʻana.
- Inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha nui o ka umauma a i ʻole ka paʻakikī o ka hanu ʻana, e manaʻo he pilikia ia a e hele koke i ka haukapila.
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