E aʻo kākou i nā mea āpau e pili ana i ka Atrial Septal Defect - ASD Closure ma ke ala maʻalahi.

He mea maʻamau no kekahi makuahine a makua paha ke hopohopo ke ʻōlelo ke kauka, "He lua ko ka puʻuwai o ka pēpē." ʻO ka lohe ʻana i kēia mau ʻōlelo e hāpai mai i nā manaʻo he nui. Akā inā maopopo maoli iā ʻoe, ʻaʻohe mea e makaʻu ai. I kēia lā, ke kamaʻilio nei mākou e pili ana i ka lāʻau lapaʻau no ka pani ʻana i kahi lua i loko o ka puʻuwai a ka poʻe he nui i lohe ai akā ʻaʻole maopopo maoli, i kapa ʻia ʻo ASD Closure. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

ʻO ka mea mua, e nānā kākou, he aha kēia lua i loko o ka puʻuwai (ASD)?

ʻAe, i ka ʻōlelo maʻalahi, he lua hānau kēia ma ka paia (i kapa ʻia ʻo 'septum') ma waena o nā keʻena ʻelua o luna o ko kākou puʻuwai (a mākou e kapa nei ʻo 'atria'). Ma ke ʻano lapaʻau, kapa mākou i kēia kūlana (Atrial Septal Defect) , a i ʻole (ASD) no ka pōkole.

I kēia manawa, manaʻo paha ʻoe he maʻi kēia. ʻO ka mea kupaianaha, ua hānau ʻia mākou a pau me kēia lua liʻiliʻi i loko o ko mākou puʻuwai. He mea maʻamau ia. ʻO ka maʻamau, pani ʻia kēia lua ma kona iho i loko o kekahi mau pule a i ʻole mau mahina ma hope o ka hānau ʻana o ke pēpē. Akā i kekahi manawa, loaʻa i kekahi mau keiki kahi lua nui iki aʻe ʻaʻole paha e pani ʻia ma kona iho. ʻO ia ka manawa e hoʻomaka ai nā pilikia e kū mai.

No ke aha ʻoe e pono ai e pani i kēia lua?

Inā liʻiliʻi ka lua, ʻaʻole paha ia e hoʻoulu i kahi pilikia nui. ʻAʻole paha e pono ka lāʻau lapaʻau. Akā inā nui kēia (ASD), hiki iā ia ke hoʻoulu i nā pilikia he nui.

E noʻonoʻo, i ka wā he lua nui ma waena o nā keʻena ʻelua o luna o ka puʻuwai, e kahe ana ke koko i loko o kekahi keʻena i loko o kekahi. Ua like ia me ka lua ma waena o nā pahu wai ʻelua. ʻO kēia ke kumu o ka hana ʻana o ka puʻuwai a me nā māmā ma mua o ka hana maʻamau. Ke hana ʻia kēia i ka hala ʻana o ka manawa, hiki ke loaʻa nā pilikia like ʻole.

E nānā i ka papa ma lalo no nā pilikia nui e hiki ke kū mai mai kēia.

Ma muli o kēia mau pilikia e hiki ai i kāu kauka ke kuhikuhi i kahi ASD Closure, kahi ʻoki kino e pani ai i kēia lua. Hana pinepine ʻia kēia ʻoki kino ma nā keiki ʻōpio e pale aku i kēia pōʻino hiki ke hiki mai.

Pehea e hana ʻia ai kēia ʻoki kino? ʻElua mau ʻano hana!

ʻElua mau ʻano hana nui no ka pani ʻana i kahi lua i loko o ka puʻuwai. ʻO kekahi, ʻo ia ke ʻoki puʻuwai hāmama , kahi e pili ana i ka hana ʻana i kahi ʻoki ma ka umauma. ʻO kekahi, he hana minimally invasive , kahi e pili ana i ka hoʻokomo ʻana i kahi ʻōmole liʻiliʻi ma o ka ʻūhā.

Na kāu kauka puʻuwai e hoʻoholo i ke ʻano hana kūpono nou a i ʻole kāu keiki. E hilinaʻi kēia i kekahi mau kumu:

• Ka nui o ka lua a me kona wahi i loko o ka puʻuwai.
• Nā maʻi puʻuwai ʻē aʻe i loaʻa iā ʻoe.
• Kou olakino holoʻokoʻa.

E nānā kākou i kēia mau ʻano hana ʻelua ma ke kaʻawale.

1. ʻOki Puʻuwai Hāmama (Pani ʻana o ka ASD)

ʻO kēia ke ʻano kuʻuna. Ma kēia, ua hoʻomaha loa ʻia ʻoe, ʻo ia hoʻi, ua hiamoe loa ʻoe a ʻaʻole ʻoe e manaʻo i kekahi mea.

• I ka wā o ke ʻoki kino:E hoʻopili ʻia ʻoe i kahi mīkini kūikawā (mīkini puʻuwai-māmā) e hana i ka hana o kou puʻuwai a me kou māmā no kekahi manawa. A laila e hana ke kauka ʻoki i kahi ʻoki liʻiliʻi ma ka ʻaoʻao waena a ʻākau paha o kou umauma e hiki ai i kou puʻuwai. A laila, e hoʻohana ʻia kahi ʻōmole liʻiliʻi me kahi kāmela (endoscope) e ʻike i kahi kikoʻī o ka lua.
• Pehea e pani ai i ka lua: Nui nā ala e pani ai i ka lua.
• Ua uhi ʻia me kahi ʻāpana i hana ʻia me nā mea synthetic.
• A i ʻole hiki iā ʻoe ke uhi iā ia me kahi ʻāpana lole i lawe ʻia mai kahi ʻāpana ʻē aʻe o kou puʻuwai ponoʻī.
• Hiki ke pani ʻia me nā sutures .

ʻOiai he hana ʻoki kino nui kēia, hiki ke hana ʻia me ka holomua a me ka palekana me ka ʻenehana o kēia wā.

2. Pani ʻana o ka ASD Transcatheter

ʻO kēia ke ʻano hana hou a makemake nui ʻia e nā poʻe he nui. No ka mea, ʻaʻole ia e pili ana i kahi ʻoki nui ma ka umauma. No laila, he pōkole loa ka manawa ho'ōla. Eia naʻe, hiki ke hana ʻia kēia ʻano hana inā he liʻiliʻi ka lua a aia ma kahi kūpono ma ka puʻuwai.

• Pehea e hana ʻia ai: ʻAʻole ʻoe e hoʻopau piha ʻia i ka anesthetized, akā e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e kōkua iā ʻoe e hiamoe. A laila, hana ke kauka i kahi ʻoki liʻiliʻi ma kahi aʻa nui ma kou ʻūhā (femoral vein) a hoʻokomo i kahi ʻōmole lahilahi i kapa ʻia he catheter ma loko.
• Mea hana i ka puʻuwai: Ma ka hopena o kēia ʻōmole he mea hana liʻiliʻi (mea pani) e pani ana i ka lua. Alakaʻi pono ke kauka i kēia ʻōmole ma o ke aʻa koko i ka puʻuwai me ka nānā ʻana i nā ʻenehana e like me X-ray a me ka echocardiogram.
• Ke pani ʻana i ka lua: Ke komo ka lua i loko o ka puʻuwai, e wehe ka mea liʻiliʻi e like me ka umbrella a pani i ka lua. A laila lawe ke kauka i waho i ke catheter. ʻO ia wale nō!

He aha ka mea e hana ʻia ma hope o ke ʻoki kino? Pehea ka manawa hoʻōla?

E loli ana ka manawa ho'ōla ma muli o ke kaʻina hana āu i hana ai.

• Inā ua hana ʻia ʻoe i ke ʻoki hāmama , pono ʻoe e noho i ka haukapila no kekahi mau lā. Ma hope o kou hoʻi ʻana i ka home, pono ʻoe e pale i ka hana ikaika no kekahi mau pule.
• Inā ua loaʻa iā ʻoe kahi kaʻina hana catheter , hiki iā ʻoe ke hoʻi i ka home i hoʻokahi a ʻelua paha lā a hoʻi hou i kāu mau hana maʻamau i loko o hoʻokahi pule.

No nā mahina 6 mua ma hope o ke ʻoki ʻana, pono ʻoe e lawe i ka lāʻau lapaʻau e pale ai i ke koko mai ke kāpili ʻana. Eia kekahi, inā ʻoe e hana ana i ka hana niho, e ʻōlelo paha kāu kauka i nā lāʻau antibiotic e pale aku i ka maʻi.

ʻO ka mea nui loa, ʻo ia ke hele i ke keʻena lapaʻau i kēlā me kēia lā a ke kauka e ʻōlelo ai e hele mai (nā manawa hoʻopaʻa) . A laila hiki iā mākou ke nānā inā ua pani pono ʻia ka lua a inā e hana maikaʻi ana ka puʻuwai.

Aia kekahi mau pilikia? Āhea ʻoe e ʻike koke ai i ke kauka?

E like me nā ʻoki kino āpau, aia kekahi mau pilikia. He mea kākaʻikahi loa kēia, akā he mea maikaʻi ke makaʻala iā lākou.

• Nā maʻi alerika i nā mea i hoʻohana ʻia i ke ʻoki kino.
• Puʻuwai kūpono ʻole (Arrhythmia).
• Ke kahe ʻana o ke koko.
• Ka maʻi ʻana.
• Ka pōʻino o nā puʻupaʻa.
• Hahau a i ʻole ka hoʻouka ischemic transient.

Mai hopohopo no kēia mau mea. Ke hana nei kāu hui lapaʻau i kā lākou mea maikaʻi loa e pale aku i kēia mau mea mai ka hiki ʻana mai.

Eia nō naʻe, inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei ke hoʻi ʻoe i ka home ma hope o ke ʻoki ʻana, pono ʻoe e hele i ka haukapila a kāhea koke aku paha i kāu kauka.

Pehea lā ke ʻano o ke ola ma hope o ke ʻoki kino?

ʻO kēia ka ʻāpana maikaʻi loa. Ua hōʻike ʻia e ka noiʻi inā loaʻa i kekahi ma lalo o 25 mau makahiki kēia ʻoki kino, ua like ko lākou manaʻolana ola me ka mea i loaʻa ʻole iā ASD. ʻO ia hoʻi , hiki iā ʻoe ke ola i kahi ola olakino a maʻamau .

ʻO ka mea nui, ʻo ka pani ʻana i ka lua e hiki ai iā ʻoe ke ola i kahi ola lōʻihi a olakino hoʻi ma mua o ka loaʻa ʻana o kahi (ASD) me ka ʻole o ka lāʻau lapaʻau.

No laila, inā ʻōlelo ke kauka he ASD kou a i ʻole kāu keiki, mai hopohopo no ia mea. E kamaʻilio me kāu kauka e pili ana i ia mea. E kōkua ʻo ia iā ʻoe e koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.