ʻElua mau cusps o kou puʻuwai i loko o ka valve aortic? (Bicuspid Aortic Valve) E kamaʻilio kākou e pili ana i kēia!

Ke luhi nei ʻoe i kekahi manawa a luhi paha? A i ʻole ua kau anei ke kauka i kahi stethoscope i kou umauma a ʻōlelo i kahi mea e like me, "Mmm... lohe au i kahi leo ʻē (murmur) e puka mai ana mai kou puʻuwai"? ʻO ke kumu o kēia paha he loli liʻiliʻi i loko o kou puʻuwai āu i hānau ai me ia. Mai hopohopo, i kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi maʻamau i kapa ʻia ʻo Bicuspid Aortic Valve.

I ka ʻōlelo maʻalahi, he aha kēia Bicuspid Aortic Valve?

ʻAe, e hoʻomaopopo kākou i kēia ma kēia ʻano. ʻEhā mau kiwikā nui i loko o ko kākou puʻuwai. Ua like kēia me nā puka e wehe wale ana i hoʻokahi ʻaoʻao. ʻO kēia mau mea, ʻo ka mea e hoʻouna i ke koko i ka aorta, ke kīʻaha koko nui e lawe ana i ke koko waiwai oxygen mai ka puʻuwai a i ke kino holoʻokoʻa, ua kapa ʻia ʻo ka kiwikā aortic. ʻO ka maʻamau, i ke kanaka olakino, he ʻekolu mau ʻāpana liʻiliʻi (cusps a i ʻole leaflet) kēia kiwikā aortic. Hāmama a pani ʻia kēia mau ʻāpana ʻekolu ma ke ʻano maʻamau e kāohi i ke kahe o ke koko. Eia naʻe, i ke kanaka me ke ʻano i kapa ʻia ʻo ka kiwikā aortic bicuspid, ʻelua mau ʻāpana o kēia kiwikā ma kahi o ʻekolu . He ʻano hānau kēia. No laila, ʻoiai he ʻelua wale nō ʻāpana, hiki i kēia kiwikā ke paʻakikī iki i ka wehe a me ka pani pono ʻana. Hiki i kēia ke alakaʻi i ʻelua mau pilikia nui: 1. Aortic Stenosis (ka haiki ʻana o ka kiwikā): No ka mea ʻaʻole wehe pono ka kiwikā, he wahi liʻiliʻi wale nō no ka puʻuwai e pamu i ke koko i ke kino. Hoʻoikaika kēia i ka puʻuwai. 2. Aortic Regurgitation (kahe koko hoʻi): No ka mea, ʻaʻole pani pono ka valve, ua hoʻihoʻi kekahi o ke koko i hoʻopili ʻia i ke kino i loko o ka puʻuwai. ʻAʻole paha ʻoe e loaʻa i kekahi mau hōʻailona no nā makahiki. Akā i ka hala ʻana o ka manawa, hiki i kēia kaumaha keu ke hoʻopilikia i kou puʻuwai.

Pehea ke koʻikoʻi o kēia kūlana?

ʻAʻole nā ​​kānaka a pau me ka Bicuspid Aortic Valve e loaʻa nā pilikia nui. Akā, ma kahi o hoʻokahi i loko o ʻekolu mau kānaka e loaʻa nā pilikia i ka hala ʻana o ka manawa. ʻO ia ke kumu he mea nui ka loaʻa ʻana o nā nānā maʻamau a me nā hoʻokolohua lapaʻau inā haʻi aku kāu kauka iā ʻoe he maʻi kēia. ʻAʻole ia he mea kakaikahi e like me kou manaʻo. Hoʻopilikia ia i ka 1% a i ka 2% o ka heluna kanaka o ka honua. ʻElua nō hoʻi ka nui o ka maʻamau i nā kāne ma mua o nā wahine. ʻO ka poʻe me kekahi mau maʻi genetic, e like me ka Turner syndrome, aia pū kekahi i ka pilikia kiʻekiʻe. ʻO ka mea maikaʻi loa, me ka ʻenehana lapaʻau holomua o kēia wā, hiki iā ʻoe ke ʻike i kēia maʻi a me kona mau loli liʻiliʻi ma mua o kou ʻike ʻana i nā hōʻailona. A me ka mālama pono ʻana, hiki iā ʻoe ke ola i ke ola piha, olakino, a lōʻihi.

He aha nā hōʻailona o kēia?

ʻAʻohe hōʻailona o ka nui o ka poʻe no nā makahiki. Eia nō naʻe, i ka wā e hōʻino ai ka hana o ka valve, hoʻomaka nā hōʻailona e ʻike ʻia. I nā keiki ʻōpio a me nā pēpē, inā koʻikoʻi ke kūlana, hiki ke ʻike ʻia nā hōʻailona e like me ke kala polū/ʻeleʻele o ka ʻili (` cyanosis` ) a me ka paʻakikī i ka ʻai ʻana a i ʻole ka piʻi ʻana o ke kaumaha ma hope koke iho o ka hānau ʻana. ʻO nā hōʻailona maʻamau i ʻike ʻia i nā pākeke:

He aha ke kumu o kēia? He mea hoʻoilina anei?

ʻAʻole i loaʻa ke kumu kikoʻī o kēia 'Aortic valve'. He mea kēia e hana ʻia i ka wā e ulu ai ka puʻuwai o ka ʻōpū i nā wā mua o ka hāpai ʻana. Hiki i kēia ʻano ke holo i loko o nā ʻohana i kekahi ʻano (hoʻoilina) . ʻO ia hoʻi, inā loaʻa i kekahi o kou ʻohana pili (makuahine, makuakāne, kaikaina, keiki) kēia ʻano, loaʻa paha iā ʻoe kekahi pilikia. No laila, inā loaʻa i kekahi o kou ʻohana kēia ʻano maʻi valve puʻuwai, he mea nui loa ia e haʻi i kāu kauka e pili ana i ia mea. A laila, inā makemake ʻo ia, hiki ke hoʻāʻo ʻia ʻoe.

He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia?

Inā ʻaʻole i mālama ʻia i ka manawa kūpono, hiki mai nā pilikia koʻikoʻi.

• Ka hāʻule ʻana o ka puʻuwai: ʻO ka hāiki ʻana o ka valve (stenosis) ke kumu o ka hana ikaika ʻana o ka puʻuwai. Hiki i kēia ke hoʻomānoanoa a hoʻonui i ka ʻiʻo o ka puʻuwai, a i ka hopena e hiki ʻole ai ke pamu koko me ka maikaʻi. Hiki i nā mea e like me ka puhi paka a me ke cholesterol kiʻekiʻe ke hoʻolalelale i kēia kaʻina hana.
• ʻO ka haki ʻana a me ka dissection o ka aneurysm aortic: Ma kahi o hoʻokahi o ʻekolu mau kānaka me ka valve aortic bicuspid e pilikia ana i ka aorta, ke aʻa nui ma luna o ka valve, e hoʻonui ʻia. E like me ka pōpō e hoʻopiha nui ʻia ana, nāwaliwali nā paia o kēia kīʻaha koko a hoʻomaka e puʻupuʻu. Ua kapa ʻia kēia he aneurysm aortic. Inā nui loa ia, hiki ke pahū koke (rupture) a haehae paha (dissection). He pilikia weliweli kēia e pono ai ka mālama koke ʻana .

Pehea e ʻike ʻia ai kēia maʻi?

I ka manawa pinepine, e kānalua mua ke kauka i kahi murmur puʻuwai ke lohe lākou i kahi leo ʻē (kahi `murmur puʻuwai`) i ka wā e hoʻolohe ana i kou umauma me kahi stethoscope. Ma hope o kēlā, e kauoha kāu kauka i kekahi mau hoʻokolohua kūikawā e nānā i ke ʻano a me ka hana o kou puʻuwai. ʻO nā hoʻokolohua nui:

• ʻEchocardiogram (echo): He scan ultrasound kēia o ka puʻuwai. Hiki iā ia ke ʻike maopopo i ka helu o nā lau liʻiliʻi i loko o ka valve, pehea lākou e hana ai, a inā he leakage a i ʻole ka haiki ʻana.
• CT scan (Computed Tomography scan): Hiki i kēia ke hana i nā kiʻi ʻekolu-dimensional o ka puʻuwai a me ka aorta.
• MRI o ka puʻuwai (Magnetic Resonance Imaging): Hoʻohana ʻia kēia hoʻāʻo e kiʻi i nā kiʻi kikoʻī o ka puʻuwai a me nā valves.

He aha nā koho lapaʻau?

ʻOiai hiki i kekahi mau lāʻau lapaʻau, e like me nā beta-blockers, ke kōkua i ka kaohi ʻana i nā hōʻailona, ​​​​ʻaʻole hiki iā lākou ke hoʻōla piha i ka pilikia valve. Ma kahi o 4 mai 5 mau kānaka me Bicuspid Aortic Valve e pono ai ke ʻoki ʻia i kekahi manawa o ko lākou ola. Hiki i ke ʻoki ke hoʻoponopono i kāu valve a pani paha me kahi mea hou. E kūkākūkā kāu hui lapaʻau me ʻoe i ka lāʻau lapaʻau maikaʻi loa nāu, ma muli o kou kūlana, ka makahiki, a me ke olakino holoʻokoʻa.

Nā ʻano hana ʻoki kino

I kēia mau lā, ma kahi o ke ʻoki puʻuwai hāmama kuʻuna, aia nā ʻano hana hou e like me ke ʻoki kino minimally invasive a me TAVR (Transcatheter Aortic Valve Replacement), kahi e pani ai i ka valve ma o kahi kīʻaha koko. He pōkole ka manawa hoʻōla o kēia mau ʻano hana.

Pehea ke ʻano o ka hoʻōla hou ʻana a me ka wā e hiki mai ana?

Hoʻōla maikaʻi ʻia ka 98% o ka poʻe i hana ʻia i ke ʻoki valve, a ʻaʻole i hoʻopilikia ʻia ko lākou ola. ʻO ke ʻano kēia , inā loaʻa iā ʻoe kahi maʻi Bicuspid Aortic Valve, me ka mālama pono ʻana a me ka nānā ʻana o ke kauka, hiki iā ʻoe ke ola i kahi ola lōʻihi a olakino e like me nā mea ʻē aʻe. ʻO ka mea nui loa, ʻo ia ke hele i kāu mau manawa hoʻopaʻa maʻamau me kāu kauka. Ma hope o ke ʻoki ʻana, pono ʻoe e hele no kahi nānā ma ka liʻiliʻi hoʻokahi i ka makahiki.

Āhea ʻoe e pono ai e lawe koke ʻia i ka haukapila? (I ka manawa hea e hele ai i ka ETU)

He mea weliweli loa nā hōʻailona o ka haki ʻana o ka aneurysm. Inā ʻike ʻoe i kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​e kāhea koke i ka 911 no kahi kaʻa kaʻa a i ʻole e hele i ka haukapila kokoke loa ʻo Emergency Department (ETU).

• Ka ʻeha ʻoi, ʻoi, a haehae koke ma ka umauma a i ʻole ke kua.
• ʻIli pipili a hou.
• Pōʻaiʻī.
• Ka mae ʻana.
• Nā palpitations o ka puʻuwai.
• Ka luaʻi a me ka luaʻi.
• Paʻakikī nui ka hanu ʻana.

ʻO ka Bicuspid Aortic Valve, ka maʻi valve o ka puʻuwai, ka Aortic Stenosis, ka Aortic Regurgitation, ke ʻoki puʻuwai, ka ʻeha o ka umauma, ka pōkole o ka hanu