Ua ālai loa ʻia ke kīʻaha koko o ka puʻuwai? E kamaʻilio kākou e pili ana i (Chronic Total Occlusion - CTO)!

Ua lohe paha ʻoe i kahi paʻa piha o kahi kīʻaha koko e lawe ana i ke koko i ka puʻuwai? I kekahi manawa hiki ke mau kēia no nā mahina. ʻO kēia ka mea a mākou e kapa nei he chronic total occlusion (CTO) i ka lāʻau lapaʻau. He moʻolelo koʻikoʻi kēia, akā mai hopohopo, no ka mea, he mea nui e makaʻala i ia mea.

He aha ka Chronic Total Occlusion (CTO)? E hoʻomaopopo maʻalahi kākou.

I ka ʻōlelo maʻalahi, ʻo `(Chronic Total Occlusion)` a i ʻole `(CTO)` ʻo ia hoʻi, ua ālai ʻia kekahi a ʻoi aku paha o nā aʻa coronary e hoʻolako ana i ke koko i kou puʻuwai, a i ʻole 100%. Hoʻohui mākou i ka huaʻōlelo `(Chronic)` i kēia ke hana ʻia kēia ālai no ʻekolu mahina a ʻoi aku paha. E noʻonoʻo e like me ka paipu wai e ālai ʻia ana e kekahi mea. Hoʻopaʻa kēia i ka oxygen a me nā meaʻai e pono ai nā ʻiʻo puʻuwai. Hiki i kēia ke hana i nā hōʻailona e like me ka ʻeha o ka umauma, ka pōkole o ka hanu, `(Dyspnea),` a i kekahi manawa he hōʻeha puʻuwai. Hiki ke koʻikoʻi kēia ʻano.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i kēia (CTO)?

ʻO kaʻoiaʻiʻo, ʻo kēia kūlana i kapa ʻia ʻo `(Chronic Total Occlusion)` ka mea i ʻike pinepine ʻia i nā poʻe me ka maʻi Coronary Artery (CAD) . Wahi a kekahi mau noiʻi, hiki i hoʻokahi o kēlā me kēia ʻekolu o ka poʻe me `(CAD)` ke loaʻa iā `(CTO)`.

I kēia manawa, ʻo nā kumu pilikia no ka ulu ʻana o `(CTO)` ua like like ia me nā mea no `(CAD)`. Inā he mea puhi paka ʻoe, a inā paha he mau kumu pilikia kou, ʻoi aku ka nui o kou hiki ke ulu i `(CTO)`:

• ʻO ka helu helu o ke kino (BMI) o 30 a ʻoi aku paha (ʻo ia hoʻi ka momona).
• ʻO ka maʻi diabetes (Diabetes Mellitus) .
• Inā loaʻa i kekahi o ka ʻohana ka maʻi puʻuwai (loulou hoʻoilina).
• Ke koko kiʻekiʻe (hypertension) .
• Ke kiʻekiʻe o ka cholesterol i loko o ke koko (Hyperlipidemia) .
• Inā ua loaʻa mua iā ʻoe nā hōʻeha puʻuwai a i ʻole ke ʻoki ʻana i ke aʻa coronary artery .
• Inā ʻoe e alakaʻi i kahi nohona hana ʻole (ʻo ia hoʻi, nele i ka hoʻoikaika kino).

E noʻonoʻo i ko kākou ʻanakala ʻo Sunil. He nui kāna puhipaka, he nui iki ke kō, a he koko kiʻekiʻe kona. ʻAʻole ʻo ia e hoʻoikaika kino pono. ʻO ka poʻe e like me ia ka mea i loaʻa i kēia maʻi i kapa ʻia ʻo ``(CTO)''.

(CTO) Pehea ka maʻamau o kēia ʻano?

ʻO kēia kūlana, i kapa ʻia ʻo ``(CTO)``, lilo ia i mea maʻamau me ka makahiki. Wahi a nā helu helu:

• Ma kahi o 37% o ka poʻe ma lalo o 65 mau makahiki.
• Ma kahi o 40% o nā kānaka ma waena o 65 a me 79 mau makahiki.
• Ma kahi o 41% o nā kānaka ma luna o 85 mau makahiki.

Penei ke ʻano o ka hana ʻana. Eia nō naʻe, ʻoi aku ka laha o ke kūlana `(CTO)` i loko o ke kaiāulu ma mua o ka manaʻo o nā loea. No ka mea, ʻaʻole hōʻike kekahi `(CTO)` i kekahi mau hōʻailona. No laila, ʻaʻole paha e ʻike kekahi poʻe he `(CTO)` ko lākou. ʻO ia hoʻi, me ka loaʻa ʻole o kahi hōʻailona kūhelu.

He aha nā hōʻailona o ka (Chronic Total Occlusion)?

ʻAe, e nānā kākou i nā hōʻailona āu e ʻike ai inā loaʻa iā ʻoe kahi `(CTO)`. Hiki i kēia mau hōʻailona ke hoʻonui i kekahi manawa ke luhi ʻoe, ke hoʻoikaika kino ʻoe, a emi iho ke hoʻomaha ʻoe. Eia nō naʻe, hiki i kekahi poʻe ke ʻike i kēia mau hōʻailona ʻoiai ke hoʻomaha nei lākou. He mea nui hoʻi e hoʻomanaʻo i kekahi manawa ʻaʻohe ou hōʻailona iki.

ʻO nā hōʻailona nui e ʻike ʻia:

• ʻEha ka umauma, paʻa, a i ʻole ke kaomi , me he mea lā e ʻomi ana kekahi i kou umauma.
• Manaʻo puni ke poʻo .
• Luhi loa . Manaʻo luhi ʻoiai ma hope o ka hana ʻana i kahi mea liʻiliʻi.
• Puʻuwai kūpono ʻole .
• Ka luaʻi .
• Ka heihei a i ʻole ka wikiwiki o ka puʻuwai .
• Paʻakikī ka hanu ʻana (Dyspnea) . Manaʻo ʻoe ua pōkole kou hanu ʻoiai ma hope o ka hele wāwae ʻana no kekahi manawa pōkole.
• ʻEha e hele ana mai ka poʻohiwi a i lalo i ka lima .

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka no ka ʻōlelo aʻo, no ka mea, he mau hōʻailona paha kēia o ka maʻi puʻuwai.

He aha ke kumu nui o ka hoʻokumu ʻia ʻana o (CTO)?

I ka ʻōlelo maʻalahi, ʻo ke kumu nui o ka `(Chronic Total Occlusion)` ʻo ia ka waiho ʻana o kahi mea momona i loko o hoʻokahi a ʻoi aku paha o kou mau aʻa coronary. Kāhea mākou i kēia `plaque` . Ma muli o ka waiho ʻana o kēia plaque, ʻili mālie nā paia o ke aʻa a lilo i paʻakikī. Ua kapa ʻia kēia kaʻina hana ʻo `(Atherosclerosis)` i ka lāʻau lapaʻau. Ke kū mai kēia ʻano `(Atherosclerosis)` i loko o kou mau aʻa coronary, kapa mākou ia he Coronary Artery Disease (CAD) . I ka hala ʻana o ka manawa, hōʻiliʻili kēia plaque a i ka hopena ua ālai loa ʻia ke aʻa (100%). ʻO ia ka manawa e hana ʻia ai kahi `(CTO)`.

Pehea e ʻike ai nā kauka i ka Chronic Total Occlusion? (Diagnosis)

Hoʻohana pinepine nā kauka i kahi hoʻāʻo i kapa ʻia he angiogram coronary e ʻike ai i kahi occlusion holoʻokoʻa mau loa. ʻO kēia ka hoʻokomo ʻana i kahi dye kūikawā (contrast dye) i loko o kahi kīʻaha koko ma kou lima a wāwae paha. Hōʻike maopopo kēia dye i kou mau kīʻaha koko ma kahi X-ray. A laila hiki i ke kauka ke ʻike pehea e kahe ai ke koko ma o kou mau aʻa coronary a inā he mea paʻa.

Eia kekahi, hiki i ke kauka ke hana i kekahi mau hoʻokolohua ʻē aʻe. ʻO kekahi o kēia mau mea:

• MRI puʻuwaiʻAe kēia iā ʻoe e ʻike i ke ʻano o ka puʻuwai a me ke kahe ʻana o ke koko.
• Hoʻāʻo Koʻikoʻi o ka Puʻuwai : Hana ʻia kēia hoʻāʻo e ʻike i ke ʻano o ka pane ʻana o kou puʻuwai i ka hoʻoikaika kino, e like me ka holo ʻana ma luna o ka treadmill.
• Echocardiogram (Echocardiogram - echo) : Hiki i kēia ke loiloi i nā paia o ka puʻuwai, nā valves, a me ke kahe ʻana o ke koko ma o ka puʻuwai.
• Electrocardiogram (EKG) : Hiki i kēia ke nānā i nā hōʻailona uila o ka puʻuwai a me ka ʻōhumu o ka puʻuwai.

Ma hope wale nō o ka hana ʻana i kēia mau hoʻokolohua a pau, hiki mai ke kauka i kahi hopena paʻa e pili ana i ka ``(CTO)''.

Pehea e mālama ʻia ai kahi (CTO)?

ʻElua mau pahuhopu nui i ka mālama ʻana i kekahi me ka `(CTO)`. ʻO kekahi, ʻo ia ka hōʻemi ʻana i nā hōʻailona . ʻO kekahi, ʻo ia ka hōʻemi ʻana i ka pilikia o kahi hanana e pili ana i ka puʻuwai, e like me ka hōʻeha puʻuwai . ʻO ke ʻano o ka lāʻau āu e pono ai e hilinaʻi ʻia i ke koʻikoʻi o kāu mau hōʻailona a inā paha e mālama ʻia nei ʻoe no ka `(CAD)`.

Hiki i kāu kauka ke kuhikuhi i kēia mau lāʻau lapaʻau:

• ʻO ke komo ʻana o ka coronary Percutaneous (PCI) : Ua kapa pinepine ʻia kēia he angioplasty a me ka stenting . Ma kēia kaʻina hana, hoʻokomo kāu kauka i kahi ʻōmole liʻiliʻi, hakahaka (catheter) ma kou lima a i ʻole ka pulima lima i loko o kahi aʻa coronary i loko o kou puʻuwai. A laila, hoʻopiha ʻia kahi pōpō liʻiliʻi ma o ka catheter e hoʻokuke i ka plaque i paʻa i ka ʻaoʻao. A laila, kau ʻia kahi ʻōmole mesh liʻiliʻi (stent) i loko o ke aʻa e pale aku ai i ka haiki hou ʻana. Hoʻihoʻi kēia i ke kahe koko.

• ʻO ke kāpili ʻana o ke ala coronary artery (CABG) : He ʻoki puʻuwai hāmama kēia. Ma kēia kaʻina hana, lawe ke kauka lapaʻau i kahi aʻa olakino a i ʻole vein mai kahi ʻāpana ʻē aʻe o kou kino (ʻo kou wāwae a umauma paha) a hana i kahi ala hou (he bypass) a puni ke aʻa coronary i ālai ʻia. Ua like ia me ka lawe ʻana i kahi ala ʻokoʻa ke loaʻa kahi ālai ma ke alanui.

E hoʻomanaʻo, hiki i kēia mau lāʻau ʻelua ke mālama pono i ke kūlana `(CTO).` E kōkua kāu kauka iā ʻoe e koho i ka lāʻau lapaʻau kūpono loa iā ʻoe.

He aha ka manaʻo me ke kūlana (CTO)?

He maʻi koʻikoʻi ka Chronic Total Occlusion, akā mai hopohopo, hiki ke mālama maikaʻi ʻia kēia maʻi me ka mālama kūpono.

Ua hōʻike kekahi mau haʻawina e hiki i ka PCI ke mālama pono i ka CTO a hiki i ka 86% o nā maʻi, aʻo nā haʻawina ʻē aʻe e hōʻike ana hiki i ka CABG ke mālama pono i kahi 60% o nā maʻi.

No laila, me ka mālama kūpono a me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki iā ʻoe ke ola i kahi ola olakino.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Inā loaʻa iā ʻoe ka `(Chronic Total Occlusion)`, a inā manaʻo ʻoe he maʻi paha kou, he mea nui loa e nīnau i kāu kauka i nā nīnau e like me kēia:

• He aha nā hōʻailona mua o ka `(CTO)`?
• He aha nā hoʻokolohua e pono ai iaʻu e hana e ʻike ai inā he `(CTO)` kaʻu?
• He aha nā hoʻololi o ke ʻano o ka nohona e hiki iaʻu ke hana e hōʻemi i koʻu pilikia o ka loaʻa ʻana o kahi `(CTO)`? (e.g. ʻai, hoʻoikaika kino)
• He aha nā koho lapaʻau no ka `(CTO)`? ʻO wai ka mea maikaʻi loa iaʻu?
• He aha ka manawa kūpono e ulu hou ai kahi CTO ma hope o ka mālama ʻana? He aha ka mea e hiki ke hana ʻia e pale aku ai?

E nīnau i kēia mau nīnau e loaʻa ai kahi ʻike maopopo o kou kūlana. A laila hiki iā ʻoe ke kākoʻo maikaʻi i kāu lāʻau lapaʻau.

Leka Lawe-Home

ʻAe, no laila, i ka hōʻuluʻulu manaʻo, eia nā mea nui e hoʻomanaʻo e pili ana i ka `(Chronic Total Occlusion - CTO)` a mākou i kamaʻilio ai.

ʻO ka paʻa ʻana o ke aʻa coronary (CTO) he kūlana ia i paʻa loa ai ke aʻa coronary e hoʻolako ana i ke koko i kou puʻuwai no ʻekolu mahina a ʻoi. Hiki i kēia ke hōʻemi i ke kahe koko i ka puʻuwai a alakaʻi i nā pilikia koʻikoʻi, e like me ka hōʻeha puʻuwai.

Eia nō naʻe, me ka ʻike pono ʻana a me ka mālama ʻana, hiki ke kaohi ʻia nā hōʻailona a hiki ke ola i kahi ola maikaʻi. Hoʻohana ʻia nā Percutaneous Coronary Intervention (PCI) a me Coronary Artery Bypass Graft (CABG) e mālama pono ai i ka CTO.

Inā he kānalua a nīnau paha kāu e pili ana i kēia, he mea naʻauao ke ʻimi koke i ke kōkua lapaʻau . E mālama i kou puʻuwai!

ʻO ka maʻi puʻuwai, ke aʻa coronary, ke aʻa i ālai ʻia, CTO, hōʻeha puʻuwai, angioplasty, ʻoki bypass