E aʻo kākou e pili ana i nā mea hana pani puʻuwai.

Ke haʻi aku ke kauka iā ʻoe a i ʻole kāu keiki he "lua i loko o ka puʻuwai" ko lākou, makaʻu paha ʻoe. He mea maʻamau ka noʻonoʻo ʻana i nā nīnau e like me "He aha kaʻu e hana ai i kēia manawa? Pono anei au e hana i kahi ʻoki nui?" Akā, mai hopohopo. I kēia lā, ua holomua nui ka ʻepekema lapaʻau. Ma kahi o ka wehe ʻana i ka umauma e like me ka wā ma mua, hiki ke pani i kēlā mau lua ma ke ʻano maʻalahi loa. I kēia lā, e kamaʻilio mākou e pili ana i kahi mea hana kūikawā i hoʻohana ʻia no kēia, he Cardiac Closure Device.

He aha kēia "lua i loko o ka puʻuwai"? (ASD a me PFO)

I ka ʻōlelo maʻalahi, ʻehā mau keʻena nui o ko kākou puʻuwai. Ua kapa ʻia nā keʻena ʻelua o luna ʻo ka atria. Aia kahi ʻāpana e like me ka paia ma waena o kēia mau atria ʻākau a me hema ʻelua. Ua kapa ʻia kēia ʻo ka septum interatrial. Ma muli o kahi lua ma kēia paia a mākou e kapa pinepine ai he "lua ma ka puʻuwai."

ʻElua ʻano nui o kēia mau kūlana:

1. Atrial Septal Defect (ASD): He "lua i loko o ka puʻuwai" kēia. Aia kahi lua ma kēia paia i ka wā hānau. Ke kahe nei ke koko i mua a i hope ma waena o nā keʻena ʻelua o ka puʻuwai ma o kēia lua.

2. Patent Foramen Ovale (PFO): ʻAʻole kēia he lua maoli e like me ka ASD. E noʻonoʻo e pili ana, i ko kākou wā i loko o ka ʻōpū o ko kākou makuahine, aia kahi puka liʻiliʻi ma ka paia ma waena o kēia mau atria. He mea nui ia i kēlā manawa. Ma hope o ko kākou hānau ʻia ʻana, pani ʻia kēia puka ma kāna iho. Akā i kekahi poʻe, ʻaʻole ia e pani pono. Noho ia e like me kahi ʻāpana liʻiliʻi. ʻO ia ka mea i kapa ʻia he PFO.

I kekahi manawa e pani ʻia kēia mau lua ma o lākou iho, a i ʻole hiki iā lākou ke lilo i mea liʻiliʻi e ola ai me ka ʻole o nā pilikia. Eia nō naʻe, pono paha i kekahi poʻe ke pani ʻia kēia mau lua inā loaʻa iā lākou nā hōʻailona e like me ka paʻakikī o ka hanu ʻana, ka luhi pinepine, a i ʻole ka puʻuwai puʻuwai kūpono ʻole .

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

I mea e maopopo ai i kēia, pono ʻoe e ʻike iki e pili ana i ke ʻano o ka hana a ka puʻuwai. ʻO ka ʻaoʻao hema o ko kākou puʻuwai e lawe i ke koko "maikaʻi" i piha i ka oxygen a pono e hoʻouna ʻia i ke kino. ʻO ka ʻaoʻao ʻākau e lawe i ke koko "maikaʻi ʻole" i haʻahaʻa i ka oxygen a pono e hoʻomaʻemaʻe ʻia mai ke kino.

I kēia manawa, e noʻonoʻo i ka mea e hana ʻia inā he lua ma waena o kēia mau ʻaoʻao ʻelua? ʻAe, e hui pū kekahi koko oxygenated a me kekahi koko deoxygenated. A laila, ʻaʻole e loaʻa i nā cell i loko o ko mākou kino ka nui kūpono o ka oxygen. ʻO ia ke kumu e luhi ai mākou a pilikia ka hanu ʻana.

Pehea ʻoe e hoʻokomo ai i kēia hāmeʻa i loko o ka puʻuwai?

I ka wā ma mua, hiki ke hana ʻia kēia ma o ke ʻoki puʻuwai hāmama wale nō, ʻo ia hoʻi ka wehe ʻana i ka umauma. Akā, ʻaʻole ia ka hihia i kēia manawa. I kēia lā, ua pani ʻia ma mua o 80% o nā ASD me ka hoʻohana ʻana i kahi kaʻina hana maʻalahi i kapa ʻia ʻo cardiac catheterization.

He mea kupaianaha loa ke ʻano o kēia hana ʻana.

• ʻO ka mea mua, ua hoʻokomo ʻia kahi ʻōmole lahilahi (catheter) i loko o kahi kīʻaha koko nui i loko o kou wāwae, kokoke i kou ʻūhā.
• A laila, me ka hoʻohana ʻana i ka ʻenehana like me X-ray, alakaʻi pono ke kauka i ka ʻōmole kokoke i ka lua ma ka puʻuwai.
• Ua lawe ʻia ka mea pani i loko o kēia paipu. Ua like kēia mea me ʻelua mau umbrellas liʻiliʻi i hoʻopili ʻia kekahi.
• Ke hoʻokokoke aku ʻoe i ka lua, i kou huki ʻana mai loko mai o ka ʻōmole, e wehe ana kekahi ʻaoʻao o kēia mea hana ma kekahi ʻaoʻao o ka lua, a ʻo kekahi ʻaoʻao ma kekahi ʻaoʻao, e pani loa ana i ka lua e like me ke pihi.

Loaʻa kēia mau mea hana i nā nui like ʻole, mai 4 a 40 millimeters. E koho kāu kauka i ka mea hana e kūpono loa i ka nui o ka lua i loko o kou puʻuwai.

Nā pōmaikaʻi a me nā hopena ʻaoʻao hiki ke hoʻohana ʻia o kēia ʻano hana

E like me nā lāʻau lapaʻau a pau, aia nā pono a me nā pōʻino liʻiliʻi loa.

He aha kāu e hana ai e pale aku i nā hopena ʻaoʻao?

Hana nā kauka i nā mea like ʻole e hōʻemi ai i kēia mau pilikia.

• Kāohi i nā ʻūpā koko: E hāʻawi ʻia ʻoe i nā anticoagulants no nā mahina 6 mua ma hope o ka hoʻokomo ʻia ʻana o ka hāmeʻa.
• I mea e pale ai i ka hāmeʻa mai ke keakea ʻana me nā lāʻau lapaʻau ʻē aʻe: Ua hoʻolālā ʻia nā hāmeʻa hou i hiki ai ke hoʻokomo ʻia ke catheter ma o ka hāmeʻa hoʻokahi inā pono kekahi lāʻau lapaʻau puʻuwai ʻē aʻe i ka wā e hiki mai ana.
• Ke koho ʻana i ka nui kūpono: ʻO ke kī i ka pale ʻana i ka ʻino ʻana o ka paia o ka puʻuwai, ʻo ia ke koho ʻana i ka nui kūpono no kēlā me kēia mea maʻi.

Nā mea hiki iā ʻoe ke hana no kou palekana

I mea e pale ai iā ʻoe iho mai ka endocarditis, kahi maʻi e hiki ke loaʻa, ʻoiai i ka wā o nā mālama niho, pono ʻoe e mālama i kēia mau mea i nā mahina 6 mua.

• E haʻi aku i nā kauka a me nā kauka niho āu e ʻike ai he lako kāu. He manaʻo maikaʻi e lawe i kahi kāleka me kēlā ʻike.
• Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi e like me ke kuni, ka ʻeha kino, a i ʻole ka ʻeha puʻu, e kāhea koke aku i kāu kauka.
• E mālama pono i kou mau niho a me ke olakino o kou ʻāʻī. E palaki i kou mau niho i kēlā me kēia lā a e ʻike mau i ke kauka niho.
• Ma mua o ka hana ʻana i kekahi mea e hiki ai ke kahe ke koko, e like me ka unuhi ʻana i ka niho a i ʻole ka hoʻomaʻemaʻe ʻana, e noi i kāu kauka e hōʻoia inā pono ʻoe e lawe i nā lāʻau antibiotic.

Pehea ka lōʻihi o ka ho'ōla ʻana a me nā ʻoiaʻiʻo ʻē aʻe

Me kēia ʻano catheter, hoʻokahi wale nō pō e pono ai ʻoe e noho ma ka haukapila ma hope o ke kau ʻia ʻana o ka hāmeʻa. Ma hope o kēlā, pono ʻoe e pale i nā hana ikaika no ʻelua pule. Akā hiki iā ʻoe ke hoʻi i nā hana maʻamau i hoʻokahi a ʻelua paha lā. ʻOi aku ka pōkole o ka manawa hoʻōla ma mua o ke ʻoki kino hāmama.

Hana ʻia kēia mea hana ma ke kau ʻana i kahi lole polyester i kahi ʻōnaehana uea i hana ʻia me kahi mea hoʻohuihui nickel-titanium (Nitol). I ka hala ʻana o ka manawa, ulu aʻe nā ʻiʻo o ko mākou kino ponoʻī a puni kēia mea hana, e lilo ana i ʻāpana o ka puʻuwai ponoʻī.

ʻAʻole hiki i kekahi poʻe ke hana i kēia ʻano catheter. I kēlā mau hihia, pono ke ʻoki kino. Akā i kēia manawa aia ka ʻenehana e hana i kēlā ʻoki kino me ka liʻiliʻi o ka ʻoki ʻana (minimally invasive).

Pono ʻoe e kamaʻilio me kāu kauka e pili ana i ka hiki ke loaʻa iā ʻoe kahi scan MRI ma hope o ka hoʻokomo ʻia ʻana o kēia hāmeʻa. Palekana kekahi mau hāmeʻa no ka MRI, akā aia paha kekahi mau palena.