Ua paʻa anei ka valve puʻuwai? E kamaʻilio kākou e pili ana i ke ʻoki kino 'Commissurotomy' (Surgical Mitral Commissurotomy)

Ke manaʻo nei ʻoe i kekahi manawa i ka pōkole o ka hanu a i ʻole ke kaumaha o kou umauma ke luhi iki ʻoe, a i ʻole ke piʻi ʻana i nā alapiʻi? Malia paha ua haʻi aku kāu kauka iā ʻoe e pili ana i kahi pilikia me kahi valve i loko o kou puʻuwai. Ke wehe pono ʻole kahi valve o ka puʻuwai a paʻa, kapa mākou ia he 'stenosis'. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻoki kūikawā i hana ʻia ma ke ʻano he lāʻau lapaʻau no ia ʻano maʻi. ʻOiai he kumuhana koʻikoʻi loa kēia, e hoʻomaopopo maʻalahi kākou i nā mea āpau.

I ka ʻōlelo maʻalahi, he aha kēia 'commissurotomy'?

ʻAe, e hoʻomaopopo mua kākou i kēia me ka maʻalahi. ʻEhā mau keʻena nui o kou puʻuwai. E noʻonoʻo iā lākou he ʻehā lumi. I mea e kahe ai ke koko mai kekahi keʻena a i kekahi, pono e wehe a pani pono nā puka ma waena o lākou. ʻO kēlā mau puka ka mea a mākou e kapa nei he mau valves puʻuwai .

ʻO ka commissurotomy kahi hana e pili ana i ka valve mitral i loko o kou puʻuwai. Aia ia ma waena o nā keʻena ʻelua o ka puʻuwai, ka atrium hema a me ka ventricle hema. ʻO kēia ka puka ma waena o nā keʻena ʻelua. He ʻelua mau ʻāpana o kēia puka.

Ma muli o kekahi mau kūlana olakino, ʻoiai ke kūlana i kapa ʻia ʻo 'Mitral Valve Stenosis' , ʻaʻole e wehe pono kēia mau puka ʻelua. Ua like ia me ka puka paʻa. He aha ka mea e hana ai? Hoʻemi ʻia ke kahe ʻana o ke koko mai ke keʻena luna a i ke keʻena lalo. Hoʻihoʻi kēia i ke koko, e kau ana i ka nui o ke kaumaha ma ka puʻuwai a me nā māmā. I ka hala ʻana o ka manawa, hiki i kēia ke alakaʻi i nā kūlana koʻikoʻi e like me ka hāʻule ʻana o ka puʻuwai .

ʻO wai ka mea e pono ai kēia ʻoki kino?

ʻAʻole no nā kānaka a pau kēia ʻoki kino. Aia kekahi mau kumu nui e paipai ai kāu kauka i kēia ʻoki kino:

• Inā ʻaʻole i loaʻa kahi hopena maikaʻi i nā lāʻau ʻē aʻe (e like me ka lāʻau lapaʻau) i hāʻawi ʻia iā ʻoe.
• Inā ʻaʻole ʻoe kūpono no kahi kaʻina hana i kapa ʻia ʻo 'Balloon Valvuloplasty', ʻo ia hoʻi ka hoʻonui ʻana i ka valve me kahi pōpō.
• Inā loaʻa iā ʻoe kekahi ʻoki puʻuwai ʻē aʻe, hiki iā ʻoe ke hana i kēia ʻoki i ka manawa like.

Akā ʻo ka mea nui loa, ʻo ka holomua o kēia ʻoki kino e pili ana i ke kumu o kou mitral valve stenosis. E nānā kākou i nā kumu nui ʻelua.

He aha ke ʻano o ka wā e pipili ai nā uhi valve?

He mea maʻalahi loa kēia e hoʻomaopopo. E noʻonoʻo ʻoe e minoʻaka ana i mua o ke aniani me kou mau lehelehe i pani ʻia. E nānā i nā kihi o kou mau lehelehe luna a me lalo. ʻO ia kahi e hui ai nā ʻaoʻao ʻelua o ka valve mitral (nā commissures). I kēia manawa e noʻonoʻo ʻoe e paʻa ana kekahi i nā kihi o kou mau lehelehe me nā manamana lima ʻelua. Hiki iā ʻoe ke wehe pono i kou waha? ʻAʻole, ʻaʻole hiki iā ʻoe? ʻO ia ka mea e hana ʻia ke ālai ʻia ka valve mitral. ʻO ka 'commissurotomy' kahi hana ʻoki e hoʻokuʻu i kēlā mau kihi ʻelua.

Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?

ʻOiai he hana ʻoki kino nui kēia, hoʻomaka ka hoʻomākaukau ʻana i nā pule ma mua. E hana kāu hui lapaʻau (cardiologist, kauka puʻuwai) i kahi hoʻokolokolo piha iā ʻoe.

• He hoʻokolokolo kino piha
• Nā hoʻāʻo koko
• Ke kamaʻilio lōʻihi nei e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino

E hoʻāʻo ʻia hoʻi ʻoe e ʻike inā he mau poloka i loko o kāu valve mitral a me nā aʻa ʻē aʻe i loko o kou puʻuwai, e like me:

• Echocardiography - ʻO kēia ke nānā ʻana i ka puʻuwai.
• Nā scan CT
• ʻO ka Angiography Coronary

Pehea e hana ʻia ai ke ʻoki kino?

He ʻoki puʻuwai hāmama kēia. Eia ke kaʻina o nā hanana e hana ʻia ana ma ka lumi hana:

1. E hāʻawi ʻia ʻoe i ka lāʻau hoʻomaha e hoʻohiamoe loa iā ʻoe.

2. Hana ʻia kahi ʻoki ma waenakonu o ka iwi umauma (sternum).

3. E hoʻopili ʻia ʻoe i kahi mīkini bypass cardiopulmonary . ʻO kēia ke hāʻawi i kou kino i ke koko a me ka oxygen e pono ai ʻoiai e kū ana kou puʻuwai i ka wā o ke ʻoki ʻana.

4. Wehe ke kauka lapaʻau i ka atrium hema o ka puʻuwai a nānā i ka valve mitral.

5. Hana ʻia nā ʻoki liʻiliʻi ma nā commissures o ka valve e hoʻokuʻu iā lākou.

6. A laila e lawe ʻia aku ʻoe mai ka mīkini puʻuwai-māmā a e hoʻomaka hou ʻia kou puʻuwai.

7. ʻO ka hope loa, hana ʻia kahi echocardiogram transesophageal e hōʻoia i ka hana pono ʻana o ka valve.

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

Ma hope o ke ʻoki kino, pono ʻoe e noho ma ka haukapila no hoʻokahi pule. No ka lā mua a ʻelua paha, e mālama ʻia ʻoe i loko o ka keʻena mālama koʻikoʻi (ICU) a e nānā pono ʻia.

Ma mua o kou haʻalele ʻana i ka haukapila, e aʻo aku kāu kauka iā ʻoe ma kēia mau mea:

• Hoʻōla Puʻuwai: He mea kōkua nui kēia i ka loaʻa hou ʻana o ka ikaika a me ka maʻa ʻana i ke ola maʻamau ma hope o ke ʻoki ʻana.
• Pehea e mālama ai i ka ʻoki: He mea nui loa kēia e pale ai i ka maʻi a ho'ōla koke i ka ʻeha.
• Ma kahi o ka wā e hiki ai iā ʻoe ke hoʻomaka e hoʻokele a hana hou .

Nā hopena, nā pilikia, a me ka wā e ʻike ai i ke kauka

He kiʻekiʻe loa ka holomua o ka open mitral commissurotomy. Hoʻomaikaʻi ia i ke kahe koko a hōʻemi nui i nā hōʻailona. Eia naʻe, ʻaʻole ia he hopena mau loa. Nui ka poʻe i loaʻa i kēia kaʻina hana e pono ai ke ʻoki pani valve i kekahi manawa i ka wā e hiki mai ana.

E like me nā ʻoki kino a pau, aia kekahi mau pilikia.

• ʻO ka Mitral Regurgitation
• Kahe nui ʻana o ke koko
• Nā maʻi
• Nā hewa o ka puʻuwai (Arrhythmia)
• Hahau

Eia nō naʻe, ua hoʻemi ʻia kēia mau pilikia ma kahi haukapila nui me nā kauka ʻokiʻoki akamai. Inā loaʻa iā ʻoe nā maʻi e like me ka maʻi diabetes, ka maʻi puʻupaʻa, a i ʻole ka momona, hiki ke kiʻekiʻe iki aʻe ka pilikia. E kamaʻilio me kāu kauka e pili ana i kēia.

Inā ʻike ʻoe i kēia mau hōʻailona, ​​e haʻi koke aku i kāu kauka:

• kuni
• ʻUlaʻula, pehu, a pus paha kokoke i ka ʻoki ʻia
• ʻEha a kaomi paha o ka umauma

Inā ʻike ʻoe i nā hōʻailona o ka hōʻeha puʻuwai koke (ʻeha nui o ka umauma, paʻakikī ka hanu ʻana) a i ʻole nā ​​​​hōʻailona o ka hahau ʻana (ʻōlelo hū, kūlou o kekahi ʻaoʻao o ka maka), e kelepona koke iā 1990 a hele i ka Emergency Treatment Unit (ETU) o ka haukapila.