Inā hoʻopilikia ʻia kou puʻuwai, ʻo ia hoʻi, ʻo Atrial Fibrillation (Afib), kahi maʻi puʻuwai puʻuwai, e hoʻomau nei ʻoiai ke lawe nei i ka lāʻau lapaʻau a me nā lāʻau lapaʻau ʻē aʻe, hiki paha iā ʻoe ke manaʻo ʻaʻohe hopena mau loa no kēia? I kekahi manawa hiki i kēia kūlana ke hoʻopūhoihoi nui iā ʻoe. Akā, mai hopohopo, me ka holomua o ka ʻepekema lapaʻau, aia nā lāʻau lapaʻau kūpono loa no ia mau kūlana. No ia poʻe kēia e kamaʻilio nei mākou e pili ana i kēia ʻano lapaʻau hou i kēia lā.
He aha kēia Kaʻina Hana Hui?
I ka ʻōlelo maʻalahi, he hui pū ʻana kēia o ʻelua mau lāʻau lapaʻau. ʻO ia hoʻi, he ʻoki liʻiliʻi a me kahi lāʻau i kapa ʻia ʻo ka catheter ablation . Kāhea pū mākou i kēia he lāʻau lapaʻau hybrid.
E noʻonoʻo, he ʻōnaehana hōʻailona uila ko ko kākou puʻuwai. ʻO kēia ka mea e hoʻomau i ka puʻuwai e kuʻi pono ana. Ma Afib, ua huikau kēia mau hōʻailona, a hoʻouna nā keʻena o luna (atria) o ka puʻuwai i nā hōʻailona wikiwiki a ʻano ʻē. Ma ke kaʻina hana hui pū, hana pū nā kauka lapaʻau a me nā kauka puʻuwai e hana i nā ʻoki liʻiliʻi loa i loko a ma waho o kou puʻuwai kahi e puka mai ai kēia mau hōʻailona ʻano ʻē. Hoʻōki kēia mau ʻoki i nā hōʻailona uila ʻano ʻē mai ka hele ʻana. Ua like ia me ka pani ʻana i ke alanui hewa a hoʻihoʻi i nā kaʻa ma ke alanui kūpono.
No wai kēia lāʻau lapaʻau kūpono loa?
ʻAʻole no nā kānaka a pau kēia lāʻau lapaʻau. Paipai nui ʻia no:
- No ka poʻe me ka Afib mau loa .
- No ka poʻe i loaʻa hou nā hanana Afib me ka lawe ʻana i ka lāʻau lapaʻau a me ke kau ʻana i ka lāʻau lapaʻau catheter ablation maʻamau.
Inā loaʻa iā ʻoe kahi maʻi like, hiki iā ʻoe ke kamaʻilio me kāu kauka e hoʻoholo inā kūpono kēia lāʻau lapaʻau iā ʻoe.
Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?
E like me nā ʻoki kino āpau, aia kahi hoʻomākaukau liʻiliʻi e pili ana.
- Nā lāʻau hoʻokahe koko (anticoagulants): Inā ʻoe e lawe nei i kēia mau lāʻau lapaʻau, pono ʻoe e hoʻōki iā lākou i kekahi mau lā ma mua o ke ʻoki ʻana. E haʻi pololei kāu kauka iā ʻoe i ka nui o nā lā ma mua a me nā lāʻau lapaʻau e hoʻōki ai. Mai hoʻōki i ka lawe ʻana i kāu mau lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a kāu kauka.
- Hoʻokē ʻai: Ma mua o ke ʻoki ʻana, e noi ʻia ʻoe e hoʻōki i ka ʻai ʻana a me ka inu ʻana no kekahi manawa kikoʻī (hoʻokē ʻai). E hoʻomaopopo pū kāu kauka iā ʻoe e pili ana i kēia wā.
I kekahi manawa, hana ʻia nā ʻāpana ʻelua o kēia lāʻau lapaʻau i ka lā hoʻokahi. I kekahi manawa, hana ʻia lākou ma kahi o ʻehā pule ka mamao. E wehewehe kāu hui lapaʻau i kēia iā ʻoe.
Pehea e hana ʻia ai ke ʻoki kino?
ʻElua ʻāpana nui o kēia lāʻau lapaʻau. E nānā kākou i nā mea e hana ʻia ana ma kēlā me kēia ʻāpana.
| ʻĀpana o ka lāʻau lapaʻau | He mea maʻalahi ka mea e hana ʻia. |
|---|---|
| Māhele ʻEkahi: ʻOki Hana (Lāʻau ʻana i ka Puʻuwai mai waho) | Ma hope o kou hoʻopau piha ʻia ʻana o ka anesthetized, hana ke kauka lapaʻau puʻuwai i kahi ʻoki liʻiliʻi loa, ma kahi o 3-4 kenimika ma lalo o kou iwi umauma (sternum). A laila, ʻoki ʻia ka membrane lahilahi a puni ka puʻuwai (pericardium) a hoʻokomo ʻia kahi kāmela (endoscope). A laila, hoʻohana ʻia kahi paipu hoʻokele ikehu kūikawā (catheter) e mālama (ablate) i nā wahi ma waho o ka puʻuwai e hana ana i nā hōʻailona uila ʻē. ʻO ka lōʻihi o kēia ʻāpana ma kahi o hoʻokahi hola a me ka hapa. |
| Māhele ʻElua: Catheter Ablation (Lapaʻau mai loko mai o ka puʻuwai) | Hana pinepine ʻia kēia ʻāpana i kahi lā ʻokoʻa, i kekahi mau pule ma hope. Maanei, hoʻokomo kahi cardiologist (electrophysiologist) i kahi catheter i loko o kou puʻuwai ma o kahi aʻa koko i loko o kou ʻūhā. A laila mālama ʻo ia i loko o kou puʻuwai , ma nā wahi i paʻakikī ke hiki aku i ka wā o ke ʻoki kino ma mua. E hāʻawi ʻia ʻoe i ka anesthesia māmā a i ʻole ka anesthesia laulā i ka wā o kēia kaʻina hana. |
He aha ka Convergent Plus?
I kekahi manawa, i ka manawa like me kēia ʻoki kino, hana nā kauka i kahi mea ʻē aʻe e hōʻemi ai i ka pilikia o ka hahau ʻana. ʻO ia hoʻi, pani lākou i kahi ʻāpana liʻiliʻi o ka atrium hema o ka puʻuwai (ka ʻāpana atrial hema). Ke hoʻohui ʻia kēia mau ʻanuʻu hou, kapa mākou ia he kaʻina hana "Convergent Plus".
He aha nā pōmaikaʻi o kēia lāʻau lapaʻau?
He nui nā pono kūikawā o kēia ʻano lapaʻau:
- Ka nui o ka holomua: ʻOi aku ka holomua o kēia ma mua o ka mālama ʻana i ka catheter ablation maʻamau no ka mea mālama ia i loko a me waho o ka puʻuwai.
- Ka pilikia haʻahaʻa:I ka wā o kēia ʻoki kino, hiki i nā kauka ke ʻike maopopo i ka esophagus, aia ma hope o ka puʻuwai, no laila ua haʻahaʻa loa ka pilikia o ka hōʻino ʻana.
- ʻAʻole ke ʻoki puʻuwai hāmama: ʻAʻole pono kēia e hoʻōki i kou puʻuwai a hoʻohui iā ia i kahi mīkini puʻuwai-māmā (cardiopulmonary bypass).
Aia kekahi mau pilikia a i ʻole nā pilikia?
E like me nā ʻoki kino āpau, aia kekahi mau pilikia a me nā pilikia e hiki ke loaʻa. Eia naʻe, he mea kakaikahi kēia i ka hapa nui o nā hihia. ʻO lākou kekahi:
- Kuke
- Luhi
- Paʻakikī ka hanu ʻana
- Hahau
- Ke kahe ʻana o ke koko
- Ka hōʻiliʻili ʻana o ka wai a puni ka puʻuwai (pericardial effusion)
- Ka pōʻino o ke aʻalolo
- Hoʻouka ischemic kuikilana (TIA)
ʻAʻohe pono e hopohopo no kēia. E wehewehe pono kāu kauka iā ʻoe i nā mea āpau ma mua o ke ʻoki ʻana.
ʻEhia ka lōʻihi e ho'ōla ai?
Pono ʻoe e noho ma ka haukapila no hoʻokahi a ʻelua paha lā ma hope o ka hapa mua o ke ʻoki kino. Inā e hana ʻia ka hapa ʻelua, e hana ʻia paha ia ma kahi o ʻekolu mahina.
E hoʻonohonoho ʻia ʻoe e ʻike hou i kāu kauka i kou wā e hoʻōla ai. ʻO ka maʻamau kēia he 3 mau pule ma hope o ke ʻoki ʻana, a laila hou i 3, 6, a me 12 mau mahina. I kēlā manawa, hāʻawi ʻia paha ʻoe i kahi mīkini liʻiliʻi (Holter monitor) i kau ʻia ma kou umauma no kekahi mau lā e nānā i kou puʻuwai.
Āhea ʻoe e makemake ai e ʻike hou i ke kauka?
Inā ʻike ʻoe i nā hōʻailona ma lalo nei, e hoʻomaopopo koke i kāu kauka.
- Inā hoʻi hou nā hōʻailona o Afib (manaʻo e like me ka wikiwiki o ka puʻuwai, ka paʻa o ka umauma, ka luhi).
- Inā he kahe koko a i ʻole ka maʻi (pehu, ʻulaʻula, pus) ma kahi i ʻoki ʻia ai.
Leka Lawe-Home
- He lāʻau lapaʻau hou a kūpono loa ke Kaʻina Hana Convergent no ka Atrial Fibrillation (Afib) lōʻihi i kāohi ʻole ʻia e nā lāʻau lapaʻau a i ʻole nā lāʻau lapaʻau kuʻuna.
- He hui pū ʻana kēia o ke ʻoki kino a me ka lāʻau lapaʻau catheter, no laila hiki iā ia ke hoʻoponopono i nā pilikia ma loko a ma waho o ka puʻuwai.
- He kiʻekiʻe loa ka holomua o kēia lāʻau lapaʻau, a he pōkole ka manawa hoʻōla.
- ʻO ke kanaka maikaʻi loa e ʻike inā kūpono kēia lāʻau lapaʻau iā ʻoe ʻo ia kāu kauka puʻuwai. E kamaʻilio me ia e pili ana i kēia me ka makaʻu ʻole, a hoʻoholo.
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