Ke hoʻokahe nei ke kīʻaha puʻuwai i ke koko? E aʻo kākou e pili ana i ke ʻano lapaʻau ʻoki ʻole (Paravalvular Leak Closure)

E noʻonoʻo ua loaʻa iā ʻoe kahi ʻoki pani valve puʻuwai a ke manaʻolana nei ʻoe e holo pono ana nā mea āpau. ʻO ka hapa nui o ka manawa, holo pono nā mea āpau. Akā, i kekahi manawa, i loko o kahi heluna liʻiliʻi loa o ka poʻe, ua waiho ʻia kahi hakahaka liʻiliʻi ma waena o ka valve hana hou i hoʻokomo ʻia a me ka paia o ka puʻuwai, a hiki i kahi koko liʻiliʻi ke hoʻomaka e kahe hou ma o ia mea. Ua like ia me ka wā e hoʻopaʻa ai mākou i kahi paipu wai, kahe iki ka wai mai loko mai o ke ami. I ka lāʻau lapaʻau, kapa mākou i kēia he 'Paravalvular Leak' (PVL) . No laila i kēia lā e kamaʻilio mākou e pili ana i kahi lāʻau lapaʻau maʻalahi loa a hou e hiki ke pani i kēia ʻano leaka me ka ʻole o ka wehe ʻana i ka umauma a hana i ke ʻoki nui.

I ka ʻōlelo maʻalahi, he aha ka Paravalvular Leak Closure?

He mea maʻalahi loa kēia. ʻO ka Paravalvular Leak Closure kahi lāʻau lapaʻau ʻoki ʻole. Hoʻōki ia i ke kahe koko aʻu i ʻōlelo ai ma mua e hana ʻia ma hope o ke pani ʻana i kahi valve puʻuwai. ʻO ka maʻamau, ke hana ʻia kahi leaka e like me kēia, hiki ke hoʻoponopono ʻia ma ka hana ʻana i kahi ʻoki ʻē aʻe. Akā e noʻonoʻo e pili ana i ka pilikia o ka mea i hana ʻia i ke ʻoki puʻuwai i hoʻokahi manawa e hana hou i kahi ʻoki nui. He kiʻekiʻe loa kēia pilikia no ka mea i ʻelemakule a loaʻa i nā maʻi ʻē aʻe.

No laila, hoʻohana nā cardiologists interventional i kēia ʻano hana hou e hōʻemi i kēia pilikia.

I ka hapanui o nā hihia, inā liʻiliʻi ka leaka, e kuhikuhi kāu kauka i ka lāʻau lapaʻau. Eia nō naʻe, inā ʻaʻole ka lāʻau lapaʻau e kāohi i ka leaka a manaʻo ʻoe he mea weliweli loa ke ʻoki hou ʻana, hiki i kāu kauka ke paipai i ka pani ʻana o PVL. He hana hoʻopilikia iki kēia e hiki ke hoʻoponopono i ka leaka a puni ka valve puʻuwai a hōʻemi nui i kāu mau hōʻailona.

ʻO wai ka mea e pono maoli ai kēia lāʻau lapaʻau?

ʻAʻole pono nā kānaka a pau i kēia lāʻau lapaʻau. Akā, aia kekahi mau hihia kūikawā kahi e hiki ai i kēia lāʻau lapaʻau ke lilo i mea pono nui. E nānā kākou i ke ʻano o ia mau mea.

He aha ka mea e hana ʻia ma mua o ka lāʻau lapaʻau?

Ma mua o ka hana ʻana i kēia ʻano lapaʻau, e hana kāu kauka i kahi hoʻokolokolo piha iā ʻoe. E loiloi lākou i kou olakino a pehea e hana ai kou puʻuwai. Hiki iā lākou ke hana i kekahi mau moʻomeheu koko e kāpae i kahi maʻi o ka puʻuwai (endocarditis).

Eia kekahi, ua hana ʻia kekahi mau hoʻokolohua kūikawā e ʻike pono ai i kahi o ka leaka, pehea kona nui, a pehea e hiki ai iā ia. ʻO kēia mau mea ke kiʻi ʻana i nā kiʻi o ka puʻuwai.

• ECG (Electrocardiogram): He hoʻāʻo e nānā i ka hana uila o ka puʻuwai.
• Echocardiogram: He scan o ka puʻuwai. ʻAe kēia iā ʻoe e ʻike maopopo i nā keʻena o ka puʻuwai, nā valves, a me ke kahe koko.
• ʻO ka echocardiogram Transesophageal (TEE): He scan echo nō hoʻi kēia. Eia nō naʻe, hoʻokomo ʻia kahi ʻōmole liʻiliʻi me ke kāmela ma o ka waha, hoʻoili ʻia i lalo o ka esophagus, a lawe ʻia nā kiʻi maopopo o ke kua o ka puʻuwai. He mea nui loa kēia no ka loaʻa ʻana o kahi kikoʻī o ka leaka.
• Angiogram: He kaʻina hana e lawe i nā kiʻi X-ray o nā kīʻaha koko o ka puʻuwai ma ke komo ʻana i kahi wai kūikawā i loko o lākou.
• ʻO ke scan CT Cardiac a me ka MRI cardiac: Hiki i kēia mau mea ke hana i nā kiʻi kikoʻī loa, ʻekolu-dimensional (3D) o ka puʻuwai.

Pehea e hana ʻia ai ka lāʻau lapaʻau a pehea ʻoe e hoʻomākaukau ai?

Hana ʻia kēia lāʻau lapaʻau e kahi kauka cardiologist interventional. Kōkua ʻia ʻo ia e nā loea kiʻi puʻuwai. Hana pinepine ʻia kēia ma kahi keʻena hoʻokolohua kūikawā ma kahi haukapila. Kapa mākou ia ʻo 'Cardiac Catheterization Lab' .

ʻO kāu hoʻomākaukau ʻana ma mua o ka mālama ʻana

E hāʻawi ke kauka iā ʻoe i nā kuhikuhi maopopo no ka mea e hana ai ma mua o ka mālama ʻana.

• ʻAi ʻana a me ka inu ʻana: E noi ʻia ʻoe e hoʻōki i ka ʻai ʻana a me ka inu ʻana i kekahi mau hola ma mua o ka lāʻau lapaʻau.
• Nā lole: Nā ʻōlelo aʻoaʻo no nā mea e ʻaʻahu ai i kēlā lā.
• Nā lāʻau lapaʻau: Hiki ke noi ʻia ʻoe e hoʻōki a hoʻololi paha i ka nui o kekahi mau lāʻau lapaʻau āu e lawe nei, ʻoiai nā anticoagulants a i ʻole nā ​​​​lāʻau anti-inflammatory nonsteroidal (NSAIDs).
• Nā mea e hoʻomaopopo ai: Pono ʻoe e haʻi i kāu kauka e pili ana i nā maʻi allergies āu e loaʻa nei, nā lāʻau lapaʻau, a i ʻole nā ​​​​wikamina āu e lawe nei.

Pehea e hana ʻia ai ka lāʻau lapaʻau

Mai makaʻu ʻoe ke lohe ʻoe i kēia, he hana maʻalahi loa ia.

1. ʻO ka mea mua, e hāʻawi ʻia ʻoe i kahi lāʻau hoʻomālielie e hoʻomālielie i ka ʻeha. No laila, ʻaʻole ʻoe e manaʻo i kekahi mea, e hoʻomaha ʻoe.

2. A laila, hoʻokomo ke kauka i kahi ʻōmole lahilahi loa, i kapa ʻia he catheter , i loko o ke kīʻaha koko nui (femoral artery) ma kou wāwae luna, aia ma kou ʻūhā.

3. A laila, ma lalo o ke alakaʻi ʻana a nā scanners, ua hoʻokomo ʻia kahi uea ʻoi aku ka maikaʻi ma o kēia catheter a hiki i kahi kikoʻī o ka leaka i loko o ka puʻuwai.

4. Ke loaʻa ka liki, e hoʻouna ʻia kahi mea liʻiliʻi (mea pani) ma ke kaula, e pani loa ana i ka hakahaka. Ua like kēia me ke sila ʻana i kahi lua me kahi plug.

5. Ma hope o ka nānā ʻana a me ka hōʻoia ʻana ua hana pololei ʻia ka hana, wehe pono ka mea nona ka ʻōmole.

I kekahi manawa, inā loaʻa iā ʻoe ʻelua mau kiwikā prosthetic, ma kahi o ke kau ʻana iā lākou ma o ka ʻūhā, hiki ke hana ʻia kahi ʻoki liʻiliʻi loa ma ka ʻaoʻao o ka umauma a hiki ke hoʻokomo ʻia ke catheter ma o ia mea. ʻO ka mea nui, ʻaʻole pono ʻoe e wehe loa i kou umauma, e like me kāu e hana ai me kahi hana nui.

ʻEhia ka lōʻihi o ka mālama ʻana? He aha ka mea e hana ʻia ma hope?

ʻO ka maʻamau , ʻelua a ʻekolu hola ka lōʻihi o ke kaʻina hana holoʻokoʻa. Ke noʻonoʻo nei paha ʻoe i ka mea e hana ʻia ana i kēlā mea liʻiliʻi i kau ʻia i loko o kou puʻuwai. I ka hala ʻana o ka manawa, ulu aʻe kou ʻiʻo puʻuwai a puni ka mea hana, a lilo ia i ʻāpana maoli o kou puʻuwai.

Ma hope o ka lāʻau lapaʻau, e noho ʻoe ma ka haukapila i ka pō no ka nānā ʻana. Hiki iā ʻoe ke hoʻi i ka home i ke kakahiaka aʻe. E hāʻawi kāu kauka iā ʻoe i nā ʻōlelo aʻoaʻo maopopo e pili ana i ka noho ʻana ma ka home, nā mea e hana ai, a me nā mea e hana ʻole ai. Hiki iā ʻoe ke nīnau i kāu kauka i ka wā e hiki ai iā ʻoe ke hoʻi i kāu mau hana maʻamau.

ʻO ka maʻamau, ma kahi o ʻekolu mahina ma hope o ka mālama ʻana, hana hou ʻia kahi scan e nānā inā ua pani loa ka liki a inā paha e hana pono ana ka valve.

He aha nā pono o kēia ʻano hana ma mua o ke ʻoki kino kuʻuna?

I ka hoʻohālikelike ʻia me ke ʻoki kino hāmama, he nui nā pono maopopo o ke ʻano PVL Closure.

• Hoʻōla wikiwiki: ʻOiai ʻaʻohe ʻoki nui, ua pōkole loa ka manawa hoʻōla.
• Haʻahaʻa ka pilikia o ka maʻi: ʻOiai ʻaʻohe ʻeha nui, haʻahaʻa loa ka pilikia o ka maʻi.
• Ka manawa liʻiliʻi ma ka haukapila: ʻOiai hiki iā ʻoe ke hoʻi i ka home i ka pō, ʻaʻole pono ʻoe e noho i ka haukapila no nā pule.
• Nā ʻoki liʻiliʻi a me nā palapū: He ʻoki liʻiliʻi wale nō i koe ma ke kino.

Āhea wau e ʻike hou ai i ke kauka?

He mea nui loa ia e hahai pono i nā ʻōlelo a kāu kauka a hele i kāu mau manawa i ka manawa kūpono. Inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē ma hope o ka mālama ʻana, e like me ke kuni i wehewehe ʻole ʻia, ka ʻeha ma ka ʻāpana groin, a i ʻole ka pehu ʻana , e hoʻomaopopo koke i kāu kauka.

Inā ua loaʻa iā ʻoe kahi pani valve puʻuwai, he mea nui e hana i nā nānā maʻamau. I kekahi manawa, hiki i kahi valve hou ke liki i ka hala ʻana o ka manawa. Inā hana ʻia kēlā, hiki i ka lāʻau lapaʻau ke komo pū me ka lāʻau lapaʻau, ke ʻoki hou ʻana, a i ʻole ke kaʻina hana Paravalvular Leak Closure a mākou i kūkākūkā ai. E kamaʻilio me kāu kauka e pili ana i ke koho kūpono loa no kou mau pono a me ke olakino.