ʻO ka ʻohi ʻana i ke aʻa Radial a me nā ʻaʻa Saphenous (RA&SV)

Ua haʻi ʻia anei ʻoe a i ʻole kekahi āu i ʻike ai e ke kauka ua paʻa kahi aʻa puʻuwai a pono e hana ʻia kahi bypass? Ua lohe mākou a pau i ka huaʻōlelo 'bypass'. E noʻonoʻo he nui ke kaʻa ma ke alanui, a laila ua like kēia me ke kūkulu ʻana i kahi ala ʻē aʻe no nā kaʻa e hele ai. Ke paʻa kahi aʻa koko e hoʻolako ana i ke koko i ka puʻuwai, ua hoʻopili ʻia kahi ala hou, ʻo ia hoʻi, kahi aʻa koko hou, i ka puʻuwai, kahi i kapa ʻia ʻo ke ʻoki bypass. Akā ua noʻonoʻo paha ʻoe i kahi e lawe ʻia ai kahi aʻa koko e kūkulu i kēia ala hou? ʻO ka hapa pinepine, hoʻohana ʻia kahi aʻa koko olakino mai kou kino ponoʻī no kēia. ʻO ia ke kaʻina hana a mākou e kamaʻilio ai i kēia lā, kahi e lawe ʻia ai kēlā aʻa koko mai kekahi ʻāpana o ke kino a hoʻoili ʻia i ka puʻuwai.

He aha ke ʻano o ka 'ʻohi' ʻana i kahi kīʻaha koko?

I ka ʻōlelo maʻalahi, ua like kēia me ka ʻohi ʻana i kahi kīʻaha koko. I ka pololei, pili ia i ka wehe ʻana i kahi kīʻaha koko olakino mai kahi ʻāpana o kou kino ponoʻī (ʻo ka lima a i ʻole ka wāwae) a hoʻohana iā ia ma ke ʻano he pani no kahi aʻa i paʻa i loko o kou puʻuwai. ʻO ke kīʻaha koko i lawe ʻia ma kēia ʻano ua kapa ʻia ʻo "graft."

Hoʻopili ʻia kekahi ʻaoʻao o kēia graft i ke aʻa nui a nui loa o ke kino, ʻo ia hoʻi ka aorta, a ua hoʻopili ʻia kekahi ʻaoʻao i ke aʻa i paʻa i loko o ka puʻuwai ma lalo o ka mea i paʻa. A laila, kahe ke koko ma o ke aʻa i hoʻopili hou ʻia i ka puʻuwai me ka ʻole o ke keʻakeʻa, e pale ana i ka ʻāpana i paʻa. Ua kapa ʻia kēia ʻoki kino ʻo Coronary Artery Bypass Grafting (CABG) i ka lāʻau lapaʻau.

No hea mai kēia mau aʻa koko?

ʻElua ʻano kīʻaha koko i hoʻohana pinepine ʻia no ke ʻoki ʻana ma o ka bypass.

1. ʻO ke aʻa Radial ma ka lima

He kīʻaha koko nui kēia e holo ana mai loko o kou lima mai kou kuʻekuʻe lima a i kou pulima . ʻO kēia ke aʻa koko hiki iā ʻoe ke ʻike ke ʻike ʻoe i kou pulse. Aia ia ma kahi ʻili loa o ka ʻili.

2. ʻO ke aʻa Saphenous ma ka wāwae

ʻO kēia ka aa koko lōʻihi loa o ko kākou kino. He aa koko ia e lawe ana i ke koko lepo i ka puʻuwai. Holo ia mai lalo o ke kino a hiki i ka ʻūhā. ʻAʻole ia e pilikia i ka wehe ʻana. No ka mea, aia kahi ʻōnaehana venous hohonu i loko o ka wāwae. Ma hope o ka wehe ʻia ʻana o ka aa saphenous, ua lawe ʻia ka hana āna i hana ai e ka ʻōnaehana venous hohonu.

He aha kāu e hana ai ma mua o ke ʻoki kino?

Ma mua o ka hoʻoholo ʻana e hana i kēia ʻoki kino, e hana ke kauka i kekahi mau hoʻokolohua e hoʻoholo ai i ka nui a me kahi o ka paʻa ʻana i loko o kou puʻuwai. Ma muli o nā hopena, e hoʻoholo ʻo ia inā ʻo ke aʻa koko kūpono loa no ka bypass ma kou lima a i ʻole kou wāwae.

Eia kekahi, he mea nui loa e hahai i nā ʻōlelo a kāu kauka e hāʻawi ai iā ʻoe ma mua o ke ʻoki ʻana.

• Ka hoʻokē ʻai ʻana (ka haʻalele ʻana i ka ʻai ʻana a me ka inu ʻana) no kekahi mau hola ma mua o ke ʻoki kino.
• Inā ʻoe e puhipaka, e hoʻōki loa.
• Hiki ke noi ʻia ʻoe e hoʻōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau (me nā huaora a me nā lāʻau lapaʻau lāʻau).

Pehea e hana ʻia ai ke ʻoki kino?

Ua like ke ʻoki ʻana e wehe i ke kīʻaha koko me ke ʻoki bypass. Hoʻokomo ʻia ʻoe ma lalo o ka anesthesia laulā. ʻElua mau ʻano nui no ka wehe ʻana i ke kīʻaha koko.

1. ʻO ke ʻoki ʻana o ka ʻili (Endoscopic Surgery): Pili kēia i ka hana ʻana i hoʻokahi a ʻelua paha mau ʻoki liʻiliʻi loa ma ka ʻili o ka lima a i ʻole ka wāwae.Hoʻokomo ia i kahi ʻōmole lahilahi loa (endoscope) i lako me kahi kāmela a me nā mea hana ʻoki. Wehe pono ke kauka i ke kīʻaha koko me ka nānā ʻana i ka monitor. He liʻiliʻi loa ka ʻeha i hana ʻia e kēia.

2. ʻOki Hāmama: Ma kēia, wehe ʻia ke kīʻaha koko ma ka hana ʻana i kahi ʻoki nui a lōʻihi ma kahi o ke kīʻaha koko a wehe i ka ʻili.

I ka wā o ke ʻoki bypass, hiki ke hoʻololi ʻia kou puʻuwai a me kou māmā i kahi "Mīkini Bypass Heart-Lung." A laila lawe ke kauka ʻoki i ke kīʻaha koko olakino i wehe mua ʻia "graft" a hoʻoili iā ia i loko o ka puʻuwai me ke kāpae ʻana i ka mea i ālai ʻia.

He aha nā pōmaikaʻi a me nā pilikia o kēia ʻano hana?

ʻO kēia ʻano hana o ke kāpili ʻana i kahi aa koko mai ke kino ke kumu nui o ka holomua o ke ʻoki bypass. Nui nā pono o ka hana ʻana i kēia, ʻoiai me ke ʻano endoscopic.

Nā Pōmaikaʻi:

• Hoʻōla wikiwiki a emi ka ʻeha.
• Ua hoʻemi ʻia ka manawa i hoʻolilo ʻia ma ka haukapila.
• ʻAʻohe ʻeha nui a ua emi ka pilikia o ka maʻi .
• Hoʻemi ʻia ka pilikia o ke kahe ʻana o ke koko a me nā ʻōpū koko (Hematomas).

Nā Pōʻino:

E like me nā ʻoki kino āpau, aia kekahi mau pilikia, akā ʻaʻole kēia mau mea i nā kānaka a pau.

• Ke kahe ʻana o ke koko a i ʻole ka palapū ma kahi i ʻoki ʻia.
• Nā ʻūpā koko.
• Ka maneʻo a i ʻole ka nalowale o ka ʻike ma kahi ma muli o ka hōʻino ʻia ʻana o nā aʻalolo e hoʻopuni ana i ka ʻoki.
• Pehu (Edema).
• Nā kūlana maʻi.

I ka wā e pono ai ʻoe e ʻike koke i ke kauka

Ke hoʻi ʻoe i ka home ma hope o ke ʻoki ʻana, mai hoʻowahāwahā i kekahi ʻeha. Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​e ʻimi koke i ke kōkua lapaʻau a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

• ʻEha ka umauma a i ʻole ka manaʻo o ka ʻūmiʻi ma ka umauma (Angina).
• Ka hou anu koke .
• Paʻakikī ka hanu ʻana (Dyspnea).
• Nā hōʻailona o ka maʻi, e like me ke kahe ʻana o ke wai melemele mai nā ʻeha ʻoki a me ke kuni .

ʻO ka mea hope loa, ua hōʻike ʻia nā haʻawina e ʻoi aku ka holomua o ke ʻoki ʻana me ka hoʻohana ʻana i ke aʻa radial a i ʻole ke aʻa mammary kūloko i ka hala ʻana o ka manawa ma mua o ka hoʻohana ʻana i ke aʻa saphenous. ʻO kēia no ka mea ʻoi aku ka ikaika o nā paia arterial ma mua o nā aʻa, no laila ʻaʻole lākou e ālai hou ʻia. Eia nō naʻe, e nānā kāu kauka i kāu mau moʻolelo lapaʻau āpau e hoʻoholo ai i ka aʻa kūpono loa iā ʻoe a pehea e komo ai iā ia.