E aʻo maʻalahi kākou e pili ana i ka Coronary Revascularization (lāʻau lapaʻau e hoʻihoʻi i ke kahe koko i ka puʻuwai).

Ua ʻike paha ʻoe i ka ʻeha a me ka ʻeha o ka umauma e hele mai me ka loaʻa ʻole o ke koko lawa i kou puʻuwai. Ua makaʻu paha ʻoe i ka hōʻeha puʻuwai. ʻO ke kumu nui o kēia, ʻo ia ka paʻa ʻana o nā aʻa coronary e hoʻolako ana i ke koko i ka puʻuwai. ʻO ka mea pōmaikaʻi, i kēia lā, aia nā lāʻau lapaʻau holomua e hiki ke wehe hou i kēia mau kīʻaha koko i paʻa a ʻae i ke koko e kahe pono i ka puʻuwai. I kēia lā, ke kamaʻilio nei mākou e pili ana i kēia mau lāʻau lapaʻau e hiki ke hoʻōla hou i ka puʻuwai.

He aha ke ʻano o ka 'Coronary Revascularization'?

I ka ʻōlelo maʻalahi, he mau lāʻau lapaʻau kēia i hoʻohana ʻia e hoʻihoʻi i ke kahe koko i kou ʻiʻo puʻuwai ke loaʻa ʻole ke koko e pono ai. Ua kapa ʻia kēia ʻano ma ke ʻano lapaʻau he "Ischemia". Hiki i kēia mau lāʻau lapaʻau ke kōkua i ka pale ʻana i ka hōʻeha puʻuwai ma hope o ka hana ʻia ʻana, a me nā poʻe i loaʻa i ka pilikia nui o ka loaʻa ʻana o hoʻokahi.

Ma lalo nei mākou e kamaʻilio nui nei e pili ana i ʻelua mau ʻano lapaʻau:

• ʻO ke komo ʻana o ka coronary Percutaneous (PCI): ʻAʻole kēia he ʻoki kino. He hana ia e hoʻokomo ʻia ai kahi ʻōmole lahilahi i loko o kahi kīʻaha koko a hoʻohana ʻia e hoʻonui i ka wahi i ālai ʻia mai loko mai, e hoʻihoʻi ana i ke kahe koko. Ua ʻike ka poʻe he nui i kēia ʻo 'stenting'.
• ʻO ke kāpili ʻana o ke ala coronary artery (CABG): He ʻoki kino kēia e hana ai i kahi 'bypass' hou, a i ʻole ke ala ʻaoʻao, no ke kahe ʻana o ke koko a puni kahi aʻa i paʻa i loko o ka puʻuwai.

No ke aha i hoʻohana ʻia ai kēia mau lāʻau lapaʻau?

E like me ka paʻa ʻana o nā ʻauwai o kā mākou poho holoi kīhini me ka ʻaila a me ka lepo i ka hala ʻana o ka manawa, hoʻomaka kahi mea waxy e like me ka momona e hōʻiliʻili i loko o nā kīʻaha koko o ko mākou puʻuwai. Kāhea mākou i kēia plaque . ʻO kēia ke kūlana e hōʻiliʻili ai ka plaque i loko o nā kīʻaha koko a hoʻohaiki iā lākou, ʻo ia hoʻi ʻo "Atherosclerosis." He hōʻailona nui kēia o ka maʻi ʻaʻa coronary.

I ka hala ʻana o ka manawa, hiki i kēia mau waihona ke lilo i mea haiki loa i loko o nā kīʻaha koko. I kekahi manawa, inā haki kekahi o kēia mau waihona, hiki i kahi ʻūpā koko ke hana a ālai loa i ke kīʻaha koko. ʻO kēia ke kumu o ka nalowale ʻana o kahi hapa o ka puʻuwai i ke kahe koko a hoʻomaka nā ʻāpana o ia ʻāpana e make. Ua kapa ʻia kēia he hōʻeha puʻuwai .

Pono kēia mau lāʻau lapaʻau no kekahi maʻi puʻuwai e hāʻule ana ma lalo o ka māhele o "Acute Coronary Syndrome". Eia kekahi laʻana:

• Maʻi hohola
• ʻO ka angina paʻa - ʻeha umauma i hoʻomaha ʻia e ka hoʻomaha a ʻoi aku ka ʻino me ka hoʻoikaika kino
• ʻO ka angina paʻa ʻole - ʻO ka ʻeha umauma i manaʻo ʻole ʻia e kū mai ana i ka wā hoʻomaha

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 nā kauka i kekahi mau hoʻokolohua e loiloi pololei i kou kūlana a koho i ka lāʻau lapaʻau kūpono loa iā ʻoe. ʻO kekahi o lākou:

• ECG (Electrocardiogram): Ke hoʻāʻo ʻana i ka hana uila o ka puʻuwai.
• Echocardiogram: He scan o ka puʻuwai.
• ʻO ke Catheterization Cardiac (Angiogram): He kaʻina hana e hoʻokomo ʻia ai kahi kala i loko o nā kīʻaha koko o ka puʻuwai a hoʻohana ʻia kahi X-ray e nānā i nā mea i ālai ʻia.
• X-ray Angiography a i ʻole CT Angiography: Ka nānā ʻana i nā kīʻaha koko me ka hoʻohana ʻana i kahi scan tomography kamepiula.
• Nā hoʻāʻo koko: Helu Koko Piha, Nā Enzymes Cardiac, a pēlā aku.

Inā ʻaʻole he pilikia ke kaʻina hana, e aʻo aku kāu kauka iā ʻoe e hoʻokē ʻai no kekahi mau hola ma mua o ke kaʻina hana. Eia kekahi, ma mua o ka hoʻomaka ʻana o ke kaʻina hana, e hoʻokomo ʻia kahi laina IV i loko o kahi aa koko ma kou lima. E ʻae kēia iā ʻoe e hāʻawi maʻalahi i nā lāʻau lapaʻau a me nā wai e pono ai. I ka wā o ka PCI, e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e hoʻomoe iā ʻoe i ka hiamoe māmā, ʻoiai i ka wā o ke ʻoki ʻana o CABG, e hāʻawi ʻia ʻoe i kahi anesthetic laulā.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

ʻOiai he like ka pahuhopu o PCI a me CABG, ʻokoʻa loa ke ʻano o kā lākou hana ʻana. E nānā kākou pehea.

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

Pono ʻoe i kekahi manawa e hoʻōla ai ma hope o ke kaʻina hana. Pili kēia manawa i ke ʻano o ke kaʻina hana āu i loaʻa ai, kou olakino holoʻokoʻa, a inā he pilikia paha. ʻO ka maʻamau, he mau lā wale nō e hoʻōla ai mai ka PCI. Eia nō naʻe, hiki ke hala i nā pule a i ʻole nā ​​mahina e hoʻōla piha ai mai ke ʻoki ʻana o CABG.

Hiki i kāu kauka ke kuhikuhi iā ʻoe e komo i kahi papahana hoʻoponopono puʻuwai . Ma kēia mau papahana, hana pū nā kauka, nā kahu maʻi, nā kumu aʻo hoʻoikaika kino, a me nā mea ʻai meaʻai e aʻo iā ʻoe pehea e hoʻoikaika kino kūpono ai, kaohi i kāu ʻai, a lawe pololei i kāu mau lāʻau lapaʻau.

Eia kekahi, he mea nui e kipa hou i ke kauka i ka manawa i hoʻonohonoho ʻia (nā kipa hahai) a hana i nā hoʻokolohua. ʻO ka hahai pono ʻana i nā ʻōlelo a ke kauka e kōkua i ka wikiwiki o kou hoʻōla ʻana.

He aha nā pōmaikaʻi o kēia mau lāʻau lapaʻau?

• Ke pale ʻana i nā hōʻeha puʻuwai: Inā ʻike ʻia ka maʻi ʻaʻa coronary ma mua o ka hiki ʻana mai o ka hōʻeha puʻuwai, hiki i kēia lāʻau ke pale aku.
• Ke hoʻōla ola: He pilikia hoʻoweliweli ka hāʻule puʻuwai. I ia mau hihia, hiki i kēia mau lāʻau lapaʻau ke hoʻōla i nā ola.
• Ka mālama ʻana i ka hana o ka puʻuwai: Hiki i ka mālama mua ʻana ke pale i ka make ʻana o nā hunaola puʻuwai ma muli o ka ischemia. Hiki i kēia ke hōʻemi i ka hōʻino mau loa i ka puʻuwai.

Aia kekahi mau pilikia i kēia mau lāʻau lapaʻau?

E like me nā lāʻau lapaʻau āpau, aia kekahi mau pilikia e pili ana, ma muli o kou kūlana olakino a me ka lāʻau e hana ʻia nei.

• No PCI: Aia paha kahi pilikia liʻiliʻi o ka hōʻino ʻana o nā kīʻaha koko, nā puʻuwai puʻuwai kūpono ʻole (arrhythmias), nā ʻūpā koko, ka hahau ʻana, a i ʻole ke kahe ʻana o ke koko.
• No CABG: Loaʻa i ke ʻoki ʻana ka pilikia o ka ʻeha, ke kahe koko, a me ka maʻi.

E kūkākūkā i kāu kauka i nā nīnau a hopohopo paha e pili ana i kēia. E wehewehe pono ʻo ia i nā pilikia e kū mai ana ma muli o kou kūlana.

Āhea ʻoe e ʻike hou ai i ke kauka?

Ma hope o ka lāʻau lapaʻau, inā hoʻi hou nā hōʻailona ma lalo nei , e ʻike koke i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) .

• ʻEha a paʻa paha ka umauma (Angina)
• Ka paʻakikī o ka hanu ʻana (Dyspnea)
• Manaʻo poniuniu a nāwaliwali paha
• Ka mae ʻana

He mea maʻamau ka makaʻu a me ka hopohopo ke aʻo ʻoe e pili ana i ka maʻi puʻuwai. Akā ma ka hoʻomaopopo ʻana i nā lāʻau lapaʻau holomua e like me kēia, hiki iā ʻoe ke lanakila ma luna o kēlā makaʻu, loaʻa ka lāʻau lapaʻau e pono ai, a ola hou i kahi ola olakino.