Ua haʻi ʻia aku anei kāu pēpē e pono ana ʻo ia i kahi septostomy? E ʻike kākou i nā mea hou aʻe e pili ana i kēia.

Pono ʻoe i makaʻu loa i ka wā i haʻi aku ai ke kauka iā ʻoe he kīnā puʻuwai hānau ko kāu keiki liʻiliʻi. A laila, ua haʻi aku paha lākou iā ʻoe e pono ana kahi hana i kapa ʻia he septostomy e hoʻopakele i ke ola o kāu pēpē. He mea maʻamau ka manaʻo kaumaha a huikau ke lohe ʻoe i kēia mau ʻōlelo. Akā, mai hopohopo. I kēia lā, e kamaʻilio mākou e pili ana i ke ʻano o ia mea, no ke aha i hana ʻia ai, a pehea e hana ʻia ai ma ke ʻano maʻalahi loa hiki iā ʻoe ke hoʻomaopopo.

He aha maoli ka septostomy?

I ka ʻōlelo maʻalahi, he hana kūikawā ka septostomy e kōkua ai i nā pēpē me kekahi mau maʻi puʻuwai hānau e ola a hiki i ko lākou mākaukau no ke ʻoki kino nui e hoʻoponopono ai i ke kūlana. Ua kapa pū kekahi poʻe iā ia he 'Balloon Atrial Septostomy'.

E noʻonoʻo, aia kahi pā liʻiliʻi ma waena o nā keʻena ʻelua o luna o ko kākou puʻuwai (atria). Ma kēia lapaʻau ʻana, ua hoʻonui iki ʻia kahi lua liʻiliʻi i loaʻa maoli i loko o kēlā pā me ka hoʻohana ʻana i kahi mea e like me ka pōpō pehu.

Ke nui aʻe kēia lua, hoʻomaka ke koko me ka nui o ka oxygen (koko maikaʻi) a me ke koko me ka liʻiliʻi o ka oxygen (koko maikaʻi ʻole) e hui pū. A laila, hele kekahi o kēia koko i hui pū ʻia ma ke kino o ka pēpē. A i ʻole, ʻo ke koko me ka ʻole o ka oxygen wale nō e hele ma ke kino o ka pēpē, he mea weliweli loa ia no ke ola.

He aha ke ʻano o ka pēpē e pono ai kēia lāʻau lapaʻau?

Hānau ʻia kekahi mau pēpē me kekahi mau kīnā puʻuwai. Ma muli o kēia mau kīnā, ʻaʻole hele ke koko nele i ka oxygen i loko o ke kino i nā māmā a ʻaʻole hoʻomaʻemaʻe ʻia. A laila, ʻaʻole loaʻa i nā ʻiʻo o ka pēpē ka oxygen e pono ai lākou. Kāhea mākou i kēia maʻi ʻo 'cyanosis'. Ua ʻike paha ʻoe i kekahi mau pēpē me ka ʻili polū. ʻO ia ka hōʻailona nui o kēia. He maʻi weliweli loa kēia, a pono e mālama koke ʻia.

ʻO kēia kaʻina hana, i kapa ʻia ʻo septostomy, hoʻohana pinepine ʻia i ʻelua ʻano maʻi puʻuwai.

He aha kēia 'lua kūlohelohe' i kapa ʻia ʻo Foramen Ovale?

He mea kupanaha loa kēia. I loko o ka ʻōpū, aia i kēlā me kēia pēpē kahi lua liʻiliʻi ma ka paia (septum) ma waena o nā ʻaoʻao ʻākau a me hema o ko lākou puʻuwai. Ua kapa ʻia ʻo ia he foramen ovale.

I ko lākou wā i loko o ka ʻōpū, ʻaʻole hanu nā pēpē ma o ko lākou mau māmā. Loaʻa iā lākou ka oxygen mai ka placenta o ka makuahine, ma o ke kaula umbilical. Hele mai kēia koko oxygen mai ka ʻaoʻao ʻākau o ka puʻuwai o ke pēpē, hele pololei ma o kēlā lua a i ka ʻaoʻao hema. Mai laila mai, hele ia ma ke kino holoʻokoʻa. ʻO ia hoʻi, i ko lākou wā i loko o ka ʻōpū, ʻaʻole hele ke koko i nā māmā.

Eia nō naʻe, i ka wā e hānau ʻia ai ke pēpē, hoʻomaka ka hana ʻana o nā māmā. A laila, ʻaʻohe pono no kēlā lua. No laila, pani maoli ka lua i kekahi mau lā ma hope o ka hānau ʻana.

No laila, no ka pēpē me ka maʻi puʻuwai i ʻōlelo ʻia ma luna, ʻo ka pilikia nui loa ka wā e pani ʻia ai kēia lua. No ka mea, inā e waiho ana kēlā lua, hui pū kekahi koko oxygenated me ke koko deoxygenated a komo i loko o ke kino. I ka wā e pani ʻia ai, nalowale kēlā ala a ʻaʻole lawa ka oxygen i ka pēpē. ʻO ka hana a ka septostomy, ʻo ia ka wehe hou ʻana i kēlā puka pani a pani ʻia paha a hoʻonui iki aʻe.

Pehea e hana ʻia ai kahi septostomy?

Hana ʻia kēia ma loko o kahi lumi kūikawā ma ka ʻāpana puʻuwai o ka haukapila (catheterization lab) a i ʻole ka neonatal intensive care unit (NICU). Hana ʻia ia e kahi cardiologist i loaʻa i ka hoʻomaʻamaʻa kūikawā no kēia.

1. Hoʻomākaukau: Hāʻawi ʻia ka pēpē i ka lāʻau lapaʻau e pono ai e hoʻomālielie iā ia a ʻaʻohe ʻeha.

2. Ke hoʻokomo ʻana i ka catheter: ʻO ka maʻamau, hoʻohana ʻia kahi nila liʻiliʻi e hou i kahi kīʻaha koko nui i loko o ka ʻūhā o ke pēpē, a hoʻokomo ʻia kahi paipu lahilahi a palupalu (catheter) ma loko. He pōpō liʻiliʻi kēia paipu ma ka hopena. I kekahi manawa hana ʻia kēia ma o kahi paipu i loko o ke kaula umbilical.

3. Ke neʻe nei i ka puʻuwai: Nānā ke kauka i kahi mīkini scan, e like me ka 'echocardiogram', a alakaʻi pono i ka ʻōmole ma o nā kīʻaha koko a hiki i ka puʻuwai.

4. Ke hoʻonui nei i ka lua:Komo ka ʻōmole i loko o ka atrium ʻākau o ka puʻuwai, a mai laila aku e hoʻokomo ʻia ai i loko o ka atrium hema ma o ka foramen ovale. A laila, hoʻopiha ʻia ka pōpō ma ka hopena o ka ʻōmole a huki ʻia i hope i ka ʻaoʻao ʻākau. A laila e kīkoʻo ka lua a lilo i mea nui.

5. Pau: Ke pau ka hana, e wehe i ka ea mai loko mai o ka pōpō a wehe pono i ka ʻōmole.

ʻO ka maʻamau, ʻaʻole i hala i hoʻokahi hola kēia kaʻina hana holoʻokoʻa.

Pehea ʻoe e ʻike ai inā ua holomua kēia? He aha nā pono a me nā pilikia?

Hoʻoholo nā kauka inā ua holomua ka lāʻau lapaʻau ma muli o nā mea e like me:

• Piʻi aʻe ka pae oxygen i loko o ke koko o ke pēpē ma ka liʻiliʻi he 10% ke hoʻohālikelike ʻia me ka wā ma mua.
• Ua lilo ka lua ma ka puʻuwai i ʻoi aku ka nui ma mua o hoʻokahi hapakolu ma mua o ka wā ma mua.
• Nalo aku ka ʻokoʻa nui o ke kaomi koko ma waena o ka atrium ʻākau a me ka atrium hema o ka puʻuwai.

ʻO ka pōmaikaʻi nui , ʻo ia ka hoʻopakele ʻana i ke ola o ka pēpē. ʻO kahi pēpē hiki ʻole ke loaʻa ka oxygen ma kekahi ʻano ʻē aʻe, loaʻa iā ia ka manawa e ola ai a hiki i ke ʻoki kino nui.

Ma ke kamaʻilio ʻana e pili ana i nā pilikia , aia nā pilikia me kekahi kaʻina hana lapaʻau. ʻOi loa aku no nā pēpē me nā maʻi puʻuwai koʻikoʻi e like me kēia, he pilikia nā mea āpau. Ua ʻike kekahi mau noiʻi i kahi pilina ma waena o kēia lāʻau lapaʻau a me ka hahau ʻana, akā ʻaʻole i hōʻoia ʻia ma ke ʻano paʻa. ʻAʻole paha ma muli o ka lāʻau lapaʻau ponoʻī ka pilikia, akā, no ka nele o ka oxygen i ke kino ma muli o ka maʻi puʻuwai.

Pehea ke ʻano o ka pēpē i ka wā e hiki mai ana ma hope o ka mālama ʻana?

He kiʻekiʻe loa ka pakeneka o nā pēpē i hana ʻia i kahi septostomy, 94%, e hoʻopau pono i ke kaʻina hana. Ma hope o kēlā, hana ʻia ke ʻoki kino nui (e laʻa, kahi hana hoʻololi arterial) e hoʻoponopono i ka hemahema o ka puʻuwai i ka manawa kūpono. ʻO ka nui o ka holomua o kēia mau ʻoki kino i kēia manawa he kiʻekiʻe loa, ma 97-98%.

ʻOiai ma hope o ke ʻoki ʻana, pono kāu pēpē i ka mālama olakino mau. Pono ʻoe e mālama i nā manawa a kāu kauka, loaʻa nā scans, a lawe i nā lāʻau lapaʻau. He ʻokoʻa kēlā me kēia pēpē, no laila hiki i kāu kauka ke hāʻawi iā ʻoe i ka ʻike maikaʻi loa e pili ana i ka holomua o kāu pēpē.

Maopopo iaʻu ka makaʻu a me ka hopohopo āu e manaʻo ai ke hana ʻoe i kekahi mea e like me kēia i kāu pēpē. Akā e hoʻomanaʻo, ua holomua loa ka ʻepekema lapaʻau i kēia lā. Aia kahi hui o nā kauka akamai a me nā kahu maʻi e mālama i kāu pēpē. Mai makaʻu e nīnau iā lākou i nā nīnau a kānalua paha āu.