ʻO nā mea e pono ai ʻoe e ʻike e pili ana i ke kaʻina hana TAVR (Transcatheter Aortic Valve Replacement), kahi e pani ai i kahi valve me ka wehe ʻole ʻana i ka puʻuwai

Ke lohe ʻoe i ka huaʻōlelo "ʻoki puʻuwai," he aha ka mea e hiki mai ana i ka noʻonoʻo? ʻO ka hapa nui o ka manawa, manaʻo mākou i kahi ʻoki nui e pili ana i ka wehe ʻana i ka umauma, ʻeā? Akā me ka holomua o ka ʻepekema lapaʻau, aia i kēia manawa nā lāʻau lapaʻau maʻalahi a emi iki ka pilikia no kekahi mau pilikia puʻuwai. I kēia lā, e kamaʻilio mākou e pili ana i kekahi o ia ʻano lāʻau lapaʻau hou a holomua.

He aha ʻo TAVR? E hoʻomaopopo maʻalahi kākou.

ʻO ke ʻano piha o TAVR ʻo ia ka Transcatheter Aortic Valve Replacement . I kekahi manawa ua kapa ʻia ʻo TAVI (Transcatheter Aortic Valve Implantation). Pili kēia mau inoa ʻelua i ke ʻano lapaʻau like.

I ka ʻōlelo maʻalahi, ʻo TAVR kahi ʻano hana e pani ai i ka valve aortic o ka puʻuwai ma o kahi ʻoki liʻiliʻi loa, me ka wehe ʻole ʻana i ka umauma.

E noʻonoʻo i ko kākou puʻuwai e like me ka pamu wai i loko o kahi hale. Hoʻouna kēia pamu i ke koko i ke kino holoʻokoʻa ma o kahi paipu nui. Ua kapa ʻia kēia paipu nui ʻo ka aorta. Ke hele ke koko mai ka puʻuwai a i kēia aorta, aia kekahi mea e like me ka puka e hoʻomalu ana i kēlā kahe koko. ʻO ia ka mea a mākou e kapa nei he valve aortic. Inā ʻaʻole e wehe a pani pono kēia valve, kū mai nā pilikia koʻikoʻi i ke kahe koko i ke kino holoʻokoʻa. Pili ʻo TAVR i ka hoʻololi ʻana i ka valve i hōʻino ʻia a hana hewa me kahi valve hou.

ʻO wai ka mea e pono ai ke kaʻina hana TAVR?

ʻO kēia lāʻau lapaʻau ka mea e pono ai no ka poʻe me ke ʻano i kapa ʻia ʻo aortic stenosis . ʻO ia hoʻi, ua haiki ka valve aortic a mākou i kamaʻilio ai ma mua. E like me ka puka ʻōpala, ʻaʻole e wehe piha kēia valve.

Aia kekahi mau kumu nui no ke kumu e emi ai ka valve ma kēia ʻano:

• Ka ʻelemakule: I ka poʻe ma luna o 70 mau makahiki, hōʻiliʻili nā waihona calcium i loko o ka valve, e hoʻomānoanoa a paʻakikī.
• Nā kūlana olakino ʻē aʻe: Hiki ke hōʻino koke ʻia kēia valve ma muli o nā kūlana e like me ka maʻi puʻuwai rheumatic a i ʻole kekahi mau kīnā puʻuwai hānau (e.g., bicuspid aortic valve).

Ke emi ka valve, pono ka puʻuwai e hana ikaika ma mua o ka wā ma mua e pamu i ka nui o ke koko e pono ai ke kino. Ua like ia me kahi motika e pamu ana i ka wai hou aku ma o kahi paipu i paʻa. I ka hala ʻana o ka manawa, hiki i kēia kaumaha keu ma ka puʻuwai ke hoʻonāwaliwali i ka ʻiʻo o ka puʻuwai, a i ka hopena e alakaʻi ai i ka hāʻule ʻana o ka puʻuwai.

He aha ka mea e hana ʻia ma mua o kahi TAVR?

Ma mua o kou hana ʻana i ka TAVR, e hana kāu kauka i kekahi mau hoʻokolohua e loiloi pololei i kou kūlana. Hiki i kēia mau hoʻokolohua ke hāʻawi i kahi kiʻi maopopo o ke kahe ʻana o ke koko ma kou puʻuwai a inā he mau pilikia ʻē aʻe.

Eia nā hoʻokolohua i hana pinepine ʻia:

• Nā hoʻāʻo koko
• Echocardiogram - Ua like kēia me ke scan o ka puʻuwai.
• ʻElectrocardiogram (ECG)
• ʻO ke kiʻi CT a i ʻole ka kiʻi MRI
• Catheterization Cardiac - Nānā kēia no nā ālai ʻana i nā aʻa coronary e hoʻolako koko i ka puʻuwai.

Ma hope o ka pau ʻana o kēia mau hoʻokolohua a pau, e kamaʻilio ke kauka me ʻoe a wehewehe i nā mea āpau e pili ana i ka lāʻau lapaʻau, nā mea e manaʻo ai ma hope, a pehea e hāʻawi ʻia ai ʻoe i ka anesthesia. Hiki iā ʻoe ke nīnau i nā nīnau āu e loaʻa ai i kēia manawa.

E noi ʻia ʻoe e hoʻōki i ka ʻai ʻana a me ka inu ʻana i 4-6 mau hola ma mua o ka lāʻau lapaʻau. Eia kekahi, pono ʻoe e nīnau i kāu kauka inā pono ʻoe e hoʻōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau a me ka manawa hea.

Pehea e hana ʻia ai ka mālama ʻana iā TAVR

He hana maʻalahi loa kēia. E hāʻawi ʻia ʻoe i ka anesthesia i ʻole ʻoe e ʻeha. E hāʻawi pū ʻia ʻoe i ka lāʻau lapaʻau e pale aku ai i nā ʻūpā koko.

A laila, hahai ka cardiologist interventional i kēia mau hana:

1. Ke hana ʻana i kahi ʻoki liʻiliʻi: Hana ʻia kahi ʻoki liʻiliʻi loa, ma kahi kokoke i kahi kīʻaha koko nui (femoral artery) ma ka ʻaoʻao o luna o kou ʻūhā, kokoke i ka ʻūhā.

2. Ke hoʻokomo ʻana o ke catheter: Ma o ka ʻoki ʻana, ua hoʻokomo ʻia kahi ʻōmole lahilahi a palupalu i kapa ʻia he catheter ma ke aʻa koko a hiki i ka puʻuwai.

3. Ke kau ʻana i ka valve hou: Lawe ʻia ka valve hou ma o kēia catheter, waiho ʻia i loko o kāu valve kahiko i hōʻino ʻia, a hoʻonui ʻia. A laila kau ʻia ka valve hou ma ia wahi. Hoʻokuke ʻia ka valve kahiko e ka mea hou a noho ma laila.

4. Hoʻāʻo ʻana: Nānā ʻia ka valve hou e ʻike inā e hana pono ana a inā he mau leaka.

5. Ka wehe ʻana a me ke kāpili ʻana: Inā maikaʻi nā mea a pau, e wehe pono ʻia ke catheter, e kāpili ʻia ka ʻoki liʻiliʻi i hana mua ʻia, a e kau ʻia kahi plaster.

ʻO ka maʻamau, ʻo kēia kaʻina holoʻokoʻa e lawe ai ma kahi o hoʻokahi a ʻelua paha hola.

He aha nā pōmaikaʻi o kēia?

He nui nā pono o TAVR ma mua o ke ʻoki puʻuwai hāmama kuʻuna.

ʻOiai kēia mau pono, ʻoi aku ka kūpono o ke ʻoki puʻuwai hāmama no kekahi mau maʻi. Pono ʻoe e kūkākūkā me kāu kauka inā ʻo TAVR a i ʻole ke ʻoki hāmama ke koho lapaʻau maikaʻi loa nāu.

ʻAʻohe hopena ʻaoʻao? E kamaʻilio pū kākou e pili ana i nā pilikia

He lāʻau lapaʻau holomua loa ʻo TAVR. Me ka holomua o ka ʻenehana, ua kakaikahi nā pilikia i kēia manawa. Eia nō naʻe, e like me nā kaʻina hana lapaʻau āpau, aia kekahi mau pilikia liʻiliʻi.

• Ua hoʻopilikia ʻia ka ʻōnaehana uila o ka puʻuwai, e koi ana i ke kau ʻana o kahi pacemaker .
• Ke kahe nei ke koko a puni ka valve hou.
• Hahau.
• Ke kahe ʻana o ke koko.
• Ka maʻi ʻana.
• Ka hōʻino ʻana i nā puʻupaʻa, ka puʻuwai, a i ʻole nā ​​​​​​kīʻaha koko.

E wehewehe pono ana kāu kauka i kēia mau pilikia iā ʻoe. Ma muli o ka hana ʻia ʻana o kēia e kahi hui lapaʻau akamai loa, ua haʻahaʻa loa nā pilikia.

ʻAʻole kūpono anei ke kaʻina hana TAVR no nā kānaka a pau?

ʻOiai he mea maikaʻi loa kēia lāʻau lapaʻau, ʻaʻole kūpono ia no nā mea āpau. ʻAʻole paha e ʻōlelo aku kāu kauka iā TAVR no kekahi me kēia mau kūlana:

• Inā ua loaʻa iā ʻoe kahi hōʻeha puʻuwai i loko o hoʻokahi mahina.
• Inā he mau kīnā puʻuwai hānau paʻakikī kou.
• Inā he mau pilikia me nā valves puʻuwai ʻē aʻe (e.g. Mitral regurgitation).
• Inā ua loaʻa iā ʻoe kahi hahau a i ʻole TIA (Transient ischemic attack).
• Inā he maʻi puʻupaʻa koʻikoʻi kou.

Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa nāu ma muli o kou kūlana olakino holoʻokoʻa.

ʻEhia ka lōʻihi e ho'ōla ai?

Hiki i ka hapa nui o ka poʻe ke hoʻi i ka home mai ka haukapila i loko o hoʻokahi a ʻelua paha lā ma hope o ka mālama ʻana iā TAVR. ʻOkoʻa ka manawa e hoʻōla piha ai mai kēlā kanaka a kēia kanaka.

• Hiki iā ʻoe ke hoʻomaka hou i ka hapa nui o kāu mau hana o kēlā me kēia lā i loko o kekahi mau lā.
• Pono ʻoe e kali ma kahi o hoʻokahi pule ma mua o ka hana ʻana i nā mea e like me ka hāpai ʻana i nā mea kaumaha.
• Hiki iā ʻoe ke hele i ka hana i loko o ʻelua pule a kalaiwa i loko o hoʻokahi mahina.
• Hiki ke hala ma waena o 6 a me 10 mau pule e ho'ōla piha ai.

E aʻo aku kāu kauka iā ʻoe i ka nui o ka hoʻomaha āu e pono ai, nā mea e hana ai, a me nā mea e hana ʻole ai. He mea nui loa ka hahai ʻana i kēlā ʻōlelo aʻoaʻo no ka hoʻōla wikiwiki ʻana.

Eia kekahi, hiki ke kuhikuhi ʻia ʻoe i kahi papahana hoʻoponopono puʻuwai , ʻo ia hoʻi kahi moʻo o nā hoʻomaʻamaʻa kūikawā e hoʻoikaika i kou puʻuwai. E wikiwiki kēia i kāu kaʻina hana hoʻōla.

Āhea ʻoe e pono ai e ʻike i ke kauka?

Ma hope o ka mālama ʻana iā TAVR, e noi ʻia ʻoe e hele no nā nānā kino, ma kahi o hoʻokahi manawa i ka mahina a laila hoʻokahi manawa i ka makahiki. He mea nui loa kēia mau kipa hahai ʻana e hōʻoia i ka hana pono ʻana o ka valve hou. Eia nō naʻe, inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, pono ʻoe e kāhea koke i kāu kauka.

I ka hanana o kahi pilikia e like me ka ʻeha nui o ka umauma a i ʻole ka paʻakikī nui o ka hanu ʻana , e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.