He ʻano hana hou no ke pani ʻana i ka valve puʻuwai! (Transcatheter Pulmonary Valve Replacement - TPVR)

Hiki iā ʻoe ke noʻonoʻo i ke pani ʻana i kahi valve puʻuwai me ka wehe ʻole ʻana i ka umauma? ʻAe, he mea maoli ia i kēia manawa. I kēia lā, ke kamaʻilio nei mākou e pili ana i kēia ʻenehana i lawe mai i ka manaʻolana hou i nā poʻe he nui me nā pilikia valve pulmonary ma muli o ka maʻi puʻuwai hānau. E hoʻomaka kākou i kēia me kahi kamaʻilio maʻalahi a aloha.

I ka ʻōlelo maʻalahi, he aha ka TPVR?

ʻO TPVR, ʻo ia hoʻi ʻo Transcatheter Pulmonary Valve Replacement , he ʻoki kino ia e pani ana i ka valve pulmonary i hana hewa i loko o kou puʻuwai me kahi valve hou ma o kahi ʻoki liʻiliʻi loa. ʻO ka maʻamau, ke noʻonoʻo mākou i ke ʻoki kino puʻuwai, manaʻo mākou i kahi ʻoki kino e pili ana i ka hana ʻana i kahi ʻoki nui ma waenakonu o ka umauma a me ka wehe ʻana i ka umauma. Eia nō naʻe, i kēia kaʻina hana, ʻaʻole i hana ʻia kahi ʻoki nui.

Akā, hana nā kauka i kahi lua liʻiliʻi i loko o ka ʻili o kou ʻūhā a hana i ka hana ma o ia mea. He mea nui loa kēia valve pulmonary, ka mea e hana ana ma ke ʻano he puka e hoʻouna ana i ke koko mai kou puʻuwai i kou mau māmā. Hiki i ka poʻe i hānau ʻia me ka maʻi puʻuwai hānau ke loaʻa nā pilikia me kēia valve i ko lākou ʻelemakule ʻana ma hope o ke ʻoki ʻana i ko lākou wā kamaliʻi. No laila, ʻo ka hoʻololi ʻana i kēlā valve me kēia ʻano hana hiki ke hoʻomaikaʻi nui i kou ola a me ke ʻano o ke ola, a pale aku i ka pono e hana hou i nā ʻoki nui.

He aha ka mea e hana maoli ana ma ka ʻōnaehana TPVR?

I ke ʻoki puʻuwai hāmama kuʻuna, ʻoki ʻia ka iwi umauma, hoʻopili ʻia ka mea maʻi i kahi mīkini bypass puʻuwai-māmā, wehe ʻia ka valve kahiko, a hoʻokomo ʻia kahi mea hou. He lōʻihi kēia manawa, ʻoi aku ka lōʻihi o ka ho'ōla ʻana, a no kekahi poʻe, he mea pilikia kēia ʻoki.

Akā, ʻaʻole pēlā ka hihia me TPVR. Hoʻokomo kahi kauka cardiologist interventional i kahi paipu liʻiliʻi (catheter) ma o kahi aa koko i loko o kou ʻūhā a alakaʻi i ka valve hou ma o ka paipu i loko o kou puʻuwai. Hana ʻia kēia mau mea a pau ma lalo o ke alakaʻi ʻana o ka ʻenehana e like me nā X-ray. Ke kau ʻia ma kahi kūpono, hoʻopiha ʻia ka valve hou me kahi pōpō a hoʻopaʻa ʻia ma kahi.

Ma hope o ka hana ʻia ʻana o kēia, hoʻihoʻi pono ʻia ke kahe o ke koko mai ka puʻuwai a i nā māmā. Hoʻemi ʻia ka ukana hana ma ka puʻuwai, a loaʻa i ke kino ka oxygen maikaʻi aʻe. I ka hapanui o nā hihia, hiki i ke kanaka i hana ʻia kēia ʻoki kino ke hoʻi i ka home i ka lā hoʻokahi .

He aha ka mea e hana ai inā ʻaʻole hana pono kaʻu valve pulmonary?

ʻElua mau pilikia nui i ʻike ʻia ma ka valve pulmonary. E nānā iki kākou i kēia mau mea.

Ma kēia mau kūlana ʻelua, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka paʻakikī o ka hanu ʻana (dyspnea)
• ʻO ka pehu ʻana o ka ʻōpū a me nā wāwae (edema)
• ʻEha umauma
• Manaʻo e like me ka wikiwiki o kou puʻuwai (palpitations)

Hoʻokumu ʻia kēia mau hōʻailona e ka hāʻule ʻana o ka puʻuwai a i ʻole nā ​​puʻuwai puʻuwai kūpono ʻole (arrhythmias). Hoʻomaikaʻi pinepine kēia mau hōʻailona ma hope o ke ʻoki ʻana o TPVR.

No wai kēia ʻoki kino TPVR kūpono loa?

Inā hānau ʻia ʻoe me kahi maʻi e hoʻopilikia ai i ka valve pulmonary o kou puʻuwai, hiki iā ʻoe ke pōmaikaʻi mai kēia ʻoki kino. Ma ke ʻano kūikawā,

• ʻO ka poʻe i hana ʻia ke ʻoki valve pulmonary i ko lākou wā kamaliʻi.
• Ua pani ʻia a liki paha nā pākeke a me nā ʻōpio i loaʻa kēlā kiwikā i ka hala ʻana o ka manawa.
• I ka manawa pinepine, noʻonoʻo nā kauka i ke kaʻina hana TPVR no ka poʻe i loaʻa i kahi homograft (kahi hoʻoili valve) mai kahi mea hāʻawi i ka wā ʻōpiopio, i ka wā e nāwaliwali ai kēlā valve i ka hala ʻana o ka manawa.

ʻO kekahi o nā kūlana nui i mālama ʻia me kēia ʻoki kino:

• ʻO ka Atresia Pulmonary: ʻO ia ke ʻano i hoʻokumu ʻole ʻia ai ka valve pulmonary i ka wā hānau.
• ʻO ka Regurgitant Pulmonary Valve: He kūlana kahi e kahe ai ke koko i hope ma o ka valve.
• Tetralogy o Fallot: ʻO ia ke ʻano o ka hui pū ʻana o ke koko maikaʻi a me ke koko maikaʻi ʻole ma muli o ka hui pū ʻana o nā kīnā puʻuwai ʻehā.
• ʻO Truncus Arteriosus: He kūlana kahi i hui pū ʻia ai nā kīʻaha koko nui ʻelua e puka mai ana mai ka puʻuwai.
• Ke Hoʻololi ʻana o nā Aʻa Nui: ʻO ke ʻano kahi e hoʻololi ʻia ai a hoʻopili ʻia ai nā kīʻaha koko nui ʻelua o ka puʻuwai.

Ua hoʻopuka ke ʻoki ʻana o TPVR i nā hopena holomua loa ma ke ʻano he lāʻau lapaʻau no ia mau kūlana.

He aha ka mea e hana ʻia ma mua, i ka wā, a ma hope o ke ʻoki kino?

Hoʻomākaukau ma mua o ke ʻoki kino

No ka hoʻoholo ʻana inā kūpono kēia ʻoki kino iā ʻoe, e nānā pono mua kāu kauka iā ʻoe. Hiki iā ia ke hana i kekahi mau hoʻokolohua, e like me:

• ʻAngiogram
• ʻO ke kiʻi CT puʻuwai
• MRI o ka puʻuwai
• ʻEchocardiogram
• ʻElectrocardiogram (ECG)

Ma muli o nā hopena o kēia mau hoʻokolohua, e ʻōlelo aku kāu kauka i ke ʻoki kino TPVR a i ʻole e hoʻoholo e nānā i kou kūlana no kekahi manawa. E aʻo pū ʻo ia iā ʻoe i nā meaʻai e ʻai ai a me nā lāʻau lapaʻau e hoʻōki ai i ka lawe ʻana (ʻoi aku hoʻi nā lāʻau hoʻokahe koko) ma mua o ke ʻoki kino. Mai poina e haʻi i kāu kauka e pili ana i nā maʻi allergies āu e loaʻa ai.

I ka wā o ke ʻoki kino

Ma mua o ka hoʻomaka ʻana o ke ʻoki ʻana, e hāʻawi ʻia ʻoe i ka anesthesia i ʻole ʻoe e ʻeha. A laila wale nō e hoʻomaka ai ke kauka loea i ka hana.

1. ʻO ka mea mua, hana ʻia kahi ʻoki liʻiliʻi ma kou ʻāʻī (femoral vein) a i ʻole kou ʻāʻī paha (jugular vein) a hoʻokomo ʻia kahi paipu (catheter) ma loko.

2. A laila, me ka hoʻohana ʻana i nā ʻenehana e like me nā kukuna X, alakaʻi ʻia ka valve hou ma o ka paipu a ma ke kaula i kahi kūpono i loko o ka puʻuwai. Ua pelu ʻia kēia valve ma luna o kahi pōpō.

3. Ke hiki i ke kūlana kūpono, hoʻopiha ʻia ka pōpō. Hoʻonui ʻia ka valve hou a kūpono i loko o ka valve kahiko. Mai ia manawa mai, hoʻomaka ka valve hou e hana.

4. ʻO ka hope loa, e nānā i ka hana pono ʻana o ka valve a wehe i nā ʻōmole i hoʻokomo ʻia.

ʻO ka maʻamau, ʻelua a ʻekolu paha hola ka lōʻihi o kēia kaʻina hana holoʻokoʻa.

Ma hope o ke ʻoki kino

Ma hope o ke ʻoki kino, e mālama ʻia ʻoe i ka haukapila i ka pō no ka nānā ʻana. Inā holo pono nā mea āpau, hiki iā ʻoe ke hoʻi i ka home i ke kakahiaka aʻe . E hāʻawi kāu kauka iā ʻoe i kahi hoʻonohonoho o nā kuhikuhi e hahai ai ke hoʻi ʻoe i ka home. I ka hapanui o nā hihia , hiki iā ʻoe ke hoʻi hou i kāu mau hana maʻamau i loko o ʻehiku mau lā .

He aha nā pōmaikaʻi a me nā pilikia o ke ʻano TPVR?

E like me nā hana lapaʻau a pau, aia nā pono a me nā pilikia liʻiliʻi. E makaʻala kākou i nā mea ʻelua.

He mea kākaʻikahi loa, hiki ke loaʻa nā pilikia koʻikoʻi e like me ka hōʻeha puʻuwai, ka hahau ʻana, a i ʻole ka make. Akā, he mea kākaʻikahi loa kēia. E kamaʻilio kāu kauka iā ʻoe e pili ana i kēia mau mea āpau me nā kikoʻī.

Kekahi mau nīnau hou aʻe paha āu e loaʻa ai

Pehea ka lōʻihi o kēia kiwikā hou?

Aia ia i nā mea he nui, e like me kou olakino holoʻokoʻa a me ka hana o ka puʻuwai. Pono paha kekahi poʻe e hana hou i kēia ʻano ʻoki kino ma hope o kekahi manawa.

Pono anei iaʻu e hana i kekahi mea kūikawā ma mua o ka mālama ʻana i nā niho?

ʻAe, he mea nui loa kēia. I ka wā o ka mālama ʻana i nā niho, hiki i ka bacteria mai kou waha ke komo i ke kahe koko a hoʻoulu i kahi maʻi o ka valve puʻuwai hou (endocarditis). No laila, ke hele ʻoe e ʻike i kahi kauka niho, pono ʻoe e haʻi mua iā lākou ua loaʻa iā ʻoe kahi pani valve puʻuwai. Pono paha ʻoe e lawe i nā antibiotics ma mua o ka unuhi ʻia ʻana o ka niho.

Hiki iaʻu ke hele i nā hōʻoia palekana ma ke kahua mokulele?

ʻAe, ʻaʻohe pilikia. ʻAʻole e hōʻeha nā kukuna X a me nā mīkini nānā palekana mokulele i kāu valve. Eia nō naʻe, pono ʻoe e kamaʻilio me kāu kauka ma mua o ka loaʻa ʻana o kahi scan MRI.