Hoʻokahi ʻāpana o ka valve aortic o kou puʻuwai? (Unicuspid Aortic Valve) - E kamaʻilio kākou e pili ana i kēia!

I kekahi manawa lohe mākou, 'Auē, he pilikia puʻuwai liʻiliʻi ko kaʻu keiki, ua hānau ʻia me ka rumors puʻuwai'? A i ʻole, i ka wā e paʻakikī ai ka hanu ʻana o kahi ʻōpio a i ʻole ka ʻeha o ka umauma, ʻōlelo nā kauka, 'Aia kahi pilikia liʻiliʻi me ka valve puʻuwai.' Pēlā mākou e kamaʻilio ai e pili ana i kahi maʻi puʻuwai i kakaʻikahi loa, akā he mea nui loa e ʻike.

He aha kēia valve aortic lau hoʻokahi (`Unicuspid Aortic Valve`)?

I ka ʻōlelo maʻalahi, hoʻokahi wale nō leaflet o ka valve aortic i loko o kou puʻuwai ma kahi o nā ʻekolu i loaʻa mau. ʻO ke ʻano o ka huaʻōlelo "unicuspid" ʻo ia hoʻi "single-leaflet." E noʻonoʻo iā ia e like me ka puka me hoʻokahi laka wale nō ma kahi o ʻelua.

Ua like kēia mau pepa liʻiliʻi me nā puka liʻiliʻi. Wehe a pani lākou e ʻae i ke koko maʻemaʻe a waiwai i ka oxygen e hele mai ka ventricle hema o ka puʻuwai - ke keʻena hema ma lalo o ka puʻuwai - i ka aorta . A laila e pamu ka aorta i ke koko ma ke kino holoʻokoʻa. No laila, i ka wā e emi ai ka helu o nā pepa liʻiliʻi i loko o kēia valve, hiki ke loaʻa nā mea keakea liʻiliʻi i ke kahe o ke koko.

ʻO kekahi poʻe me kēia kūlana, ʻo Unicuspid Aortic Valve, hiki ke loaʻa iā lākou nā pilikia puʻuwai ʻē aʻe. Eia kekahi laʻana:

• Aortopathy : ʻO ke ʻano kēia o ka nāwaliwali o nā paia o ka aorta.
• ʻO ke kīnā septal ventricular (VSD) : He lua ma ka paia ma waena o nā keʻena haʻahaʻa ʻelua o ka puʻuwai.
• ʻO ka Patent Ductus Arteriosus (PDA) : ʻO kahi kīʻaha koko i pono e pani ʻia ma hope o ka hānau ʻana e waiho hāmama ana.
• Nā ʻano ʻē o ke aʻa coronary : Kekahi mau loli i loko o nā aʻa e hoʻolako koko i ka puʻuwai.

He maʻi laha ʻole kēia. Hoʻopilikia ia ma kahi o 0.02% o ka heluna kanaka. Eia kekahi, ʻoi aku ka maʻamau i nā kāne.

Aia kekahi mau ʻano o kēia?

ʻAe, aia ʻelua ʻano nui o ka "Unicuspid Aortic Valve". ʻO ka ʻokoʻa ma waena o kēia mau ʻano ʻelua ʻo ia ka hakahaka kahi e pili ai nā leaflet ʻelua (leaflets) i ka paia valve, i kapa ʻia ʻo "Commissure" . Hiki iā ʻoe ke hoʻomaopopo i kēia penei. E noʻonoʻo ua pili mau kou mau lehelehe i kou maka, akā hiki iā lākou ke hui pū a kaʻawale, ʻeā? ʻO ia ke ʻano o "Commissure".

ʻO kēia mau ʻano ʻelua:

1. ʻAno Acommissural: ʻO kēia ke ʻano koʻikoʻi loa . I kēia hihia, ʻaʻohe commissure, ʻo ia hoʻi, ʻaʻohe hakahaka. A ʻaʻole ia e pili ana i ka aorta. Hoʻopili ʻia nā lau a pau, me he mea lā ua hoʻopaʻa ʻia. Ke kahe wale nei ke koko ma o kahi lua liʻiliʻi, e like me ka pinhole.

2. ʻAno Unicommissural:ʻOi aku ka liʻiliʻi o kēia ma mua o ka mea ʻē aʻe, a ʻo ia nō hoʻi ke ʻano maʻamau . Loaʻa iā ia hoʻokahi "Commissure", ʻo ia hoʻi, hoʻokahi hakahaka. Hoʻopili pū ʻia ia i ka aorta. Ke wehe ʻia kēia ʻano valve, ua like ia me kahi laina. Hoʻohālikelike kekahi poʻe me ka waha o ka iʻa.

He aha nā hōʻailona āu e ʻike ai?

Inā loaʻa i kahi pākeke kēia maʻi (Unicuspid Aortic Valve), ʻo nā hōʻailona e ʻike pinepine ʻia:

• Pōkole o ka hanu : Ke luhi iki ʻoe, manaʻo paha ʻoe e like me ʻoe e hiolo ana i ka piʻi ʻana i ke alapiʻi.
• Pōniuniu : Ke kū koke ʻoe i luna, hiki paha iā ʻoe ke pōniuniu.
• Angina : He manaʻo ʻeha kēia a i ʻole ka paʻa ʻana i ka umauma. No kekahi poʻe, hiki i kēia ke laha i ka ʻauwae, ka ʻāʻī, a i ʻole nā ​​​​lima.
• Nāwaliwali/nāwaliwali : Nalowale koke ka ʻike.

ʻO ka maʻamau, loaʻa i nā keiki ʻōpio me kēia maʻi nā maʻi e like me ka hāʻule ʻana o ka puʻuwai hema . Loaʻa iā lākou ke kaumaha e like me nā keiki ʻē aʻe o ko lākou mau makahiki, ʻo ia hoʻi, ʻaʻole nui ko lākou kaumaha.

ʻO ke ʻano "Acommissural" i ʻōlelo mua ʻia, ʻo ia ke ʻano koʻikoʻi, hōʻike i nā hōʻailona i nā pēpē ʻōpiopio loa . Akā, ʻo ka poʻe me ke ʻano "Unicommissural" ʻaʻole paha e hōʻike i kekahi mau hōʻailona a hiki i ko lākou 20 a 30 paha mau makahiki, ʻo ia hoʻi, a hiki i ko lākou hiki ʻana i ka wā ʻōpio.

No ke aha lā kēia e hana nei? He aha ke kumu?

ʻO kēia kūlana, i kapa ʻia ʻo "Unicuspid Aortic Valve", e hana ʻia i ka wā e hoʻomaka ai nā lau ʻekolu e hana maʻamau e ulu i ka wā e noho ana ke pēpē i loko o ka ʻōpū, a laila ma kahi o ka hoʻokaʻawale ʻana, hui pū lākou a lilo i hoʻokahi. Hana ʻia kēia ma mua o ka hānau ʻana o ke pēpē .

ʻOiai ʻaʻole hiki i nā kānaka noiʻi ke hōʻoiaʻiʻo pono, ke manaʻo nei lākou he "kūlana hoʻoilina" paha kēia. ʻO ia hoʻi, aia paha kahi mana hoʻoilina.

He aha nā pilikia e hiki ai i kēia ke hana?

Hiki i ke kanaka me ka valve aortic unicuspid ke loaʻa i nā pilikia like ʻole i ka hala ʻana o ka manawa. ʻO nā mea nui:

• ʻO ka stenosis valve aortic: Hana ʻia kēia ke wehe pono ʻole ka valve, e ālai ana i ke kahe o ke koko. Hoʻoikaika kēia i ka puʻuwai e hana e pamu i ke koko.
• Ka luaʻi ʻana o ka valve aortic: ʻAʻole pani pono ka valve, e hoʻihoʻi ana i kekahi o ke koko i hoʻomoʻa ʻia i loko o ka puʻuwai.
• ʻO ka Endocarditis maʻi : He maʻi ia o ka uhi o ka puʻuwai, ʻoiai nā valves. ʻOi aku ka nui o ka pilikia o ka poʻe me nā valves kūpono ʻole.
• ʻO ka hoʻonui ʻia o ka pilikia o ka Aortic Dissection : He kūlana koke a koʻikoʻi kēia kahi e haehae ai ka paia o ka aorta mai loko mai.

Mea nui: He mea nui loa ka ʻike ʻana a me ka mālama ʻana i ka maʻi i ka manawa kūpono, ma mua o ka hiki ʻana mai o kēia mau pilikia.

Pehea ʻoe e ʻike ai i kēia?

Ke hele ʻoe e ʻike i ke kauka, e hoʻolohe ʻo ia i kou puʻuwai me kahi stethoscope i kāu hoʻokolokolo kino . Inā lohe ke kauka i kahi kani puʻuwai ʻē (he "heart murmur") kokoke i kou aorta, hiki iā ia ke kānalua i kēia. A laila, hiki iā ia ke paipai i kekahi mau hoʻokolohua hou aʻe.

He aha nā hoʻokolohua e hana ʻia nei?

ʻO nā hoʻāʻo nui i hana ʻia e hōʻoia pololei i ke alo o kēia kūlana "Unicuspid Aortic Valve":

• ʻO ka Transthoracic Echocardiogram (TTE) : Ua like kēia me ka ultrasound scan o ka puʻuwai. Hana ʻia ia ma ka ʻili o ka umauma. Hiki iā ia ke loiloi maikaʻi i ke ʻano o ka puʻuwai a me ka hana o kona mau valves.
• ʻO ka Transesophageal Echocardiogram (TEE) : He echocardiogram nō hoʻi kēia. Eia nō naʻe, hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o ka puʻu a nānā ʻia ka puʻuwai ma o ka esophagus. Hiki i kēia ke hana i nā kiʻi ʻoi aku ka maopopo ma mua o ka TTE.
• ʻO ke kiʻi ʻana o ka Cardiac Computed Tomography (CT) : Hiki i kēia ke hana i nā kiʻi 3D cross-sectional o ka puʻuwai a me ka aorta.
• MRI o ka puʻuwai (Magnetic Resonance Imaging) : Hiki i kēia ke hāʻawi i ka ʻike kikoʻī e pili ana i ke ʻano a me ka hana o ka puʻuwai.

Pehea e mālama ʻia ai?

ʻOkoʻa ka lāʻau lapaʻau no kēia ma muli o ka makahiki a me ke koʻikoʻi o nā hōʻailona.

ʻO nā koho lapaʻau maʻamau no nā keiki ʻōpio :

• ʻO ka Valvotomy ʻoki kino : Pili kēia i ka hana ʻana i ke ʻoki ʻana e ʻoki i ka ʻiʻo valve i hoʻopaʻa ʻia a hana i nā pepa hou.
• Valvuloplasty : Pili kēia i ka hoʻohana ʻana i kahi mea e like me ka pōpō e wehe ai i ka valve.
• Commissurotomy : Hoʻokaʻawale ʻoki ʻana i nā wahi i kapa ʻia ʻo "Commissures" kahi e hoʻopili ʻia ai nā lihilihi maka.
• Ke Kaʻina Hana Ross : He ʻoki kino paʻakikī iki kēia. E kamaʻilio hou mākou e pili ana i kēia ma hope.

No nā pākeke , koi pinepine ʻia ke ʻoki ʻana e hoʻoponopono i ka valve aortic (Unicuspid Aortic Valve repair) a pani paha me kahi valve hou (pani) .

Aia kekahi mau hopena ʻaoʻao/pilikia o ka lāʻau lapaʻau?

E like me nā ʻoki kino āpau, aia kekahi mau pilikia e hiki mai ana me kēia lāʻau lapaʻau. Akā, ʻaʻole e ʻike nā kānaka a pau i kēia mau mea. Mai hopohopo, e hoʻomaopopo pono kāu kauka iā ʻoe e pili ana i kēia mau mea.

ʻO kekahi mau pilikia maʻamau e hiki ke hana penei:

• Maʻi
• Nā ʻūpā koko
• Ke kahe nui ʻana o ke koko (`Bleeding`)
• ʻO ka Endocarditis (kahi maʻi valve)
• Nā pilikia me kahi ʻāpana i hoʻohana ʻia i ka hoʻoponopono ʻana i ka valve.
• Ka Pale ʻana o ka Puʻuwai Piha : Ka hoʻōki ʻana o ka hoʻoili ʻana o nā hōʻailona uila o ka puʻuwai.
• Maʻi hohola
• Ke kahe nei ke koko mai ka valve a i ka ʻaoʻao hewa.
• ʻAno ʻē ka Rhythm o ka Puʻuwai

ʻEhia ka lōʻihi e ho'ōla ai?

E loli kēia ma muli o ke ʻano o ke kaʻina hana āu i hana ai. Hiki ke hala i hoʻokahi pule a i kekahi mau mahina e hoʻōla ai. E haʻi pololei kāu kauka iā ʻoe i ka lōʻihi o kou pono e hoʻomaha a me ka wā e hiki ai iā ʻoe ke hoʻi hou i nā hana maʻamau.

Pehea lā ke ʻano o ke ola me kēia kūlana?

Inā loaʻa iā ʻoe kahi Unicuspid Aortic Valve, pono paha ʻoe i ke ʻoki kino . ʻOiaʻiʻo, pono paha ʻoe e hoʻoponopono a hoʻololi paha i kāu valve ma mua o hoʻokahi manawa i kou wā e ola ana. Loaʻa paha iā ʻoe nā pilikia puʻuwai ʻē aʻe. Pono paha ʻoe e hoʻomau i ka lawe ʻana i nā lāʻau hoʻokahe koko (anticoagulants) ma hope o ke ʻoki kino, ma muli o ke ʻano o ka valve āu.

Akā, pono hoʻi e ʻōlelo ʻia ʻaʻole kēia "Unicuspid Aortic Valve" he mea e hoʻomaikaʻi koke ʻia . E mau ana ke ʻano a hiki i kou hana ʻoki kino e hoʻoponopono ai.

He nūhou maikaʻi. Ua ʻike ʻia kekahi noiʻi he 97% o ka poʻe i hana ʻia ke ʻoki valve aortic no kahi kūlana i kapa ʻia ʻo "Unicuspid Aortic Valve" e ola mau ana he 10 mau makahiki ma hope .

Eia nō naʻe, aia kekahi manaʻo inā hāʻawi ʻia kahi valve aortic prosthetic i kahi kanaka ma lalo o 65 mau makahiki ma muli o kēia kūlana, hiki iā ia ke hōʻemi i ka manaʻolana ola ma mua o 10 mau makahiki. ʻO ia ke kumu e ʻōlelo ai nā kānaka noiʻi ʻo ke Kaʻina Hana Ross ka mea maikaʻi loa no ka poʻe ʻōpio a ikaika. Ma kēia "kaʻina hana Ross", lawe ʻoe i kāu valve pulmonary ponoʻī a hoʻoili iā ia i kahi o ka valve aortic maʻi. A laila, hoʻoili ʻia kahi homograft pulmonary mai kahi kanaka i make i kahi i loaʻa ai ka valve pulmonary i wehe ʻia. ʻOiai he mea paʻakikī iki kēia, ua ʻōlelo ʻia he maikaʻi nā hopena.

He aha kāu makemake e hana ma kou ʻaoʻao?

Ma hope o ke ʻoki ʻana, pono ʻoe e hahai pono i nā ʻōlelo a kāu kauka e pili ana i ka mālama ʻana i kāu mau ʻoki/ʻoki . E haʻi pū ʻo ia iā ʻoe i ka lōʻihi o kou hoʻomaha a me ka wā e hiki ai iā ʻoe ke hoʻomaka i ka hoʻokele kaʻa a me nā hana ʻē aʻe o kēlā me kēia lā.

Mai poina: He mea nui loa ka lawe ʻana i kāu lāʻau lapaʻau i ka manawa kūpono, e like me ke kauoha a ke kauka, a e hele i ke keʻena lapaʻau i nā lā i hoʻonohonoho ʻia.

I kekahi manawa manaʻo ʻoe, "ʻAuē, ʻaʻole au i lawa ka makahiki e loaʻa ai ka maʻi puʻuwai," akā, loaʻa mau nō iā ʻoe ka ʻeha o ka umauma a me ka paʻakikī o ka hanu ʻana.Inā loaʻa iā ʻoe kekahi o kēia mau mea, e ʻike pono i ke kauka. Ma hope o ke ʻoki ʻana no ka Unicuspid Aortic Valve, e hoʻomau ʻoe i nā manawa hoʻopaʻa me kāu kauka. Inā loaʻa kahi pilikia (e like me ka maʻi) ma hope o ke ʻoki ʻana, pono paha ʻoe i ka mālama ulia pōpilikia.

He aha nā nīnau āu e nīnau ai i ke kauka?

Ke hele ʻoe e ʻike i ke kauka, mai makaʻu e nīnau i kāu mau nīnau. Eia kekahi mau nīnau hiki iā ʻoe ke nīnau:

• He aha ka lāʻau lapaʻau maikaʻi loa noʻu?
• He aha nā ʻokoʻa ma waena o nā ʻano pani valve like ʻole? (e laʻa, valve artificial vs. biovalve)
• ʻEhia ka manawa e pono ai iaʻu ke hana ʻoki kino?
• ʻEhia ka lōʻihi o ka mau ʻana o kahi valve i hoʻokomo hou ʻia?

Ke lohe ʻoe ʻaʻole hana pono kekahi mea i loko o kou puʻuwai, ʻaʻole ia he mea maʻalahi. Eia nō naʻe, i ka hala ʻana o ka manawa, ua hoʻomohala nā kauka i nā lāʻau lapaʻau maikaʻi aʻe no kēia kūlana. E kamaʻilio me kāu kauka e pili ana i ka mea maikaʻi loa iā ʻoe. ʻOiai he kūlana kakaikahi kēia, ʻo kou pono ke loaʻa i kahi kauka i loaʻa ka ʻike me ia. No ka laʻana, ʻōlelo nā kānaka noiʻi e pono i kahi kauka lapaʻau ke hana ma ka liʻiliʻi he 15 mau kaʻina hana Ross i kēlā me kēia makahiki.

ʻO ka mea hope loa, ʻo ka mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, ke lana nei koʻu manaʻo ua loaʻa iā ʻoe kahi ʻike maikaʻi i kēia maʻi puʻuwai i kapa ʻia ʻo `(Unicuspid Aortic Valve)` a mākou i kamaʻilio ai i kēia lā. E hoʻomanaʻo, he mea kēia i hānau ʻia me ia a ʻike pinepine ʻole ʻia. Eia nō naʻe, inā ʻike pololei ʻia a mālama ʻia i ka manawa kūpono, hiki iā ʻoe ke ola i kahi ola maikaʻi . Inā ʻoe a i ʻole kekahi āu i ʻike ai i kēia mau hōʻailona, ​​​​mai makaʻu e ʻike i ke kauka a loaʻa ka ʻōlelo aʻoaʻo. ʻOi loa, he mea nui loa ka loaʻa ʻana o ke kākoʻo o kahi hui lapaʻau akamai i ka wā e mālama ai i kēlā mau kūlana kakaikahi. E mālama i kou puʻuwai. ʻO ia ka waiwai makamae loa i kou ola!

ʻO ka maʻi puʻuwai, ka valve aortic, ka valve aortic unicuspid, ke ʻoki puʻuwai, ka maʻi puʻuwai hānau, ka pōkole o ka hanu, ka ʻeha umauma