Yu go dɔn yɛri bɔt di aorta, we na di men blɔd vesel we de pɔmp blɔd ɔlsay na wi bɔdi. Imajin, wetin if dis men vessel, rayt usay i kכnekt to di at, na di "rut," wik sכmtεm εn bulg kכmכt lεk balכn? Na dat wi kin kɔl aneurysm na mɛrɛsin. Dis kin rili denja, bikɔs ɛni tɛm dis wɔl we wik kin kɔt ɔ brok. If dat apin, blɔd kin kɔmɔt pasmak insay di bɔdi ɛn ivin bad bad tin dɛn kin apin we kin mek pɔsin in layf de pan denja. So, Aortic Root Replacement na wan rili impɔtant ɔpreshɔn we dɛn kin du fɔ stɔp dɛn kayn tin ya we kin mek pɔsin in layf de pan denja. Tide, wi go tɔk bɔt dis simpul wan, di we we yu go ɔndastand.
Wetin na dis Aortic Root Replacement ɔpreshɔn?
Fɔ tɔk am simpul wan, dis na ɔpreshɔn fɔ mek wan anɛrizm we de na di aɔta rut, we na di men at we de kɔnɛkt yu at. Sɔntɛnde, dɛn kin chenj di rut na yu aorta ɛn di valv we de insay de. כda tεm dεm, na di rut fכ yu aorta nכmכ dεn kin riples, we de lεf yu nכmal valv intakt. Yu dɔktɔ go disayd us kayn ɔpreshɔn we fayn fɔ yu bay bɔku tin dɛn, lɛk aw yu valv de.
Wetin na di men kayn ɔpreshɔn we dɛn kin du?
Tu men we dɛn de fɔ du dis ɔpreshɔn. wan na fכ riples di rut fכ di aorta εn di valv. Di ɔda wan na fɔ chenj di rut nɔmɔ, ɛn lɛf di valv intakt. Dɛn ɔl tu gɛt bɛnifit ɛn bad tin.
1. Riplesmɛnt fɔ di Aɔta Rut (ARR) .
Dɛn kin kɔl dis prosidur bak di Bentall prosidur . Dɛn kin du am fɔ pipul dɛn we gɛt aortic aneurysm ɛn prɔblɛm wit di valv. fכ egzampl, if di valv nכ kכloz fayn εn di bכdi lik bak (aortic valve regurgitation) כ if di valv dכn kכlכs (hardened).
- Men advantej: Di big advantej fɔ dis na dat yu nɔ nid fɔ gɛt sɛpret ɔpreshɔn fɔ mek di valv bak afta di ɔpreshɔn. כl tu di anεvrizm εn di valv prכblεm de sכlv di sem tεm.
- Risk dɛm: If yu gɛt mɛkanikal valv we dɛn put insay dis ɔpreshɔn, yu go nid fɔ tek blɔd thinner/anticoagulants fɔ di res ɔf yu layf. Smɔl risk de fɔ mek blɔd klot ɔ blɔd bikɔs ɔf dɛn mɛrɛsin ya.
2. Valv-Sparing Rut Riplesmɛnt (VSRR) .
Dis na di bεst opshכn if yu aorta valv de wok fayn fayn wan we yu nכ gεt nכ prכblεm. Fɔ ɛgzampul, if blɔd nɔ lik ɔ tik frɔm di valv, dɛn kin pik dis we. Dis na di bεst sכlushכn spεshal fכ pipul dεm we de divεlכp anεvrizm we dεn yכng bikoz fכ di jεnεtik kכndishכn dεm.
dis prosidur involv fכ riples jכs di rut fכ yu aorta εn riatta yu כwn nεchכral valv to am. Tu men we dɛn de, we dɛn gi di nem to di dɔktɔ dɛn we bin fɛn dɛn.
- Yacoub prosidur: Dis involv fכ rimodεl di aorta valv. Bɔrku tɛm dis kin fayn fɔ ol pipul dɛm wae gɛt aneurism bikɔs ɔf tin dɛm wae nɔr gɛt jɛnɛtik.
- Devid prosidur: Dis involv fɔ put di aorta valv bak. Dis na tin we kɔmɔn bɔt i kɔmplikt pas di we aw Jekɔb kin du am. I bεst fכ yכng pipul dεm we gεt jεnεtik kכndish כn כ bicuspid aortic valve .
Di big bɛnifit fɔ VSRR ɔpreshɔn na dat, nid nɔ de fɔ tek blɔd tin fɔ di res ɔf yu layf. I de ridyus bak di risk fɔ gɛt strok ɔ infɛkshɔn lɛk ɛndokarditis.
Wi go lan smɔl bɔt di aɔta rut?
di rut fכ di aorta na di fכs pat pan di bכdi in big bכdi we de na di aorta, usay i de kכnεkt to di at. I tan lɛk di rut fɔ tik. di aorta we de kכmכt na di at de kכba כp, lεk kכv. Dat kכv de stat usay di rut fכ di aorta de bigin. Dis pat rili kɔmpleks.
- di aorta Valv: Dis na di say we di valv we de wok lεk get de mek bכdi fכ fכm na di at go insay di aorta, bכt i de mek i nכ fכ fכlכ bak.
- Koronari Atεri dεm: di tu imכtant bכdi we de gi bכdi to di at de bigin na di bכs pat pan dis aorta.
- di sayn dεm fכ Valsalva: Dis na di nem we dεn gi di sכm sכm swεla dεm we de fכm usay di korona at dεm de bigin.
We wi yɔŋ, ɔl dɛn pat ya kin rili chenj. Bɔt as wi de ol, dis we aw wi kin ebul fɔ chenj chenj kin stɔp. Dis na di rizin we mek sɔm prɔblɛm dɛn kin kam. Bikɔs dis pat rili kɔmpleks, di ɔpreshɔn dɛn we dɛn kin du pan am kin kɔmpleks bak. Bɔt if dɔktɔ dɛn we gɛt ɛkspiriɛns ɛn we sabi du ɔpreshɔn ɛp yu, yu go ebul fɔ du dis ɔpreshɔn fayn fayn wan ɛn yu at go gɛt wɛlbɔdi bak.
Udat rili nid dis ɔpreshɔn?
Dis ɔpreshɔn nid fɔ de fɔ pipul dɛn we gɛt aneurysm na di aorta we de pan risk fɔ bɔs ɔ rupchɔ. sכmtεm dεn kin divεlכp bikoz fכ chenj dεm na di aorta wit di ej. כlso, di jεnεtik kכndyushכn dεm lεk Marfan sεndr כm εn Loeys-Dietz sεndr כm kin mek di anεrizm dεm we de kil am we i yכng.
Imajin, if pɔrsin wae gɛt Marfan syndrome nɔr gɛt tritmɛnt, e kin gɛt bɔrku risk fɔ mek di aneurism bɔs ɛn day. Di avrej ej fɔ pipul dɛn na da grup de fɔ day na lɛk 32 ia so. Bɔt, if yu gɛt dis ɔpreshɔn, yu kin ɛkstɛnd yu layf span to di wan we nɔmal pɔsin kin liv.So, if ɛnibɔdi na yu famili gɛt dɛn kayn sik ya we dɛn kin gɛt frɔm yu bɔdi, i impɔtant fɔ tɔk to yu dɔktɔ bɔt di prɔblɛm we yu gɛt ɛn no di bɛst tɛm fɔ mek dɛn du yu ɔpreshɔn.
| Medikal kɔndishɔn/risk factor | di dayamita fכ di anεvrizm we nid כpεrayshכn |
|---|---|
| Apat frɔm wan patikyula jɛnɛtik kɔndishɔn ɔ ɔda tin dɛn we kin mek pɔsin gɛt dis sik | 5.5 sɛntimita |
| If yu gɛt Marfan sindrom | 5.0 sɛntimita |
| If yu gɛt ɔda prɔblɛm dɛn lɛk Marfan syndrome ɛn yu famili histri, yu de gro kwik kwik wan, ɔ yu de plan fɔ gɛt bɛlɛ | 4.5 sɛntimita |
| If yu gɛt ɔda prɔblɛm dɛn, lɛk bicuspid aortic valve ɛn ay blɔd prɛshɔn | 5.0 sɛntimita |
Di impɔtant tin na dat dɛn nɔmba ya nɔto di sem fɔ ɔlman. Dis disishun kin difrɛn difrɛn wan bay yu ej, ɔl yu wɛl bɔdi, ɛn tin lɛk ay blɔd prɛshɔn we yu nɔr kin kɔntrol ɛn smok. So, tɔk to yu dɔktɔ bɔt di patikyula prɔblɛm dɛn we yu go gɛt ɛn di bɛst tɛm fɔ ɔpreshɔn.
Wetin kin apin bifo, di tɛm we dɛn de du di ɔpreshɔn ɛn afta di ɔpreshɔn?
Bikɔs dis na big ɔpreshɔn, i nid fɔ pripia gud gud wan.
Bifo dɛn du di ɔpreshɔn
Yu dɔktɔ go gi yu wan ful ɛgzam. I go rifer yu bak to dɛntist fɔ mek dɛn chɛk yu tit. Apat frɔm dat, dɛn go du bɔku tɛst dɛn, lɛk:
- Blɔd tɛst: Chɛk aw di kidni de wok.
- CT ɔ MRI skan fɔ di at: Dis kin chɛk ɔl di pat dɛn na di aorta. Sɔntɛnde, dɛn kin sɔlv ɔda prɔblɛm dɛn we dɛn de du di sem ɔpreshɔn.
- Koronari Angiografi: Chɛk di kɔndishɔn fɔ di korona at we de gi blɔd to di at.
- Duplex Ultrasound: I de chɛk di kɔndishɔn fɔ di karotid at dɛn na di nɛk. Prɔblɛm wit dɛn tin ya kin mek di risk fɔ paralayz we dɛn de du ɔpreshɔn, bɔku.
Dɔn bak, yu dɔktɔ go aks yu bɔt dɛn tin ya:
- Di mɛrɛsin dɛn we yu de tek: Yu fɔ tɛl yu dɔktɔ bɔt ɛni mɛrɛsin ɔ vaytamɛn we yu de tek. Sɔm mɛrɛsin dɛn kin mek yu stɔp fɔ tek dɛn bifo dɛn du yu ɔpreshɔn.
- Ɔda mɛrɛsin: If yu gɛt ɛni mɛrɛsin lɛk ay blɔd prɛshɔn, yu fɔ kɔntrol am fayn fayn wan bifo yu du di ɔpreshɔn.
- Di sik we yu gɛt naw: Mek shɔ se yu tɛl wi if yu gɛt ɛni sik, lɛk kol ɔ fiva.
- Smok: Dɛn fɔ stɔp fɔ smok ɔltogɛda wan mɔnt bifo dɛn du di ɔpreshɔn.
We dɛn de du di ɔpreshɔn
Dɛn go gi yu anestezi fɔ mek yu slip kpatakpata. Dɔn dɛn go kɔnɛkt yu to wan mashin we de na di at-lɔng (cardiopulmonary bypass) . Dis mashin go du di wok we yu at ɛn yu lɔng dɛn de du we dɛn de du di ɔpreshɔn. Dɔn di dɔktɔ we de du di ɔpreshɔn go fala dɛn tin ya:
.
2. Rimobul di aneurism: dεn kin kכt di pat we wik εn bulging na di aorta εn pul am.
3. Graft Insertion: Dɛn kin put atifishal blɔd vesel (graft) fɔ tek di pat we dɛn pul.
4. Riples ɔ sev di valv: Yu riples di valv ɔ riinstɔl yu yon valv akɔdin to di ARR ɔ VSRR we wi bin dɔn tɔk bɔt.
5. Korona at baypas graftin: di korona at we de gi bכdi to di at de kכnekt to di nyu graft.
6. Stich di say we dɛn kɔt: Fɔ dɔn, dɛn kin stich di say we dɛn kɔt di chɛst bak togɛda.
Dis ɔpreshɔn kin tek bitwin 4 ɛn siks awa.
Afta di ɔpreshɔn
Afta dɛn dɔn du di ɔpreshɔn, yu go nid fɔ de na di say usay dɛn de kia fɔ pipul dɛn we sik bad bad wan (ICU) fɔ sɔm dez. Dɔn dɛn go transfa yu to wan rɛgyula wɔd. Di ɔl di ɔspitul we yu de de kin tek lɛk wan wik so. Insay dis tɛm:
- A go gi yu pen kil.
- Yu kin kɔnɛkt yu to mashin fɔ ɛp yu fɔ blo.
- Dɛn kin wɛr spɛshal stɔkin fɔ mek blɔd nɔ klɔt.
- Dɛn kin gi sɔm pipul dɛn mɛrɛsin fɔ mek dɛn blɔd tan.
Afta yu dɔn go na os frɔm ɔspitul, fala di dɔktɔ in instrɔkshɔn dɛn gud gud wan. Nɔ rɔsh tin. Gɛt wɛlbɔdi kwik kwik wan. Yu nɔ go ebul fɔ drayv te yu wɛl.
Wetin na di bɛnifit dɛn, di prɔblɛm dɛn we kin apin, ɛn di tin dɛn we kin apin we dɛn du di ɔpreshɔn?
| Pat | Tɔk bɔt |
|---|---|
| Men advantej | Fɔ mek dɛn nɔ gɛt ɛni imejensi we kin kil pɔsin usay wan anɛrizm bɔs ɔ brok. Fɔ tɔk am simpul wan, dis na ɔpreshɔn we go sev pɔsin in layf. |
| Risk ɛn kɔmplikeshɔn dɛn | Lɛk ɛni big ɔpreshɔn, prɔblɛm dɛn de we kin apin. Blɔd, blɔd klɔt, infɛkshɔn, at atak ɔ strok, ɛn kidni fayl kin pɔsibul. Bɔt dɛn tin ya nɔ kin apin so ɔltɛm. |
| Di tɛm fɔ mek pɔsin wɛl | I kin tek 6 to 12 wik ɔ tu to tri mɔnt fɔ mek i wɛl. I rili impɔtant fɔ tek pat pan wan program fɔ rihabilite yu at insay dis tɛm. |
| Sakses ɛn fɔ liv | Dɛn ɔpreshɔn dɛn ya kin rili wok fayn. Bitwin 98% ɛn 99% pan di pipul dɛn kin sev we dɛn du di ɔpreshɔn. Ivin afta 10 ia, lɛk 86% - 90% pan pipul dɛn nɔ go nid ɔda ɔpreshɔn. Dis na sɔlv we go tek lɔng tɛm. |
Ustɛm yu fɔ go to dɔktɔ?
Pe atɛnshɔn gud wan to yu bɔdi we yu de wɛl. If yu notis ɛni wan pan dɛn tin ya , kɔl yu dɔktɔ wantɛm wantɛm:
- Kwɛstyɔn dɛn we gɛt fɔ du wit di say we dɛn kɔt am:
- Rɛd, pen, swel, ɔ wam rawnd di say we dɛn kɔt.
- Di bandej kin so wet dat blɔd ɔ klia wata kin kɔmɔt.
- Grin ɔ yɔlɔ pus dischaj.
- Di ed dɛn na di say we dɛn kɔt de muf apat.
- Ɔda kwɛstyɔn dɛn:
- Chɛst pen ɔ i nɔ kin izi fɔ blo ivin we yu rɛst.
- Di leg dɛn we de swel ɔ we nɔ ebul fɔ muv di leg dɛn.
- Diziz, slip, ɔ taya pasmak.
- Fɔ kɔf blɔd ɔ grɛn/yɔlɔ mכkus.
- Fɔ gɛt kol ɛn gɛt fiva.
- Blɔd we de na di stɔl.
Ustɛm yu nid fɔ go na di Imejɛnsi Tritmɛnt Yunit (ETU)?
If yu gɛt aneurism we dɛn nɔ trit, go na di ɔspitul imejensi dipatmɛnt (ETU) we de nia yu wantɛm wantɛm if yu si dɛn sik ya. Dis kin bi sayn dɛm fɔ se di anɛrizm dɔn brok:
- Wantɛm wantɛm, pen we pɔsin nɔ go ebul fɔ bia na in chɛst ɔ ɔp bak. I kin tan lɛk se sɔntin de kɔmɔt insay di bɔdi.
- Swet ɛn fil lɛk se yu gɛt klem.
- I nɔ kin izi fɔ yu fɔ blo.
- Diziz ɔ layt ed.
- Di at rit de go ɔp.
- Nɔs ɛn vɔmit.
Na nɔmal tin fɔ mek yu fil fred we yu yɛri bɔt ɔpreshɔn fɔ yu at. Bɔt mɛmba se dis ɔpreshɔn na sɔntin we go sev yu layf ɛn gi yu di chans fɔ liv wɛlbɔdi layf fɔ lɔng tɛm. Yu dɔktɔ ɛn di mɛdikal tim gɛt ɛkspiriɛns fɔ du dɛn kayn ɔpreshɔn ya. So tɔk to dɛn bɔt ɛni kwɛstyɔn ɔ fred we yu go gɛt.
Mɛsej we dɛn kin kɛr go na os
- Aortic Root Replacement na ɔpreshɔn we de sev layf we dɛn kin du fɔ mek wan aneurysm we de na di rut na di at in aorta nɔ brok.
- dipכnt pan di kכndishכn fכ yu aorta valv, dεn kin du dis כpεrayshכn wit di valv (ARR) כ wit di valv spared (VSRR).
- Dis ɔpreshɔn kin rili wok fayn. di rεt we de liv pas 98%. Dɔn bak, na sɔlv we go tek lɔng tɛm.
- I impɔtant fɔ lɛ yu stɔp fɔ smok ɛn kɔntrol sik dɛn lɛk ay blɔd prɛshɔn bifo yu du ɔpreshɔn.
- If yu gɛt ɛnitin we nɔ kɔmɔn (infɛkshɔn na di say we dɛn kɔt, bad bad pen na yu chɛst) we yu de wɛl, tɛl yu dɔktɔ wantɛm wantɛm.
- If yu gɛt ɛnitin fɔ wɔri bɔt ɔ dawt bɔt dis ɔpreshɔn, tɔk to yu dɔktɔ bɔt am opin wan. Dɛn go ɛp yu.
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