Sɔntɛnde, yu smɔl pikin kin fil lɛk se i gɛt prɔblɛm fɔ blo? I kin chok we i de gi pikin tin fɔ it ɔ we i de gi pikin in bɛlɛ? Ɔ i de mek strenj nɔys dɛn we i de blo? Pan ɔl we dɛn sik ya kin bi kɔmɔn sik dɛn we dɛn kin gɛt we dɛn smɔl, wan sik kin de we rili siriɔs, bɔt we dɛn kin trit biɛn dis. Wan pan dɛn kayn tin ya we nɔ kin apin bɔt we impɔtant fɔ no bɔt na in dɛn kɔl "Double Aortic Arch." Lɛ wi tɔk bɔt am ditayli tide.
Fɔ tɔk am simpul wan, di men blɔd vesel we de kɛr blɔd kɔmɔt na yu pikin in at to di ɔda pat na in bɔdi na di aorta . Bɔku tɛm, na wan big bɔtul. di pat we kכba pan dis vessel we de oba di at dεn kכl am di aortic arch .
כltu, insay pikin we gεt "Dכbul Aortic Arch", dis "aortic arch" de fכm tu. dat min se, wan adishכnal bכdi vεsεl de kכnekt to dis men "aortic arch", we de fכm sεkכn arch. Dɛn tu arch ya kin kam togɛda, ɛn dɛn kin mek wan ring rawnd di pikin in briz paip (trachea) ɛn it paip (ɛsophagus) . Imajin, wetin go apin if dis ring blok? na da tεm de di pikin kin bigin fכ gεt siriכs sayn dεm lεk i at fכ brith, i de mek nכys we i de blo, εn i at fכ sכlow it.
dis "aortic arch" de fכm insay di fכs stej dεm fכ di bεlε, bitwin tu εn sεvin wik. Insay dis tɛm, di at ɛn di blɔd vesel dɛn kin divɛlɔp insay wan we we rili kɔmpleks. Sɔm pat dɛn kin fɔm, ɛn afta sɔm tɛm dɛn nɔ kin nid dɛn igen ɛn dɛn kin dɔnawe wit dɛn. di "double aortic arch" de fכm biכs fכ sכmtin lεk dis. arawnd di fayv wik we di bεlε de, wan bכdi we fכ dכn sכpכt, fכ sכm rizin we wi nכ no, nכ de sכpכt εn dis "dכbul aorta arch" de fכm. Dis na di at we dɛn bɔn wit , we min se dɛn bɔn di pikin wit am.
dis kכndyushכn we dεn kכl "dכbul aorta arch," de pan wan grup we dεn bכn wit di at dεm we dεn kכl "vaskulεr ring dεm." dis dεm kin mek di pikin in briz paip εn εsophagus kכmprεs.
Wetin na dɛn "vaskul ring" ya?
okay, "Vascular Rings" na, lεk aw a bin tεn bifo, kכndishכn dεm we di "aortic arch" de divεlכp abnכmal, we kin mek di pikin in winda paip (trachea), it paip (esophagus), כ dεn tu kכmprεs. Dis na tin dɛn we nɔ kin apin we pɔsin bɔn wit at . Tink bɔt dis, lɛk wan pan ɛvri 100 pikin dɛn we dɛn bɔn wit sɔm kayn at prɔblɛm we dɛn bɔn wit. bכt wan "vaskulכr ring" de כnli afekt wan pan 10,000 bebi dεm. Na dat rare.
Wetin na di men kayn "Vascular Rings"?
difrεn men tכp dεm de fכ dεn "vaskulεr ring dεm". Lɛ wi si wetin dɛn bi:
- Dabl Aortic Arch: insay dis, tu "aortic arches" (lef εn rayt) de rawnd di trakya εn εsophagus. Dis na di men tɔpik we wi de tɔk bɔt.
- di rayt aorta arch wit aberrant lεft sabklavian atεri εn lεft ligamentum: wan aorta arch de ya, bכt i de na di rayt say na di trakya (nכmal wan na di lεft). insay dis kes, di lεft sabklavian at we de gi bכdi to di pikin in an dεm, de bigin na di aorta εn pas bihayn di trakya εn εsophagus. dis vaskulεr ring de kכmplit bay we i de jכyn wit di lεft ligamentum arteriosus, we na wan rεmεnt fכ wan bכdi vεsεl we bin de di tεm we di pikin de liv εn afta dat i de disappear.
- di lεft aorta arch wit aberrant rayt sabklavian atεri: na ya, di rayt sabklavian at de pas bihayn di trakya εn εsophagus, we de kכmprεs dεm.
- innominate atεri kכmpreshכn: di innominate (brachiocephalic) atεri na wan branch pan di aorta. insay dis kayn we, i kin stat na di lεft say na di trakya, dεn kin pas bifo di trakya na di rayt say. Dis kin put prɛshɔn pan di trakya.
- di pulmonary artery sling: di lεft pulmonary artery de stat frכm di rayt pulmonary artery εn pas bitwin di trachea εn esophagus.
Wetin kin apin pan ɔl dɛn tin ya na dat di aywe ɔ di εsophagus kin afɛkt sɔm we.
Yu tink se kayn "Dɔbul Aɔtik Ak" de?
yes, tri men tכp dεm de fכ "double aortic arch." Dɛn kin difrɛns dɛn bay us ak big, ɛn if da big ak de na di rayt ɔ lɛft say na di trakya.
- Dominant rayt arch wit smɔl lɛft arch: Dis na di kayn we we dɛn kin yuz mɔ, i kin apin na lɛk 80 pasɛnt pan di kes dɛm.
- Dominant left arch wit smɔl rayt arch: Dɛn kin si dis pan lɛk 10 pasɛnt pan di kes dɛm.
- Balans arch: Dɛn kin si dis bak pan lɛk 10 pasɛnt pan di kes dɛm.
Us kayn "vaskul ring" dεn kin si mכst?
di dכkta dεm bin de tink se di "double aortic arch" na di mכst kכmכn tכp fכ "vaskulכr ring." bכt nyu risεch dεn fכnshכn se di "rayt aortic arch" na in rili kכmכn.
Bɔt ɔda tin de. di pikin dεm we gεt "rayt aorta arch" kin gεt כda hat dεm we dεn bכn wit pas di pikin dεm we gεt "dabl aorta arch." Bɔt dɛn nɔ kin no se dɛn gɛt dis sik we dɛn bɔn dɛn. dis na biכs "rayt aortic arch" kin nכ kin mek yu si di sik dεm na di fכs stej dεm. So, i kin nid fɔ du ɔpreshɔn fɔ dis prɔblɛm bitwin 6 ɛn 18 mɔnt.
wan kכndyushכn we dεn kכl ``Dכbul Aortic Arch'' na di tכp we kכmכn pas כl di vaskulεr ring. So, yu pikin in dɔktɔ kin no di prɔblɛm kwik kwik wan. we yu kכmpεr di pikin dεm we gεt כda kayn vaskulכr ring dεm, di pikin dεm we gεt ``Dכbul Aortic Arch'' kin nid כpεrayshכn sכm tεm afta dεn bכn dεm.
Wetin na di sayn dɛm fɔ "Double Aortic Arch"?
di simptom dεm fכ "double aortic arch" kin apin we di pikin in winda paip, εsophagus, כ כl tu dεn kכmprεs. dis kכmpreshכn kin afekt di pikin in brith, it, כ in at wok.
Bɔrku tɛm, dɛn kayn sayn ya kin kam wae dɛn smɔl (especially if de sik tranga), bɔt sɔmtɛm dɛn kin apia as ali as tri ia ol, ɔr ivin we dɛn yɔŋ.
Sɔm pikin dɛn kin mistek no se dɛn gɛt asma bikɔs di sayn dɛn we de sho se dɛn gɛt asma kin fiba. Dɛn kin no bɔt dis sik nɔmɔ we di tritmɛnt fɔ asma nɔ wok ɛn dɛn du ɔda tɛst.
Di simptom dɛm we pɔsin kin gɛt we i de blo
lεk 91 pasεnt pan di pikin dεm εn pikin dεm we gεt "double aortic arch" de gεt dεn simptom dεm ya we de apin we dεn de blo. Dɛn na:
- wan strenj sawnd we yu de blo (wan ay sawnd we dεn kכl `stridor` כ wan sawnd we de wis we dεn kכl `wheezing`) .
- Kɔf we de sawnd lɛk "sil barking." Dis kin fiba di kɔf we kin apin pan wan kɔndishɔn we dɛn kɔl "krɔp."
- Infεkshכn dεm we de na di lכw rεspiretכri trakt bכ ku tεm .
Di simptom dɛm we de na di bɛlɛ
lεk 40 pasεnt pan di pikin dεm εn pikin dεm we gεt "dabl aortic arch" kin gεt dεn dijestiv simptom dεm ya. Dɛn tin ya na:
- Chok we yu de gi pikin in bɛlɛ ɔ we yu de gi pikin in bɛlɛ.
- I nɔ kin izi fɔ swɛla (dysphagia) . Bɔku tɛm dis kin apin afta di pikin bigin fɔ it sɔlid it dɛn.
- I nɔ kin izi fɔ mek yu gɛt bɔku bɔku bɔdi .
- Fɔd we de kam bak ɔp insay di trot (`Regurgitation/reflux`) .
Di sayn dɛn we de sho se pɔsin gɛt at
lεk 30 pasεnt pan di pikin dεm εn pikin dεm we gεt "double aortic arch" kin gεt di hat rεlatεd simptom dεm. Dɛn tin ya na:
- Chɛst pen .
- Wan abnɔmal at sawnd (`At grɔmbul`) .
- Blu skin (saynɔsis) .
Wetin kin mek "Dɔbul Aɔtik Ak"?
di ekzak kכz fכ "double otic arch" dεn nכ dכn fכ no yet . pan tap we dεn kin si dis kכndyushכn pan pikin dεm we dεn bכn tru "in-vitro fεtilayzεshכn" (IVF) , dεn nכ no di εksakεt kכz.
Dabl aorta arch kin gɛt fɔ du bak wit ɔda mɛdikal kɔndishɔn dɛn. na lɛk 12 pasɛnt pan di pikin dɛn we gɛt dabl aɔta arch gɛt ɔda at prɔblɛm we dɛn bɔn wit, lɛk ventricular septal defect (VSD) ɛn tetralogy of Fallot . pan tap dat, lεk 20 pasεnt pan di pikin dεm we gεt dכbl aorta arch gεt jεnεtik kכndyushכn lεk kromozom 22q11 dεlish כn εn trisomy 21 (Down syndrome) .
Aw fɔ no "Dɔbul Aɔtik Ak"?
Dɛn kin no di dabl aɔta arch bay chans ɔ we di sik bigin. Sɔntɛnde, dɛn kin no am bay we dɛn gɛt bɛlɛ, afta dɛn bɔn am, ɔ we dɛn de du imej tɛst fɔ ɔda rizin. Frɔm 2004, di nɔmba fɔ pipul dɛn we dɛn kin no se gɛt dis sik tru skan we dɛn gɛt bɛlɛ dɔn bɔku. Dis kin rili yusful, bikɔs dɛn kin plan fɔ trit am jɔs afta dɛn bɔn di pikin.
Ɔ, dɛn kin no am we di sayn dɛn de sho afta dɛn bɔn di pikin. Yu pikin in dɔktɔ go tɔk to yu bɔt di sayn dɛm ɛn afta dat i go du sɔm tɛst dɛm.
Test fɔ no "Dɔbul Aɔtik Ak".
Di men tɛst dɛm wae dɛn kin yuse fɔ no dis sik na:
- Chɛst X-ray: Bɔku tɛm dis na di fɔs tɛst we dɛn kin du.
- CT skan we dɛn kin du.
- Echocardiogram (Echo) test: Dis kin ɛp mɔ fɔ no if ɔda at prɔblɛm dɛn de.
- MRI (MRI) tɛst we dɛn kin du.
Sɔntɛnde dɛn kin du brɔnkoskɔpi fɔ chɛk di pikin in winda. dis kin bi fכ ansa to difεlεns fכ brith bifo dεn no se dεn gεt dכbl aorta arch. Ɔ, dɛn kin du am bifo dɛn du di ɔpreshɔn fɔ ɛp di dɔktɔ we de du di ɔpreshɔn fɔ no wetin de mek di prɔblɛm de.
Tεst fכ jεnεtik de εp fכ no di jεnεtik kכndishכn dεm.
Aw fɔ mɛn "Dɔbul Aɔtik Ak"?
כpεrayshכn fכ kכrekt di kכndishכn fכ "dכbul aorta arch." Ivin fɔ pikin dɛn we nɔ gɛt ɛni sayn, i bɛtɛ fɔ du ɔpreshɔn bitwin 6 ɛn 9 mɔnt. Bebi dɛn we gɛt di sik, mɔ if di sayn dɛn rili bad, kin nid fɔ gɛt ɔpreshɔn ivin bifo tɛm.
Jɔs tink bɔt, dɛn bin no di kɔndishɔn "double aortic arch" fɔ di fɔstɛm insay 1737. Dɛn bin du di fɔs ɔpreshɔn fɔ am insay 1947. Aw fa wi dɔn kam frɔm da tɛm de! Bebi dɛn we gɛt dis prɔblɛm we dɛn bɔn dɛn dɔn ebul fɔ liv lɔng, wɛlbɔdi layf bikɔs dɛn dɔn du ɔpreshɔn pan dɛn.
"Dɔbul Aɔtik Ak" ɔpreshɔn
Di "Double Aortic Arch" ɔpreshɔn rili sef, ɛn di rizɔlt dɛn rili saksesful . yu pikin nכ go nid fכ kכnekt to "cardiopulmonary bypass" (at-lכng mashin) .
Dɛn kin du di ɔpreshɔn bay we dɛn de yuz wan we we dɛn kɔl "lateral thoracotomy." Dis min se di dɔktɔ we de du di ɔpreshɔn kin kɔt wan say na di pikin in chɛst, bitwin tu rib dɛn. dis kin du bכku tεm na di lεft sayd, biכs na de mכst pikin dεm gεt da "εkstra" sכm sכm rib kεj de. di imej tεst dεm we dεn kin du bifo dεn כpεrayshכn kin mek di כpεrayshכn ebul fכ luk gud wan insay di pikin in bכdi εn plan di כpεrayshכn akɔdin to dat.
di sajin de yuz wan "ligating and dividing" tεknik . Dis min se dɛn tay di smɔl arch fɔ stɔp di blɔd we de pas tru am. Dɔn dɛn kin kɔt am ɛn sutura am. dis prכsεs de ripit te di arch kכmplitli separet εn di prεshכn we de pan di briz paip εn εsophagus dεn kכl am.
Yu pikin go de na ɔspitul fɔ lɛk wan wik so, dɔn i go wɛl ɛn kam bak na os.
Tritmεnt fכ "Kommerell divεrtikulכm" (`Kommerell divεrtikul - KD`)
sכm pikin dεm we gεt "dabl aortic arch" kin gεt sכmtin bak we dεn kכl "Kommerell diverticulum (KD)." dis kin kכmכn mכr pan pikin dεm we gεt "rayt aorta arch," bכt i kin rili rεsכn bak wit "dכbl aorta arch."
dis `KD` na `aneurysm`, we na bכdi we de divεlכp na di `aorta` we de dכn nia di `aortic arch`. dis bulge kin tek spεs εn prεs pan di pikin in winda paip εn it paip. Sɔntɛm i nɔ go mek ɛni prɔblɛm wantɛm wantɛm. כltu, di sכja dεm lεk fכ pul dis bak we dεn de mek di `dabl aortic arch` fכ mek i nכ gεt prכblεm leta.
Tritmɛnt fɔ ɔda at prɔblɛm dɛn
If yu pikin gɛt ɔda at prɔblɛm dɛn we nid fɔ ɔpreshɔn, dɛn kin trit am di sem tɛm we dɛn kin trit di dabl aɔta arch. dis kin nid fכ du tin we dεn kכl ``median sternotomy'' , we involv fכ mek wan insayshכn dכn di midul pan di chεst. Yu pikin in ɔspitul dɔktɔ go tɔk bɔt di bɛst tin fɔ yu, i go dipen pan di prɔblɛm dɛn we nid fɔ trit.
Wetin na di prɔblɛm dɛn we kin apin we pɔsin du ɔpreshɔn?
di risk fכ komplikεshכn dεm frכm dכbl aorta arch כpεrayshכn rili lכw . Na smɔl tɛm nɔmɔ di pikin kin gɛt prɔblɛm fɔ it ɔ i kin gɛt prɔblɛm wit in brith ɔltɛm. If ɛni prɔblɛm de we pɔsin kin gɛt we i de blo ɔltɛm, i kin go insay wan ia afta dɛn dɔn du di ɔpreshɔn.
Di prɔblɛm dɛn we kin apin we dɛn du ɔpreshɔn fɔ kɔrɛkt dabl aɔta arch ɛn ɔda at prɔblɛm dɛn kin difrɛn. Tɔk bɔt ɔl dɛn risk ɛn prɔblɛm dɛn ya wit yu pikin in ɔpreshɔn dɔktɔ.
Yu kin ebul fɔ stɔp "Dɔbul Aɔtik Ak"?
nכ, wan kכndyushכn we dεn kכl "double aortic arch" dεn nכ kin ebul fכ sכpכt . na tin we de divεlכp ali we uman bεlε εn i de de we dεn bכn am.
Wetin na di fiuja fɔ pipul dɛm wae gɛt "Double Aortic Arch"?
Bebi ɛn pikin dɛn we dɛn dɔn du "Double Aortic Arch" ɔpreshɔn gɛt rili brayt fiuja . Dɛn kin liv ɛn du nɔmal tin dɛn we dɛn nɔ gɛt ɛnitin fɔ stɔp dɛn.
Afta di ɔpreshɔn, yu pikin kin kɔntinyu fɔ blo wit nɔys fɔ te wan ia. dis na biכs di pikin in winda paip nכ de fulכp divεlכp bikoz fכ di "dכbul aorta arch." So, i go tek sɔm tɛm fɔ mek di winda paip strɔng.
Na smɔl tɛm nɔmɔ, bebi ɛn pikin dɛn kin stil gɛt di sik dɛn we dɛn kin gɛt fɔ blo pas wan ia afta dɛn dɔn du di ɔpreshɔn.
Di tin we impɔtant pas ɔl na fɔ kɛr yu pikin go chɛk ɔltɛm ɛn tɛl yu dɔktɔ if yu gɛt ɛni sik we de kɔntinyu. Fɔ kia fɔ lɔng tɛm fɔ fala di pikin rili impɔtant fɔ ɛvri pikin we dɛn dɔn du ɔpreshɔn pan in at.
Ustɛm a fɔ kɔl mi pikin in dɔktɔ?
If yu notis ɛni nyu sayn, ɔ if i tan lɛk se di sayn dɛn we yu dɔn gɛt de wɔs, tɔk to yu pikin in dɔktɔ wantɛm wantɛm. Bebi ɛn yɔŋ pikin dɛn kin chenj so dat sɔntɛnde i kin at fɔ no wetin nɔmal ɛn wetin nɔrmal. Bɔt if yu pikin gɛt da "sil-layk" kɔf ɔ wan sawnd we de swɛt , tɛl yu dɔktɔ wantɛm wantɛm. I kin bi nɔmal sik we pɔsin kin gɛt we i smɔl. Bɔt nɔto ɔltɛm, i kin bi sayn fɔ yu pikin in at prɔblɛm we de afɛkt di we aw yu pikin de ebul fɔ blo.
Ustɛm yu fɔ kɔl 911 (imejɛnsi nɔmba)?
"dabl aortic arch" kin put prεshכn we de mek yu layf de pan denja pan yu pikin in winda paip. If yu pikin in skin tan lɛk blu (cyanosis) , ɔ if yu pikin gɛt siriɔs prɔblɛm fɔ blo , kɔl 911 wantɛm wantɛm.
Us kwɛstyɔn dɛn a fɔ aks mi pikin in dɔktɔ?
if dεn no se yu pikin gεt "double aortic arch," i nכmal fכ yu fכ gεt bכku kכwεshכn. I impɔtant fɔ no yu pikin in kɔndishɔn, ivin we yu nid fɔ du ɔpreshɔn, ɛn if yu pikin gɛt ɛni ɔda wɛlbɔdi prɔblɛm. Yu kin aks kwɛstyɔn dɛn lɛk:
- Ustɛm dɛn fɔ du ɔpreshɔn pan mi pikin?
- Usay dɛn kin du di ɔpreshɔn? Udat de du am?
- Us sayn dɛn a fɔ wach fɔ na os?
- Wetin a go du fɔ mek i izi fɔ mi pikin fɔ de na os?
- Mi pikin gɛt ɔda at prɔblɛm dɛn?
- A fɔ du jenɛtik tɛst fɔ mi pikin ɔ fɔ di ɔda pipul dɛn na mi famili?
- Aw mi pikin in fiuja go tan lɛk?
Wetin na "Aortic Arch Syndrome"? I difrɛn frɔm "Dɔbul Aɔtik Ak"?
Yɛs, nɔ kɔnfyus di tu. "Aortic Arch Syndrome" na wan kayn "Vasculitis" we nɔ kin bɔku. Dɛn kin kɔl am bak "Takayasu in arteritis" .
"Vasculitis" na inflamɛns na di wɔl dɛm na yu blɔd vesel dɛm. I kin apin na ɛni blɔd vesel, ivin di smɔl smɔl blɔd vesel dɛn, di kapilari dɛn. "Takayasu in atεraytis" na inflameshn na di midul saiz εn big bכdi vεsul dεm. i kin apin mכst na di "aortic arch" εn in mεjכr branch dεm. na dat mek dεn kin kכl am bak "aortic arch syndrome."
Takayasu in atεraytis (dεn kin kכl am bak "aortic arch syndrome") kin apin pan yכŋ pipul dεm εn yכng pipul dεm . dis na komplit difrεnt prכblεm frכm di kכnεkshכn "dכbul aortik arch" we wi bin dכn tכk bכt, εn di tritmεnt we dεn nid difrεnt.
Bɔku tɛm, we dɛn bɔn pikin, na tɛm we pipul dɛn kin gladi ɛn sɛlibret. Bɔt we yu kam fɔ no se yu pikin gɛt at prɔblɛm, ilɛksɛf i gɛt bɛlɛ ɔ afta i bɔn am, da gladi at de kin tek ples fɔ wɔri ɛn nɔ kin no wetin fɔ du. if yu jכs fכnכt se yu pikin gεt "double aortic arch," yu go probabli de wanda wetin de nεks.
Nɔ wɔri. Yu mɛdikal tim go ɛp yu fɔ du ɔl dis stɛp bay stɛp. Yu dɔn ɔlrɛdi du di fɔs tin we yu fɔ du, we na fɔ lan mɔ bɔt di sik we yu pikin gɛt. Di gud nyus na dat, dubl aortic arch ɔpreshɔn rili sef ɛn i kin wok fayn. If yu pikin gɛt ɔda at prɔblɛm ɔ in jenɛtik sik, di tritmɛnt kin tranga smɔl. Bɔt we dɛn dɔn go bifo pan aw fɔ kia fɔ pikin dɛn we dɛn jɔs bɔn, yu kin ɛp yu pikin fɔ gɛt di rayt kia we i nid, fɔ mek i wɛl, ɛn fɔ gɛt gladi-at we i bin smɔl.
So, wetin na di impɔtant tin dɛn we wi fɔ mɛmba frɔm wetin wi dɔn tɔk bɔt? (Mɛsej we dɛn kin tek go na os)
Okay, lɛ wi sɔmariz sɔm pan di tin dɛm we yu nid fɔ mɛmba frɔm wetin wi dɔn tɔk bɔt wit wetin i kam pan dis "Double Aortic Arch":
- "Dɔbul aɔta arch" na wan at prɔblɛm we dɛn bɔn wit . di pikin in aorta dεn sheb to tu arch dεm, we de mek di trakya εn εsophagus kכmprεshכn.
- Di men sayn dɛm na we i nɔ kin izi fɔ blo, i kin swɛt, i nɔ kin izi fɔ swɛla, ɛn i kin gɛt infekshɔn na di say we i de blo ɔltɛm .
- dis kכndyushכn dεn kin no tru tεst dεm lεk `CT scan`, `MRI`, `Echocardiogram` . Sɔntɛnde, dɛn kin ivin no se i gɛt bɛlɛ.
- Di tritmɛnt na ɔpreshɔn . Dis ɔpreshɔn kin rili sef ɛn i kin wok fayn.
- Fɔ di pikin afta dɛn dɔn ɔpreshɔn amYu kin liv nɔmal layf we gɛt wɛlbɔdi.
- If yu pikin gɛt sɔm sayn dɛn lɛk we i nɔ izi fɔ blo ɔ we i de chok, go to dɔktɔ wantɛm wantɛm .
- Nɔ wɔri . We di mɛrɛsin dɛn we dɛn de yuz tide dɔn go bifo, dɛn kin ebul fɔ trit dis sik fayn fayn wan. Yu mɛdikal tim go gi yu di sɔpɔt we yu nid.
` Dabl Aortik Ak, Kɔnjɛnital At Sik, Vaskul Ring, Bebi Asfiksia, Bebi Hɛlth, At Ɔpreshɔn
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