Yu go dɔn yɛri bɔt Atrial Fibrillation (Afib), we na wan sik we yu at kin bit ɔltɛm ɛn kwik kwik wan. Sɔntɛm yu ɔ sɔmbɔdi na yu famili gɛt dis sik. Di big risk fɔ Afib na fɔ inkris risk fɔ strok. Fɔ sɔlv dis, bɔku tɛm dɔktɔ dɛn kin gi yu mɛrɛsin fɔ mek yu blɔd tan. Bɔt fɔ tek dɛn mɛrɛsin ya fɔ lɔng tɛm nɔ kin izi fɔ ɔlman. Fɔ dɛn kayn pipul ya, wi de tɔk bɔt wan spɛshal tritmɛnt we go mek dɛn nɔ gɛt strok.
Fɔ tɔk am simpul wan, wetin na Lɛft Atrial Apɛndij Klɔz (LAA Klɔz)?
Fɔ ɔndastand dis, lɛ wi lan fɔs bɔt wan smɔl pat na wi at. Insay di ɔp lɛft chɛmba na wi at, we dɛn kɔl di Lɛft Atrium, wan smɔl say de we tan lɛk pɔch we de kɔmɔt na do. Dis na wetin wi kɔl di Lɛft Atrial Apɛndij (LAA) .
nכmal wan, we di at de bit insay wan ritm, di bכdi we de insay dis LAA de pכmp to di rεst כf di at. Bɔt pan pɔsin we gɛt Atrial Fibrillation (Afib) , di at nɔ de bit ɔltɛm, so di blɔd we de insay dis bag we dɛn kɔl LAA nɔ de pɔmp fayn ɛn i kin bigin fɔ gɛda. Dis blɔd we kin gɛda kin tɔn to blɔd klot .
Bɔt i sɔri fɔ no se if dis klɔt brok ɛn stɔp na blɔd vesel we de go na di bren, i kin mek pɔsin gɛt strok . כlmost 90% pan di strכk dεm na pipul dεm we gεt Afib de kכz fכ klot we de fכm na di LAA.
So, insay dis tritmɛnt we dɛn kɔl LAA Klɔz, dɛn kin lɔk di bag we dɛn kɔl LAA usay blɔd klɔt fɔm, ɔ tru ɔpreshɔn ɔ tru wan rili smɔl say we dɛn kɔt. Afta dis dɔn lɔk, ivin if blɔd klɔt fɔm, dɛn nɔ kin ebul fɔ go insay di blɔd. So, di risk fɔ gɛt strok kin ridyus bad bad wan.
Di impɔtant tin na dat dis tritmɛnt nɔ de mɛn Afib, bɔt i de ridyus di risk fɔ gɛt strok we i kin gɛt bad bad wan.
Udat dis tritmɛnt bɛtɛ fɔ? Wetin mek yu nɔ jɔs yuz tin dɛn we de mek blɔd tan?
LAA Klɔz nɔto tritmɛnt fɔ ɔlman we gɛt ay risk fɔ gɛt strok bikɔs ɔf Afib. Dɛn kin tink bɔt am mɔ fɔ pipul dɛn we:
- Fɔ di wan dɛn we nɔ want fɔ tek antikɔagulant fɔ lɔng tɛm.
- Pipul dɛn we kin fɔdɔm bɔku tɛm ɛn dat kin mek dɛn gɛt mɔ blɔd (bikɔs ivin smɔl injury kin mek dɛn blɔd bɔku we dɛn de tek mɛrɛsin we de mek dɛn blɔd tan).
- Fɔ di wan dɛn we kin gɛt ɔda bad bad tin dɛn we kin apin to dɛn we dɛn kin tek mɛrɛsin we kin mek dɛn blɔd tan.
- Fɔ di wan dɛn we nɔ ebul fɔ pe fɔ di ay kɔst fɔ mɛrɛsin dɛn we de mek dɛn blɔd tan.
Bɔku pipul dɛn kin gɛt difrɛn prɔblɛm dɛn we dɛn de tek ol mɛrɛsin dɛn we de mek dɛn blɔd tan lɛk Warfarin.
| Prɔblɛm fɔ tek mɛrɛsin lɛk Warfarin |
|---|
| - Yu nid fɔ go na ɔspitul ɔltɛm fɔ mek dɛn tɛst yu blɔd fɔ mek shɔ se di mɛrɛsin we dɛn gi yu kɔrɛkt. |
| - Sɔm it dɛn we gɛt vaytamɛn K (lɛk spinach) nid fɔ smɔl. |
| - Di risk fɔ mek yu blɔd kɔmɔt na yu bɔdi rili bɔku. |
| - Sɔm pipul dɛn bɔdi nɔ kin ebul fɔ bia wit dis mɛrɛsin. |
Pan ɔl we nyu mɛrɛsin dɛn de lɛk Apixaban ɛn Rivaroxaban, dɛn ay kɔst ɛn di kɔntinyu risk fɔ blɔd na prɔblɛm fɔ sɔm pipul dɛn. Yu fɔ rili tɔk to yu dɔktɔ we de mɛn yu at fɔ disayd us tritmɛnt go fayn fɔ yu.
Us we dɛn kin yuz fɔ lɔk dis LAA?
Difrɛn we dɛn ɛn difrɛn tin dɛn de fɔ du dis. Tink bɔt am lɛk fɔ lɔk wata bɔtul in mɔt, dɛn kin yuz dis divays fɔ lɔk dis bag in mɔt we dɛn kɔl LAA.
- di divays dεm we de insay di oklushכn: dεn tin ya lεk sכmכl כmbrela. dεn kin put dεm insay di at bay we dεn de yuz kateshכn εn dεn kin yuz dεm fכ sial di opin fכ di LAA frכm insay. Divays dɛn we pipul dɛn lɛk na WATCHMANTM ɛn AmuletTM.
- di divays dεm we de kכloz na do: sכmtεm, we dεn de du כda at כpεrayshכn, dεn kin kכloz di LAA na do wit klip (`AtriClipTM`) כ wit spεshal sutura (`LariatTM`).
Dɛn kin pik di we we fayn fɔ yu afta yu ɛn yu dɔktɔ dɔn tɔk.
Fɔ pripia fɔ tritmɛnt ɛn aw di tritmɛnt kin apin
Bifo dɛn trit am...
Bifo dis prɔsidyu, yu dɔktɔ go nid fɔ mɛzhɔ di rayt saiz ɛn shep fɔ yu LAA. Nɔto ɔlman in LAA na di sem. Sɔm pipul dɛn se i shep lɛk chukchuk wing, kaktus, ɔ kɔliflawa. Dis go involv Transesophageal Echocardiogram (TEE) (dɛn kin du wan skan fɔ di at tru wan tiub we dɛn kɔl larynx) ɔ wan Kadiak CT skan. Dɛn go tɛl yu bak fɔ fast (nɔ fɔ it ɔ drink) fɔ sɔm awa bifo di prɔsidyu.
We dɛn de du tritmɛnt...
Wi kin du dis tu men we dɛn:
1. Wit ɔda at ɔpreshɔn:If yu de du ɔda big ɔpreshɔn pan yu at, lɛk baypas ɔpreshɔn, di dɔktɔ kin pul ɔ siŋ di LAA we dɛn lɔk bak di sem tɛm.
2. Minimally Invasive: Dis na di we aw dɛn kin yuz mɔ. Na ya, dɛn kin put wan tint tiub, we dɛn kɔl kateta, tru yu groin insay wan vein ɛn gayd am ɔlsay te to yu at. Dɔn, dɛn kin put wan tin we dɛn dɔn pik bifo tɛm na di say we di LAA opin ɛn sial am fɔ mek di blɔd nɔ kɔmɔt. dis ol prosidכs dεn de du am כnda di gayd fכ spεshal εks-ray (Fluoroscopy) εn skan (TEE/Intracardiac Ultrasound) tεknכlכji.
Afta tritmɛnt...
- Bɔku tɛm yu kin gɛt fɔ de na ɔspitul fɔ wan nɛt.
- Dɛn go du TEE skan bak insay lɛk 45 dez fɔ si if di tritmɛnt bin wok fayn.
- Dɛn go gi yu wan blɔd tin ɛn aspirin fɔ tek te di bɔdi in tisu gro rawnd dis divays, we kin tek lɛk wan ɛn af mɔnt.
- Afta dat, yu go gɛt fɔ stɔp fɔ tek di blɔd thinner ɛn tek Clopidogrel ɛn aspirin fɔ lɛk 6 mɔnt. Yu kin ivin gɛt fɔ tek aspirin fɔ di res ɔf yu layf. Ɔl dis go bi bay di advays we yu dɔktɔ gi yu.
Wetin na di bɛnifit ɛn prɔblɛm dɛn we dis tritmɛnt de gi?
Lɛk ɛni mɛrɛsin, dis wan gɛt bɛnifit ɛn prɔblɛm dɛn.
| Bɛnifit dɛn | Risk/Kɔmplikeshɔn dɛn |
|---|---|
| I dɔn ridyus di risk fɔ gɛt strok bad bad wan. | Wan prɔblɛm wit di divays we dɛn de yuz fɔ put di tin dɛn. |
| Fɔ ebul fɔ fri frɔm fɔ tek mɛrɛsin dɛn we de mek yu blɔd tan fɔ lɔng tɛm (anticoagulants). | Wan bad tin we kin apin to pɔsin we dɛn tek anestezi. |
| Kwik fɔ wɛl bikɔs dɛn kin du am tru smɔl say we dɛn kɔt am. | Blɔd we de kɔmɔt. |
| Fɔ mek di kwaliti fɔ layf bɛtɛ. | Chɛst pen, infekshɔn. |
| di akyumyuleshכn fכ wata rawnd di at (pεrikardial efyushכn). | |
| Wan tin we nɔ kin apin so ɔltɛm we tan lɛk strok. |
Dis tritmɛnt kin rili wok. Sɔm stɔdi dɔn sho se dis we ya kin ridyus di risk fɔ gɛt strok bay lɛk 80%. Bɔt mɛmba se i impɔtant fɔ tɔk bɔt ɔl dis wit yu dɔktɔ bifo yu disayd if dis fayn fɔ yu.
Ustɛm a fɔ go to di dɔktɔ?
Apat frɔm we yu go na di say dɛn we yu dɔn plan fɔ fala yu, tɛl yu dɔktɔ wantɛm wantɛm if yu gɛt dɛn sik ya:
- Sayn dɛm fɔ fiva ɔ ɔda infekshɔn
- Di at we nɔ de bit ɔltɛm
- Chɛst de pen
- I nɔ kin izi fɔ yu fɔ blo
If yu gɛt ɛni wan pan dɛn sik ya, go na di ɔspitul we de nia yu in Imejɛnsi Dipatmɛnt (ETU) wantɛm wantɛm.
Mɛsej we dɛn kin kɛr go na os
- LAA Klɔz na tritmɛnt fɔ pipul dɛm wae gɛt Atrial Fibrillation (Afib) fɔ ridyus di risk fɔ gɛt strok.
- dis de wok bay we i de kכloz wan sכmכl sak na di at we dεn kכl LAA, we de mek di bכdi we de fכm de nכ go insay di bכdi.
- Dis tritmɛnt na fayn ɔda tritmɛnt fɔ di wan dɛn we gɛt prɔblɛm fɔ tek blɔd tin fɔ lɔng tɛm.
- Dis nɔ go mɛn Afib, bɔt i kin mek yu nɔ gɛt di big big prɔblɛm, we na strok.
- Mek disizhɔn afta yu dɔn tɔk to yu dɔktɔ we de mɛn yu at bɔt if dis tritmɛnt fayn fɔ yu ɛn wetin i go bɛnifit ɛn di prɔblɛm dɛn we i gɛt.
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