Yu dɔktɔ dɔn tɛl yu se yu aɔta rut dɔn big smɔl ɛn yu nid fɔ du ɔpreshɔn? Na nɔmal tin fɔ mek yu fred ɛn wɔri smɔl we yu yɛri dat. Udat nɔ lɛk di wɔd "at ɔpreshɔn"? Bɔt nɔ wɔri. Teknɔlɔji dɔn rili go bifo tide. Tide, wi go tɔk bɔt wan rili saksesful, spɛshal ɔpreshɔn we de sɔlv dis prɔblɛm we nɔ de pul di pat we gɛt valyu pas ɔl na yu at, we na yu yon natura ‘valv’.
Wetin na Valv-Sparing Aortic Root Riplesmɛnt?
Fɔ ɔndastand dis, lɛ wi tek wan simpul luk fɔs pan aw di at de wok. Tink bɔt yu at lɛk wata pɔmp na yu os. Dis pɔmp de pɔmp blɔd ɔlsay na yu bɔdi.
- Aorta: Dis na di men, big tiub we de kɔmɔt na di at. I kin kɛr blɔd go na di wan ol bɔdi.
- Aortic Root: Dis na di fכs pat pan di men at we de kכnekt to di at. I tan lɛk usay yu kin tay tiub to motoka.
- Aortic Valve: Dis na di pat we impɔtant pas ɔl na di stori. Usay i kɔnɛkt to di at, wan pat de we de wok lɛk domɔt. We di at de pɔmp blɔd, dis domɔt kin opin, ɛn i kin mek blɔd kɔmɔt. Dɔn dis domɔt kin lɔk fɔ mek blɔd nɔ kam bak na di at. Dis na wetin wi kin kɔl di `(Aortic Valve)`.
naw, insay sכm pipul dεm, di rכt fכ dis big at we de kכnekt to di at, di `(Aortic Root),` de wik sכmtεm εn i de bigin fכ bulge εn big lεk balכn. Wi kin kɔl dis `(Aortic Root Aneurysm)`. We i big lɛk dis, da domɔt de, da valv de, nɔ kin lɔk fayn. afta dat di bכdi de bigin fכ lik bak, `(Aortic Regurgitation)`.
Trade, we dis kayn prɔblɛm kin kam, di dɔktɔ dɛn we de du ɔpreshɔn kin pul ɔl tu di aɔta rut ɛn di aɔta valv, ɛn put atifishal aɔta rut ɛn valv insay dɛn. Dɛn kɔl dis ɔpreshɔn di Bentall prosidur .
bכt naw, if yu valv de insay gud kכndishכn, we min se i nכ dכn bכku bכku wan, insted fכ pul da prεsכs nεchכral valv de, na di bad bad `(Aortic Root)` nכmכ dεn de pul, dεn de put nyu atifishal tiub (`graft`), εn yu כwn valv de atak am bak. Fɔ tɔk am simpul wan, dɛn kɔl dis Valve-Sparing Aortic Root Replacement .
Us kɔndishɔn dɛn kin trit wit dis ɔpreshɔn?
dis כpεrayshכn na fכ wan kכndyushכn we dεn kכl `(Aortic Root Aneurysm)`. dis min se we di rut fכ di aorta swεla lεk balכn. Dis kin denja, bikɔs if i big pas wan patikyula limit, i kin bɔs (rupchɔ) ɔ te (aortic dissection).
Sɔm pipul dɛn kin gɛt prɔblɛm wit dɛn jenɛtik kɔnektiv tisu, lɛk Marfan syndrome. Pipul dεm wae gεt dεn kכndyushכn ya kin gεt hכy risk fכ gεt aortic rut aneurysm.
Udat fit fɔ dis ɔpreshɔn?
Yu dɔktɔ go du difrɛn tɛst dɛn fɔ no if yu na gud pɔsin fɔ dis ɔpreshɔn. Jɛnɛral wan, yu kin bi gud kandidet fɔ dis ɔpreshɔn.
- If yu Aortic Valve gɛt smɔl ɔ nɔ gɛt ɛni kalsifikeshɔn.
- pas nɔmɔ di valv dɔn pwɛl bad bad wan.
- If di valv de wok fayn, ɔ dɛn kin fiks am wit smɔl ripa.
- Dɛn kin advays fɔ mek dɛn du dis ɔpreshɔn mɔ fɔ pipul dɛn we nɔ rich 75 ia yet ɛn di wan dɛn we gɛt sik dɛn we dɛn kin gɛt frɔm dɛn jɛnɛtiks.
Aw yu kin pripia bifo dɛn du yu ɔpreshɔn?
Bikɔs dis na big ɔpreshɔn, i rili impɔtant fɔ rɛdi gud gud wan fɔ am. Yu dɔktɔ we de du ɔpreshɔn go gi yu klia tin dɛn bɔt dis.
- Mɛrɛsin: Yu fɔ tɛl yu dɔktɔ bɔt ɛni mɛrɛsin we yu de tek naw. I kin aks yu fɔ stɔp ɔ chenj sɔm mɛrɛsin dɛn (espɛshali di wan dɛn we de mek yu blɔd tan) bifo dɛn du yu ɔpreshɔn.
- Fastin: Dɛn go aks yu fɔ nɔ it ɔ drink ɛnitin afta midnayt di nɛt bifo di ɔpreshɔn. Nɔ ivin drink wata.
- Test: Di dɔktɔ go ɔda fɔ du bɔku tɛst fɔ plan di ɔpreshɔn.
- Echocardiogram (we dɛn kin skan di at) .
- Blɔd tɛst dɛn
- EKG gated CT skan
- MRI fɔ di at
- Koronari Angiogram we dɛn kin du
- Smok: If yu na pɔsin we de smok, i impɔtant fɔ lɛ yu stɔp fɔ smok kpatakpata at le wan mɔnt bifo dɛn du di ɔpreshɔn.
- Aks kwɛstyɔn: Tɔk opin wan wit yu dɔktɔ bɔt ɛnitin we de mɔna yu ɔr de fred. I go rili fil fri fɔ no ɔltin klia wan.
Aw dɛn kin du di ɔpreshɔn?
Dis ɔpreshɔn kin tek bitwin 4 ɛn 6 awa. We dɔktɔ we sabi du ɔpreshɔn wit in an, dɛn kin stɔp di at fɔ shɔt tɛm, we na lɛk wan awa so. Di step dɛm we de insay dis prɔses na jɔs lɛk dis.
1. Anesthesia: Fɔs, dɛn go gi yu anestesia fɔ put yu insay dip slip. So yu nɔ go fil ɛni pen.
2. Fכ opin di chεst: di dכkta de mek wan insayshכn na di midul pan di chεst (median sternotomy) fכ akses di at.
3. Hat-lכng mashin: Nεks, dεn go kכnekt yu to hat-lכng mashin (cardiopulmonary bypass machine). Dis mashin go du di wok we yu at ɛn yu lɔng dɛn de du we dɛn de du di ɔpreshɔn. I go gi yu mɛrɛsin bak fɔ stɔp yu at fɔ sɔm tɛm.
4. di valv separeshכn: di sכjaman go tek tεm separet yu aorta valv frכm di tisu we de rawnd.
5. Ripair: .If ɛni smɔl damej de pan di valv flap dɛn, dɛn kin mek am wantɛm wantɛm.
6. fכ pul di pat we dεn dכn pwεl: dεn de kכt di pat we swel εn we dεn dכn pwεl na di `(Aortic Root)` εn pul am.
7. artificial tube implantation: Bifo dat, dεn de tek wan artificial tube ``graft`` we dεn mek wit spεshal fabrik, mek am di rayt saiz fכ yu, εn implant am na da ples de.
8. Fɔ tay di valv bak: Dɔn , dɛn kin put yu yon natura valv , we dɛn bin tek tɛm pul insay di tiub we dɛn jɔs put insay di bɔdi ɛn siŋ am bak togɛda (ri-implant).
9. Chɛk: Chɛk fɔ si if ɔltin fayn, if di valv opin ɛn lɔk fayn, ɛn if ɛnitin de lik.
10. Klos: afta dat di korona at dεm we de gi bכdi to di at de kכnekt to di nyu graft. Dɛn kin pul yu na di at-lɔng mashin ɛn wans yu at bigin fɔ wok bak, di say we dɛn kɔt na yu chɛst kin lɔk.
11. Fainal chεk-ap: bifo dεn kכmכt na di כpεrayshכn rum, dεn kin du ``transesophageal echocardiogram'' fכ kכnfכm di sakses fכ di כpεrayshכn.
Di impɔtant tin dɛn we dɛn dɔn mek tide we dɛn de du ɔpreshɔn
As tɛm de go, dɔktɔ dɛn dɔn ad nyu we dɛn fɔ mek dis ɔpreshɔn go bifo.
- di anul rεdukshכn: fכ simpul wan, dεn kכmprεs di bays we de ol di valv (aortic annulus) fכ fit yu bכdi. Dis go mek blɔd nɔ kɔmɔt na di valv tumara bambay.
- fכ mek nyu aorta sayn dεm (Neosinus): di rut fכ di nεchכral aorta gεt sכm sכm vaybreshכn dεm. Bikɔs di nyu graft na stret tiub, i de mek smɔl smɔl vaybreshɔn dɛn bak. dis de mek di bכdi fכ fכlכ mכr nכmal εn i de ridyus di damej pan di valv liflet dεm.
Wetin na di bɛnifit dɛn we dis ɔpreshɔn de gi?
Dis ɔpreshɔn gɛt sɔm big bɛnifit dɛn pas di tradishɔnal Bɛntal ɔpreshɔn (we involv fɔ riples di valv wit di valv).
| Bɛnifit | Valv-Sparing Ɔpreshɔn | Bɛntal ɔpreshɔn (wit mɛkanikal valv) . |
|---|---|---|
| Di tin dɛn we de mek blɔd tan lɛk ɔl in layf | Yu nɔ nid fɔ tek am. | Dɛn fɔ tek mɛrɛsin lɛk Coumadin (Warfarin) fɔ layf. |
| Blɔd klɔt, strok risk | Rili low . | Impɔtant mɔ . |
| Risk fɔ gɛt valv infɛkshɔn (endokarditis) . | Rili low . | Tumɔs . |
| Di nid fɔ ɔpreshɔn fɔ riples di valv | Rili low . 95% pan pipul dɛm nɔr go nid am fɔ 10 ia. | I kin nid fɔ de as tɛm de go. |
Aw lɔng i kin tek fɔ mek i wɛl afta dɛn dɔn du di ɔpreshɔn?
Afta di ɔpreshɔn, dɛn go kip yu na di intensiv kia yunit (ICU) fɔ wan ɔ tu dez, dɔn dɛn go transfa yu to wan rɛgyula wɔd. Yu kin go na os frɔm ɔspitul insay 4 to 7 dez.
I kin tek lɛk 6 wik fɔ mek i wɛl ful wan ɛn kam bak to di nɔmal tin dɛn we i kin du.
Insay dis tɛm, .
- Fɔ tek pat pan wan program fɔ rihabilite yu at na fayn tin. I go ɛp yu fɔ wɛl kwik ɛn gɛt trɛnk.
- Di dɔktɔ se nɔ fɔ du ɛnitin lɛk fɔ es wet ɔ fɔ drayv fɔ lɛk 6 wik.
- Fɔ fala di apɔntinmɛnt: Yu nɔ go tink se yu nid fɔ go to yu dɔktɔ igen afta yu dɔn wɛl. Bɔt i impɔtant fɔ du dat . I impɔtant fɔ kip yu at kɔndishɔn ɔnda chɛk-ap ɔltɛm.
Ustɛm fɔ kɔl di dɔktɔ wantɛm wantɛm
Afta yu dɔn go bak na os, if yu gɛt ɛni wan pan dɛn sik ya, kɔl yu dɔktɔ wantɛm wantɛm ɔ go na di ɔspitul we de nia yu in Imejɛnsi Dipatmɛnt (ETU).
| Di sayn we de sho se di sik de | Wetin fɔ pe atɛnshɔn to |
|---|---|
| Chenj dɛn na di rod we dɛn de kɔt | Rɛd, swel, pen pasmak, wam, ɛn yɔlɔ ɔ grɛn pus rawnd di say we dɛn kɔt. |
| Chɛst de pen | Chɛst pen wantɛm wantɛm ɔ bad bad wan. |
| I nɔ kin izi fɔ yu fɔ blo | Di briz we kin shɔt wantɛm wantɛm. |
| Leg we de swel | Di leg dɛn we de swel ɔ we nɔ ebul fɔ muv di leg dɛn. |
| Diziz ɔ fɔdɔm | Diziz bad bad wan, fɔdɔm, ɔ taya pasmak. |
| Fiva ɔ kol | Fiva wit kol, yɔlɔ ɔ grɛn mכkus dischaj. |
Na nɔmal tin fɔ fil se yu de fred bifo yu du ɛni big ɔpreshɔn. Bɔt mɛmba se dɛn de du dis ɔpreshɔn fɔ sev yu layf ɛn ɛp yu fɔ gɛt wɛlbɔdi fɔ lɔng tɛm. Tɔk to yu fambul ɛn padi dɛn bɔt dis. Dɛn sɔpɔt go bi big trɛnk fɔ yu insay dis tɛm.
Mɛsej we dɛn kin kɛr go na os
- Valve-Sparing Aortic Root Replacement na wan advans ɔpreshɔn we de sev yu natura aorta valv ɛn trit di aorta rut dilayshɔn.
- Di big bɛnifit fɔ dis na dat yu nɔ nid fɔ tek mɛrɛsin we de mek yu blɔd tan fɔ di res ɔf yu layf, lɛk aw yu go tek wit mɛkanikal valv.
- Dis ɔpreshɔn kin bi ɔnda di sɔpɔtishɔn fɔ wan ɛkspiriɛns ɔspitul na ɔspitul we gɛt gud fasiliti ɛn i gɛt rili ay sakrifays rɛt (ɔva 99%).
- I kin tek lɛk 6 wiks fɔ mek i wɛl ɔl we dɛn du di ɔpreshɔn. Insay da tɛm de, i rili impɔtant fɔ du wetin di dɔktɔ tɛl yu fɔ du.
- Nɔr frayd fɔ tɔk to yu dɔktɔ bɔt ɛni kwɛstyɔn ɔr tin wae de mɔna yu. Na big trɛnk fɔ mek yu no gud gud wan bifo yu go na ɔpreshɔn.
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