Lɛ wi lan bɔt di las ɔpreshɔn we de sev di at valv (Valve-Sparing Aortic Root Replacement).

Yu tink se di dɔktɔ tɛl yu se yu nid fɔ du ɔpreshɔn pan yu at? Na nɔmal tin fɔ mek yu fred smɔl we i tɔk dat. Bɔt tide, mɛrɛsin dɔn rili go bifo. Sɔm ɔpreshɔn dɛn de we kin tray fɔ protɛkt bɔku pat dɛn na yu bɔdi. Tide wi go tɔk bɔt wan pan dɛn kayn ɔpreshɔn dɛn ya we rili spɛshal. Dat min se di at valv, we na ɔpreshɔn we de protɛkt di valv.

Fɔ tɔk am simpul wan, wetin na Valve-Sparing ɔpreshɔn?

Okay, fɔ ɔndastand dis, lɛ wi lan fɔs bɔt wan smɔl pat na wi at. di men pכmp chεmba na wi at (di lεft vεntrikl) de kכnekt to di big bכdi we de na wi bכdi, di aorta. Wi kin kɔl dis kɔnekshɔn di `Aortic Root`. I tan lɛk di rut fɔ tik. insay dis `Aortic Root` na wan rili imכtant get, di `Aortic Valve`.

εvri tεm we di at de bit, dis `Aortic Valve` de opin εn pכmp bכdi insay di bכdi, εn afta dat i de kכloz. Dis klos de mek di blɔd nɔ flɔ bak insay di at.

Naw imajin, insay sɔm pipul dɛm, di `Aortic Root`, dat na di pat pan di get we tan lɛk di get, dɔn wik, swel, ɛn bi big. I tan lɛk se dɛn de blo balyɔn. Wi kin kɔl dis `Aortic Root Aneurysm`. we dis get big, di doa we de insay, dat na di `Aortic Valve`, nכ de klos fayn. Dɔn di blɔd kin bigin fɔ lik bak insay di at. dis dεn kכl am `Aortic Regurgitation`.

insay di tradishכnal כpεrayshכn (di `Bentall prosidכs`), di sכja dεm de pul כl tu di bulging `Aortic Root` εn `Aortic Valve` εn implant tu nyu atifishal wan dεm.

Di big advantej fɔ dis na dat yu kin kip yu yon valv, so yu nɔ nid fɔ tek layflɔŋ antikɔagulant mɛrɛsin (lɛk Coumadin) lɛk aw yu go tek wit mɛkanikal valv.

Us kɔndishɔn dɛn dis ɔpreshɔn de trit?

Dɛn kin du dis ɔpreshɔn mɔ pan dɛn kayn tin ya:

• Aortic Root Aneurysm: As a bin dɔn tɔk, dis na abnɔmal bulge na di rut na di aorta we de kɔnɛkt to di at. if dis tu big, i kin bכs wan wan (`Aortic Dissection` כ Rupture). I rili denja fɔ layf.
• Ascending Aortic Aneurysm wit Dilated Aortic Sinus: kes dεm we di nεchכral sכm spεs dεm na di `Aortic Root` (`Aortic Sinuses`) kin big sכmtεm, wit wan bulge na di ascending pat pan di aorta.

Pipul dεm we gεt sכm hεriditri kכnektiv tisu sik dεm, lεk Marfan sεndrכm, kin gεt hכy risk fכ gεt aorta rut anεvrizm. So, di dɔktɔ dɛn we de du ɔpreshɔn kin tek tɛm luk di pɔsin in kɔndishɔn ɛn wej di bɛnifit ɛn prɔblɛm dɛn we di ɔpreshɔn go gɛt bifo dɛn disayd if i fayn fɔ du am.

Yu fit fɔ dis ɔpreshɔn?

If yu aorta valv gɛt dɛn kayn tin ya, yu kin bi kandidet fɔ dis ɔpreshɔn:

• If na smɔl ɔ nɔ gɛt kalsiɔm dipɔsit (kalsifikɛshɔn) na di valv.
• Apat frɔm we di valv dɔn pwɛl bad bad wan.
• If di valv de wok fayn ɔ dɛn kin ripɛnt am wit smɔl ripa.

Aw yu kin pripia bifo dɛn du yu ɔpreshɔn?

Yu dɔktɔ we de du di ɔpreshɔn go ɛksplen ɔl wetin yu nid fɔ du bifo dɛn du di ɔpreshɔn. I rili impɔtant fɔ fala dɛn instrɔkshɔn dɛn de di rayt we. Bɔku tɛm, na dis yu go nid fɔ du.

Apat frɔm dat, di dɔktɔ go du bɔku tɛst dɛn fɔ plan di ɔpreshɔn, lɛk:

• Echocardiogram (skan di at) .
• Blɔd tɛst dɛn
• `Kadiak ɛn chɛst EKG gated CT skan`
• Koronari Angiogram we dɛn kin du
• Jɛnɛtik blɔd tɛst if dɛn tink se pɔsin gɛt sik we pɔsin kin gɛt frɔm in mama ɛn papa

Wetin kin apin we dɛn de du di ɔpreshɔn?

Dis ɔpreshɔn kin tek bitwin 4 ɛn 6 awa. We dɔktɔ we gɛt ɛkspiriɛns du dis ɔpreshɔn, dɛn fɔ stɔp di at fɔ lɛk wan awa so. Nɔ wɔri, insay da tɛm de, mashin go du di wok we di at ɛn di lɔng dɛn de du.

Na dis na wetin kin apin stɛp bay stɛp:

1. Anestesia: Fɔs, dɛn go put yu fɔ slip kpatakpata. So yu nɔ go fil ɛni pen.

2. fכ opin di chεst: di sכjaman de mek wan insayshכn na di midul pan di chεst (a `median sternotomy`) fכ rich di at.

3. Kכnekt to di At-Lכng Mashin: Yu go kכnekt to wan `Cardiopulmonary Bypass` mashin. Dis mashin go tek di wok we yu at ɛn yu lɔng dɛn de du we dɛn de du di ɔpreshɔn. dis tεm, dεn go gi yu mεdisin we dεn kכl `cardioplegia solution` fכ stכp yu at fכ sכm tεm.

4. Fɔ rilis di Valv: Di dɔktɔ we de du di ɔpreshɔn kin tek tɛm separet yu aɔta valv frɔm di tisu we de rawnd yu.

5. Fɔ pul di pat dɛn we dɔn pwɛl: Dɛn kin kɔt di `Aortic Root` we dɔn swel ɛn ɔda pat dɛn we dɔn pwɛl.

6. Graft: dεn de implant wan atifishal tכb (a `graft`) insay di ples fכ di pat we dεn pul. Dis na wan spɛshal kayn klos (`polyester`).

7. Valv ri-implantεshכn: dεn tek yu כwn aorta valv, put nyu graft, εn sutura in ples.

8. Chɛk di Valv: Fɔ mek shɔ se ɔltin fayn, dɛn kin pas wan wata tru di `Graft` fɔ chɛk if di valv de wok fayn, i de opin ɛn lɔk.

9. di las step: di korona at dεm na di at de kכnekt to di nyu `Graft`. Dɔn dɛn kin pul yu na di `Hat-Lung Mashin` ɛn dɛn kin alaw yu at fɔ wok bak. Dɔn dɛn kin lɔk di say we dɛn kɔt di chɛst.

Di we aw dɛn de du ɔpreshɔn tide (Modified Reimplantation) .

As tɛm de go, dɔktɔ dɛn we de du ɔpreshɔn dɔn ad nyu we dɛn fɔ mek dis ɔpreshɔn go bifo. Fɔ ɛgzampul:

• fכ mek nyu aorta sayn dεm (`Neosinus`): nכmal wan, di `Graft` na wan strεt tכb. bכt di nכchכral `Aortic Root` gεt sכm sכm spεs dεm (`saynus`). Insay di nyu we, dɛn kin mek dɛn kayn spɛshal ples ya artifishal wan na di `Graft`. Dis kin mek di blɔd flɔ mɔ natura, ɛn di damej we di valv kin pwɛl kin ridyus.
• Aortic Annulus Sizing: di sayz fכ di pat we lεk ring we di valv de rεst pan (di `aortic annulus`) dεn de ajɔst am fכ fit yu bכdi saiz. Dis kin ridyus di risk fɔ mek blɔd lik frɔm di valv tumara bambay.

Wetin kin apin afta di ɔpreshɔn? Ɛn aw lɔng i kin tek fɔ mek i wɛl?

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. Bɔku tɛm yu kin go na os insay 4 to 7 dez.

Ivin if yu gɛt laysens fɔ drayv, nɔ drayv te yu dɔktɔ gi yu di rayt fɔ drayv. Yu go nid fɔ wet fɔ at le 6 wik bifo yu du ɛnitin lɛk fɔ es wet ɔ fɔ go wok.

If yu tek pat pan wan kadyak rihabiliteshɔn program (`cardiac rehab`) i go ɛp yu fɔ wɛl kwik kwik wan. Dɔn bak, mek shɔ se yu go fɔ fala-ap apɔntinmɛnt wit yu dɔktɔ. Dɛn go kɔntinyu fɔ wach aw yu at de.

Wetin na di bad tin dɛn ɛn bɛnifit dɛn we dɛn kin gɛt we dɛn du dis ɔpreshɔn?

Lɛk ɛni big ɔpreshɔn, sɔm prɔblɛm dɛn de we kin apin. Bɔt we dɔktɔ we gɛt ɛkspiriɛns du ɔpreshɔn na ɔspitul we gɛt gud tin dɛn fɔ du, dɛn prɔblɛm ya nɔ kin bɔku .

Di men bɛnifit dɛn we yu kin gɛt:

• Yu nɔ nid fɔ tek mɛrɛsin we de mek yu blɔd tan fɔ di res ɔf yu layf.
• Di risk fɔ mek blɔd klɔt, strok, ɛn valv infɛkshɔn (endocarditis) kin ridyus.
• Di chans fɔ mek dɛn gɛt ɔpreshɔn fɔ chenj di valv bak tumara bambay, rili smɔl.

Risach dɔn sho se di sakses rɛt fɔ dis ɔpreshɔn pas 99%. Ivin afta 10 ia, lɛk 95% pan di pipul dɛn we dɔn gɛt dis ɔpreshɔn nɔ go nid ɔda ɔpreshɔn.

If yu gɛt ɛni wan pan dɛn sik ya, kɔl yu dɔktɔ wantɛm wantɛm ɔ go na di Imejɛnsi Dipatmɛnt (ETU) na di ɔspitul we de nia yu.