I fate hian hetiang thinlung lama harsatna hi a nei em? (Total Anomalous Pulmonary Venous Return - TAPVR) Hemi chungchang hi han sawi ila!

I naute a lo pian hian a chang chuan thawk harsa ang maiin a awm em? A chang chuan vun chu a rawn sen chhuak ang maiin a lang em? Chutiang thil i hmuh chuan hlauhna nasa tak i neih chu thil pangngai a ni. Vawiin hian heng symptoms te hi pianpui thinlung natna (congenital heart disease) chungchang kan sawi dawn a ni. Hei hi TAPVR (Total Anomalous Pulmonary Venous Return) tih a ni . A hming hi a buaithlak deuhin lang mahse, awlsam takin i hrethiam ang u.

TAPVR chu eng nge ni? A awlsam zawngin sawi ila...

Ngaihtuah teh, kan taksa hian lung atang hian oxygen a hmu thin a ni lawm ni? Chuvangin, heng lung atang hian oxygenated thisen (hei hi "thisen tha" ti ila) chu thinlungah hian veins , thisen kalna kawng chi khat hmangin a rawn thleng thin. A tlangpuiin he "thisen tha" hi thinlung veilam sir veilam atrium-ah a lo thleng tur a ni. Chuta tang chuan thisen chu pump chhuakin taksa pum puiah oxygen pek a ni.

Mahse, TAPVR vei nauteah chuan thinlung veilam atrium-a inzawm ai chuan he pulmonary vein hi hmun dik lovah a inzawm a, chu chu right atrium a ni Atrium dinglam hian a tlangpuiin taksain a hmanral tawh "thisen tha lo" a dawng a, chu chu oxygen a tlem hle. Tunah chuan oxygen khat "thisen tha" chu he "thisen tha lo" nen hian a inhmeh ta a ni. Chuti a nih chuan eng nge thleng? Thisen chhunga oxygen awm zat, taksa pum puia kal tur chu a tlahniam a. Hei hi naute tan chuan hlauhawm tak leh nunna atana hlauhawm tak a ni. Hei hi pianpui thinlung natna a ni.

TAPVR vei naute zawng zawng deuhthaw hian an thinlung chamber pahnih, dinglam atrium leh veilam atrium inkarah hian khur te tak te (Atrial Septal Defect - ASD) an nei vek a. He khur hian oxygen nei thisen thenkhat chu thinlung veilam lamah a luang lut a, chuta tang chuan taksa dang zawng zawngah a luang lut thei a ni. Chutiang a nih loh chuan a dinhmun chu a chhe zawk thei hle.

A pawimawh ber chu TAPVR nei naute hian operation an mamawh tak zet a ni. Surgery tih hmasak a nih chuan naupang tam zawk chu puitlin thlengin nun hrisel tak an hmang thei a ni. Mahse, a châng chuan, nakin lawka thisen kalna kawng (veins) tihtlem ang chi thilte chu operation dang emaw, enkawlna dang emaw a ngai thei a ni. Chuvangin TAPVR surgery hnuah pawh i dam chhung zawng cardiologist- in a enkawl a ngai dawn a ni.

A châng chuan doctor-te chuan he natna hi TAPVC (Total Anomalous Pulmonary Venous Connection) an ti bawk. An pahnih hian dinhmun inang an ni.

TAPVR chi hrang hrang a awm em?

Ni e, TAPVR hi chi hrang hrang lian tak tak a awm. Chungte chu lung atanga "thisen tha" lo chhuak chu atrium dinglamah a inzawm dik loh dan azirin an thliar hrang a ni.

• Supracardiac TAPVR: Hetah hian pulmonary veins te hi thinlung chunga awm vein lian tak ( superior vena cava tia koh, taksa chunglam atanga thinlung dinglam panna thisen kalna vein lian tak) nen an inzawm a, an inzawm khawm a ni.
• Cardiac TAPVR: Hetah hian pulmonary veins te hi thinlung dinglam sir coronary sinus ah direct in an luang lut a.A inzawm khawm thin. He coronary artery hi oxygen tlachham thisen a tlangpuiin heart muscle atanga a lakkhawmna hmun a ni.
• Infracardiac TAPVR: Hetiang chi ah hian pulmonary vein hi thinlung hnuai lam, liver kaltlangin a kal a, taksa hnuai lam atanga thisen kalna tur vein lian tak ( inferior vena cava ) nen a inzawm a, chu chuan taksa hnuai lam atanga thisen chu thinlung dinglamah a phur a ni.
• Mixed TAPVR: Hei hi a tlem ber leh siamthat harsa ber a ni. Hetah hian lung atanga vein pakhat aia tam a inzawm thei a, chu chu a chunga kan sawi tak chi khat emaw a aia tam emaw inzawmkhawm a ni.

He classification hi doctor-te tan chuan surgery ruahmanna siam nan leh enkawl dan tur ruahmanna siam nan a pawimawh hle.

TAPVR hi engtiang chiahin nge a awm?

TAPVR hi thinlung natna hmuh tur awm lo tak a ni. America ang ramah pawh he natna hian nau piang thar 7,500 zinga pakhat chauh a nghawng a ni. Sri Lanka-ah pawh a tlem hle.

TAPVR natna lan chhuah dante chu engte nge ni?

TAPVR symptoms hi pian tirh lamah hmuh theih a ni tlangpui , a bik takin thinlung nena an inzawmna pulmonary veins te a tawi a nih chuan. Mahse, naute thenkhat chuan kar engemaw zat chhung chu natna lanchhuahna an nei lo thei.

A lan chhuah dan ber chu hengte hi a ni:

• Cyanosis: Vun, nail leh hmui (nausen vun dum neiah) rawng dum emaw, sen emaw a inthlak danglam thin. Hei hi thisenah oxygen tlakchham vang a ni.
• Suck harsa: Naute hian hnute a harsat a, tlem a in hnuah a chau thin.
• Chauhna leh hahna: Naute chu a chau reng a, a chau hmel hle.
• Heart murmur: Doctor-in naute thinlung (stethoscope hmanga) a ngaihthlak hian thawm danglam tak a ri a.
• Thâwk lak tawi (dyspnea): Naute chu a thawk rang a, thawk a harsat hmel hle.
• A thang tha lo leh a rihna a pung: Naute chu a thau tha lo a, a taksa a tichak lo hle.

I naute hian heng chhinchhiahna pakhat emaw a aia tam emaw a neih chuan doctor thurawn i la nghal tur a ni .

TAPVR hi eng thilin nge a thlen?

Dik tak chuan doctor-te hian TAPVR awm chhan dik tak hi an la hre lo . Nausen lo piang chhuak lai hian thinlung leh thisen kalna kawng a chhiatna avanga lo awm a ni .

Inherited condition anga ngaih a ni tlangpui lo. Mahse, chhungkaw khat chhunga unau zingah case a awm tih report a awm tawh bawk. Zirna thenkhatah chuan syndrome thenkhat nei naupangte leh naupai laiin paint remover, pesticide leh lead te an hman hian inzawmna a awm thei tih an sawi. Mahse, hei hi finfiah a la ni lo.

TAPVR avanga harsatna awm thei te chu engte nge ni?

TAPVR vei naute hian heart failure leh pulmonary hypertension a nei a.Operation hnuah pawh a chang chuan heart rhythm pangngai lo emaw, pulmonary veins-a blockage emaw a awm thei. Chuvang chuan medical checkup chhunzawm zel a pawimawh.

Engtin nge TAPVR hi hmuhchhuah a nih?

A châng chuan, naute pian hmain he natna hi hriat theih a ni a, naupai laiin echocardiogram (thinlung scan) tih a ni. Mahse, a tam zawkah chuan naute pian atanga kar engemaw zat emaw, thla engemaw zat emaw hnuah a natna hmuhchhuah a ni.

Naute a lo pian hunah doctor chuan taksa enfiahna a nei ang a, naute thinlung a ngaithla ang. Thil te tak te , pulse oximeter (nausen ke ruh lian vel a in fit) an tih hmangin thisenah oxygen level teh theih a ni.

Tin, thinlung leh thisen kalna kawngte dinhmun enfiah nan a hnuaia mi ang chi test te pawh tih theih a ni bawk:

• Chest X-ray neih a ni
• CT scan (CT scan - computed tomography) hmanga tih theih a ni.
• Lung lam MRI (magnetic resonance imaging) hmanga hmuh theih a ni.
• Echocardiogram hmanga tih a ni
• EKG (EKG emaw ECG emaw - Electrocardiogram) tih a ni.

Heng test thenkhat (MRI ang chi) hian naute chu sedated (muthilh awlsam taka dah) a ngai thei bawk. Mahse heng test zawng zawng hi noninvasive a ni. Heng test-na hmang hian doctor-te chuan naute thinlung leh lungte chiang takin an hmu thei a, thisen a luang dan an hmu thei a, thil danglam bikte an zawng thei bawk.

A chang chuan cardiac catheterization an tih test hmangin natna hriat theih a ni bawk. Mahse, a chunga kan sawi tak scan a\ang hian thu \ul tak tak hmuh theih a nih \hin avangin naute chu invasive testing neih a ni tlem hle.

TAPVR hi engtin nge enkawl a nih?

TAPVR vei naute zawng zawng deuhthaw hi an dam khawchhuah theih nan operation an mamawh vek. Doctor-te chuan open-heart surgery hmangin an enkawl a ni . Vawi tam tak chu he surgery hi a natna hmuhchhuah a nih hnuah a rang thei ang bera tih thin a ni.

A tlem hle nachungin, mi thenkhat chu naupan laia operation nei lovin puitling an nih laiin TAPVR hi an vei tih hmuhchhuah a ni. Mahse, chutih hunah chuan pulmonary hypertension ang chi condition an nei thei a, chu chuan surgery chu a ti harsa hle mai thei.

Operation hmaa enkawl a ni

Operation nghah lai hian naute chu oxygen pek belh emaw, thawk chhuah theihna tura ventilator-a connect emaw a ngai mai thei. Damdawi chi khat inotrope an tih pawh pek i ni thei a, chu chuan thinlung chu a tichak zawk a ni.

Surgery tih dan tur

Naute chu general anesthesia hnuaia a muhil vek hnuah, surgeon chuan a hnuaia mi ang hian a ti ang:

1. Naute rilru leh thinlungah incision siam a ni.

2. Pulmonary veins te chu hmun dik takah an inzawm leh a, chu chu thinlung veilam atrium a ni.

3. Vein inzawm dan pangngai lo chu khar a ni.

4. Pulmonary veins ah blockage a awm chuan lakchhuah a ni.

5. Vawi tam tak chu veilam leh dinglam atria inkar khur ( Atrial Septal Defect - ASD ) chu khar a ni.

Hei hi surgery buaithlak tak ni mahse, medical team tawnhriat ngah tak takte chuan hlawhtling takin an ti thin.

Enkawlna avanga harsatna awm thei

Hengte hi operation hnua harsatna awm thei thenkhat chu an ni:

• Thinlung thawk mumal lo (Arrhythmias) .
• Pulmonary hypertension a awm bawk
• Pulmonary venous tihkhawtlai a ni
• A châng chuan, zai laia heart-lung machine (bypass machine) hman a nih hnuah, thinlung chu a mah chauhin a thawk harsa hle.

Doctor te hian hetiang thil hi an lo thlir reng thin.

TAPVR hi ven theih a ni em?

Vanduaithlak takin he pianpui thinlung natna chi hi ven dan tur a awm lo . I chhungkuaa mi tu emaw hian pianpui lung natna a nei a nih chuan, emaw, TAPVR i neih chuan chhungkaw din hmain doctor nen inbiakna neih hmasak phawt a tha.

Ka fa hian TAPVR a nei a nih chuan eng nge ka beisei ang?

Operation tel lo chuan TAPVR chi thenkhat chu nau piang atanga kar engemaw zat chhungin a thihpui thei a ni. Mahse, natna hi a hmaa hriatchhuah a nih a, surgery hmanga enkawl a nih chuan TAPVR vei naute tan chuan hmalam hun a tha hle. Operation hnua damchhuah zat hi 97% vel a ni. Chu chu hlawhtlinna rate sang tak a ni.

I fa chu a lo puitlin a, a puitlin chuan, cardiologist a pan fo tur a ni . Heng dam chhung zawnga checkup tih thin te hian heart rhythm mumal lo leh thisen kalna kawng khar ang chi harsatna te hriatchhuah leh enkawlna kawngah a pui thei a ni. A châng chuan blockage a awm chuan operation dang neih belh a ngai thei a, enkawl a harsa thei bawk. Chuvang chuan doctor thupek zawm chhunzawm zel a pawimawh.

I fa hian damdawi a ei chhunzawm a ngai mai thei a , a nih loh leh cardiac catheterization ang chi enkawlna a neih a ngai mai thei .

Engtin nge ka fa ka enkawl ang?

TAPVR vei naupangte hian a chang chuan an thanlenna milestone pangngai, fine motor function ang chi te chu an harsat phah thei a ni. I fate hmasawnna tur thil pawimawh tak takte chu i enfiah thei a, a tul chuan chutiang thiamna tihhmasawn tura puitu tur mi hnenah i refer thei bawk.

I fa doctor nen infiamna leh taksa tihchaknaah a tel theih leh theih loh chungchang sawipui rawh. Exercise hahthlak tak tak kha tihtlem a ngai mai thei .

Engtikah nge ka fa hian doctor a hmuh ang?

Surgery zawhah i naute chu thla 6 atanga thla 12 danah hmuh theih a ni ang.Damdawi lam enfiahna neih a ni. I puitlin chhung zawngin doctor i pan reng tur a ni. I fa doctor chuan EKG, exercise stress test, a nih loh leh echocardiogram ang chi test a ti duh mai thei.

Engtikah nge Emergency Room (ETU) ah i kal a ngaih ?

I naute hian heng symptoms te hi a neih chuan doctor pan nghal rawh (ER-ah kal rawh) :

• Vun, nail, emaw hmui emaw chu blue/gray a nih chuan.
• Thâwk harsa emaw, bawnghnute ei/in emaw i neih chuan.
• Mutthilh lutuk emaw, nunna nei lo emaw anga i lan chuan.

Doctor hnenah eng zawhna nge ka zawh ang?

I fa doctor hnena zawh tur zawhna pawimawh thenkhat chu hetiang hi a ni:

• Ka fa hian eng ang TAPVR nge a neih?
• Ka fa hian vawi hnihna atan operation a mamawh dawn niin i hria em?
• TAPVR siamthat nan hian surgery engzat nge i neih tawh?

Take-home message pawimawh tak a ni

Naupai laiin hrisel taka awm turin i doctor thurawn i zawm a ni mai thei. Mahse a chang chuan, nausen piang thar hian thinlung natna a nei thei a. Tumah sual a ni lo. Tunlai medical science hmasawn tak hmang hian i naute hian thlah hmasa fate aiin a rah chhuah tha zawk a beisei thei a ni. Surgery hmanga enkawl hi a hlawk hle.

TAPVR hi natna khirh tak ni mahse, a hmaa hriatchhuah a nih a, operation dik tak hmanga enkawl a nih chuan naupangte hian nun tha tak an neih theihna chance a sang hle tih hre reng ang che. Surgery hnuah i fa chu medical check-up neihpui tura hruai a pawimawh hle. Hei hi i fate hriselna enfiah a nih theih nan leh harsatna lo awm thei apiang chu rang taka enkawl theih a nih theih nan a ni. Nangmah chauh i ni lo, doctor leh healthcare staff te chu nang leh i naute tanpui turin an awm reng a ni.

` TAPVR, thinlung natna, naute, surgery, pulmonary veins, cyanosis, pianpui natna