Doctor khan heart surgery i mamawh thu a hrilh che em? Chutianga a sawi laia hlauhna tlem a awm chu thil pangngai a ni. Mahse tunlai hian damdawi lam hi a changkang hle. Surgery thenkhatah chuan i taksa peng tam thei ang ber venhim tumna a awm a. Vawiin hian chutiang surgery bik tak pakhat chungchang kan sawi dawn a ni. Chu chu heart valve a ni a, chu chu valve venhimna surgery a ni.
A awlsam zawngin Valve-Sparing surgery hi eng nge ni?
Awle, hei hi hrethiam tur chuan kan thinlung hmun tlemte hi i zir hmasa phawt ang u. Kan thinlung pumpui pumping chamber (left ventricle) hi kan taksaa thisen kalna kawng lian ber aorta nen a inzawm a. He inzawmna hi `Aortic Root` kan ti a. Thingkung zung ang mai a ni. He `Aortic Root` chhungah hian kawngkhar pawimawh tak, `Aortic Valve` a awm a.
Thinlung a na apiangin he `Aortic Valve` hi a inhawng a, taksaah thisen a pump lut a, chutah chuan a khar leh thin. Hetianga khar hian thisen chu thinlungah a luang leh thei lo.
Tunah chuan mi thenkhatah chuan `Aortic Root`, chu chu kawngkhar kawngkhar ang maia lang chu a chak lo va, a lo hring a, a lian ta a ni tih hi han ngaihtuah teh. Balloon inflated ang mai a ni. Hei hi `Aortic Root Aneurysm` kan ti a. He gate hi a lian chuan a chhunga kawngkhar, chu chu `Aortic Valve` chu a khar tha lo. Tichuan thisen chu thinlungah a luang leh tan ta a ni. Hei hi `Aortic Regurgitation` an ti a.
Traditional surgery (the `Bentall procedure`)-ah chuan surgeon-te chuan bulging `Aortic Root` leh `Aortic Valve` te chu an paih vek a, artificial thar pahnih an dah a ni.
Mahse he Valve-Sparing surgery-ah hian thil danglam tak a thleng a ni . Heta tih tur chu `Aortic Root` hring hring chauh lakchhuah a ni a, nangmah ngeiin `Aortic Valve` hrisel tak chu a awm ang angin a awm a, chu chu `Aortic Root` tharah grafted a ni. A awlsam zawngin, kawngkhar hnah chauh thlak a, mahni kawngkhar hlui tha tak siam that ang mai a ni.
Hei hi a thatna lian ber chu nangmah ngeiin valve i vawng thei a, chuvangin mechanical valve hmanga i ei angin dam chhung zawnga anticoagulant damdawi (Coumadin ang chi) i ei a ngai lo.
He surgery hian eng dinhmun nge a enkawl?
He surgery hi a hnuaia mite hi tih a ni ber.
- Aortic Root Aneurysm: Ka sawi tawh ang khan hei hi aorta zung, thinlung nena inzawm, bulge pangngai lo a ni. Hei hi a lian lutuk chuan a puak darh nghal thei (`Aortic Dissection` emaw Rupture emaw). Nunna atan a hlauhawm hle.
- Ascending Aortic Aneurysm with Dilated Aortic Sinuses: `Aortic Root` (`Aortic Sinuses`)-a natural space te te chu a lian deuh a, aorta ascending part-ah bulge a awm thin.
Hereditary connective tissue natna thenkhat, Marfan syndrome ang chi nei te chu aortic root aneurysm an vei theihna a sang zawk. Chuvangin, surgeon-te chuan damlo dinhmun chu uluk takin an zirchiang a, a \ha leh \ha leh \ha loh an rel hmain a \ha leh \ha lote an teh \hin.
He surgery atan hian i tling em?
I aortic valve hian hengte hi a neih chuan he surgery neihna tur hian candidate i ni thei ang:
- Valve-ah hian calcium deposit (calcification) a tlem lutuk emaw, a awm lo emaw a nih chuan.
- Valve chu nasa taka chhiat a nih loh chuan.
- Valve a thawk tha emaw, siamthatna tenau hmanga siamthat theih a nih chuan.
Operation hmain engtin nge i inbuatsaih thin?
I surgeon chuan operation hmaa i tih tur zawng zawng a hrilhfiah ang che. Chu thupekte chu dik taka zawm a pawimawh hle. A tlangpuiin hei hi i tih a ngai dawn a ni.
| Section buatsaih tur a ni | Eng nge tih tur |
|---|---|
| Damdawi chi hrang hrang | Damdawi i ei tlangpui te doctor hnenah hrilh rawh. A thurawn tel lo chuan damdawi engmah titawp suh, thlak suh. |
| Chaw leh tui | Surgery hma zan zanlai hnuah engmah (tui pawh) ei leh in loh tur. |
| Meizial zuk | Zai hma thla khat tal meizuk leh zuk leh hmuam ei hi tihtawp vek tur a ni. |
| Mi pakhat tanpui tur | Damdawi in leh in lama zuitu tur ruahmanna siam rawh. |
Hei bakah hian doctor chuan surgery ruahman nan test eng emaw zat a ti ang a, chungte chu:
- Echocardiogram (thinlung scan) hmanga tih a ni.
- Thisen test a ni
- `Thin leh rilru EKG gated CT scan`
- Coronary Angiogram hmanga enfiah a ni
- Genetic blood test a nih chuan thlahtu natna a awm nia rinhlelh a nih chuan
Surgery neih chhung hian eng nge thleng?
He surgery hi darkar 4 leh darkar 6 inkar a ni tlangpui. Surgeon tawnhriat ngah takin he surgery hi a tih hian darkar khat vel chhung chu thinlung chu tihtawp a ngai a ni. Ngaihtuah buai suh, chutih hun chhung chuan machine pakhatin thinlung leh lung hna a thawk ang.
Step by step khata thil thleng chu hetiang hi a ni:
1. Anesthesia: Pakhatnaah chuan muthilh tir vek i ni ang. Chuvang chuan engmah hrehawm i nei lovang.
2. Chhung hawn: Surgeon chuan thinlung thleng turin rilru lai takah incision (a `median sternotomy`) a siam a.
3. Heart-Lung Machine nena inzawmna: `Cardiopulmonary Bypass` machine nena inzawm i ni ang. He machine hian operation neih chhung hian i thinlung leh lung hnathawh chu a la ang. Hetih lai hian damdawi pakhat `cardioplegia solution` tih chu pek a ni ang a, chu chuan i thinlung chu rei lo te chhung a titawp ang.
4. Valve chhuah: Surgeon chuan i aortic valve chu a chhehvel tissue atanga uluk takin a then a.
5. A chhe lai lakchhuah: `Aortic Root` a hring leh a chhia dangte chu tan chhuakin lakchhuah a ni.
6. Graft: A lakchhuahna hmunah hian artificial tube (a `graft`) dah a ni. Hei hi puan bik (`polyester`) hmanga siam a ni.
7. Valve re-implantation: Nangmah ngeiin aortic valve lak a, graft thar dah a, a hmunah suture a ni.
8. Valve enfiah: Engkim a tha em tih hriat chian nan `Graft` kaltlangin fluid an kalpui a, chu chuan valve chu a thawk tha em tih enfiah a, a inhawng leh a khar a ni.
9. Final step: Thinlung coronary arteries te chu `Graft` thar nen an inzawm a. Tichuan `Heart-Lung Machine` atangin i la chhuak a, i thinlung chu a thawk leh thei ta a ni. Tichuan chest incision chu khar a ni.
Tunlai surgery hmanraw hman dan (Modified Reimplantation) .
Hun a kal zel a, surgeon-te chuan he operation hi hlawhtling zawka siam turin technique thar an rawn dah belh ta a ni. Entir nan:
- Aortic Sinus thar siam (`Neosinus`): A tlangpuiin `Graft` hi tube dinglam a ni. Mahse natural `Aortic Root` hian hmun tlemte (`sinus`) a nei a. Method thar ah chuan chutiang space chu `Graft` ah hian artificial takin siam a ni. Hei hian thisen kal dan chu natural zawkin a siam a, valve chhiatna pawh a ti tlem bawk.
- Aortic Annulus Sizing: Valve dinna ring ang chi (`aortic annulus`) size chu i taksa size nena inmil turin siamrem a ni. Hei hian nakin lawkah valve atanga thisen chhuah theihna a ti tlem a ni.
Surgery hnuah eng nge thleng? Tin, a dam leh theih nan eng chen nge a ngaih?
Surgery zawhah intensive care unit (ICU)-ah ni khat emaw ni hnih emaw chhung dah i ni ang a, chumi hnuah regular ward-ah sawn i ni ang. Ni 4 atanga ni 7 chhungin i haw thei tlangpui.
A dam kim theih nan kar 6 vel a ngai a ni. Hetih lai hian thil hmanhmawh suh. I fimkhur a ngai a, i dinhmun pangngaiah i awm leh a ngai bawk.
Driver license nei mah la, doctor-in phalna a pek hma che chuan lirthei khalh suh . Thil rit phurh emaw hnathawhna hmuna kal emaw ang chi thil i tih hmain kar 6 tal i nghah a ngai ang.
Cardiac rehabilitation program (`cardiac rehab`)-a tel hian i dam leh thuai ang. Tin, doctor nen follow-up appointment-ah pawh kal ngei ngei tur a ni. I thinlung dinhmun chu an enkawl chhunzawm zel ang.
He surgery hian eng hlauhawmna leh hlawkna nge a neih?
Surgery lian dang ang bawkin, a hlauhawmna engemaw zat a awm bawk. Mahse, damdawi ina facility ṭha tak neia surgeon tawnhriat ngah takin a tih chuan heng hlauhawmnate hi a tlem hle .
A thatna ber chu:
- I dam chhung zawng thisen tithianghlimtu damdawi ei a ngai lo.
- Thisen zam, stroke, leh valve infection (endocarditis) hlauhawmna a tlahniam a ni.
- Nakin lawkah valve thlak lehna tur operation neih leh a ngai theihna chance a tlem hle.
Research atanga a lan dan chuan he surgery hlawhtlinna hi 99% aia tam a ni. Kum 10 hnuah pawh he surgery nei tawh zinga 95% vel chuan surgery dang an mamawh tawh lovang.
| Operation hnua doctor koh hun tur | |
|---|---|
| Cutting path-a inthlak danglamna | Incision atanga sen, na, swelling, pus emaw tui dang emaw chhuak. |
| Chhung na emaw thawk harsa emaw | Chhung natna thut emaw, thawk harsa emaw. |
| Taksa lam thil dang | Ke ruh hring, hah lutuk, muthilh, khawsik, bawlhhlawh chhunga thisen chhuak. |
| Khuh | Khuh, yellow emaw green emaw phlegm emaw, thisen khuh emaw. |
Heng symptoms te hi i neih chuan doctor ko nghal la, i hnai ber damdawi in Emergency Department (ETU) ah kal rawh.
Take-Home Thuchah a ni
- Valve-Sparing Aortic Root Replacement hi surgery hmasawn tak a ni a, aortic root chhia chauh thlak a ni a, nangmah ngeiin i aortic valve hrisel tak chu a humhim thei a ni.
- Hei hi a thatna lian ber chu i dam chhung zawng thisen tithianghlimtu damdawi i ei a ngai tawh lo va, nakin lawkah operation dang neih leh a ngaihna pawh a tlem phah a ni.
- He surgery hi mi zawng zawng tan a tha lo. I surgeon chuan i dinhmun nena inmil a nih leh nih loh a rel ang.
- Surgery atanga a dam kim theih nan kar 6 vel a ngai thin. Hemi chhung hian doctor thupek dik takin zawm tur a ni.
- Zawhna i neih chuan i doctor zawh hreh suh. I chhungte tanpuina pawh tun dinhmunah chuan a hlu hle.
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