Me ako tātou mō te Whakakapinga Pūtake Aorta i roto i ngā kupu māmā noa iho.

Kua rongo pea koe i te aorta, te uaua toto matua e pupuhi ana i te toto puta noa i tō tātou tinana. Whakaarohia, me pēhea mēnā ka ngoikore tēnei uaua matua, kei te wāhi tonu e hono ana ki te ngākau, i te "pūtake", ka pupuhi ake, ka pūwero atu pērā i te poihau? Koinei te mea e kiia nei e tātou he aneurysm i roto i te rongoā. He tino morearea tēnei, nā te mea i ngā wā katoa ka taea e tēnei pakitara ngoikore te wehe, te pakaru rānei. Ki te tupu tēnā, ka nui te toto i roto i te tinana, ā, ka puta he hua morearea ki te ora. Nō reira, he tino nui te pokanga Whakakapinga Pūtake Aorta e mahia ana hei whakamutu i ēnei āhuatanga morearea ki te ora. I tēnei rā, ka kōrerohia e tātou tēnei mea mā te ngāwari, i roto i te huarahi e mārama ai koe.

He aha tēnei pokanga whakakapinga pakiaka aorta?

He whakarāpopototanga noa iho tēnei, he mahi tākuta hei whakatika i te aneurysm i roto i te pūtake aortic, te uaua matua e hono ana i tō ngākau. I ētahi wā, ka whakakapia te pūtake o tō aorta me te takirere i roto. I ētahi wā anō, ko te pūtake o tō aorta anake ka whakakapia, ka waiho tō takirere noa kia ora tonu. Mā tō tākuta e whakatau ko tēhea momo tākuta e tika ana māu i runga i ngā āhuatanga maha, tae atu ki te āhua o tō takirere.

He aha ngā momo matua o tēnei pokanga?

E rua ngā tikanga matua o tēnei pokanga. Ko tētahi he whakakapi i te pūtake o te aorta me te takirere. Ko tētahi he whakakapi i te pūtake anake, me te waiho i te takirere kia mau tonu. He painga, he ngoikoretanga hoki ō ia mea.

1. Te Whakakapinga Pūtake Aorta (ARR)

Ka kiia hoki tēnei tikanga ko te tikanga Bentall . Ka mahia mō te hunga he aneurysm aortic me te raruraru ki te takirere. Hei tauira, mēnā kāore te takirere e kati tika, ā, ka turuturu te toto ki muri (regurgitation aortic valve) mēnā rānei kua whakapakeketia te takirere (kua mārō).

• Painga matua: Ko te painga nui o tēnei, kāore koe e hiahia ki tētahi pokanga motuhake hei whakatika anō i te takirere i muri i te pokanga. Ka whakatauhia te raruraru o te aneurysm me te takirere i te wā kotahi.
• Ngā Mōrearea: Mena ka whakauruhia he takirere ā-ringa ki roto i tēnei pokanga, me tango e koe ngā rongoā whakangawari toto/whakaiti toto mō te toenga o tō oranga. He iti noa te mōrearea o te toto totoka, te toto rānei nā ēnei rongoā.

2. Te Whakakapinga Pūtake Tiaki-Taurere (VSRR)

Koinei te kōwhiringa pai rawa atu mēnā kei te mahi tika tō takirere aorta, kāore he raruraru. Hei tauira, mēnā kāore he turuturu toto, he matotoru rānei mai i te takirere, ka taea te whiriwhiri i tēnei tikanga. Koinei te otinga pai rawa atu mō te hunga e pāngia ana e te aneurysms i te wā taitamariki nā ngā āhuatanga ira.

Ko tēnei tikanga he whakakapi i te pūtake o tō aorta me te hono anō i tō ake takirere tūturu ki reira. E rua ngā tikanga matua, i tapaina i muri i ngā tākuta nāna i kimi.

• Te tikanga Yacoub: Ko te mahi tēnei ko te whakahou i te takirere aorta. He pai tēnei mō te hunga kaumātua he aneurysms ā rātou nā ngā take ehara i te ira.
• Te tikanga a Rawiri: Kei roto i tēnei ko te whakaurunga anō o te takirere aorta. He tikanga noa ake tēnei engari he uaua ake i te tikanga a Hakopa. He pai ake mō te hunga rangatahi he mate ira, he takirere aorta bicuspid rānei.

Me ako tātou i ētahi kōrero mō te pūtake aorta?

Ko te pūtake o te aorta te wāhanga tuatahi o te oko toto nui rawa atu o te tinana, te aorta, te wāhi e hono atu ai ki te ngākau. He rite ki te pūtake o te rākau. Ko te aorta, e puta mai ana i te ngākau, ka piko ki runga, pērā i te piko. Ka tīmata taua piko i te wāhi e tīmata ai te pūtake o te aorta. He tino uaua tēnei wāhanga.

• Takirere Aorta: Koinei te wāhi e tukuna ai e te takirere e mahi ana hei kēti te toto kia rere mai i te ngākau ki te aorta, engari ka ārai i te rere hoki mai.
• Ngā uaua coronary: Ko ngā oko toto tino nui e rua e tuku toto ana ki te ngākau ka tīmata i te turanga o tēnei aorta.
• Ngā Sinuse o Valsalva: Koinei te ingoa i hoatu ki ngā pupuhi iti e puta mai ana i te wāhi e tīmata ai ngā uaua coronary.

I a tātou e tamariki ana, he tino ngāwari ēnei wāhanga katoa. Engari i a tātou e pakeke haere ana, ka heke te ngāwari o tēnei wāhanga. Koinei te take e puta ai ētahi raruraru. Nā te mea he tino uaua tēnei wāhanga, he uaua hoki ngā pokanga e mahia ana ki runga. Heoi, mā te āwhina a ngā taote pokanga mātau me ngā tohunga, ka taea te mahi angitu i tēnei pokanga, ā, ka ora anō tō ngākau.

Ko wai rā te tangata e hiahia ana ki tēnei pokanga?

E hiahiatia ana tēnei pokanga mō te hunga he aneurysm kei roto i te aorta e mōrearea ana ki te pahū, ki te pakaru rānei. I ētahi wā ka puta ēnei nā ngā huringa o te aorta i te pakeketanga. Waihoki, ko ngā āhuatanga ira pēnei i te Marfan syndrome me te Loeys-Dietz syndrome ka taea te whakaputa i ngā aneurysm whakamate i te wā taitamariki.

Whakaarohia, ki te kore te tangata e pangia ana e te Marfan syndrome e whiwhi maimoatanga, he nui te tūponotanga ka pakaru te aneurysm ka mate. Ko te tau toharite o te mate mō te hunga o taua rōpū he 32 tau te pakeke. Engari, ki te whiwhi koe i tēnei pokanga, ka taea e koe te whakaroa i tō roanga o te ora ki te oranga o te tangata noa.Nō reira, ki te mea he mate ira tō tetahi o tō whānau, he mea nui kia kōrero koe ki tō tākuta mō tō mōrearea, kia whakatauhia ai hoki te wā pai mō te pokanga.

He aha ngā mea ka tū i mua, i te wā, me muri i te pokanga?

I te mea he pokanga nui tēnei, me whakarite pai.

I mua i te pokanga

Ka tirohia koe e tō tākuta i roto i te whakamātautau katoa. Ka tukuna atu hoki koe e ia ki tētahi tākuta niho mō tētahi tirotiro niho. Hei tāpiritanga, ka whakahaerehia e rātou ētahi whakamātautau, pēnei i:

• Ngā whakamātautau toto: Tirohia te mahi a te whatukuhu.
• Matawai CT, MRI rānei o te ngākau: Ka taea e tēnei te tirotiro i ngā wāhanga katoa o te aorta. I ētahi wā ka taea te whakatika i ētahi atu raruraru i roto i te pokanga kotahi.
• Angiography Coronary: Tirohia te āhua o ngā uaua coronary e tuku toto ana ki te ngākau.
• Uira-orooro Duplex: Ka tirohia te āhua o ngā uaua carotid i te kaki. Mēnā he raruraru ki ēnei, ka nui ake te tūponotanga o te pararutiki i te wā e pokanga ana.

I tua atu, ka pātai atu tō tākuta ki a koe mō ēnei mea:

• Ngā rongoā e tangohia ana e koe: Me kōrero koe ki tō tākuta mō ngā rongoā, ngā huaora rānei e tangohia ana e koe. Tērā pea ka hiahiatia kia mutu te tango i ētahi rongoā i mua i te pokanga.
• Ētahi atu āhuatanga hauora: Mena he āhuatanga hauora tōu pēnei i te toto toto tiketike, me whakahaere pai i mua i te pokanga.
• Tō āhua o nāianei: Me whakamōhio mai ki a mātou mēnā he mate tōu, pērā i te makariri, te kirika rānei.
• Te kai paipa: Me mutu rawa te kai paipa i te iti rawa i te kotahi marama i mua i te pokanga.

I te wā o te pokanga

Ka hoatu he rongoā whakamoe ki a koe kia moe rawa koe. Kātahi ka honoa koe ki tētahi mīhini ngākau-pūkahukahu (cardiopulmonary bypass) . Mā tēnei mīhini e mahi te mahi a tō ngākau me ō pūkahukahu i te wā o te pokanga. Kātahi ka whai te taote pokanga i ēnei mahi:

1. Median Sternotomy: Ka tapahia te waenganui o te uma hei wehe i te wheua uma (sternum) me te uru atu ki te ngākau.

2. Te tango i te aneurysm: Ka tapahia, ka tangohia te wāhanga ngoikore me te pupuhi o te aorta.

3. Tāurunga o te hononga toto: Ka tāuruhia he oko toto horihori (whakapiri) hei whakakapi i te wāhanga kua tangohia.

4. Te whakakapi, te tiaki rānei i te takirere: Ka whakakapia e koe te takirere, ka tāuta anō rānei i tō ake takirere e ai ki te tikanga ARR, VSRR rānei i kōrerotia i mua ake nei.

5. Te tārai toto i te uaua o te ngākau: Ka honoa ngā uaua o te ngākau e tuku toto ana ki te ngākau ki te tārai hou.

6. Te tuitui i te tapahi: Hei whakamutunga, ka tuituia anō te tapahi o te uma.

E whā ki te ono hāora te roa o tēnei pokanga.

I muri i te pokanga

I muri i te pokanga, me noho koe ki te wāhanga tiaki nui (ICU) mō ētahi rā. Kātahi ka whakawhitia koe ki tētahi wāhanga noa. E tata ana ki te wiki te roa o te noho hōhipera katoa. I roto i tēnei wā:

• Ka hoatu e ahau he rongoā whakamamae ki a koe.
• Tērā pea ka honoa koe ki tētahi mīhini hei āwhina i a koe ki te manawa.
• Hei ārai i te toto totoka, ka mauhia he tōkena motuhake.
• Ka hoatu he rongoā whakaiti toto ki ētahi tāngata.

He aha ngā painga, ngā mōrearea, me ngā reiti angitu o te pokanga?

Āhea koe me toro atu ki te tākuta?

Kia tino aro ki tō tinana i a koe e ora ana. Ki te kite koe i tētahi o ēnei e whai ake nei , waea atu ki tō tākuta tonu:

• Ngā pātai e pā ana ki te tapahi:
• Te whero, te mamae, te pupuhi, te mahana rānei huri noa i te wāhi i tapahia.
• Ka tino mākū te takai, ka turuturu mai te toto, te wai mārama rānei.
• He rerenga waikura kakariki, kōwhai rānei.
• Kei te neke haere ngā taha o te tapahi.
• Ētahi atu pātai:
• Te mamae o te uma, te uaua rānei ki te manawa ahakoa te okiokinga.
• Te pupuhi o ngā waewae, te kore rānei e taea te neke i ngā waewae.
• Te whanoke, te hiamoe, te ngenge nui rānei.
• Te maremare toto, te hūpē kakariki/kōwhai rānei.
• E mātao ana, e pāngia ana hoki e te kirika.
• Toto i roto i te tūtae.

Āhea koe me haere ki te Wāhanga Maimoatanga Ohotata (ETU)?

Mena he aneurysm tōu kāore anō kia rongoatia, haere tonu ki te tari ohorere o te hōhipera tata (ETU) mena ka pāngia koe e ēnei tohu. Tērā pea he tohu ēnei o te pakaru o te aneurysm:

• He mamae ohorere, kāore e taea te whakamātau i te uma, i te tuara rānei o runga. Tērā pea ka rite ki te mea e haehaetia ana i roto i te tinana.
• Te werawera me te mākūkū.
• Te uaua ki te manawa.
• Pōuriuri, māuiui rānei te upoko.
• Ka piki ake te tere o te manawa.
• Whakapairuaki me te ruaki.

He mea noa te mataku ina rongo koe mō te pokanga ngākau. Engari kia maumahara, he mea tēnei pokanga hei whakaora i tō ora, hei hoatu hoki i te whai wāhi ki a koe ki te ora hauora mō te wā roa. He mātau tō tākuta me tō rōpū hauora ki te mahi i ēnei momo pokanga. Nō reira, kōrero ki a rātou mō ō pātai, ō mataku rānei.