Kia ako tātou mō te pokanga takirere ngākau (Pokanga Mitral Commissurotomy) i roto i ngā kupu māmā noa iho.

Whakaarohia tō ngākau he papu wai e mahi tonu ana. I roto i tēnei papu, e whā ngā wāhanga iti rite ki te tatau e āwhina ana i te rere o te toto ki te taha kotahi anake. I roto i ngā kupu hauora, ka kiia ēnei he takirere ngākau. Ki te kore ēnei tatau e tuwhera, e kati tika, he raruraru nui, kāore? Waihoki, i tēnei rā kei te kōrero tātou mō tētahi pokanga motuhake e mahia ana ina kore e tuwhera tika te takirere mitral, tētahi o ngā takirere tino nui o tō tātou ngākau, ka whaiti.

He aha te commissurotomy?

He whakarāpopototanga noa iho, he pokanga te commissurotomy e taea ai te rere o te toto mā roto i te takirere o tō ngākau. Ko te nuinga o te wā ka mahia i runga i te takirere mitral . Kei waenganui i te rūma maui o runga (atrium maui) me te rūma maui o raro (ventricle maui) te takirere mitral.

Whakaarohia kāore tēnei tatau e tuwhera tika ana, ā, kua mau, kua whaiti hoki. Ka kiia tēnei āhuatanga ko te mitral valve stenosis. Ko te mea ka tupu, ka āraia te ara e rere ai te toto mai i te ruma o runga ki te ruma o raro. Ka hoki whakamuri te toto, ka nui te taumahatanga ki te ngākau me ngā pukahukahu. I roto i te wā, ka arahi pea tēnei ki ngā āhuatanga kino pēnei i te ngoikore o te ngākau.

E whakamahia ana tēnei pokanga commissurotomy hei rongoā mō ngā wāhanga tōmua o te mitral valve stenosis. Engari ki te pono, he iti ake te auau o te mahi i ēnei rā. Nā te mea he pokanga ngākau tuwhera te tikanga. He mōrearea anō hoki. Nō reira, i ngā wā katoa e taea ana, ka ngana ngā tākuta ki te whakamahi i ngā tikanga māmā ake, iti ake te mōrearea. Ko tētahi o ngā maimoatanga matua e wātea ana i tēnei wā ko te balloon valvuloplasty . I roto i tēnei, ka whakauruhia he ngongo angiangi, ā, ka pupuhihia he mea pērā i te poihau ki roto i te valve whaiti, ka whānui ake.

Heoi, mō ētahi tāngata, kāore e taea te mahi i te tikanga poihau nā te tūnga o tō rātou ngākau, nā ētahi atu take rānei. I roto i ēnei āhuatanga, ko te pokanga commissurotomy te kōwhiringa pai rawa atu.

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

Mena he mitral stenosis tōu, ā, ka pā mai tētahi o ēnei e whai ake nei, ka tūtohu pea tō tākuta i tēnei pokanga:

• Mena kāore anō kia ora koe i ētahi atu maimoatanga.
• Mena kāore e taea e koe te mahi i te valvuloplasty balloon.

Hei tāpiritanga, mēnā kua mahia ētahi atu pokanga ngākau ki a koe, ka taea te mahi i tēnei pokanga i te wā kotahi.

Engari kotahi te mea nui kia maumahara. Kāore e taea e te katoa e pāngia ana e te mitral valve stenosis te mahi i tēnei pokanga. Kei te pūtake o tō valve stenosis.

E rua ngā take matua:

1. Ngā kino i puta mai i te mate manawa rūmātiki:Ka taea e te kirika rūmātiki, e whai ake nei i te mate korokoro i te tamarikitanga, te kino i ngā takirere o te ngakau i ngā tau i muri mai.

2. Te Stenosis Mitral Degenerative: I roto i te wā, ka ngoikore haere te takirere, ka whaiti, ka kapi i ngā putunga konupūmā.

He tino āwhina te pokanga commissurotomy mō te hunga whai mate manawa rūmātiki . I tēnei āhua, ka matotoru ngā kokonga e rua o te takirere e tūtaki ai ngā rau e rua, e kiia nei ko ngā commissures , ā, i ētahi wā ka piri tetahi ki tetahi.

I roto i te pokanga commissurotomy, ka tapahia ngā koki iti ki ngā kokonga e rua o te takirere, ā, ka tukuna. Kātahi ka tīmata te whakatuwheratanga tika anō o te takirere. Heoi, mō te hunga kua tawhito ngā takirere nā te koroheketanga, kāore ngā komihana e pakaru. Engari, me whakatika ētahi atu wāhanga o te takirere. Nō reira, kāore tēnei pokanga e pai mō rātou. Me whakatika rātou i tētahi momo whakatika takirere rerekē, me whakakapi katoa rānei i te takirere (whakakapinga takirere mitral).

He aha ngā mea ka tupu i mua i te pokanga?

Ka tīmata ngā whakaritenga i ngā wiki, i ētahi wā he marama, i mua i te rā o tō pokanga. Ka huihui mai tō rōpū hauora (tō tākuta whānau, tō tākuta ngakau, me tō taote ngakau) ki te tuku i tētahi tirotiro hauora hōhonu ki a koe.

Mena he pātai, he wehi, he ruarua rānei āu mō te pokanga, kōrero ki tō tākuta mō ēnei mea. Kaua e huna tetahi mea māu ake. He mea tino nui kia mōhio koe ki ngā mea katoa, kia haere hoki ki te pokanga me te hinengaro marino.

Mā tō tākuta koe e tohutohu mō te whakarite mō te pokanga, tae atu ki te wā me mutu te kai me te inu i mua i te pokanga, me ngā huringa katoa ki ō rongoā.

Me pēhea te mahi i te pokanga?

I roto i te rūma pokanga, ka whai te tīma hauora i ēnei mahi:

1. Tuatahi, ka hoatu he rongoā whakamoe ki a koe, ā, ka meinga koe kia moe kia oti rā anō te pokanga. Kāore koe e mamae.

2. Muri iho, ka tapahia e te taote pokanga he pokanga i waenganui o tō uma, ki raro i te wheua uma (sternum). Ka kiia tēnei ko te median sternotomy .

3. Ka honoa koe ki tētahi mīhini karo manawa . Ka tangohia e tēnei mīhini te mahi a tō ngākau me ō pukahukahu i te wā e pokanga ana. Mā tēnei ka taea e te tākuta te mahi i te pokanga i a koe e noho puku ana, me te kore e pao tō ngākau.

4. Ka whakatuwheratia te atrium maui o te ngākau, ā, ka tirohia te takirere mitral.

5. Kātahi ka tapahia ngā koki e rua (ngā komihana) o te takirere kua piri, kua matotoru hoki, hei wehe i a rāua tetahi i tetahi, hei tuku i a rāua.

6. Kia oti te mahi, ka momotuhia tō hononga mai i te mīhini ngākau-pūkahukahu, ā, ka tīmata anō te mahi a tō ngākau me ō pūkahukahu.

7. Hei whakamutunga, he echocardiogram transesophagealKa mahia he matawai motuhake hei whakaū mēnā kei te tika te mahi a te takirere, me te mea kei te tika te mahi a ngā mea katoa.

I ētahi wā, ka taea te mahi i ētahi atu pokanga ngākau, pērā i te whakatika i ētahi atu takirere ngākau (takirere aortic, takirere tricuspid rānei), i te wā kotahi e pokangahia ana. Mēnā e tika ana tēnei, ka whakamāramahia e te tīma hauora tēnei ki a koe i mua i te wā.

He aha ngā mea ka tupu i muri i te pokanga?

Me noho koe ki te hōhipera mō te wiki pea i muri i te pokanga. Mō ngā rā tuatahi, e rua rānei, ka puritia koe ki te wāhanga tiaki nui (ICU) ā, ka tirotirohia rawatia. Hei āwhina i te kimi i ngā raruraru ka puta mai i muri i te pokanga i te wā e taea ai.

I mua i tō hokinga ki te kāinga i te hōhipera, ka hoatu e tō tākuta ki a koe ētahi kōrero mō:

• Whakaora i te Manawa: He tino whai hua tēnei mō te hunga e ora ana i te pokanga manawa. Ka āwhina i a koe ki te whakahoki mai i tō kaha me te tīmata ki te mahi i ngā mahi o ia rā.
• Me pēhea te tiaki i te tapahi: He mea tino nui kia noho ma te tapahi hei ārai i te mate me te whakaora wawe i te patunga.
• Ngā Here: He tohutohu mō te roa o te tatari i mua i te tīmatanga o ngā mahi pēnei i te taraiwa, te mahi taumaha rānei.

I mua i tō hokinga ki te kāinga, kaua e wareware ki te whakarite kia tikina koe e tetahi.

He aha ngā painga me ngā mōrearea o tēnei pokanga?

Ngā Painga

Ka taea e tēnei pokanga te whakaora i ngā tohu pēnei i te poto o te manawa me te ngenge i puta mai i te whaiti o te takirere mitral. Ka taea hoki e ia te tiaki i a koe mai i ngā raruraru nui ka puta ake i te heke mai. He maimoatanga tino pai tēnei mō te hunga kāore i te tino kino te āhua o te mate hei whakakapi katoa i te takirere, ā, kāore anō kia angitu i ētahi atu maimoatanga.

Ngā Tūponotanga, Ngā Āhuatanga rānei

Pērā i ngā pokanga katoa, he tūponotanga anō kei reira. Ko te raruraru tino noa ko te regurgitation mitral valve .

Ka taea te whakaiti i te nuinga o ēnei mōrearea mā te whiwhi maimoatanga i tētahi hōhipera nui kei reira ngā whare hauora me ngā taote pokanga ngākau mātau.

He aha te tirohanga i muri i te pokanga?

He tino angitu te pokanga tuwhera (open commissurotomy). Mā tēnei pokanga ka whakatikatika i te whaiti o te takirere, ka whakahokia mai te rere o te toto.

Mā tō tākuta koe e āwhina ki te kōrero pai mō tō hauora ā muri ake nei. He rerekē te whakaoranga o te katoa. He maha ngā āhuatanga e pā ana ki tēnei, tae atu ki tō tau, tō hauora whānui, me te nui o te kino o tō takirere i mua i te pokanga.

Āhea koe me toro atu ki te tākuta?

Mena ka puta he tohu o te mate i a koe e ora ana i te kāinga i muri i te pokanga, waea atu ki tō tākuta tonu.

• Te mamae o te uma, te kikī, te kore whakamarie rānei.
• Te kirika.
• He whero, he wai rānei e rite ana ki te pūhā e maringi mai ana i te wāhi i tapahia ai.

Ki te pāngia koe e tētahi o ngā tohu kino e whai ake nei, waea atu ki tō nama urupare ā-rohe, haere rānei ki te Tari Urupare (ETU) o te hōhipera tata rawa atu:

• Ngā tohu o te whakaeke ngakau (mamae nui o te uma, uaua ki te manawa, ruaki, werawera).
• Ngā tohu o te pararutiki (te uaua ki te kōrero, te piko o tetahi taha o te mata, te ngaronga o te rongo i te ringa, i te waewae rānei).