Kua mau te takirere o te ngākau? Me kōrero tātou mō te pokanga 'Commissurotomy' (Pokanga Mitral Commissurotomy)

Ka pāngia koe e te poto o te manawa, e te taumaha rānei o tō uma i ētahi wā ina ngenge koe, ina piki arawhata rānei koe? Tērā pea kua kōrerotia e tō tākuta he raruraru ki te takirere o tō ngākau. Ina kore e tuwhera tika te takirere o te ngākau, ā, ka āraia, ka kiia e tātou ko te 'stenosis'. I tēnei rā ka kōrero tātou mō tētahi pokanga motuhake e mahia ana hei rongoā mō tēnei āhuatanga. Nā te mea he kaupapa tino nui tēnei, kia mārama tātou ki ngā mea katoa.

He aha te tikanga o tēnei 'commissurotomy'?

Āe, me mārama tātou ki tēnei i te tuatahi. E whā ngā rūma matua o tō ngākau. Whakaarohia ēnei he rūma e whā. Kia rere ai te toto mai i tētahi rūma ki tētahi atu, me tuwhera, me kati tika ngā tatau i waenganui i a rātou. Ko aua tatau ko ngā mea e kiia nei e tātou he takirere ngākau .

He tikanga te commissurotomy e uru ana te takirere mitral i roto i tō ngākau. Kei waenganui i ngā rūma e rua o te ngākau, te atrium maui me te ventricle maui. Koinei te tatau i waenganui i ngā rūma e rua. E rua ngā taupoki o tēnei tatau.

Nā ētahi āhuatanga hauora, inā koa te āhuatanga e kiia nei ko te 'Mitral Valve Stenosis' , kāore ēnei tatau e rua e tuwhera tika. He rite ki te tatau kua mau. Ka ahatia? Ka heke te rere o te toto mai i te rūma o runga ki te rūma 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 .

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

Ehara tēnei pokanga i te mea mā te katoa. He maha ngā take matua e taunaki ai tō tākuta i tēnei pokanga:

• Mena kāore i angitu ngā hua o ētahi atu maimoatanga (pēnei i te rongoā) i hoatu ki a koe.
• Mena kāore koe i te pai mō tētahi tikanga e kīia nei ko te 'Balloon Valvuloplasty', arā, ko te whakawhānui i te takirere ki tētahi poihau.
• Mena ka pokangahia anō tō ngākau, ka taea e koe te mahi i tēnei pokanga i te wā kotahi.

Engari ko te mea nui ko te angitu o tēnei pokanga e whakawhirinaki ana ki te take o tō mitral valve stenosis. Me titiro tātou ki ngā take matua e rua.

He aha te tikanga ina piri ngā taupoki takirere?

He tino māmā tēnei ki te mārama. Whakaarohia kei te menemene koe i mua i te whakaata me ō ngutu kua katia. Tirohia ngā kokonga o ō ngutu o runga me ō ngutu o raro. Koinei te wāhi e tūtaki ai ngā parirau e rua o te takirere mitral (ngā commissure). Inaianei whakaarohia kei te pupuri tetahi i ngā kokonga o ō ngutu ki ngā maihao e rua. Ka taea e koe te whakatuwhera tika i tō waha? Kāo, kāore e taea e koe? Koinei te mea ka tupu ina aukatia te takirere mitral. Ko te 'commissurotomy' he tikanga pokanga e wetekina ai aua kokonga e rua.

Me pēhea te whakarite i mua i te pokanga?

I te mea he pokanga nui tēnei, ka tīmata te whakarite i ngā wiki i mua. Ka tirotirohia koe e tō rōpū hauora (te tākuta ngakau, te taote ngakau) me te hōhonu.

• He whakamātautau tinana katoa
• Ngā whakamātautau toto
• He kōrero roa mō ō tohu me tō hītori hauora

Ka whakamatautauria hoki koe kia kitea ai mēnā he aukati kei roto i tō takirere mitral me ētahi atu uaua o tō ngākau, pēnei i:

• Echocardiography - He matawai tēnei mō te ngākau.
• Ngā matawai CT
• Angiography Coronary

Me pēhea te mahi i te pokanga?

He pokanga ngākau tuwhera tēnei. Anei te raupapa o ngā mahi e tū ana i roto i te rūma pokanga:

1. Ka hoatu he rongoā whakamoe ki a koe kia moe rawa ai koe.

2. Ka tapahia te wheua o te uma (sternum).

3. Ka honoa koe ki tētahi mīhini karo manawa . Ko tā tēnei he whakarato i te toto me te hāora e hiahiatia ana e tō tinana i te wā e mutu ana tō manawa i te wā e pokangahia ana.

4. Ka whakatuwherahia e te taote pokanga te atrium maui o te ngākau, ka tirotirohia te takirere mitral.

5. Ka tapahia kia iti ngā kōhao o te takirere hei whakawātea.

6. Kātahi ka tangohia koe i te mīhini ngākau-pūkahukahu, ā, ka tīmata anō tō ngākau.

7. Hei whakamutunga, ka mahia he echocardiogram transesophageal hei whakaū kei te mahi tika te takirere.

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

I muri i te pokanga, me noho koe ki te hōhipera mō te wiki pea. Mō te rā tuatahi, e rua rānei, ka puritia koe ki te wāhanga tiaki nui (ICU) ā, ka tino tirotirohia.

I mua i tō wehenga atu i te hōhipera, ka tohutohu atu tō tākuta ki a koe mō ēnei mea e whai ake nei:

• Te Whakaora i te Manawa: He tino āwhina tēnei mō te whakahoki mai i te kaha me te taunga ki te oranga noa i muri i te pokanga.
• Me pēhea te tiaki i te tapahi: He mea tino nui tēnei hei ārai i te mate me te whakaora wawe i te patunga.
• Mō te wā ka taea e koe te tīmata anō ki te taraiwa me te mahi .

Ngā hua, ngā mōrearea, me te wā e tika ai kia kite i te tākuta

He tino teitei te angitu o te open mitral commissurotomy. Ka whakapai ake i te rere o te toto, ā, ka tino whakaiti i ngā tohu. Heoi, ehara i te otinga pumau. He maha ngā tāngata e whai ana i tēnei tikanga, me hiahia pea ki te pokanga whakakapinga takirere ā muri ake nei.

Pērā i ngā pokanga katoa, he tūponotanga anō kei reira.

• Te Regurgitation Mitral
• Te toto nui
• Ngā mate urutā
• Ngā rerekētanga o te pā o te ngakau (Arrhythmia)
• Whiu

Heoi, ka whakaitihia ēnei mōrearea i roto i tētahi hōhipera nui me ngā taote pokanga mātau. Mena he mate hauora tōu pēnei i te mate huka, te mate tākihi, te momona rānei, tera pea ka paku teitei ake te mōrearea. Kōrero ki tō tākuta mō tēnei.

Ki te pāngia koe e ēnei tohu, me kōrero tonu atu ki tō tākuta:

• Kirika
• Te whero, te pupuhi, te pupuhi rānei e tata ana ki te tapahi
• Te mamae tonu o te uma, te pēhanga rānei

Ki te pāngia koe e ngā tohu o te whakaeke ngakau ohorere (mamae nui o te uma, uaua ki te manawa) ngā tohu rānei o te whiu (koretake o te kōrero, te piko o tetahi taha o te mata), waea atu ki te 1990 tonu atu ka haere ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera.