Kia ako tātou mō te Whakatikatika i te Reera Mitral i tētahi ara māmā.

Ka pāngia hoki koe e te poto o te manawa ina ngenge koe, te ahua ngoikore ina piki koe i ngā arawhata, te ahua taumaha rānei i roto i tō uma? I ētahi wā ko te take o ēnei tohu he raruraru kei roto i tō tātou ngākau, he takirere. Nō reira, i tēnei rā ka kōrero tātou mō te takirere mitral i roto i te ngākau me te pokanga whakatikatika e hiahiatia ana nā ngā raruraru ki a ia.

He aha te whakatikatika i te takirere mitral?

Ki te kī māmā noa, ko te whakatika i te takirere mitral he pokanga ngākau tuwhera e whakatika ana i ngā raruraru o te takirere mitral i roto i tō ngākau.

Whakaarohia tō tātou ngākau he whare e whā ngā rūma. Ko te takirere mitral te kuaha i waenganui i te rūma o runga i te taha maui (atrium maui) me te rūma o raro i te taha maui (ventricle maui). Ko te toto ma, he nui te hāora, mai i ō tātou pūkahukahu ka tomo tuatahi ki te atrium maui. Kātahi, ka tomo taua toto mā te kuaha e kiia nei ko te takirere mitral ka haere ki te ventricle maui. Mai i reira, ka pupuhihia te toto ki te tinana katoa.

Nō reira, ina kore e mahi tika tēnei takirere, te takirere mitral, ina pāngia e te mate, ka uaua te mahi tika a te ngākau. I roto i te wā, ka pā kino pea tēnei ki te ngākau me ngā pukahukahu. Kua hangaia tēnei pokanga hei ārai, hei whakaroa rānei i taua kino.

Mena he mate kino tōu mō te takirere mitral, tera pea ka tūtohu tō tākuta kia pokangahia hei whakatika, hei whakakapi rānei i te takirere. Engari i roto i te nuinga o ngā wā, ina koa mēnā kei te turuturu te toto i te takirere, ka ngana ngā tākuta ki te whakatika i te takirere kaua ki te whakakapi. Nā te mea he maha ngā painga me te iti ake o ngā mōrearea ki te tiaki i tētahi wāhanga o tō tinana.

He aha ngā āhuatanga ka rongoatia e tēnei pokanga?

Ko te nuinga o te wā ka whakamahia tēnei pokanga hei rongoā i ngā āhuatanga e whai ake nei:

Tērā pea ka hiahiatia tēnei pokanga mēnā kāore te taha maui o tō ngākau e pupuhi ana i te toto e ranea ana ki te tinana (te ngoikore o te ngākau i te taha maui) mēnā rānei kua rahi tō ngākau. Heoi, ki te kore te mate e kino rawa, ka taea e tō tākuta te tohu rongoā hei whakahaere i ō tohu. Heoi anō, me whai tonu koe i ngā echocardiograms auau hei aroturuki i te āhua o tō takirere. Ki te haere tonu te mate, ki te pakaru rānei tō ngākau, tērā pea ka hiahiatia he pokanga i muri mai.

Me pēhea te whakarite i mua i te pokanga?

Mā tō tākuta me tō tīma hauora koe e āwhina ki te whakarite mō te pokanga. He mea tino nui kia tino whai koe i ā rātou tohutohu.

• Tērā pea ka tonoa koe kia mutu te tango i ētahi rongoā: Tērā pea ka tonoa koe kia mutu te tango i ngā rongoā whakaiti toto (anticoagulants) pērā i te aspirin me te warfarin i ētahi wiki i mua i te pokanga.
• Āwhina i a koe ki te whakamutu i te kai paipa: Mena he kai paipa koe, ka taea e tō tākuta te āwhina i a koe ki te whakamutu.
• Whakamahia he hopi patu huakita: Ka kīia atu ki a koe kia horoia tō tinana ki te hopi patu huakita i te pō i mua i te pokanga.
• Ngā rongoā hei tango i te rā o te pokanga: Mā te tākuta koe e kī atu ko ēhea ngā rongoā hei tango i te ata o taua rā.
• Nohopuku: I te rā o te pokanga, ka tohutohuhia koe kia kaua e kai, e inu rānei i tetahi mea i muri i tētahi wā kua whakaritea.

He aha ngā mea ka tupu i te wā o te pokanga?

I tēnei pokanga, ka whakatikahia e te taote pokanga tētahi, ētahi rānei o ngā raruraru o tō takirere. Koinei ngā mahi e mahia ana i te nuinga o te wā i te wā o te pokanga.

1. Whakamoemiti: Ka hoatu he rongoā whakamoemiti ki a koe hei mea i a koe kia moe hohonu, kia kore ai koe e mōhio.

2. Hononga ki te mīhini ngākau-pūkahukahu:I te wā o te pokanga, ka honoa koe ki tētahi mīhini motuhake (mīhini karo manawa) hei whakahaere i te mahi a tō ngākau me ō pukahukahu.

3. Te tapahi: Ka tapahia te uma. Ka rerekē te rahi o tēnei tapahi i runga i te tikanga pokanga.

4. Mowhiti whakatārewatanga: Ka whakatakotoria he mowhiti rite ki te mīhini horoi i hangaia ki te papanga huri noa i te takirere. Mā tēnei ka tautoko i te takirere, ā, ka āwhina i a ia kia hoki ki tōna āhua noa.

5. Te whakatikatika i te takirere: Ka whakatikatikaina te takirere mitral mā te whakamahi i tētahi, i ētahi atu tikanga pokanga rānei.

6. Tirotiro: Tirohia mēnā kua tika te whakatikatika i te takirere, ā, me mahi ētahi atu whakatikatika mēnā e tika ana.

7. Te whakamutu i te whāngai ū: Whai muri i te pokanga, ka tangohia koe i te mīhini. Kātahi ka tīmata anō te mahi a tō ngākau me ō pukahukahu.

8. Tirotiro whakamutunga: Ka whakahaerehia he whakamātautau echo motuhake (transesophageal echocardiogram) hei whakaū mēnā kua whakatikahia te takirere.

He aha ngā tikanga pokanga e whakamahia ana mō te pokanga?

He rerekē ngā tikanga e whakamahia ana e ngā taote pokanga mō tēnei mahi. Kōrero ki tō tākuta mō te tikanga e whakamahia ana mō tō mahi pokanga.

Ngā huarahi hei whakamahi i ngā tapahi

• Te pokanga uma: Ka tapahia katoatia te uma puta noa i waenganui o te wheua uma.
• Te tapahi wāhanga o te sternotomy: Te tapahi i tētahi wāhanga anake o te uma o waenganui.
• Te pokanga o te uma matau: Ka tapahia he wahi iti i waenganui i ngā rara e rua i te taha matau.
• Tikanga āwhina-rorohiko: Ka mahia te pokanga mā te whakamahi i tētahi rōpoto mā te whakamahi i ētahi tapahi iti rawa ki ngā rara.

Ētahi atu tikanga pokanga

• Annuloplasty: E ai ki tā tātou i kōrero ai i mua ake nei, ko te whakatakoto i tētahi mowhiti huri noa i te takirere. He maha ngā wā ka mahia tēnei i ia whakatikatika takirere mitral.
• Te tango tapatoru, tapawhā rānei: Ka tapahia, ka tangohia tētahi wāhanga iti o te takirere kua pakaru, ā, ka tuia ngā wāhanga pai e toe ana.
• Te whakatikatika i ngā aho: Mena ka pakaru ngā muka iti rite ki te aho (chordae) e pupuri ana i te takirere ki tōna tūranga, ka tangohia ngā wāhanga kua pakaru ka whakakapia ki ngā muka horihori (i hangaia mai i tētahi rauemi pēnei i te Gore-Tex®) me ngā muka rānei i tangohia mai i tētahi atu wāhanga hauora o te ngākau.

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

I muri i te pokanga, ka taea e koe te tumanako i ngā mea e whai ake nei:

• Me noho koe ki te wāhanga tiaki nui (ICU) mō te rā kotahi, e rua rānei, ka aroturukihia e te tīma hauora tō manawa me tō manawa.
• I muri i tēnā, me noho koe ki te wāhanga noa mō ētahi atu rā.
• Ka kōrero atu ahau ki a koe mō te whakaora i te ngakau .
• I muri i tō hokinga ki te kāinga, ka akona koe ki te tiaki i te patunga pokanga.

Ko te nuinga o te tangata me noho ki te hōhipera mō te wiki pea i muri i tēnei pokanga.

He aha ngā painga o tēnei pokanga?

He maha ngā painga o te whakatika i tētahi takirere o nāianei, kaua ki te whakakapi ki tētahi mea hou.

• Ka piki ake te tūponotanga kia roa ake te ora: Ka piki ake te tūponotanga kia roa te ora, kia hauora hoki i muri i te pokanga.
• Te tiakitanga tino pai mō te mahi a te ngākau: He iti noa te kino ki te mahi a te ngākau.
• Te whakaiti i te mōrearea o ngā raruraru: He iti ake te mōrearea o ngā raruraru pēnei i te whiu me te endocarditis (te mate o ngā takirere o te ngākau).
• Kāore e hiahiatia he rongoā whakaiti toto mō te wā roa: I te nuinga o te wā, kāore e hiahiatia he rongoā whakaiti toto (anticoagulants) kia roa te tango.

He pēhea te angitu o te pokanga? He aha ngā raruraru ka pā mai?

He angitu te nuinga o tēnei pokanga. E ai ki ngā pūrongo, ahakoa 10 tau i muri i te pokanga, tata ki te 94% o ngā tūroro kāore he toto nui e pāngia ana e te mate.

Heoi, pērā i ngā pokanga katoa, tera pea ētahi mōrearea me ngā raruraru ka pā mai.

• Ngā rerekētanga o te pā o te ngakau (Arrhythmias)
• Te toto
• Poraka ngākau
• Te ngoikore o te ngākau
• Mate pāwera
• Whiu

Kōrero ki tō tākuta mō ēnei mōrearea me pēhea te whakaiti i aua mōrearea.

Kia pēhea te roa o te wā e ora ai?

E whā ki te waru wiki te roa o te wā hei whakaora katoa i tēnei pokanga, ahakoa ka roa ake pea te wā mō ētahi tāngata.

Ko te roa o te wā e ora ai koe ka whakawhirinaki ki ētahi āhuatanga:

• Te kaha o tō mate ngakau i mua i te pokanga: Mena kua ngoikore kē te mahi a tō ngakau i mua i te pokanga, ka roa te wā ka hoki mai te kaha.
• Tō hauora whānui i mua i te pokanga: Ka whakawhirinaki tēnei ki te mea he kaha tō mahi, he mate hauora rānei tōu i pā ki a koe i uaua ai te mahi.
• Tikanga pokanga i whakamahia:Ki te tapahia he wahi nui ki waenganui o te uma (median sternotomy), e 6-8 wiki pea te roa mō te whakaora o te wheua. Ki te mahia te pokanga mā roto i ngā wahi iti, ka tere te ora o ngā patunga.

Āhea koe me toro atu ki te tākuta?

He mea noa te pāngia e te mamae i muri i te pokanga. Ka hoatu e tō tākuta he rongoā whakamamae mamae mō tēnei. Heoi, ki te pāngia koe e tētahi o ngā tohu e whai ake nei, kaua e whakaaro he mea noa ēnei, engari me whakapā atu tonu ki tō tākuta.

I ētahi wā, kāore e taea te kī mēnā he wāhanga noa tēnei o te whakaoranga, he mea nui rānei. Mēnā he ruarua koe, he pai ake te waea atu ki tō tākuta me te pātai atu.