Me kōrero tātou mō te Pokanga Ārai i te Pump-Off!

Kua rongo pea koe i te pokanga arai manawa, tika? Tērā pea kua pāngia tētahi o tō whānau, tētahi hoa rānei e tēnei momo pokanga. I te nuinga o te wā, ina kōrero tātou mō te pokanga arai, ka whakaarohia he pokanga nui e aukati ana i te manawa me te hono atu ki tētahi mīhini. Engari i mōhio koe kei reira anō hoki tētahi pokanga arai ka taea te mahi me te kore e aukati i te manawa, arā, i te wā e patupatu tonu ana te manawa? Koinei te mea e kiia nei e tātou ko te pokanga arai "Off-pump", ko te "Beating Heart Surgery" rānei. Me kōrero tātou mō tēnei i tēnei rā.

Āe, he aha tēnei pokanga whakawhiti e mahia ana me te kore e aukati i te manawa?

He whakarāpopototanga noa iho tēnei, he momo pokanga whakawhiti uaua coronary (CABG). I roto i te pokanga whakawhiti, ka hangaia he uaua hou hei whakawhiti i te uaua kua āraia (koronary artery) e tuku toto ana ki te ngākau. Ka mahia tēnei mā te whakamahi i tētahi uaua toto hauora (graft) i tangohia mai i tētahi atu wāhanga o te tinana, hei tauira, te waewae, te uma rānei.

Whakaarohia, he nui ngā waka i runga i te rori, nō reira kāore ngā waka e neke. Kātahi ka hangaia he ara karo hei karo i taua waka. Mā tēnei ka tīmata anō te rere o te toto ki te ngākau.

I roto i te pokanga whakawhiti tuku iho (On-pump CABG) , ka mutu katoa te manawa o te tūroro i ngā taote pokanga. Kātahi ka mahia te mahi a te manawa me ngā pukahukahu e tētahi mīhini motuhake kia oti rā anō te pokanga. Ka kiia tēnei he mīhini whakawhiti manawa manawa. Ka tangohia e tēnei mīhini te toto mai i te tinana, ka tāpirihia he hāora ki roto, ka tangohia te hauhā waro, ka panaia te toto ma ki roto i te tinana.

Engari i roto i te CABG kore-pamu, kāore e whakamahia te mīhini ngākau-pūkahukahu. Ka mahia te pokanga e te taote pokanga i te wā e patupatu ana tō ngākau . Koia i kiia ai ko te pokanga "patupatu ngākau".

Ko wai e hiahia ana ki tēnei pokanga?

Ko te nuinga o tēnei pokanga ka mahia ki ngā tūroro e pāngia ana e te mate uaua o te ngākau (CAD). I roto i te CAD, ka hanga ngā putunga ngako (plaque) ki roto i ngā oko toto o te ngākau, ka whakawhāiti i te rere o te toto. Ka puta pea ngā tohu pēnei i te mamae o te uma me te poto o te manawa. Mena ka aukatia katoatia ēnei oko toto, he tino teitei te mōrearea o te mate ngākau.

Ina tino kino rawa te mate, kāore e taea te whakahaere mā te whakarerekē i te āhua noho, ngā rongoā, me ētahi atu maimoatanga, ka tūtohu ngā tākuta i te pokanga arai. Ka taea e tēnei pokanga te whakaiti i ngā tohu, te whakaiti i te mōrearea o ngā mate manawa, me te whakapiki ake i te oranga. Nō reira, mō ētahi tūroro e whakatau ana ki te pokanga arai, he kōwhiringa pai pea tēnei tikanga kore-pūpū.

Me pēhea te whakarite i mua i te pokanga?

Mena kua whakaritea kia mahia tēnei pokanga, ka hoatu e tō tīma hauora he tohutohu mō te whakarite. Kei roto pea i ēnei tohutohu:

• Ki te kai paipa koe, kati tonu.
• Ka tohutohu tō tākuta kia mutu te tango i ētahi rongoā mō te wā poto, inā koa ngā rongoā ārai toto.
• Ko te rā i mua i te pokanga, ka kīia atu ki a koe kia kaua e kai, e inu rānei i tetahi mea mai i waenganui pō.

Hei tāpiritanga, tera pea ka whai whakamātautau koe kia kite ai mēnā kei te pai tō āhua mō te pokanga:

• Ngā whakamātautau toto
• Whakamātautau X-ray o te uma
• Te Echocardiogram (Echo)
• Whakamātautau ECG (Electrocardiogram)
• Ngā whakamātautau motuhake pēnei i te Whakamātautau Taumahatanga o te Ngākau Nuclear

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

Mā tō taote pokanga koe e whakamārama ki ngā mea ka puta i te wā o te pokanga. Anei ētahi mea ka puta i te nuinga o te wā:

1. Whakamoe: Ka whakamoea rawatia koe, ā, ka whakamoea kia kore ai koe e mamae.

2. Te Kohi i te Pūrua: Ko te wahi o te uaua toto hauora e hiahiatia ana mō te pokanga toto ka tangohia mai i tō waewae, ringa, i roto rānei i te uma.

3. Tapahi: Ka tapahia te uma ki waenganui, ka nekehia te wheua uma ki ia taha. I ētahi wā, i runga i te wāhi o te awaawa kua purua, ka tapahia pea he wahi iti i waenganui i ngā rara i te taha maui o te uma.

4. Te whakau i te ngākau: Nā te mea ka mahia te pokanga i te wā e patupatu ana te ngākau, ka whakamahia he taputapu motuhake e kiia nei ko te "Whakau" hei pupuri i te wāhi iti o te ngākau e pokangahia ana kia kore ai e neke. Mā tēnei ka taea e te taote pokanga te noho puku me te mahi mārama i te pokanga.

5. Te Ārai: Ka mutu te rere o te toto i roto i te uaua kua āraia mō te wā poto, ā, ka honoa tetahi pito o te uaua hauora kua tangohia i mua ki te aorta, me tetahi pito ki te uaua coronary i raro i te aukati. Mā tēnei ka hangaia he arai hou.

6. Katinga: Kia oti te mahi, ka mutu te rere o te toto mō tētahi wā, ka honoa anō te wheua o te uma ki ngā waea motuhake, ā, ka tuituia te kiri, ka kati.

He pai ake te pokanga tuku iho (i runga i te papu) me tēnei tikanga hou (i waho i te papu)?

Kei te haere tonu ngā rangahau hei whakatau ko tēhea o ēnei tikanga e rua te mea pai ake mō te wā roa. Ka kōrero tahi tō taote pokanga me koe ko tēhea tikanga te mea pai mōu. Me titiro tātou ki ngā rerekētanga matua me ngā painga me ngā huakore o ēnei tikanga e rua.

He aha ngā mōrearea o tēnei pokanga?

Pērā i ngā pokanga nui katoa, kei reira ētahi mōrearea. Heoi, he angitu ngā hua o te nuinga o te tangata. Ko ngā mōrearea pea ko:

• Te toto
• Ngā toto totoka (ka pā mai pea te whiu, te mate ngakau rānei)
• Ngā raruraru nā te rongoā whakamoe
• Ngā mate urutā
• Te pā o te manawa kāore i te tika (Arrhythmia)
• Te ngoikore o te whatukuhu

Kia pēhea te roa o te wā e ora ai?

Ko te roa o te wā whakaora i muri i te pokanga ka whakawhirinaki ki ētahi āhuatanga, pērā i tō tau, tō hauora whānui, me te rahi o te motu. Ko te tikanga penei:

• Ka taea e koe te tīmata ki te tango wai me te kai iti i taua rā anō, i te rā i muri mai rānei i te pokanga.
• I roto i ngā rā tuatahi, e rua rānei, ka taea e koe te noho ki runga i tētahi tūru me te āwhina, me te hikoi paku.
• Me noho koe ki te hōhipera mō ētahi rā.
• He mea tino nui kia whai hoa hei āwhina i a koe i ngā rā tuatahi i muri i tō hokinga ki te kāinga.
• Ka tangohia ngā tuitui i roto i te tekau wiki pea.
• He pai ake kia kaua e hiki i ngā taumaha mō ētahi wiki.
• Tērā pea ka roa pea ētahi wiki, ka roa ake rānei, kia tino ora ai.
• Ka tohutohu ngā tākuta kia uru atu koe ki tētahi kaupapa whakaora ngākau hei hanga anō i tō kaha.

I roto i ēhea āhuatanga me rapu wawe koe i te tohutohu hauora?

I a koe e ora ana, me haere koe ki te whare hauora i ngā rā kua whakaritea, kia kite ai i tō tākuta. Heoi, ki te puta mai ētahi o ngā tohu e whai ake nei i a koe, waea atu ki tō tākuta tonu atu, haere rānei ki te Tari Whawhati Tata (ETU) o te hōhipera tata.