He okana whakamiharo tō tātou ngākau e mahi tonu ana. I roto i tēnei ngākau, e whā ngā takirere e mahi ana pērā i ngā kēti e whā hei whakahaere tika i te rere o te toto. Mā ēnei ka taea te rere o te toto i te taha kotahi anake. Ko tētahi o ēnei takirere e kiia ana ko te 'takirere Mitral'. Kei te taha maui o te ngākau tēnei kei waenganui i te rūma o runga (atrium maui) me te rūma o raro (ventricle maui). Engari i ētahi wā ka pāngia tēnei takirere mitral e te mate. Ko te tikanga ka taea e te toto te turuturu whakamuri me te kore e kati tika, ka taea rānei te aukati me te kore e tuwhera tika. Nō reira, i tēnei wā, me whakakapi taua takirere.
Nā, he aha te TMVR?
He whakarāpopototanga noa iho, ko te TMVR (Transcatheter Mitral Valve Replacement) he tikanga maimoatanga hou e whakakapi ana i te takirere mitral kua pakaru ki tētahi takirere hou, me te kore e pokanga nui ki te ngākau tuwhera.
Whakaarohia, hei utu mō te pokanga nui e whakatuwhera ana i te uma me te whakamutu i te manawa, ka tukuna he ngongo angiangi (catheter) mā roto i tētahi tapahi iti rawa i te hope, i te uma rānei, i te taha o te uaua toto, ki roto i te manawa, ā, ka whakaurua he takirere hou mā roto i te ngongo ka whakapūmau ki te wāhi o te takirere tawhito, mate. Tērā pea he takirere hanga-tangata tēnei takirere hou, ka taea rānei te hanga mai i te kiko kararehe (kau, poaka). I roto i tēnei tikanga, kāore te takirere tawhito e tangohia, engari ka whakanohoia te mea hou ki roto ka whakapūmau.
Ko wai rā te tangata e hiahia ana ki tēnei maimoatanga?
E rua ngā momo matua o te mate takirere mitral:
1. Te ruakitanga o te takirere mitral: Koinei te wā kāore e kati tika ngā taupoki e rua o te takirere, ka turuturu whakamuri te toto e pupuhihia ana e te ngākau. He rite ki te wai e turuturu ana mai i te taputapu pakaru.
2. Te whakatōtōtanga o te takirere mitral: Koinei te wā ka whaiti te takirere, ā, kāore e tuwhera tika. Ka whakawhāitihia e tēnei te nui o te toto ka taea te rere whakamua. Pērā i te aukati i te paipa, ka heke te rere o te wai.
Ina kino rawa atu ēnei āhuatanga e rua, ka puta pea ngā tohu kino pērā i te poto o te manawa, te fibrillation atrial, te toto toto tiketike o te pūkahukahu, me te ngoikore o te ngakau.
Ko te tikanga, ka mahia te pokanga ngākau tuwhera i roto i ēnei momo take. Heoi, he kōwhiringa pai te TMVR mō te hunga kua kaumātuatia, he mate hauora anō ō rātou, ā, kāore e taea te utu i ngā mōrearea o tētahi pokanga nui pēnei.
He rite tonu te TMVR me te MitraClip?
Kāo. Ahakoa he maimoatanga ēnei e rua e mahia ana me te kore e whakatuwhera i te ngākau, e rua ngā tikanga.
- MitraClip™: Ko te mahi tēnei ko te whakatika i tētahi takirere e turuturu ana. Ko te mahi tēnei ko te whakatakoto i tētahi taputapu iti rite ki te topenga i waenganui i ngā rau e rua o te takirere hei aukati i te turuturu o te toto.
- TMVR:Ehara tēnei i te whakatikatika, engari kua whakauruhia he takirere hou rawa.
He aha ngā mea ka tū i mua i te maimoatanga TMVR?
I muri i te whakatau ki te hoatu i tēnei maimoatanga ki a koe, ka tirotirohia koe e te tīma hauora.
- Ngā Whakamātautau: He maha ngā whakamātautau ka mahia, pērā i te "Echocardiogram" hei tirotiro i te mahi a te ngākau me te "CT scan" hei tirotiro i te hanganga o te ngākau. Ka whakamahia ēnei hei whakarite i te maimoatanga.
- Te kōrero mō te rongoā whakamoe: Ka kōrero te tohunga ki a koe mō te momo rongoā whakamoe ka hoatu ki a koe hei karo i te mamae i te wā e rongoatia ana. Ka whakatauhia i runga i tō āhua, ahakoa ka hoatu he rongoā whakamoe whānui, he rongoā whakamoe rānei.
- Tohutohu: Ka hoatu e te tākuta ētahi tohutohu motuhake ki a koe.
- Ko ētahi rongoā (ina koa ko ngā rongoā whakaiti toto) me whakamutu mō ētahi rā.
- Ka tonoa koe kia nohopuku mō ētahi haora i te rā o te maimoatanga.
- Ka whakamōhiotia koe kia whakahokia mai tētahi ki te kāinga i muri i te maimoatanga.
He aha ngā mea ka tupu i te wā e rongoatia ana?
E rua ki te toru hāora te roa o tēnei maimoatanga. Ka uru atu tētahi rōpū tohunga ki tēnei mahi, tae atu ki ngā taote pokanga ngākau, ngā tākuta ngākau, me ngā tākuta whakamoe.
Hei whakarāpopototanga, koinei ngā mea ka tupu.
1. Ka horoia te wāhi i tapahia (te hope, te uma rānei), ā, ka whakaritea.
2. Ka whakanohoia he cannula (raina IV) ki roto i tētahi uaua i te ringa, hei tuku i ngā rongoā me ngā wai e tika ana.
3. Ka tāpirihia te takirere hou ki te pito o tētahi ngongo angiangi (kātene).
4. Ka whakaurua tēnei ngongo ki roto i tētahi oko toto mā roto i tētahi tapahi iti i te hope, i te uma rānei.
5. Mā te whakamahi i te hangarau whakaahua motuhake, ka arahina tēnei ngongo ki te takirere mitral o te ngākau.
6. Ka whakaurua te takirere hou ki roto i te takirere tawhito, kua pangia, ka whakanohoia ki te tūranga tika, kātahi ka tāuta.
7. Kātahi ka tangohia te ngongo, ā, ka kati te tapahi.
Kei te aroturukihia e te tīma hauora ngā mea katoa, tae atu ki tō toto toto me ngā taumata hāora, puta noa i tēnei wā katoa.
He aha ngā mea ka tupu i muri i te TMVR?
I muri i te maimoatanga, ka haria koe ki te rūma whakaora. Ka tirotirohia koe kia ora rā anō koe i te rongoā whakamoe. Tērā pea me noho ētahi tāngata ki te wāhanga tiaki nui (ICU) mō te rā kotahi, e rua rānei. I te nuinga o te wā, me noho koe ki te hōhipera mō ētahi rā.
Ina hoki koe ki te kāinga, ka tohutohu atu tō tākuta ki a koe mō ngā mea e whai ake nei:
- Me pēhea te whai wāhi atu ki ngā kaupapa whakaora ngākau.
- Ngā wā whakarite whai muri.
- Mō ngā rongoā hei tīmata anō me ngā rongoā hou hei tango.
- Āhea ahau ka taea ai te hoki ki ngā mahi me ngā mahi o ia rā?
Ngā painga me ngā mōrearea o te maimoatanga TMVR
Pērā i ngā maimoatanga hauora katoa, he painga, he mōrearea anō hoki. Me titiro tātou ki ēnei.
| Ngā Painga | Ngā Tūponotanga me ngā Āhuatanga Whakararuraru |
|---|---|
| Ka whakatikatikaina te mate takirere mitral. | Tērā te mōrearea o te hanganga o ngā toto totoka ka haere ki te roro, ka pā mai te whiu. |
| He iti haere te kitea o ngā tohu (pēnei i te poto o te manawa). | Te kino ki te kiko o te ngākau. Hei tauira: Te pokanga o te ventricle maui. |
| He tere ake te ora ake i te pokanga ngākau tuwhera. | Te aukati i te rere o te toto i roto i te ventricle maui. |
| Kāore he koha nui, ā, he iti iho te mamae. | Ka neke, ka neke rānei te takirere kua whakatōkia mai i tōna wāhi. |
Ko te mea nui, he tino onge ēnei mōrearea, ā, ki te puta he raruraru, kua rite te tīma hauora ki te huri tonu ki te pokanga tuwhera, ki te mahi rānei i ētahi atu mahi e tika ana.
Āhea koe me rapu tohutohu hauora ohorere?
Ina hoki koe ki te kāinga i muri i te maimoatanga, me tino tupato koe ki ētahi tohu. Mena ka pāngia koe e ēnei tohu e whai ake nei , haere tonu ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera.
| Haere ki te ETU kia tere! | |
|---|---|
| Ngā tohu o te whiu |
|
| Ngā tohu o te whakaeke ngakau | |
| Mena kei a koe ēnei tohu, whakamōhio atu ki tō tākuta. | |
| Ngā raruraru e pā ana ki te tapahi | E wetekina ana ngā tuitui, e toto ana mai i te patunga. |
| Ngā tohu o te mate | Mamae, whero, maringi wai, pupuhi rānei i te wāhi o te patunga. |
| Ngā tohu o te toto totoka | Te mamae, te pupuhi, me te rerekētanga o te tae i ngā wāhi pēnei i te huha, te turi, te pona rānei. |
| Ētahi atu tohu o te whakaeke ngakau | Te pikinga ohorere o te taumaha, te pupuhi o ngā waewae me ngā pona. |
Karere Tangohia ki te Kāinga
- He tikanga maimoatanga hou te TMVR e whakakapi ana i te takirere mitral me te kore e whakatuwhera i te ngākau, he iti te mōrearea me te tere o te ora.
- He kōwhiringa pai tēnei, inā koa mō te hunga kua kaumātuatia, mō ētahi atu āhuatanga hauora rānei e uaua ai te mahi pokanga nui.
- Mena kei a koe, kei tētahi rānei e tata ana ki a koe te mate takirere mitral, kōrero ki tō tākuta ngakau mō tēnei kōwhiringa maimoatanga. Māna e whakatau ko tēhea maimoatanga te mea pai mōu.
- I muri i te maimoatanga, he mea nui te whai i ngā tohutohu a tō tākuta kia tere ai te ora. Kia tūpato tonu ki ngā tohu whakatūpato.
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