He tikanga hou mō te whakakapi i te takirere ngākau! (Whakakapinga Takirere Pūkahukahu Transcatheter - TPVR)

Ka taea e koe te whakaaro ki te whakakapi i tētahi takirere ngākau me te kore e whakatuwhera katoa i te uma? Āe, kua tino tutuki ināianei. I tēnei rā kei te kōrero tātou mō tēnei hangarau kua kawea mai he tumanako hou ki te tini o te hunga he raruraru takirere pūkahukahu nā te mate ngākau whānau. Me tīmata tēnei me tētahi kōrerorero tino māmā, hoahoa hoki.

He aha te TPVR?

Ko te TPVR, arā, ko te Transcatheter Pulmonary Valve Replacement , he pokanga e whakakapi ana i te takirere pūkahukahu e kore e mahi tika ana i roto i tō ngākau ki tētahi takirere hou mā roto i tētahi tapahi iti rawa. I te nuinga o te wā, ina whakaaro tātou ki te pokanga ngākau, ka whakaaro tātou ki tētahi pokanga e uru ana ki te hanga i tētahi tapahi nui i waenganui o te uma me te whakatuwhera i te uma. Heoi, i roto i tēnei tikanga, kāore e mahia he tapahi nui pēnei.

Engari, ka hangaia e ngā tākuta he kōhao iti ki te kiri o tō hope, ka mahi i te mahi mā roto. He mea tino nui tēnei takirere pūkahukahu, e mahi ana hei kuaha e tuku toto ana i tō ngākau ki ō pūkahukahu. Ko te hunga i whānau mai me te mate ngākau whānau, ka pāngia pea e ngā raruraru o tēnei takirere i a rātou e pakeke haere ana i muri i te pokanga i a rātou e tamariki ana. Nō reira, mā te whakakapi i taua takirere ki tēnei tikanga ka nui ake te whakapai ake i tō roanga o te ora me te kounga o te oranga, ā, ka karohia hoki te haere tonu o ngā pokanga nui.

He aha te mea e tupu ana i roto i te pūnaha TPVR?

I roto i te pokanga ngākau tuwhera tuku iho, ka tapahia te wheua o te uma, ka honoa te tūroro ki te mīhini karo ngākau-pūkahukahu, ka tangohia te takirere tawhito, ā, ka whakaurua he takirere hou. Ka roa te wā e pau ana ki tēnei, ka roa ake te ora, ā, mō ētahi tāngata, he morearea tēnei pokanga.

Engari ehara i te mea pērā te TPVR. Ka whakauruhia e te tākuta ngakau he ngongo iti (catheter) mā roto i te uaua i roto i tō hope, ā, ka arahina te takirere hou mā roto i te ngongo ki roto i tō ngākau. Ka mahia katoatia tēnei i raro i te arataki a te hangarau pēnei i te hihi-X. Kia tae ki te wāhi tika, ka pupuhihia te takirere hou ki te poihau, ā, ka mau ki tōna wāhi.

Kia oti tēnei, ka hoki anō te rere o te toto mai i te ngākau ki ngā pukahukahu ki te tika. Ka whakaitihia te taumahatanga o te ngākau, ā, ka whiwhi te tinana i te hāora pai ake. I te nuinga o te wā, ka taea e te tangata kua oti tēnei pokanga te hoki ki te kāinga i taua rā anō .

Ka aha mēnā kāore taku takirere pūkahukahu e mahi tika?

E rua ngā raruraru matua e kitea ana i roto i te takirere pūkahukahu. Me titiro poto tātou ki ēnei.

I roto i ēnei āhuatanga e rua, ka pāngia pea koe e ngā tohu pēnei i:

• Te uaua ki te manawa (dyspnea)
• Te pupuhi o te puku me ngā waewae (edema)
• Mamae o te uma
• Te ahua kei te tere te pao o tō ngākau (palpitations)

Ko te ngoikore o te ngākau, te koretake rānei o te ngakau (arrhythmias) te take o ēnei tohu. I te nuinga o te wā ka pai ake ēnei tohu i muri i te pokanga TPVR.

Ko wai te tangata e tino tika ana mō tēnei pokanga TPVR?

Mena i whānau mai koe me tētahi mate e pā ana ki te takirere pūkahukahu o tō ngākau, tera pea ka whai hua koe i tēnei pokanga. Ina koa,

• Ngā tāngata kua pokangahia te takirere pūkahukahu i a rātou e tamariki ana.
• Ka aukati, ka turuturu rānei te takirere o ngā pakeke me ngā taiohi kua pāngia e taua takirere i te roanga o te wā.
• He maha ngā wā, ka whakaarohia e ngā tākuta te tikanga TPVR mō te hunga i whiwhi i te homograft (he whakawhitinga takirere) mai i tētahi kaituku i te wā taitamariki, i te wā e ngoikore haere ana taua takirere i te roanga o te wā.

Ko ētahi o ngā mate matua e rongoatia ana e tēnei pokanga ko:

• Atresia Pūkahukahu: He āhuatanga kāore i hangaia te takirere pūkahukahu i te whānautanga.
• Te Regurgitant Pulmonary Valve: He āhuatanga e turuturu whakamuri ai te toto mā te valve.
• Tetralogy of Fallot: He āhuatanga e whakaranua ai te toto pai me te toto kino nā te huinga o ngā hapa ngākau e whā.
• Truncus Arteriosus: He āhuatanga e honoa ai ngā uaua toto matua e rua e puta mai ana i te ngākau.
• Te Whakawhitinga o ngā Uaua Nui: He āhuatanga e whakawhitihia ai, e honoa ai hoki ngā uaua toto matua e rua o te ngākau.

Kua tino angitu ngā hua o te pokanga TPVR hei maimoatanga mō ēnei āhuatanga.

He aha ngā mea ka tū i mua, i te wā, me muri i te pokanga?

Te whakarite i mua i te pokanga

Hei whakatau mēnā he tika tēnei pokanga māu, ka tirotirohia koe e tō tākuta me te āta tirotiro. Tērā pea ka whakahaerehia e ia ētahi whakamātautau, pēnei i:

• Angiogram
• Matawai CT o te ngākau
• MRI o te ngākau
• Te Echocardiogram
• Te hiko o te manawa (ECG)

I runga i ngā hua o ēnei whakamātautau, ka tūtohu tō tākuta i te pokanga TPVR, ka whakatau rānei ia ki te aroturuki i tō āhua mō tētahi wā. Ka tohutohu anō hoki ia i a koe mō ngā kai hei kai me ngā rongoā hei whakamutu i te tango (ina koa ko ngā rongoā whakaiti toto) i mua i te pokanga. Kaua e wareware ki te kōrero ki tō tākuta mō ngā mate pāwera ka pā ki a koe.

I te wā o te pokanga

I mua i te tīmatanga o te pokanga, ka hoatu he rongoā whakamoe ki a koe kia kore ai koe e mamae. Ko reira anake ka tīmata te mahi a te tohunga.

1. Tuatahi, ka tapahia he tapahi iti ki tō hope (uaua femoral) ki tō kaki rānei (uaua jugular) ā, ka whakaurua he ngongo (catheter) mā roto.

2. Kātahi, mā te whakamahi i ngā hangarau pēnei i ngā hihi-X, ka arahina te takirere hou mā roto i te ngongo, mā te waea hoki ki te wāhi tika i roto i te ngākau. Ka whakapikohia tēnei takirere ki runga i te poihau.

3. Kia tae ki te tūranga tika, ka pupuhihia te poihau. Ka whānui te takirere hou, ā, ka piri pai ki roto i te takirere tawhito. Mai i taua wā tonu, ka tīmata te mahi a te takirere hou.

4. Hei whakamutunga, tirohia mēnā kei te mahi tika te takirere, kātahi ka tangohia ngā ngongo katoa kua whakaurua.

E rua, e toru rānei hāora te roa o tēnei tukanga katoa.

I muri i te pokanga

I muri i te pokanga, ka noho koe ki te hōhipera i te pō hei tirotiro māu. Ki te pai ngā mea katoa, ka taea e koe te hoki ki te kāinga i te ata e whai ake nei . Ka hoatu e tō tākuta he huinga tohutohu hei whai māu ina hoki koe ki te kāinga. I te nuinga o te wā , ka taea e koe te hoki anō ki ō mahi o ia rā i roto i te whitu rā pea .

He aha ngā painga me ngā mōrearea o te tikanga TPVR?

Pērā i ngā tikanga hauora katoa, he painga, he mōrearea iti anō hoki. Kia mōhio tātou ki ngā mea e rua.

He tino onge te puta o ngā raruraru nui pēnei i te mate manawa, te whiu, te mate rānei. Engari he tino onge ēnei. Ka kōrero taipitopito atu tō tākuta ki a koe mō ēnei mea katoa.

Ētahi atu pātai pea kei a koe

Kia pēhea te roa o te ora o tēnei takirere hou?

He maha ngā mea e whakawhirinaki ana ki tēnei, pērā i tō hauora whānui me te mahi a te ngākau. Tērā pea me mahi anō tēnei momo pokanga i muri i tētahi wā.

Me mahi ahau i tētahi mea motuhake i mua i te maimoatanga niho?

Ae, he mea tino nui tēnei. I te wā e rongoatia ana ō niho, ka taea e ngā huakita mai i tō waha te tomo ki roto i te toto, ka pā mai he mate ki te takirere manawa hou (endocarditis). Nō reira, ina haere koe ki te tākuta niho, me kōrero wawe atu koe kua whakakapia tō takirere manawa. Me tango pea koe i ngā paturopi i mua i te tangohanga o te niho.

Ka taea e au te tirotiro i ngā tirotiro haumaru i te taunga rererangi?

Āe, kāore he raruraru. Kāore ngā hihi-X me ngā matawai haumarutanga taunga rererangi e kino ki tō takirere. Heoi anō, me kōrero koe ki tō tākuta i mua i te whai i te matawai MRI.