He tikanga hou mō te whakakapi i ngā takirere ngākau me te kore e whakatuwhera i te uma (Whakakapinga Takirere Pūkahukahu Transcatheter - TPVR)

I ētahi wā, kua rongo pea koe mō tētahi tamaiti i whānau mai me tētahi momo raruraru ngākau i a ia e tamariki ana. Tērā pea i pokaina taua tamaiti i taua wā, ā, i whakatikatikaina te āhua. Engari ina pakeke haere taua tamaiti, ina tae ia ki te wā taitamariki, ka puta anō te raruraru ngākau i roto i taua tamarikitanga i tētahi ara rerekē. Mēnā he pērā te āhua, i tēnei rā ka kōrero tātou mō tētahi tikanga maimoatanga tino nui ka taea te homai he kaha nui ki te ora.

Nā, he aha te TPVR?

Ki te whakarapopoto, ko te TPVR , te Transcatheter Pulmonary Valve Replacement rānei, he tikanga motuhake e whakakapi ana i te takirere pūkahukahu e kore e mahi tika ana i roto i tō ngākau, engari kāore e whakatuwhera i tō uma. He mea whakamiharo tēnei, kāore? I te nuinga o te wā, ina whakaaro tātou ki te whakakapi i te takirere ngākau, ka whakaaro tātou ki te pokanga ngākau tuwhera, arā, ko te tapahi nui i waenganui o te uma. Heoi, i roto i tēnei tikanga TPVR, ka tapahia e te taote pokanga he tapahi iti rawa ki te kiri o tō hope, ā, ka mahia te tukanga katoa mā roto.

Ko te takirere pūkahukahu te kuaha e whakahaere ana i te rere o te toto mai i te ngākau ki ō tātou pūkahukahu. Ki te kore e mahi tika, ka whakararuraruhia te rere o te toto ki te tinana katoa. Nō reira, mā tēnei tikanga, ina whakakapia te takirere ngoikore ki tētahi mea hou, ka tino piki ake tō roanga oranga me te kounga o te oranga. Waihoki, ka āwhina i te whakaroa, i te karo rānei i te hiahia mō ngā pokanga nui.

He aha te mea ka tupu me tēnei maimoatanga TPVR?

Whakaarohia i roto i te pokanga ngākau tuwhera tuku iho, ka tapahia e ngā tākuta te wheua o te uma, ka whakawhitihia te mahi a te ngākau ki tētahi mīhini (mīhini whakawhiti ngākau-pūkahukahu), kātahi ka tangohia te takirere tawhito ka whakauruhia he mea hou. He roa te wā e pau ana ki tēnei, he roa ake te ora, ā, he tino mōrearea pea mō ētahi tūroro ki te mahi i tētahi pokanga nui pēnei.

Engari he tino rerekē te tikanga TPVR. He tikanga iti rawa te whakaekenga . Anei ngā mea ka tupu:

1. Ka tapahia e te tākuta ngakau he uaua iti ki roto i tētahi oko toto nui i roto i tō hope (uaua femoral) ka whakauruhia he ngongo angiangi, ngāwari, e kiia nei ko te catheter, mā roto.

2. Kei roto i tēnei katitere te takirere hou, he poihau iti kua whakapikoa ki runga.

3. Mā te whakamahi i ngā tikanga motuhake pēnei i te hihi-X, ka ārahi marie te tākuta i tēnei katitere mā roto i te uaua toto ki te wāhi kei reira te takirere pūkahukahu i roto i te ngākau.

4. Kia tau te pūnga, ka pupuhihia te poihau. Ka whānui te takirere hou, i whakapikoa, ka mau ki te wāhi i tū ai te takirere tawhito.

5. Mai i taua wā tonu, ka tīmata te mahi a te takirere hou. Ka hoki anō te rere o te toto mai i te ngākau ki ngā pukahukahu ki te āhua noa.

Ko tētahi o ngā painga nui o tēnei ko te nuinga o te hunga kua whiwhi i tēnei maimoatanga ka taea te hoki ki te kāinga tonu. He poto rawa te wā whakaora.

Nā, he aha te mea ka tupu mēnā kāore tēnei takirere pūkahukahu e mahi tika?

E rua ngā raruraru matua ka pā ki te takirere pūkahukahu.

Nā ēnei āhuatanga e rua, ka pāngia pea koe e ngā tohu pēnei i te poto o te manawa (dyspnea) , te pupuhi o ngā waewae me te puku (edema) , te mamae o te uma , me te pā o te ngakau kāore i te rite . Ka tino heke iho ēnei tohu i muri i te maimoatanga TPVR.

Mā wai tēnei maimoatanga e tino tika?

Mena i whānau mai koe me te mate manawa whānau , ā, i pokangahia koe i a koe e tamariki ana, tera pea ka pai tēnei maimoatanga mōu. Nā te mea ka kino haere te takirere i whakatōkia i te tamarikitanga (he homograft te nuinga o te wā). Kātahi ka puta ngā āhuatanga kua whakahuatia ake nei, pērā i te stenosis, te regurgitation rānei, i te wā taitamariki. Koia te take e taunaki ana ngā tākuta i te tikanga TPVR mō ēnei tāngata.

Ka whakamahia tēnei tikanga hei rongoā i ngā mate ngakau whānau e whai ake nei:

• Tetralogy o Fallot: He huinga o ngā hapa e whā, tae atu ki ngā kōhao i roto i te ngākau, e whakaranu ai te toto pai me te toto kino.
• Atresia Pūkahukahu: He āhuatanga kāore i hangaia te takirere pūkahukahu i te whānautanga.
• Truncus Arteriosus: Ko ngā oko toto matua e rua e ahu mai ana i te ngākau (aorta me te uaua pūkahukahu) e honoa ana hei hanga i te oko toto kotahi.
• Te Whakawhiti o ngā Uaua Nui: Ka whakawhitihia, ka honoa hoki ngā uaua toto nui e rua ki ngā taha hē.

He aha ngā mahi i mua atu, ā, i muri mai i te maimoatanga?

Te whakarite i mua i te maimoatanga

Hei tirotiro mēnā ka taea e koe te mahi TPVR, ka tirotirohia koe e tō tākuta, ā, ka whakahaerehia pea he whakamātautau ahotea whakakori tinana. Hei tāpiri, ka taea te mahi i ēnei whakamātautau e whai ake nei:

• Angiogram
• Matawai CT o te ngākau
• MRI o te ngākau
• Te Echocardiogram
• Whakamātautau ECG

I muri i te whakaaroaro i ēnei mea katoa, ka whakatau te tākuta ko tēhea te otinga pai rawa atu māu.

I te wā o te maimoatanga

Ka whakamoea koe i mua i te tīmatanga o te maimoatanga, nō reira kāore koe e mamae. E rua ki te toru hāora te roa o te tukanga katoa. Ka whakauruhia e ngā tākuta te catheter, ka whakanoho i te takirere, ka tirohia tana mahi, kātahi ka tangohia te catheter.

I muri i te maimoatanga

Ka puritia koe ki te hōhipera hei tirotiro māu i te pō, ā, i te nuinga o te wā ka tukuna koe ki te kāinga i te aonga ake. Ka taea e koe te hoki anō ki ō mahi o ia rā i roto i te wiki pea.

He aha ngā painga me ngā mōrearea?

Pērā i ngā maimoatanga hauora katoa, he painga, he mōrearea hoki ō tēnei.

He tino onge te puta o ngā raruraru nui pēnei i te mate manawa, te whiu, te mate rānei. Nō reira, he mea nui kia kōrerohia ngā painga me ngā huakore o tēnei maimoatanga ki tō tākuta i mua i te whakatau.

Ētahi atu mea nui hei mōhio

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

Kei tō hauora whānui me te āhua o tō ngākau tēnei. Tērā pea me mahi anō he pokanga mō ētahi tāngata i muri i tētahi wā. Engari ko te rongo pai, ki te tika, ka taea te whakakapi i tētahi atu takirere mā te tikanga TPVR.

Me tūpato koe i te wā e mahi ana koe i ngā maimoatanga niho?

Ae, he mea tino nui tēnei. I roto i ngā mahi pēnei i te tango niho me te horoi niho, ka taea e ngā huakita i roto i te waha te uru ki roto i te toto ka haere mā roto i taua mea ka puta he mate kino e kiia nei ko te endocarditis , he mate o te takirere ngākau hou kua whakatōkia. Nō reira, i mua i tō maimoatanga niho, me whakamōhio atu koe ki tō tākuta niho kua pāngia koe e te TPVR. Tērā pea ka tonoa koe kia tango i ngā paturopi i mua i te maimoatanga.

He raruraru kei roto i te haumarutanga o te taunga rererangi?

Kāo. Kāore ngā hihi-X me ngā tirotiro haumaru o te taunga rererangi e pā kino ki a koe. Heoi, ki te mea kei te whakaaro koe ki te tirotiro MRI, kōrero ki tō tākuta i te tuatahi.