Kotahi te pūrua o te takirere aorta o tō ngākau? (Takirere Aorta Unicuspid) - Me kōrero tātou mō tēnei!

I ētahi wā ka rongo tātou, 'Āe, he iti noa te raruraru o te ngākau o taku tamaiti, i whānau mai me te ngunguru ngākau'? Mēnā rānei, ina uaua te manawa o te taiohi, ina mamae rānei te uma, ka mea ngā tākuta, 'He iti noa te raruraru o te takirere ngākau.' Koinei te huarahi e kōrero ai tātou mō tētahi mate ngākau he tino onge, engari he mea nui kia mōhiotia.

He aha tēnei takirere aorta kotahi-raupapa ('Takirere Aorta Unicuspid')?

Ki te whakarāpopototanga, kotahi anake te rau o te takirere aorta i roto i tō ngākau, kaua ki ngā rau e toru e mau ana i te nuinga o te wā. Ko te tikanga o te kupu "unicuspid" he "rau kotahi". Whakaarohia he tatau kotahi anake te raka, kaua ki ngā rau e rua.

He rite ēnei pepa iti ki ngā tatau iti. Ka tuwhera, ka kati hoki kia rere ai te toto ma, whai rawa i te hāora mai i te ventricle maui o te ngākau - te rūma maui kei raro o te ngākau - ki te aorta . Kātahi ka pupuhi te aorta i te toto puta noa i te tinana. Nō reira, ina heke te maha o ngā pepa iti i roto i tēnei takirere, tera pea he ārai iti ki te rere o te toto.

Tērā pea ētahi atu raruraru ngākau o ētahi tāngata e pāngia ana e tēnei mate, arā, te Unicuspid Aortic Valve. Hei tauira:

• Aortopathy : Ko te tikanga tēnei he ngoikore i ngā pakitara o te aorta.
• Koha Septal Ventricular (VSD) : He kōhao kei te pakitara i waenganui i ngā rūma o raro e rua o te ngākau.
• Te Puku Arteriosus Patent (PDA) : Ka noho tuwhera tonu te uaua toto i tika kia kati i muri i te whānautanga.
• Ngā Āhuatanga Kāore i te Pai o te Arorangi o te Ngākau : Ko ētahi huringa i roto i ngā uaua e tuku toto ana ki te ngākau.

He tino onge tēnei mate. Tata ki te 0.02% o te taupori whānui ka pāngia. Waihoki, he nui ake te kitea i roto i ngā tāne.

He momo pēnei kei reira?

Ae, e rua ngā momo matua o te "Unicuspid Aortic Valve". Ko te rerekētanga i waenga i ēnei momo e rua ko te āputa e hono ana ngā pepa iti e rua (ngā pepa iti) ki te pakitara o te takirere, e kiia nei ko te "Commissure" . Ka taea e koe te mārama ki tēnei pēnei. Whakaarohia kei te piri tonu ō ngutu ki tō mata, engari ka taea e rāua te huihui me te wehe, tika? Koinei te "Commissure".

Ko ēnei momo e rua:

1. Momo Acommissural: Koinei te momo tino kino . I tēnei wā, kāore he commissure, arā, kāore he āputa. Ā, kāore e hono ana ki te aorta. Ka piri katoa ngā rau, me te mea kua honoa ngātahi. Ka rere noa te toto mā roto i tētahi kōhao iti, pērā i te kōhao titi.

2. Momo Kotahi-Komihana:He iti ake te kino o tēnei i tērā atu, ā, koinei hoki te momo tino noa . Kotahi te "Commissure", arā, kotahi te āputa. E hono ana hoki ki te aorta. Ina whakatuwheratia tēnei momo takirere, ka rite ki te rārangi. E whakaritea ana e ētahi ki te waha o te ika.

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He aha ngā tohu ka kitea e koe?

Mena kei te pāngia tētahi pakeke e tēnei āhuatanga (Unicuspid Aortic Valve), ko ngā tohu ka kitea i te nuinga o te wā ko:

• Te poto o te manawa : Ina ngenge koe, tera pea ka rite koe ki te hemo i a koe e piki ana i ngā arawhata.
• Pōuriuri : Ina tū ohorere koe, ka pōuri pea koe.
• Angina : He mamae, he kōpiripiri rānei tēnei i roto i te uma. Mō ētahi tāngata, ka horapa pea tēnei ki te kauae, ki te kaki, ki ngā ringaringa rānei.
• Ngāwari/ngoikore : Te ngaromanga ohorere o te māramatanga.

Ko ngā tamariki nohinohi e pāngia ana e tēnei mate ka pāngia e ngā mate pēnei i te ngoikore o te ngākau i te taha maui . Ka heke hoki tō rātou taumaha pērā i ētahi atu tamariki o tō rātou tau, arā, he iti noa iho te pikinga o tō rātou taumaha.

Ko te momo "Acommissural" kua whakahuatia ake nei, arā, te momo kino rawa atu, ka whakaatuhia ngā tohu i roto i ngā pēpi nohinohi rawa . Engari ko te hunga whai momo "Unicommissural" kāore pea e whakaatu i tētahi tohu tae noa ki te 20, 30 rānei tau te pakeke, arā, kia tae rā anō ki te pakeketanga.

He aha tēnei e tupu nei? He aha te take?

Ko tēnei āhuatanga, e kiia nei ko te "Unicuspid Aortic Valve", ka puta ina tīmata te whanake o ngā rau e toru e tika ana kia puta i te wā e noho tonu ana te pēpi i roto i te kōpū, ā, hei utu mō te wehewehe, ka honoa ngātahi, ka noho hei kotahi. Ka puta tēnei i mua i te whānautanga o te pēpi .

Ahakoa kāore anō kia taea e ngā kairangahau te whakaū pono, e whakapae ana rātou he "mate tuku iho" pea tēnei. Ko te tikanga he awe ira kei roto.

He aha ngā raruraru ka pā mai i tēnei?

Tērā pea ka pāngia te tangata whai takirere aorta unicuspid e ngā momo raruraru i roto i te wā. Ko ngā mea matua ko:

• Te whakatōtōtanga o te takirere aorta: Ka puta tēnei ina kore e tuwhera tika te takirere, ka aukati i te rere o te toto. Ka kaha ake te mahi a te ngākau ki te pupuhi toto.
• Te ruakitanga o te takirere aorta: Kāore te takirere e kati tika, ka turuturu te toto kua pupuhihia ki roto i te ngākau.
• Te mate puku o te ngākau : He mate pāwera ki te arai o te ngākau, inā koa ko ngā takirere. He nui ake te mōrearea o te hunga he takirere rerekē ō rātou.
• Te nui ake o te mōrearea o te Wehenga o te Aorta : He āhuatanga ohorere, kino hoki tēnei e pakaru ai te pakitara o te aorta mai i roto.

He mea nui: He mea tino nui kia tautuhia me te rongoā i te mate i te wā tika, i mua i te puta mai o ēnei raruraru.

Me pēhea e kitea ai tēnei e koe?

Ina haere koe ki te tākuta, ka whakarongo ia ki tō ngākau mā te whakamahi i te stethoscope i te wā e tirotirohia ai tō tinana . Mēnā ka rongo te tākuta i tētahi tangi ngākau rerekē (he "ngākau murmur") e tata ana ki tō aorta, tera pea ka whakapae ia i tēnei. Kātahi ka tūtohu pea ia i ētahi atu whakamātautau.

He aha ngā whakamātautau e mahia ana?

Ko ngā whakamātautau matua i mahia hei whakaū tika i te aroaro o tēnei āhuatanga "Unicuspid Aortic Valve" ko:

• Te Echocardiogram Transthoracic (TTE) : He rite tēnei ki te matawai ultrasound o te ngākau. Ka mahia ki te mata o te uma. Ka taea te aromatawai pai ake i te āhua o te ngākau me te mahi a ōna takirere.
• Te Echocardiogram Transesophageal (TEE) : He echocardiogram anō hoki tēnei. Heoi, ka whakauruhia he ngongo iti mā roto i te korokoro, ā, ka tirohia te ngākau mā roto i te esophagus. Ka taea e tēnei te whakaputa whakaahua mārama ake i te TTE.
• Matawai Tomography Rorohiko o te Ngākau (CT) : Ka taea e tēnei te whakaputa whakaahua 3D whakawhiti-wāhanga o te ngākau me te aorta.
• MRI o te Ngākau (Imaging Aukume) : Ka taea hoki e tēnei te whakarato i ngā kōrero taipitopito mō te hanganga me te mahi a te ngākau.

Me pēhea te rongoā?

Ka rerekē te maimoatanga mō tēnei i runga i te tau me te kaha o ngā tohu.

Ko ngā kōwhiringa maimoatanga noa mō ngā tamariki nohinohi ko:

• Valvotomy Pokanga : Kei roto i tēnei ko te mahi pokanga hei tapahi i te kiko takirere e piri ana, me te hanga i ngā pepa hou.
• Valvuloplasty : Ko te whakamahi i tētahi mea pēnei i te poihau hei whakatuwhera i te takirere.
• Commissurotomy : Te wehenga pokanga o te "Commissure", te wāhi e honoa ai ngā taupoki.
• Tikanga Ross : He pokanga uaua ake tēnei. Ka kōrerohia anō tēnei i muri mai.

Mō ngā pakeke , ko te tikanga he pokanga hei whakatika i te takirere aorta (te whakatikatika i te takirere aorta Unicuspid) hei whakakapi rānei ki tētahi takirere hou (whakakapinga) .

He pānga taha/ngā raruraru rānei kei te rongoā?

Pērā i ngā pokanga katoa, tera pea ētahi raruraru ka pā mai i tēnei maimoatanga. Engari kāore e pāngia te katoa e ēnei. Kaua e manukanuka, mā tō tākuta koe e whakamōhio atu ki ngā āhuatanga o tēnei.

Ko ētahi o ngā raruraru noa ka puta ko:

• Mate pāwera
• Ngā toto totoka
• Te toto nui rawa (Te toto)
• Endocarditis (he mate takirere)
• Ngā raruraru ki te papaki e whakamahia ana hei whakatika i te takirere.
• Ārai Katoa o te Manawa : Te whakakorenga o te tuku tohu hiko o te manawa.
• Te whakaekenga o te ngakau
• E turuturu ana te toto mai i te takirere ki te taha hē.
• Te Manawa o te Ngākau Rerekē

Kia pēhea te roa o te wā e ora ai?

Ka rerekē tēnei i runga i te momo pokanga i mahia ki a koe. Tērā pea ka roa te wā e ora ai koe, mai i te wiki ki te maha o ngā marama . Mā tō tākuta koe e kī atu kia pēhea te roa e hiahiatia ana e koe kia okioki, me te wā ka taea e koe te hoki anō ki ngā mahi o ia rā.

Ka pēhea rā te āhua o te ao me tēnei āhuatanga?

Mena he Unicuspid Aortic Valve tōu, tera pea me pokanga koe . Inaa, me whakatika, me whakakapi rānei tō takirere neke atu i te kotahi i roto i tō oranga. Tērā pea he raruraru ngākau anō ōu. Me haere tonu pea te tango i ngā rongoā whakangawari toto (anticoagulants) i muri i te pokanga, i runga i te momo takirere kei a koe.

Engari me kī anō hoki ehara tēnei "Unicuspid Aortic Valve" i te mea ka ora tonu . Ka noho tonu te āhua kia tāea rā anō te pokanga hei whakatika.

He rongo pai tēnei. I kitea i roto i tētahi rangahau e 97% o te hunga i pokangahia te takirere aorta mō tētahi āhuatanga e kiia nei ko te "Unicuspid Aortic Valve" i ora tonu i muri i ngā tau 10 .

Heoi anō, kei reira anō te whakaaro mēnā ka hoatu he takirere aorta prosthetic ki te tangata kei raro iho i te 65 tau te pakeke nā tēnei āhuatanga, ka taea e ia te whakaiti i te roanga o te oranga mā te neke atu i te 10 tau. Koia te take e kī ai ngā kairangahau ko te Tikanga Ross te mea pai rawa atu mō te hunga rangatahi, te hunga hihiko. I roto i tēnei "tikanga Ross", ka tangohia e koe tō ake takirere pūkahukahu ka whakatōkia ki te wāhi kei reira te takirere aorta mate. Kātahi ka whakatōkia he homograft pūkahukahu mai i te tangata kua mate ki te wāhi i mua i noho ai te takirere pūkahukahu kua tangohia. Ahakoa he uaua tēnei, e kiia ana he pai ngā hua.

He aha tāu e hiahia ana ki te mahi māu ake?

I muri i te pokanga, me āta whai koe i ngā tohutohu a tō tākuta mō te tiaki i ō tapahi/motu . Māna hoki e kī atu ki a koe te roa o te wā e hiahia ana koe ki te okioki me te wā ka taea e koe te tīmata taraiwa me ētahi atu mahi o ia rā.

Kaua e wareware: He mea tino nui kia tangohia e koe tō rongoā i te wā tika, e ai ki te tohutohu a te tākuta, ā, kia haere hoki koe ki te whare hauora i ngā rā kua whakaritea.

I ētahi wā ka whakaaro koe, "Āe, kāore anō kia pakeke ahau ki te pāngia e te mate manawa," engari kei te mamae tonu tō uma, kei te uaua hoki te manawa.Mena kei a koe tētahi o ngā āhuatanga e whai ake nei, me toro atu ki te tākuta. Whai muri i te pokanga mō te Unicuspid Aortic Valve, ka haere tonu ō wā tirotiro me tō tākuta. Mena ka puta he raruraru (pēnei i te mate) i muri i te pokanga, me hiahia pea koe ki te maimoatanga ohorere.

He aha ngā pātai me pātai atu koe ki te tākuta?

Ina haere koe ki te tākuta, kaua e wehi ki te pātai i ō pātai. Anei ētahi pātai ka taea e koe te pātai:

• He aha te maimoatanga pai rawa atu mōku?
• He aha ngā rerekētanga i waenga i ngā momo whakakapinga takirere rerekē? (arā, takirere horihori me takirere koiora)
• Kia pēhea te roa e hiahiatia ai te pokanga?
• Kia pēhea te roa o te ora o tētahi takirere hou kua tāutahia?

Ina rongo koe kei te kore e mahi tika tetahi mea i roto i tō ngākau, ehara i te mea ngāwari. Heoi, i roto i te wā, kua whakawhanakehia e ngā tākuta he maimoatanga pai ake mō tēnei mate. Kōrero ki tō tākuta mō te mea pai mōu. I te mea he mate onge tēnei, he mea pai ki a koe te kimi i tētahi tākuta he wheako ki tēnei mate. Hei tauira, e kī ana ngā kairangahau me mahi e te taote pokanga kia 15 ngā tikanga Ross i te tau.

Hei whakamutunga, ko te mea nui hei maumahara (Karere hei tango ki te kāinga)

Āe, ko tāku tumanako kua mārama pai koe ki tēnei mate manawa e kiia nei ko te (Unicuspid Aortic Valve) i kōrerohia e tātou i tēnei rā. Kia maumahara, he mea tēnei e whānau mai ana, ā, he onge te kitenga. Heoi, ki te tika te tautuhi me te rongoā i te wā tika, ka taea e koe te ora i te oranga pai . Mena kei a koe, kei tētahi rānei e mōhio ana koe, kaua e wehi ki te toro atu ki te tākuta me te tiki tohutohu. Ina koa, he mea tino nui te tiki tautoko mai i tētahi tīma hauora mātau i te wā e rongoā ana i ēnei mate onge. Tiakina tō manawa. Koinei te taonga tino utu nui o tō ao!

Mate Manawa, Takirere Aorta, Takirere Aorta Unicuspid, Pokanga Manawa, Mate Manawa Whānau, Poto Manawa, Mamae Uma