ꯍꯥꯔꯠ ꯚꯜꯌꯨ (Valve-Sparing Aortic Root Replacement) ꯀꯅꯕꯥ ꯉꯝꯕꯥ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯅꯧꯕꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯈꯪꯖꯤꯅꯁꯤ꯫

ꯗꯣꯛꯇꯔꯅꯥ ꯅꯍꯥꯀꯄꯨ ꯍꯥꯔꯇꯀꯤ ꯁꯔꯖꯔꯤ ꯃꯊꯧ ꯇꯥꯏ ꯍꯥꯌꯅꯥ ꯍꯥꯌꯕꯤꯔꯝꯂꯕ꯭ꯔꯥ? ꯃꯍꯥꯛꯅꯥ ꯍꯥꯌꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯈꯔꯥ ꯂꯥꯡꯇꯛꯅꯕꯥ ꯐꯥꯑꯣꯕꯁꯤ ꯅꯣꯔꯃꯦꯂꯅꯤ꯫ ꯑꯗꯨꯕꯨ ꯉꯁꯤꯗꯤ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯛ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯆꯥꯎꯈꯠꯂꯦ꯫ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯁꯔꯨꯛ ꯌꯥꯔꯤꯕꯃꯈꯩ ꯉꯥꯀꯊꯣꯛꯅꯕꯥ ꯍꯣꯠꯅꯔꯤꯕꯥ ꯁꯔꯖꯔꯤ ꯈꯔꯗꯤ ꯂꯩ꯫ ꯉꯁꯤ ꯑꯩꯈꯣꯌꯅꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯌꯥꯝꯅꯥ ꯑꯈꯟꯅꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯒꯤ ꯃꯇꯥꯡꯗꯥ ꯋꯥꯔꯤ ꯁꯥꯅꯔꯤ꯫ ꯍꯥꯌꯕꯗꯤ ꯍꯥꯔꯠ ꯚꯜꯌꯨ, ꯍꯥꯌꯕꯗꯤ ꯚꯜꯌꯨ ꯑꯗꯨ ꯉꯥꯀꯊꯣꯀꯄꯥ ꯉꯝꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯅꯤ꯫

ꯌꯥꯝꯅꯥ ꯂꯥꯏꯅꯥ ꯍꯥꯌꯔꯕꯗꯥ, ꯚꯜꯌꯨ-ꯁ꯭ꯄꯦꯔꯤꯡ ꯁꯔꯖꯔꯤ ꯍꯥꯌꯕꯁꯤ ꯀꯔꯤꯅꯣ?

ꯑꯣꯀꯦ, ꯃꯁꯤ ꯈꯉꯅꯕꯒꯤꯗꯃꯛ, ꯑꯍꯥꯅꯕꯗꯥ ꯑꯩꯈꯣꯌꯒꯤ ꯊꯝꯃꯣꯌꯒꯤ ꯑꯄꯤꯀꯄꯥ ꯁꯔꯨꯛ ꯑꯃꯒꯤ ꯃꯔꯃꯗꯥ ꯈꯉꯁꯤ꯫ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯥꯔꯇꯀꯤ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯄꯝꯄ ꯆꯦꯝꯕꯔ (left ventricle) ꯑꯁꯤ ꯑꯩꯈꯣꯌꯒꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯆꯥꯎꯕꯥ ꯕ꯭ꯂꯗ ꯚꯦꯁꯦꯜ, ꯑꯦꯑꯣꯔꯇꯥꯒꯥ ꯁꯝꯅꯩ꯫ ꯑꯩꯈꯣꯌꯅꯥ ꯀꯅꯦꯛꯁꯟ ꯑꯁꯤꯕꯨ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ` ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯃꯁꯤ ꯎꯄꯥꯜ ꯑꯃꯒꯤ ꯃꯔꯨꯃꯒꯨꯝꯕꯅꯤ꯫ ꯃꯁꯤꯒꯤ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ` ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏꯕꯥ ꯒꯦꯠ ꯑꯃꯥ ꯂꯩ, ꯃꯗꯨꯗꯤ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯚꯜꯌꯨ`꯫

ꯍꯥꯔꯇꯅꯥ ꯁꯣꯀꯄꯥ ꯈꯨꯗꯤꯡꯗꯥ, `Aortic Valve` ꯑꯁꯤꯅꯥ ꯍꯥꯡꯗꯣꯛꯇꯨꯅꯥ ꯍꯀꯆꯥꯡꯗꯥ ꯏ ꯄꯝꯄ ꯇꯧꯏ, ꯑꯃꯁꯨꯡ ꯃꯗꯨꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯊꯤꯡꯖꯤꯜꯂꯤ꯫ ꯃꯁꯤꯒꯤ ꯀ꯭ꯂꯣꯖꯤꯡ ꯑꯁꯤꯅꯥ ꯏ ꯑꯗꯨ ꯍꯥꯔꯇꯇꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯆꯦꯅꯕꯥ ꯊꯤꯡꯏ꯫

ꯍꯧꯖꯤꯛ ꯈꯅꯕꯤꯌꯨ, ꯃꯤꯑꯣꯏ ꯈꯔꯗꯗꯤ, `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ`, ꯍꯥꯌꯕꯗꯤ ꯒꯦꯇꯀꯤ ꯁꯔꯨꯛ ꯑꯗꯨ ꯒꯦꯇꯒꯨꯝꯅꯥ ꯎꯕꯥ ꯐꯪꯏ, ꯁꯣꯟꯊꯔꯦ, ꯁꯣꯟꯊꯔꯦ ꯑꯃꯁꯨꯡ ꯑꯆꯧꯕꯥ ꯑꯣꯏꯔꯦ꯫ ꯃꯁꯤ ꯕꯦꯂꯨꯟ ꯑꯃꯥ ꯐꯨꯃꯖꯤꯅꯕꯒꯨꯝꯕꯅꯤ꯫ ꯃꯁꯤꯕꯨ ꯑꯩꯈꯣꯌꯅꯥ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ ꯑꯦꯅꯤꯎꯔꯤꯖꯝ` ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫ ꯒꯦꯠ ꯑꯁꯤ ꯑꯆꯧꯕꯥ ꯑꯣꯏꯔꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯃꯗꯨꯗꯥ ꯂꯩꯔꯤꯕꯥ ꯊꯣꯡ ꯑꯗꯨ, ꯍꯥꯌꯕꯗꯤ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯚꯜꯌꯨ` ꯑꯁꯤ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯊꯤꯡꯖꯤꯜꯂꯤ꯫ ꯑꯗꯨꯗꯒꯤ ꯏ ꯑꯗꯨ ꯍꯥꯔꯇꯇꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯂꯤꯛ ꯑꯣꯏꯕꯥ ꯍꯧꯔꯀꯏ꯫ ꯃꯁꯤꯕꯨ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯤꯒꯔꯖꯤꯇꯦꯁꯟ` ꯍꯥꯌꯅꯥ ꯀꯧꯏ꯫

ꯇ꯭ꯔꯦꯗꯤꯁ꯭ꯅꯦꯜ ꯁꯔꯖꯔꯤ (`ꯕꯦꯟꯇꯜ ꯄ꯭ꯔꯣꯁꯤꯖꯔ`)ꯗꯥ, ꯁꯔꯖꯔꯤꯁꯤꯡꯅꯥ ꯄꯣꯃꯈꯠꯂꯛꯂꯤꯕꯥ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ` ꯑꯃꯁꯨꯡ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯚꯜꯌꯨ` ꯑꯅꯤꯃꯛ ꯂꯧꯊꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯑꯅꯧꯕꯥ ꯑꯥꯔꯇꯤꯐꯤꯁꯤꯑꯦꯜ ꯑꯅꯤ ꯊꯥꯏ꯫

ꯃꯁꯤꯒꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯆꯥꯎꯕꯥ ꯀꯥꯟꯅꯕꯗꯤ ꯅꯍꯥꯛꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯏꯁꯥꯒꯤ ꯚꯜꯌꯨ ꯑꯃꯥ ꯊꯝꯕꯥ ꯌꯥꯏ, ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯅꯍꯥꯛꯅꯥ ꯃꯦꯀꯥꯅꯤꯀꯦꯜ ꯚꯜꯌꯨ ꯑꯃꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯂꯧꯕꯒꯨꯝꯅꯥ ꯄꯨꯟꯁꯤ ꯆꯨꯞꯄꯥ ꯑꯦꯟꯇꯤꯀꯣꯒꯅꯤꯁ꯭ꯠ ꯍꯤꯗꯥꯛ (ꯀꯧꯃꯥꯗꯤꯅꯒꯨꯝꯕꯥ) ꯂꯧꯕꯒꯤ ꯃꯊꯧ ꯇꯥꯗꯦ꯫

ꯁꯔꯖꯔꯤ ꯑꯁꯤꯅꯥ ꯀꯔꯤ ꯀꯟꯗꯤꯁꯅꯁꯤꯡ ꯂꯥꯌꯦꯡꯕꯒꯦ?

ꯃꯁꯤꯒꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯃꯔꯨꯑꯣꯏꯅꯥ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤꯕꯥ ꯀꯦꯁꯁꯤꯡ ꯑꯁꯤꯗꯥ ꯄꯥꯡꯊꯣꯀꯏ:

• ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ ꯑꯦꯅꯤꯎꯔꯤꯖꯝ (Aortic Root Aneurysm): ꯑꯩꯅꯥ ꯃꯃꯥꯡꯗꯥ ꯍꯥꯌꯈꯤꯕꯒꯨꯝꯅꯥ, ꯃꯁꯤ ꯍꯥꯔꯇꯀꯥ ꯁꯝꯅꯕꯥ ꯑꯦꯑꯣꯔꯇꯥꯒꯤ ꯃꯔꯨꯃꯗꯥ ꯂꯩꯕꯥ ꯑꯦꯕꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯕꯥ ꯈꯣꯡꯖꯦꯜ ꯑꯃꯅꯤ꯫ ꯀꯔꯤꯒꯨꯝꯕꯥ ꯃꯁꯤ ꯌꯥꯝꯅꯥ ꯆꯥꯎꯔꯕꯗꯤ, ꯃꯁꯤ ꯈꯪꯍꯧꯗꯅꯥ ꯄꯣꯀꯄꯥ ꯌꯥꯏ (`Aortic Dissection` ꯅꯠꯠꯔꯒꯥ Rupture)꯫ ꯄꯨꯟꯁꯤꯗꯥ ꯌꯥꯝꯅꯥ ꯈꯨꯗꯣꯡꯊꯤꯅꯤꯡꯉꯥꯏ ꯑꯣꯏ꯫
• ꯗꯤꯂꯥꯏꯇꯦꯗ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯁꯥꯏꯅꯣꯁꯀꯥ ꯂꯣꯌꯅꯅꯥ ꯍꯦꯅꯒꯠꯂꯛꯂꯤꯕꯥ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯑꯦꯅꯤꯎꯔꯤꯖꯝ: `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ` (`ꯑꯦꯑꯣꯔꯇꯤꯛ ꯁꯥꯏꯅꯣꯁ`)ꯗꯥ ꯂꯩꯕꯥ ꯃꯍꯧꯁꯥꯒꯤ ꯑꯣꯏꯕꯥ ꯑꯄꯤꯀꯄꯥ ꯃꯐꯃꯁꯤꯡ ꯑꯗꯨ ꯈꯔꯥ ꯍꯦꯟꯅꯥ ꯆꯥꯎꯈꯠꯂꯀꯄꯥ, ꯑꯦꯑꯣꯔꯇꯥꯒꯤ ꯋꯥꯡꯈꯠꯄꯥ ꯁꯔꯨꯛ ꯑꯗꯨꯗꯥ ꯈꯣꯡ ꯍꯥꯝꯂꯕꯥ ꯀꯦꯁꯁꯤꯡ꯫

ꯃꯥꯔꯐꯟ ꯁꯤꯟꯗꯣꯃꯒꯨꯝꯕꯥ ꯑꯀꯛꯅꯕꯥ ꯍꯦꯔꯤꯇꯦꯖ ꯀꯅꯦꯛꯇꯤꯚ ꯇꯤꯁꯨꯒꯤ ꯂꯥꯌꯅꯥꯁꯤꯡ ꯂꯩꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯗꯥ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ ꯑꯦꯅꯤꯎꯔꯤꯖꯝ ꯑꯃꯥ ꯂꯥꯀꯄꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯦꯟꯅꯥ ꯂꯩ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯁꯔꯖꯔꯤꯁꯤꯡꯅꯥ ꯑꯅꯥꯕꯥ ꯑꯗꯨꯒꯤ ꯐꯤꯚꯝ ꯑꯗꯨ ꯆꯦꯀꯁꯤꯟꯅꯥ ꯏꯚꯥꯂꯨꯑꯦꯠ ꯇꯧꯏ ꯑꯃꯁꯨꯡ ꯁꯔꯖꯔꯤ ꯑꯗꯨꯒꯤ ꯀꯥꯟꯅꯕꯥ ꯑꯃꯁꯨꯡ ꯈꯨꯗꯣꯡꯊꯤꯕꯁꯤꯡ ꯑꯗꯨ ꯆꯨꯃꯗ꯭ꯔꯤꯡꯅꯥ ꯂꯦꯄꯊꯣꯛꯂꯕꯥ ꯃꯇꯨꯡꯗꯥ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫

ꯁꯔꯖꯔꯤ ꯑꯁꯤꯒꯤꯗꯃꯛꯇꯥ ꯅꯍꯥꯛ ꯆꯨꯝꯂꯕ꯭ꯔꯥ?

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯀꯤ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯚꯜꯌꯨꯒꯤ ꯃꯑꯣꯡ-ꯃꯇꯧꯁꯤꯡ ꯑꯁꯤ ꯂꯩꯔꯕꯗꯤ, ꯅꯍꯥꯛꯅꯥ ꯁꯔꯖꯔꯤ ꯑꯁꯤꯒꯤ ꯀꯦꯟꯗꯤꯗꯦꯠ ꯑꯃꯥ ꯑꯣꯏꯕꯥ ꯌꯥꯏ:

• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯚꯜꯌꯨꯝ ꯑꯗꯨꯗꯥ ꯀꯦꯂꯁꯤꯌꯝ ꯗꯤꯄꯣꯖꯤꯠ (ꯀꯦꯂꯁꯤꯐꯤꯀꯦꯁꯟ) ꯌꯥꯝꯅꯥ ꯅꯦꯝꯂꯕꯗꯤ ꯅꯠꯠꯔꯒꯥ ꯂꯩꯠꯔꯕꯗꯤ꯫
• ꯚꯜꯌꯨ ꯑꯗꯨ ꯌꯥꯝꯅꯥ ꯁꯥꯊꯤꯅꯥ ꯁꯣꯀꯍꯜꯂꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯚꯜꯌꯨ ꯑꯗꯨ ꯐꯖꯅꯥ ꯊꯕꯛ ꯇꯧꯔꯕꯗꯤ ꯅꯠꯠꯔꯒꯥ ꯑꯄꯤꯀꯄꯥ ꯔꯤꯄꯦꯌꯥꯔ ꯑꯃꯅꯥ ꯔꯤꯄꯦꯌꯥꯔ ꯇꯧꯕꯥ ꯌꯥꯕꯥ ꯑꯣꯏꯔꯕꯗꯤ꯫

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯀꯔꯝꯅꯥ ꯁꯦꯝ-ꯁꯥꯕꯒꯦ?

ꯅꯍꯥꯛꯀꯤ ꯁꯔꯖꯔꯤ ꯑꯗꯨꯅꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯃꯥꯡꯗꯥ ꯅꯍꯥꯛꯅꯥ ꯇꯧꯒꯗꯕꯥ ꯄꯨꯝꯅꯃꯛ ꯈꯪꯍꯜꯂꯛꯀꯅꯤ꯫ ꯍꯥꯌꯔꯤꯕꯥ ꯏꯅꯁ꯭ꯠꯔꯛꯁꯅꯁꯤꯡ ꯑꯗꯨ ꯑꯆꯨꯝꯕꯥ ꯃꯑꯣꯡꯗꯥ ꯉꯥꯛꯅꯥ ꯆꯠꯄꯥ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯃꯔꯨꯑꯣꯏ꯫ ꯃꯍꯧꯁꯥꯅꯥ, ꯃꯁꯤ ꯅꯍꯥꯛꯅꯥ ꯇꯧꯒꯗꯕꯥ ꯊꯕꯛ ꯑꯗꯨꯅꯤ꯫

ꯃꯁꯤꯒꯤ ꯃꯊꯛꯇꯥ, ꯗꯣꯛꯇꯔꯅꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯊꯧꯔꯥꯡ ꯇꯧꯅꯕꯥ ꯇꯦꯁ꯭ꯠ ꯀꯌꯥ ꯑꯃꯥ ꯇꯧꯒꯅꯤ, ꯃꯈꯣꯌꯁꯤꯡ ꯑꯗꯨꯗꯤ:

• ꯏꯀꯣꯀꯥꯔꯗꯤꯑꯣꯒ꯭ꯔꯥꯐ (ꯍꯥꯔꯠ ꯁ꯭ꯀꯦꯟ)
• ꯕ꯭ꯂꯗ ꯇꯦꯁ꯭ꯠ ꯇꯧꯕꯥ꯫
• `ꯀꯥꯔꯗꯤꯌꯦꯛ ꯑꯃꯁꯨꯡ ꯆꯦꯁ꯭ꯠ ꯏ.ꯀꯦ.ꯖꯤ.ꯒꯤ ꯒꯦꯠ ꯇꯧꯔꯕꯥ ꯁꯤ.ꯇꯤ
• ꯀꯣꯔꯣꯅꯥꯔꯤ ꯑꯦꯟꯖꯤꯑꯣꯒ꯭ꯔꯥꯝ꯫
• ꯀꯔꯤꯒꯨꯝꯕꯥ ꯍꯦꯔꯤꯇꯦꯖꯒꯤ ꯂꯥꯌꯅꯥ ꯑꯃꯥ ꯂꯩꯔꯦ ꯍꯥꯌꯅꯥ ꯆꯤꯡꯅꯕꯥ ꯂꯩꯔꯕꯗꯤ ꯖꯦꯅꯦꯇꯤꯛ ꯕ꯭ꯂꯗ ꯇꯦꯁ꯭ꯠ ꯇꯧꯕꯥ꯫

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯀꯔꯤ ꯊꯣꯀꯏ?

ꯃꯁꯤꯒꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯃꯍꯧꯁꯥꯅꯥ ꯄꯨꯡ 4 ꯑꯃꯁꯨꯡ 6ꯒꯤ ꯃꯔꯛꯇꯥ ꯆꯪꯏ꯫ ꯑꯦꯛꯁꯄꯤꯔꯤꯑꯦꯟꯁ ꯂꯩꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯅꯥ ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ ꯍꯥꯔꯠ ꯑꯗꯨ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯄꯨꯡ ꯑꯃꯥ ꯊꯤꯡꯖꯤꯅꯕꯥ ꯃꯊꯧ ꯇꯥꯏ꯫ ꯋꯥꯈꯜ ꯋꯥꯕꯥ ꯂꯩꯔꯣꯏ, ꯃꯇꯝ ꯑꯗꯨꯗꯥ ꯃꯦꯁꯤꯟ ꯑꯃꯅꯥ ꯊꯝꯃꯣꯌ ꯑꯃꯁꯨꯡ ꯂꯪꯁꯀꯤ ꯊꯕꯛ ꯇꯧꯒꯅꯤ꯫

ꯈꯣꯡꯊꯥꯡ ꯈꯨꯗꯤꯡꯒꯤ ꯊꯣꯛꯂꯤꯕꯁꯤꯡ ꯑꯁꯤ ꯃꯈꯥꯗꯥ ꯄꯤꯔꯤ:

1. ꯑꯦꯅꯥꯁ꯭ꯇꯦꯁꯤꯌꯥ: ꯑꯍꯥꯅꯕꯗꯥ ꯅꯍꯥꯛ ꯃꯄꯨꯡꯐꯥꯅꯥ ꯇꯨꯝꯕꯥ ꯌꯥꯍꯅꯒꯅꯤ꯫ ꯃꯔꯝ ꯑꯗꯨꯅꯥ ꯑꯗꯣꯝꯅꯥ ꯑꯋꯥꯕꯥ ꯑꯃꯠꯇꯥ ꯐꯥꯑꯣꯔꯣꯏ꯫

2. ꯆꯦꯁ꯭ꯠ ꯍꯥꯡꯗꯣꯀꯄꯥ: ꯁꯔꯖꯔꯤꯅꯥ ꯊꯝꯃꯣꯌꯗꯥ ꯌꯧꯕꯥ ꯉꯝꯅꯕꯥ ꯆꯦꯁ꯭ꯇꯀꯤ ꯃꯔꯛꯇꯥ ꯏꯅꯁꯤꯁꯟ (`ꯃꯤꯗꯤꯌꯝ ꯁ꯭ꯇꯦꯔꯅꯣꯇꯣꯃꯤ`) ꯑꯃꯥ ꯁꯦꯝꯃꯤ꯫

3. ꯍꯥꯔꯠ-ꯂꯪꯁ ꯃꯦꯁꯤꯅꯒꯥ ꯁꯝꯅꯕꯥ: ꯅꯍꯥꯛꯅꯥ `ꯀꯥꯔꯗꯤꯑꯣꯄꯂꯃꯣꯅꯥꯔꯤ ꯕꯥꯏꯄꯥꯁ` ꯃꯦꯁꯤꯟ ꯑꯃꯒꯥ ꯁꯝꯅꯒꯅꯤ꯫ ꯃꯁꯤꯒꯤ ꯃꯦꯁꯤꯟ ꯑꯁꯤꯅꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯃꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯍꯥꯔꯠ ꯑꯃꯁꯨꯡ ꯂꯪꯁꯀꯤ ꯐꯉ꯭ꯀꯁꯟ ꯑꯗꯨ ꯂꯧꯒꯅꯤ꯫ ꯃꯇꯝ ꯑꯁꯤꯗꯥ ꯅꯍꯥꯛꯀꯤ ꯊꯝꯃꯣꯌꯕꯨ ꯃꯇꯝ ꯈꯔꯒꯤ ꯑꯣꯏꯅꯥ ꯊꯤꯡꯅꯕꯥ `ꯀꯥꯔꯗꯤꯑꯣꯞꯂꯦꯖꯤꯌꯥ ꯁꯣꯜꯌꯨꯁꯟ` ꯀꯧꯕꯥ ꯍꯤꯗꯥꯛ ꯑꯃꯥ ꯄꯤꯒꯅꯤ꯫

4. ꯚꯜꯌꯨ ꯔꯤꯂꯤꯖ ꯇꯧꯕꯥ: ꯁꯔꯖꯔꯤꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯚꯜꯌꯨ ꯑꯗꯨ ꯑꯀꯣꯌꯕꯗꯥ ꯂꯩꯕꯥ ꯇꯤꯁꯨꯁꯤꯡꯗꯒꯤ ꯆꯦꯀꯁꯤꯟꯅꯥ ꯇꯣꯈꯥꯌꯍꯜꯂꯤ꯫

5. ꯑꯁꯣꯀꯄꯥ ꯁꯔꯨꯀꯁꯤꯡ ꯂꯧꯊꯣꯀꯄꯥ: ꯁꯣꯀꯄꯥ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ` ꯑꯃꯁꯨꯡ ꯑꯇꯩ ꯑꯁꯣꯀꯄꯥ ꯁꯔꯨꯀꯁꯤꯡ ꯑꯗꯨ ꯀꯀꯊꯠꯇꯨꯅꯥ ꯂꯧꯊꯣꯀꯏ꯫

6. ꯒ꯭ꯔꯥꯐꯠ: ꯂꯧꯊꯣꯀꯈꯤꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨꯒꯤ ꯃꯍꯨꯠꯇꯥ ꯑꯥꯔꯇꯤꯐꯤꯁꯤꯑꯦꯜ ꯇꯨꯕ (`ꯒ꯭ꯔꯥꯐ` ꯑꯃꯥ) ꯊꯥꯏ꯫ ꯃꯁꯤ ꯑꯈꯟꯅꯕꯥ ꯐꯤ (`ꯄꯣꯂꯤꯁ꯭ꯇꯔ`) ꯑꯃꯅꯥ ꯁꯦꯝꯕꯅꯤ꯫

7. ꯚꯜꯌꯨ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯏꯃꯞꯂꯥꯟꯇ ꯇꯧꯕꯥ: ꯅꯍꯥꯛꯀꯤ ꯏꯁꯥꯒꯤ ꯑꯣꯏꯕꯥ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯚꯜꯌꯨ ꯑꯃꯥ ꯂꯧꯊꯣꯀꯏ, ꯑꯅꯧꯕꯥ ꯒ꯭ꯔꯥꯐ ꯑꯃꯥ ꯊꯥꯗꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯃꯐꯝ ꯑꯗꯨꯗꯥ ꯁꯨꯃꯗꯣꯀꯏ꯫

8. ꯚꯜꯌꯨ ꯑꯗꯨ ꯆꯦꯛ ꯇꯧꯕꯥ: ꯄꯨꯝꯅꯃꯛ ꯑꯐꯕꯥ ꯑꯣꯏꯔꯦ ꯍꯥꯌꯕꯥ ꯁꯣꯌꯗꯅꯥ ꯈꯪꯗꯣꯛꯅꯕꯥ, ꯐ꯭ꯂꯨꯏꯗ ꯑꯃꯥ `ꯒ꯭ꯔꯥꯐ`ꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯄꯥꯁ ꯇꯧꯗꯨꯅꯥ ꯚꯜꯌꯨ ꯑꯗꯨ ꯃꯑꯣꯡ ꯆꯨꯝꯅꯥ ꯊꯕꯛ ꯇꯧꯔꯤꯕ꯭ꯔꯥ, ꯍꯥꯡꯗꯣꯀꯄꯥ ꯑꯃꯁꯨꯡ ꯊꯤꯡꯖꯤꯜꯂꯤꯕ꯭ꯔꯥ ꯍꯥꯌꯕꯗꯨ ꯌꯦꯡꯁꯤꯜꯂꯤ꯫

9. ꯑꯔꯣꯏꯕꯥ ꯈꯣꯡꯊꯥꯡ: ꯍꯥꯔꯇꯀꯤ ꯀꯣꯔꯣꯅꯥꯒꯤ ꯑꯥꯔꯇꯦꯔꯤꯁꯤꯡ ꯑꯁꯤ ꯑꯅꯧꯕꯥ `ꯒ꯭ꯔꯥꯐ`ꯒꯥ ꯁꯝꯅꯍꯜꯂꯤ꯫ ꯃꯗꯨꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯅꯍꯥꯀꯄꯨ `ꯍꯥꯔꯠ-ꯂꯪꯁ ꯃꯦꯁꯤꯟ`ꯗꯒꯤ ꯂꯧꯊꯣꯀꯏ ꯑꯃꯁꯨꯡ ꯅꯍꯥꯛꯀꯤ ꯍꯥꯔꯠ ꯑꯗꯨ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯊꯕꯛ ꯇꯧꯕꯥ ꯌꯥꯍꯜꯂꯤ꯫ ꯃꯗꯨꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯆꯦꯁ꯭ꯠ ꯏꯅꯁꯤꯁꯟ ꯑꯗꯨ ꯊꯤꯡꯖꯤꯜꯂꯤ꯫

ꯃꯣꯗꯔꯟ ꯁꯔꯖꯤꯀꯦꯜ ꯇꯦꯛꯅꯤꯀꯁꯤꯡ (ꯃꯣꯗꯤꯐꯥꯏꯗ ꯔꯤꯏꯃꯞꯂꯥꯟꯇꯦꯁꯟ)

ꯃꯇꯃꯒꯤ ꯃꯇꯨꯡ ꯏꯟꯅꯥ ꯁꯔꯖꯔꯤꯁꯤꯡꯅꯥ ꯃꯁꯤꯒꯤ ꯑꯣꯄꯔꯦꯁꯟ ꯑꯁꯤ ꯍꯦꯟꯅꯥ ꯃꯥꯌ ꯄꯥꯛꯅꯕꯥ ꯑꯅꯧꯕꯥ ꯇꯦꯛꯅꯤꯀꯁꯤꯡ ꯍꯥꯄꯆꯤꯜꯂꯦ꯫ ꯈꯨꯗꯝ ꯑꯣꯏꯅ:

• ꯑꯅꯧꯕꯥ ꯑꯦꯑꯣꯔꯇꯤꯛ ꯁꯥꯏꯅꯣꯁ (`Neosinus`) ꯁꯦꯝꯕꯥ: ꯅꯣꯔꯃꯦꯜ ꯑꯣꯏꯅꯥ, `Graft` ꯑꯁꯤ ꯁ꯭ꯠꯔꯦꯠ ꯇꯨꯕ ꯑꯃꯅꯤ꯫ ꯑꯗꯨꯕꯨ ꯃꯍꯧꯁꯥꯒꯤ ꯑꯣꯏꯕꯥ `ꯑꯦꯑꯣꯔꯇꯤꯛ ꯔꯨꯠ`ꯗꯥ ꯑꯄꯤꯀꯄꯥ ꯃꯐꯃꯁꯤꯡ (`ꯁꯥꯏꯅꯣꯁ`) ꯂꯩ꯫ ꯑꯅꯧꯕꯥ ꯃꯦꯊꯗ ꯑꯁꯤꯗꯥ ꯑꯁꯤꯒꯨꯝꯕꯥ ꯁ꯭ꯄꯦꯁꯁꯤꯡ ꯑꯁꯤ `ꯒ꯭ꯔꯥꯐ`ꯗꯥ ꯑꯥꯔꯇꯤꯐꯤꯁꯤꯑꯦꯜ ꯑꯣꯏꯅꯥ ꯁꯦꯃꯒꯠꯂꯤ꯫ ꯃꯁꯤꯅꯥ ꯏꯒꯤ ꯈꯣꯡꯖꯦꯜ ꯍꯦꯟꯅꯥ ꯃꯍꯧꯁꯥꯒꯤ ꯑꯣꯏꯕꯥ ꯑꯣꯏꯍꯜꯂꯤ, ꯑꯃꯁꯨꯡ ꯚꯜꯌꯨꯗꯥ ꯑꯃꯥꯡ-ꯑꯇꯥ ꯊꯣꯀꯄꯥ ꯍꯟꯊꯍꯜꯂꯤ꯫
• ꯑꯦꯑꯣꯔꯇꯤꯛ ꯑꯦꯅꯨꯂꯁ ꯁꯥꯏꯖꯤꯡ: ꯚꯜꯌꯨꯝ ꯑꯗꯨꯅꯥ ꯂꯦꯡꯗꯅꯥ ꯂꯩꯔꯤꯕꯥ ꯔꯤꯡꯒꯨꯝꯕꯥ ꯁꯔꯨꯛ ꯑꯗꯨꯒꯤ ꯁꯥꯏꯖ (`ꯑꯦꯑꯣꯔꯇꯤꯛ ꯑꯦꯅꯨꯂꯁ`) ꯑꯗꯨ ꯅꯍꯥꯛꯀꯤ ꯍꯀꯆꯥꯡꯒꯤ ꯁꯥꯏꯖ ꯑꯗꯨꯒꯥ ꯃꯥꯟꯅꯅꯥ ꯁꯦꯃꯗꯣꯛ-ꯁꯦꯃꯖꯤꯟ ꯇꯧꯏ꯫ ꯃꯁꯤꯅꯥ ꯇꯨꯡꯗꯥ ꯚꯜꯌꯨꯗꯒꯤ ꯏ ꯂꯤꯛ ꯑꯣꯏꯕꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯟꯊꯍꯜꯂꯤ꯫

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯀꯔꯤ ꯑꯣꯏꯒꯅꯤ? ꯑꯃꯁꯨꯡ ꯐꯒꯠꯂꯀꯄꯗꯥ ꯃꯇꯝ ꯀꯌꯥ ꯆꯪꯕꯒꯦ?

ꯁꯔꯖꯔꯤꯒꯤ ꯃꯇꯨꯡꯗꯥ, ꯅꯍꯥꯀꯄꯨ ꯅꯨꯃꯤꯠ ꯑꯃꯥ ꯅꯠꯠꯔꯒꯥ ꯑꯅꯤꯒꯤ ꯑꯣꯏꯅꯥ ꯏꯟꯇꯦꯟꯁꯤꯚ ꯀꯦꯌꯔ ꯌꯨꯅꯤꯠ (ICU)ꯗꯥ ꯊꯃꯒꯅꯤ, ꯑꯃꯁꯨꯡ ꯃꯗꯨꯒꯤ ꯃꯇꯨꯡꯗꯥ ꯔꯦꯒꯨꯂꯥꯔ ꯋꯥꯔꯗ ꯑꯃꯗꯥ ꯇ꯭ꯔꯥꯟꯁꯐꯔ ꯇꯧꯒꯅꯤ꯫ ꯃꯍꯧꯁꯥꯅꯥ ꯅꯍꯥꯛꯅꯥ ꯅꯨꯃꯤꯠ 4 ꯗꯒꯤ 7 ꯐꯥꯎꯕꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯌꯨꯃꯗꯥ ꯆꯠꯄꯥ ꯌꯥꯏ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯗ꯭ꯔꯥꯏꯚꯔꯒꯤ ꯂꯥꯏꯁꯦꯟꯁ ꯂꯩꯔꯕꯁꯨ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯅꯥ ꯑꯌꯥꯕꯥ ꯄꯤꯗ꯭ꯔꯤꯐꯥꯎꯕꯥ ꯗ꯭ꯔꯥꯏꯚꯔ ꯇꯧꯔꯣꯏꯗꯕꯅꯤ꯫ ꯑꯔꯨꯝꯕꯥ ꯂꯧꯊꯣꯀꯄꯥ ꯅꯠꯠꯔꯒꯥ ꯊꯕꯛꯇꯥ ꯆꯠꯄꯒꯨꯝꯕꯥ ꯊꯕꯛ ꯑꯃꯥ ꯇꯧꯗ꯭ꯔꯤꯉꯩꯗꯥ ꯌꯥꯃꯗ꯭ꯔꯕꯗꯥ ꯅꯨꯃꯤꯠ 6 ꯉꯥꯏꯕꯥ ꯃꯊꯧ ꯇꯥꯏ꯫

ꯀꯥꯔꯗꯤꯌꯦꯛ ꯔꯤꯍꯦꯕꯤꯂꯤꯇꯦꯁꯟ ꯄ꯭ꯔꯣꯒ꯭ꯔꯥꯝ (`ꯀꯥꯔꯗꯤꯌꯦꯛ ꯔꯤꯍꯦꯕꯤꯂꯤꯇꯦꯁꯟ`) ꯑꯃꯗꯥ ꯁꯔꯨꯛ ꯌꯥꯕꯅꯥ ꯅꯍꯥꯀꯄꯨ ꯊꯨꯅꯥ ꯐꯒꯠꯍꯅꯕꯗꯥ ꯃꯇꯦꯡ ꯄꯥꯡꯒꯅꯤ꯫ ꯃꯁꯤꯗꯁꯨ ꯅꯠꯇꯅꯥ, ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯒꯥ ꯂꯣꯌꯅꯅꯥ ꯐꯣꯂꯣ-ꯑꯞ ꯑꯦꯄꯣꯏꯟꯇꯃꯦꯟꯇꯁꯤꯡꯗꯥ ꯁꯣꯌꯗꯅꯥ ꯆꯠꯀꯗꯕꯅꯤ꯫ ꯃꯈꯣꯌꯅꯥ ꯅꯍꯥꯛꯀꯤ ꯊꯝꯃꯣꯌꯒꯤ ꯐꯤꯚꯝ ꯑꯗꯨ ꯃꯈꯥ ꯇꯥꯅꯥ ꯌꯦꯡꯁꯤꯅꯒꯅꯤ꯫

ꯁꯔꯖꯔꯤ ꯑꯁꯤꯒꯤ ꯈꯨꯗꯣꯡꯊꯤꯕꯥ ꯑꯃꯁꯨꯡ ꯀꯥꯟꯅꯕꯁꯤꯡ ꯀꯔꯤꯅꯣ?

ꯑꯆꯧꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯍꯦꯛꯇꯒꯨꯝꯅꯥ, ꯃꯁꯤꯗꯥ ꯔꯤꯁ꯭ꯛ ꯈꯔꯗꯤ ꯂꯩ꯫ ꯑꯗꯨꯝ ꯑꯣꯏꯅꯃꯛ, ꯑꯐꯕꯥ ꯈꯨꯗꯣꯡꯆꯥꯕꯁꯤꯡ ꯂꯩꯕꯥ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯜ ꯑꯃꯗꯥ ꯑꯦꯛꯁꯄꯔꯤꯌꯦꯟꯁ ꯂꯩꯕꯥ ꯁꯔꯖꯔꯤ ꯑꯃꯅꯥ ꯄꯥꯡꯊꯣꯀꯄꯥ ꯃꯇꯃꯗꯥ, ꯈꯨꯗꯣꯡꯊꯤꯕꯁꯤꯡ ꯑꯁꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯅꯦꯝꯃꯤ .

ꯃꯔꯨꯑꯣꯏꯕꯥ ꯀꯥꯟꯅꯕꯁꯤꯡ: ꯱.

• ꯅꯍꯥꯛꯅꯥ ꯄꯨꯟꯁꯤ ꯆꯨꯞꯄꯥ ꯏꯁꯤꯡ ꯇꯨꯡꯁꯤꯅꯕꯥ ꯍꯤꯗꯥꯛ-ꯂꯥꯡꯊꯀꯁꯤꯡ ꯂꯧꯕꯒꯤ ꯃꯊꯧ ꯇꯥꯗꯦ꯫
• ꯏ ꯊꯣꯀꯄꯥ, ꯁ꯭ꯠꯔꯣꯛ, ꯑꯃꯁꯨꯡ ꯚꯜꯌꯨꯝ ꯏꯅꯐꯦꯛꯁꯟ (endocarditis)ꯒꯤ ꯔꯤꯁ꯭ꯛ ꯍꯟꯊꯔꯀꯏ꯫
• ꯇꯨꯡꯗꯥ ꯑꯃꯨꯛ ꯍꯟꯅꯥ ꯚꯜꯌꯨ ꯑꯗꯨ ꯍꯣꯡꯗꯣꯛꯅꯕꯥ ꯁꯔꯖꯔꯤ ꯇꯧꯕꯥ ꯃꯊꯧ ꯇꯥꯕꯒꯤ ꯆꯥꯡ ꯑꯁꯤ ꯌꯥꯝꯅꯥ ꯅꯦꯝꯃꯤ꯫

ꯔꯤꯁꯔꯆꯅꯥ ꯇꯥꯛꯂꯤ ꯃꯗꯨꯗꯤ ꯁꯔꯖꯔꯤ ꯑꯁꯤꯒꯤ ꯃꯥꯌ ꯄꯥꯀꯄꯒꯤ ꯆꯥꯡ ꯑꯁꯤ ꯹꯹%ꯒꯤ ꯃꯊꯛꯇꯥ ꯂꯩ꯫ ꯆꯍꯤ ꯱꯰ꯒꯤ ꯃꯇꯨꯡꯗꯁꯨ, ꯁꯔꯖꯔꯤ ꯑꯁꯤ ꯇꯧꯈꯤꯕꯥ ꯃꯤꯑꯣꯏꯁꯤꯡꯒꯤ ꯆꯥꯎꯔꯥꯛꯅꯥ ꯹꯵%ꯗꯤ ꯑꯇꯣꯞꯄꯥ ꯁꯔꯖꯔꯤꯒꯤ ꯃꯊꯧ ꯇꯥꯔꯣꯏ꯫

ꯀꯔꯤꯒꯨꯝꯕꯥ ꯅꯍꯥꯛꯅꯥ ꯂꯥꯏꯑꯣꯡꯁꯤꯡ ꯑꯁꯤꯒꯤ ꯃꯅꯨꯡꯗꯥ ꯑꯃꯍꯦꯛꯇꯥ ꯂꯩꯔꯕꯗꯤ, ꯈꯨꯗꯛꯇꯥ ꯅꯍꯥꯛꯀꯤ ꯗꯣꯛꯇꯔꯗꯥ ꯀꯜ ꯇꯧꯕꯤꯌꯨ ꯅꯠꯠꯔꯒꯥ ꯅꯍꯥꯛꯀꯤ ꯈ꯭ꯕꯥꯏꯗꯒꯤ ꯅꯀꯄꯥ ꯍꯣꯁ꯭ꯄꯤꯇꯥꯂꯒꯤ ꯏꯃꯔꯖꯦꯟꯁꯤ ꯗꯤꯄꯥꯔꯇꯃꯦꯟꯇ (ETU)ꯗꯥ ꯆꯠꯄꯤꯌꯨ꯫