ʻOki kino puʻuwai

Hoʻohana ʻia ke kīpoki puʻuwai e hoʻoponopono a hoʻololi i nā kiwikā o ka maʻi maʻi.

ʻO ke kahe e kahe ana ma waena o nā keʻena like ʻole o kou puʻuwai pono e kahe ma waena o ka puʻuwai puʻuwai. ʻO ke kahe e kahe ana i waho o kou puʻuwai i loko o nā aʻa nui e pono pū e kahe ma o ka puʻuwai puʻuwai.

Wehe ʻia kēia mau vaʻa i hiki i ke kahe ke kahe i loko. Hoʻopili lākou a laila, mālama i ke kahe o ke koko i hope.

Aia nā valves 4 i loko o kou puʻuwai:

• Kiwikā Aortic
• Mitral kiwikā
• Pāpale Tricuspid
• Pāpale pulmonic

ʻO ke kiwikā aortic ka kiwikā maʻamau e hoʻololi hou ʻia. ʻO ka pahū mitral ka paepae maʻamau e hoʻoponopono hou ʻia. Kākaʻikahi wale ka paepae tricuspid a i ʻole ka pulmonic valve i hoʻoponopono a i pani ʻia.

Ma mua o kou ʻoki ʻana, e loaʻa iā ʻoe ka anesthesia ākea. E hiamoe ʻoe a hiki ʻole ke ʻeha.

I ke kīʻaha puʻuwai hāmama, hana ke kaukaʻi i kahi ʻoki nui i loko o kou poli e hiki i ka puʻuwai a me ke aorta. Pili ʻoe i kahi mīkini bypass puʻuwai puʻuwai. Kāohi ʻia kou puʻuwai ke pili ʻoe i kēia mīkini. Hana kēia mīkini i ka hana o kou puʻuwai, e hāʻawi ana i ka oxygen a me ka hemo ʻana o carbon dioxide.

Hana ʻia ke kahakaha kiwikā liʻiliʻi loa ma o nā ʻoki liʻiliʻi loa ma mua o ke kaha hāmama, a i ʻole ma ka catheter i hoʻokomo ʻia i loko o ka ʻili. Hoʻohana ʻia nā ʻenehana ʻokoʻa:

• ʻOki kino (ma o ka ʻili)
• ʻOki kino kōkua ʻia e Robot

Inā hiki i kāu kauka lāʻau ke hoʻoponopono i kāu kiwikā mitral, loaʻa iā ʻoe:

• Hoʻolaha annuloplasty. Hoʻoponopono ka mea lapaʻau i ka ʻāpana e like me ke apo a puni ka paepae e ka humuhumu ʻana i ke apo o ka ea, ka lole, a i ʻole nā ​​mea a puni ka nohona.
• Hoʻoponopono Valve. Hoʻokiʻoki ke kaukoki, hana, a kūkulu hou paha i hoʻokahi o nā lau o ka nohona. ʻO nā leaflets nā pā e hāmama a hoʻopau i ka puka. ʻOi aku ka maikaʻi o ka hoʻoponopono valve no nā valves mitral a me tricuspid. ʻAʻole hoʻoponopono hou ʻia ka nohona aorta.

Inā ʻinoʻino loa kāu kiwikā, pono ʻoe i kahi kiwikā hou. Kapa ʻia kēia he ʻoki pani pani. E hoʻoneʻe aku kāu mea lapaʻau i kou kiwikā a kau i kahi hou i kahi. ʻO nā ʻano nui o nā kiwikā hou:

• Mīkini - hana ʻia i nā mea i hana ʻia e ke kanaka, e like me ka mea hao (mea kila kila a i ʻole titanium) a i ʻole pālolo. ʻO ka lōʻihi loa o kēia mau valves, akā pono ʻoe e ʻai i ka lāʻau hoʻoliʻiliʻi koko, e like me warfarin (Coumadin) a i ʻole aspirin, no ke koena o kou ola.
• ʻO Biological - hana ʻia i ke kino kanaka a holoholona paha. He 12 a 15 mau makahiki paha ka lōʻihi o kēia mau valves, akā ʻaʻole pono ʻoe e lawe i nā mea lahilahi no ke ola.

I kekahi mau hihia, hiki i nā kaukōkō ke hoʻohana i kāu kiʻikuhi pulmonic ponoʻī e pani ai i ka nohona aortic i hōʻino ʻia. Hoʻololi ʻia ka valve pulmonic me kahi kiwikā i hana ʻia (kapa ʻia kēia ʻo Ross Procedure). He mea pono paha kēia hana no ka poʻe makemake ʻole e lawe i nā mea lahilahi o ke koko no ko lākou koena o ko lākou ola. Eia nō naʻe, ʻaʻole lōʻihi ka lōʻihi o ka aorta hou a pono paha e pani hou ʻia e kekahi mechanical a i ʻole he valolo biologic.

Pili nā kumuhana pili:

• ʻOki kino Aortic - invasive minimally
• ʻOki kino Aortic - wehe
• ʻOki kino mitral - invasive minimally
• ʻOki kino Mitral - wehe

Pono ʻoe i ke ʻoki ʻana inā ʻaʻole holo pono kāu hāmole.

• ʻO kahi kiwikā ʻaʻole paʻa kokoke i nā ala āpau e ʻae i ke koko e hoʻi hope i hope. Kapa ʻia kēia regurgitation.
• ʻO kahi pahū e hāmama ʻole ʻole e kaupalena i ke kahe o mua o ke kahe. Kapa ʻia kēia stenosis.

Pono ʻoe i ka ʻoki o ka puʻuwai puʻuwai no kēia mau kumu:

• ʻO nā kīnā i loko o kou puʻuwai puʻuwai ke kumu nei i nā ʻōuli nui o ka puʻuwai, e like me ka ʻeha o ka umauma (angina), ka pōkole o ka hanu, nā haʻalulu nāwaliwali (syncope), a i ʻole nā ​​puʻuwai puʻuwai.
• Hōʻike nā hoʻokolohua ke hoʻomaka nei nā loli i kou puʻuwai puʻuwai e hana nui i kāu hana puʻuwai.
• Makemake kāu kauka e hoʻololi a hoʻoponopono hou paha i kou kiʻikuhi puʻuwai i ka manawa like ke hana nei ʻoe i kahi puʻuwai puʻuwai hāmama no kekahi kumu ʻē aʻe, e like me ke ʻoki ʻana o ke aʻa kōkō.
• Ua hōʻino ʻia kāu kiwikā puʻuwai e ka maʻi (endocarditis).
• Ua loaʻa iā ʻoe he kiʻikuhi puʻuwai hou i ka wā i hala a ʻaʻole holo maikaʻi ia, a i ʻole he pilikia ʻē aʻe e like me ke koko, maʻi maʻi, a me ke kahe ʻana o ke kahe.

ʻO kekahi o nā pilikia o ka puʻuwai puʻuwai e mālama ʻia me ke ʻoki kino:

• Ka lawa ʻole o ʻAortic
• Stenosis ʻaʻano
• ʻO ka maʻi maʻi puʻuwai congenital
• Mitral regurgitation - huʻi
• Mitral regurgitation - wā lōʻihi
• Mitral stenosis
• Hoʻopiʻi ka pahu puka Mitral
• ʻO ka stenosis valve pulmonary
• Trurguspid regurgitation
• ʻO ka stenosis valve tricuspid

ʻO nā makaʻu o ke ʻoki ʻana i ka naʻau me:

• Make
• Maʻi hohola
• Hewa puʻuwai
• ʻO ke kahe e koi ana i ka hana hou
• Rupture o ka puʻuwai
• Kuʻi naʻau kaulike (arrhythmia)
• Hewa ʻole nā ​​hakuʻala
• ʻO ka maʻi post-pericardiotomy - ke kuni liʻiliʻi a me ka ʻeha o ka umauma i hiki ke hala i 6 mau mahina
• ʻO ka hahau a i ʻole ʻeha ʻeha kūmau a kūmau paha
• Maʻi kīnā
• Nā pilikia me ka hoʻōla iwi pūpū
• Huikau kūlohelohe ma hope o ke kaha ʻana ma muli o ka mīkini puʻuwai puʻuwai

He mea nui loa ia e hana i nā pale e pale ai i nā maʻi maʻi. Pono paha ʻoe e lawe i nā lāʻau ʻaloʻalo ma mua o ka hana niho a me nā kaʻina hana hoʻoweliweli ʻē aʻe.

ʻO kāu hoʻomākaukau no ke kaʻina hana e kaukaʻi ʻia i ke ʻano o ke kaha ʻana o ka kiwikā āu e loaʻa nei:

• ʻOki kino Aortic - invasive minimally
• ʻOki kino Aortic - wehe
• ʻOki kino mitral - invasive minimally
• ʻOki kino Mitral - wehe

ʻO kāu ola ʻana ma hope o ke kaʻina hana e kaukaʻi ʻia i ke ʻano o ke kaha ʻana o ka kiwikā āu e loaʻa nei:

• ʻOki kino Aortic - invasive minimally
• ʻOki kino Aortic - wehe
• ʻOki kino mitral - invasive minimally
• ʻOki kino Mitral - wehe

ʻO ka maʻamau o ka haukapila 5 a 7 mau lā. E haʻi ke kahu iā ʻoe pehea e mālama ai iā ʻoe iho ma ka home. Lawe ʻia ke ola piha i kekahi mau pule i kekahi mau mahina, ke kaukaʻi ʻia i kou olakino ma mua o ke kahakaha ʻana.

ʻO ke kiʻekiʻe kūleʻa o ke kīpoki puʻuwai puʻuwai he kiʻekiʻe. Hiki i ka hana ke hoʻokuʻu i kāu mau hōʻailona a hoʻolōʻihi i kou ola.

ʻAʻole hāʻule pinepine nā valves puʻuwai mīkini. Eia nō naʻe, hiki i nā kōkō koko ke hoʻomohala ma kēia mau kiwikā. Inā kū kahi kōpē koko, loaʻa paha ʻoe i ka maʻi hahau. Hiki ke hele i ke kahe ʻana, akā kākaʻikahi kēia. ʻO nā kiwikā nāwaliwali i ka awelika o 12 a 15 mau makahiki, e like me ka ʻano o ka nohona. ʻO ka hoʻohana wā lōʻihi o ke kaola ʻana i ke koko ka mea pinepine pinepine ʻole ʻia me nā valves kiko.

Aia kekahi pilikia no ka maʻi. E kamaʻilio me kāu kauka ma mua o ka loaʻa ʻana i kekahi ʻano o nā kaʻina olakino.

Lohe ʻia paha ke kaomi ʻana o nā kiwikā naʻau mīkini i ka umauma. He maʻamau kēia.

Pani pani kiwikā; Hoʻoponopono kolo; Hoʻokolohua puʻuwai puʻuwai; Nā kiwikā mechanical; Nā kiwikā Prosthetic

• ʻO ke kīpoki puʻuwai puʻuwai - hoʻokuʻu

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• ʻO nā valves puʻuwai - ʻike mua
• Nā valves puʻuwai - ʻike kiʻekiʻe
• ʻO ke kīpoki puʻuwai puʻuwai - series

ʻO Carabello BA. Maʻi maʻi valvular. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 66.

Hermann HC, Mack MJ. Nā lāʻau Transcatheter no nā maʻi puʻuwai valvular. I: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 72.

Nishimura. RA, Otto CM, Bonow RO, et al. Hoʻohou hou o ka 2014 AHA / ACC kulekele no ka mālama ʻana i nā mea maʻi me nā maʻi puʻuwai valvular: kahi hōʻike o ka American College of Cardiology / American Heart Association Task Force ma nā Kumu Alakaʻi. ʻO J Am Coll Cardiol. 2017; 70 (2): 252-289. PMID: 28315732 pubmed.ncbi.nlm.nih.gov/28315732/.

ʻO Otto CM, Bonow RO. Maʻi maʻi valvular. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 67.

Rosengart TK, Anand J. Loaʻa nā maʻi puʻuwai: valvular. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 60.