Hāmeʻa kōkua Ventricular

Kōkua nā mea kōkua Ventricular (VADs) i kou puʻuwai e pīpī i ke koko mai kekahi o nā keʻena pumping nui i ke koena o kou kino a i kekahi ʻaoʻao o ka puʻuwai. Hoʻokomo ʻia kēia mau pauma i kou kino. I ka hapanui o nā hihia pili lākou i nā mīkini ma waho o kou kino.

Loaʻa i kahi hāmeʻa kōkua ventricular he 3 mau ʻāpana:

• He pauma. Kaupaona ka pauma 1 a 2 paona (0.5 a 1 kilogram). Kau ʻia i loko a i waho o kou ʻōpū.
• ʻO kahi mea hoʻokele uila. Ua like ka mea hoʻokele me kahi kamepiula liʻiliʻi e kaohi pehea e holo ai ka pauma.
• ʻO nā paila a i ʻole kahi kumu mana ʻē aʻe. Lawe ʻia nā pila i waho o kou kino. Pili lākou i ka pauma me ke kaula i hele i loko o kou ʻōpū.

Inā loaʻa iā ʻoe kahi VAD i hoʻokomo ʻia, pono ʻoe i ka anesthesia ākea. ʻO kēia e hiamoe ai ʻoe a ʻaʻole ʻehaʻeha i ke kaʻina hana.

Ma ke ʻoki kino:

• Wehe ka mea lōlō puʻuwai i ka waena o kou umauma me kahi ʻoki ʻoki a laila hoʻokaʻawale i kou umauma. ʻAe kēia i ke kiʻi i kou puʻuwai.
• Kaukaʻi ʻia i ka pauma i hoʻohana ʻia, e hoʻolilo ka mea lapaʻau i wahi no ka pauma ma lalo o kou ʻili a me nā mea i loko o ka paia o kou ʻōpū.
• A laila kau ke kauka i ka pauma i kēia wahi.

E hoʻopili kahi paipu i ka pauma i kou puʻuwai. E hoʻopili kahi paipu i ka pauma i kāu aorta a i ʻole kekahi o nā aʻa nui ʻē aʻe. E hele ʻia kekahi paipu ma kou ʻili e hoʻohui i ka pauma i ka mea hoʻoponopono a me nā paila.

E lawe ka VAD i ke koko mai kāu ventricle (kekahi o nā keʻena pumping nui o ka puʻuwai) ma o ka paipu e hiki ai i ka pauma. A laila e pīpī ka hāmeʻa i ke koko i waho i kekahi o kou mau aʻa a ma o kou kino.

ʻO ka hana ʻoki pinepine 4 a 6 mau hola.

Aia kekahi mau ʻano VAD ʻē aʻe (i kapa ʻia ʻo perkutane ventricular assist hāmeʻa) hiki ke kau ʻia me nā ʻenehana hōʻemi liʻiliʻi e kōkua ai i ka ventricle hema a ʻākau paha. Eia nō naʻe, ʻaʻole hiki i kēia mau mea ke hāʻawi i ke kahe (kākoʻo) e like me nā mea i hoʻokau ʻia me ka lāʻau.

Pono ʻoe i kahi VAD inā loaʻa iā ʻoe ka puʻuwai puʻuwai nui i hiki ʻole ke kāohi ʻia me nā lāʻau, nā pono hana, a me nā ʻano lāʻau ʻē aʻe. Hiki iā ʻoe ke loaʻa i kēia hāmeʻa ʻoiai ʻoe ma ka papa inoa kali no kahi transplant puʻuwai.ʻO kekahi poʻe i loaʻa ka VAD maʻi nui a aia paha ma ka mīkini kākoʻo puʻuwai puʻuwai.

ʻAʻole nā ​​kānaka āpau me ka puʻuwai nui ʻole he moho maikaʻi no kēia kaʻina hana.

ʻO nā pilikia no kēia ʻoki kino penei:

• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Hoʻopili ke koko i loko o ka hāmeʻa a hiki ke hele i nā ʻāpana ʻē aʻe o ke kino
• Nā pilikia hanu
• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• ʻO nā hopena āpau i nā lāʻau anesthesia i hoʻohana ʻia i ke kahakaha
• Nā maʻi ʻino
• Kahena
• Make

Nui nā poʻe e noho ana i ka haukapila no ka mālama ʻana i ko lākou puʻuwai ʻole.

ʻO ka hapa nui o ka poʻe i kau ʻia ma ka VAD e hoʻolilo kālā mai kekahi mau a i kekahi mau lā i ka keʻena mālama nui (ICU) ma hope o ke kaha ʻana. Noho paha ʻoe i ka haukapila no hoʻokahi pule a ʻoi paha ma hope o kāu kau ʻana i ka pauma. I kēia manawa e aʻo ʻoe pehea e mālama ai i ka pauma.

ʻAʻole i hoʻolālā ʻia nā VAD invasive liʻiliʻi no nā mea maʻi maʻi a pono kēlā mau mea maʻi e noho i ka ICU no ka lōʻihi o kā lākou hoʻohana. Hoʻohana ʻia lākou ma ke ʻano he alahaka i kahi VAD ʻokiʻoki a i ʻole hoʻōla puʻuwai.

Hiki i kahi VAD ke kōkua i ka poʻe i loaʻa ʻole ka puʻuwai e ola lōʻihi. Hiki paha iā ia ke kōkua i ka hoʻomaikaʻi ʻana i ke ola o nā maʻi.

VAD; RVAD; LVAD; ʻO BVAD; Kākoʻo kōkua ventricular pono; ʻO ka hāmeʻa kōkua kōkua hema; Mea kōkua kōkua Biventricular; Pahu puʻuwai; ʻŌnaehana kōkua ventricular hema; LVAS; Implantable ventricular kōkua mea; Puʻuwai puʻuwai - VAD; Cardiomyopathy - VAD

• Angina - hoʻokuʻu
• Puʻuwai puʻuwai - hoʻokuʻu
• Hewa ka puʻuwai - hoʻokuʻu
• Mālama ʻeha ʻeha - wehe

• Puʻuwai - ʻāpana ma waena o ka waena

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Holman WL, Kociol RD, Pinney S. Postoperative VAD hoʻokele: lumi hana e hoʻokuʻu ai a ma ʻō aku: nā ʻoki kino a me nā noʻonoʻo olakino. I: Kirklin JK, Rogers JG, eds. Kākoʻo Mīkini Mīkini: ʻO ka mea i hui pū me ka maʻi puʻuwai o Braunwald. ʻElua ed. Piladelapia, PA: Elsevier; 2020: chap 12.

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