ʻOki kino Aortic - wehe

Kahe ke koko mai kou puʻuwai a i loko o kahi kīʻaha koko nui i kapa ʻia ʻo aorta. Hoʻokaʻawale ka valve aortic i ka puʻuwai a me ke aorta. Wehe ka kiwikā aortic i hiki i ke kahe ke kahe i waho. Pani ia no ka mālama ʻana i ke koko mai ka hoʻi ʻana i ka puʻuwai.

Pono ʻoe i kahi ʻoki aorta aorta e hoʻololi i ka kiwikā aortic i loko o kou puʻuwai inā:

• ʻAʻole pani paʻa kāu kōwaha aortic i nā ala āpau, no laila kahe hou ke koko i loko o ka puʻuwai. Kapa ʻia kēia a regurgitation aortic.
• ʻAʻole wehe hāmama kāu ākea aorta, no laila e hoʻemi ʻia ke kahe o ke koko mai ka puʻuwai. Kapa ʻia kēia aortic stenosis.

Wehe ʻia ke kāwaha aortic ākea e pani ma ka ʻoki nui i kou umauma.

Hiki ke pani ʻia ka kiwikā aortic me ka hoʻohana ʻana i ke kīpoki aortic invasive minimally invasive. Hana ʻia kēia i ka hoʻohana ʻana i nā ʻoki liʻiliʻi.

Ma mua o kou ʻoki ʻana e loaʻa iā ʻoe ka anesthesia ākea. E hiamoe ʻoe a noa ka ʻeha.

• E ʻokiʻoki kou kaukipona i 10 mau ʻīniha-lōʻihi (25 kenimika) i ka waena o kou umauma.
• ʻO ka mea aʻe, e hoʻokaʻawale kāu kauka lāʻau i kou umauma i hiki ke ʻike i kou puʻuwai a me ke aorta.
• Pono paha ʻoe e pili i kahi mīkini bypass puʻuwai puʻuwai a i ʻole pump pump. Kāohi ʻia kou puʻuwai ke pili ʻoe i kēia mīkini. Hana kēia mīkini i ka hana o kou puʻuwai ʻoiai kaohi ʻia kou puʻuwai.

Inā ʻinoʻino loa kāu kōkō aorta, pono ʻoe i kahi kiwikā hou. Kāhea ʻia kēia mea he keʻoki pani. E lawe aku kāu kauka lāʻau i kāu kiwikā aortic a humuhumu i kahi hou i kahi. Aia he ʻano nui ʻelua o nā kiwikā hou:

• Mīkini, hana ʻia i nā mea i hana ʻia e ke kanaka, e like me ka titanium a i ʻole ke kalapona. ʻO ka lōʻihi loa o kēia mau valves. Hiki paha iā ʻoe ke lawe i ka lāʻau hoʻoliʻiliʻi koko, e like me warfarin (Coumadin) no ke koena o kou ola inā loaʻa iā ʻoe kēia ʻano kiwikā.
• ʻO Biological, i hana ʻia e nā kānaka a holoholona paha. He 10 a 20 paha mau makahiki ke lōʻihi o kēia mau valves, akā ʻaʻole pono ʻoe e lawe i nā mea lahilahi no ke ola.

Ke hana nei ke kiʻikuhi hou, e hana kāu mea kauka.

• Pani i kou puʻuwai a lawe iā ʻoe mai ka mīkini puʻuwai puʻuwai.
• E kau i nā catheters (tubes) a puni kou puʻuwai e hoʻokahe i nā wai e kūkulu.
• Pani i kou umauma me nā kaula kila kila. Ma kahi o 6 a 12 paha pule e hoola ai ka iwi. E noho nā kaula i loko o kou kino.

Lawe kēia ʻoki i 3 a 5 mau hola.

I kekahi manawa hana ʻia nā hana ʻē aʻe i ka wā o ke ʻoki ākoki ākea. Pākuʻi ʻia kēia mau mea:

• ʻOki kino by Coronary
• Aortic root replacement (ke kaʻina hana a David)
• Ke kaʻina hana ʻo Ross (a i ʻole kuapo)

Hiki paha iā ʻoe ke ʻoki inā ʻaʻole holo pono kāu aorta aorta. Hiki paha iā ʻoe ke ʻoki puʻuwai puʻuwai hāmama no kēia mau kumu:

• ʻO nā loli i kāu kiwikā ākea ke kumu nei i nā ʻōuli nui o ka puʻuwai, e like me ka ʻeha o ka umauma, ka pōkole o ka hanu, nā haʻalulu nāwaliwali, a i ʻole nā ​​puʻuwai ʻole.
• Hōʻike nā hoʻokolohua ke hoʻomaka nei nā loli i kāu kiwikā aortic e hōʻeha koʻikoʻi i ka maikaʻi o ka hana o kou puʻuwai.
• Ua hōʻino ʻia kāu kiwikā puʻuwai e ka maʻi o ka puʻuwai puʻuwai (endocarditis).
• Ua loaʻa iā ʻoe he kiʻikuhi puʻuwai hou i ka wā i hala a ʻaʻole holo maikaʻi.
• Loaʻa iā ʻoe nā pilikia ʻē aʻe e like me ke kahe o ke koko, maʻi, a i ʻole ke kahe ʻana.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Lilo ke koko
• Nā pilikia hanu
• ʻO ka maʻi, e komo pū ana me nā akemāmā, nā puʻupaʻa, ka ʻai, ka umauma, a i ʻole nā ​​kīʻaha puʻuwai
• Nā hopena i nā lāʻau

ʻO nā pilikia i hiki ke loaʻa i ke kīʻaha puʻuwai hāmama ʻo:

• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• Nā pilikia puʻuwai puʻuwai
• ʻO ka maʻi incision, ka mea e hiki ke loaʻa i ka poʻe obese, loaʻa diabetes, a i ʻole ua loaʻa i kēia ʻoki
• ʻO ka maʻi o ka nohona hou
• Hewa ʻole nā ​​hakuʻala
• Ka nalowale ʻana o ka hoʻomanaʻo ʻana a me ka lilo ʻana o ka mōakāka o ka noʻonoʻo, a i ʻole ka "fuzzy thinking"
• Hoʻōla maikaʻi ʻole i ka ʻokiʻoki
• ʻO ka maʻi post-pericardiotomy (ka maʻi fiva haʻahaʻa a me ka ʻeha o ka umauma) i hiki ke hala i 6 mau mahina
• Make

E haʻi mau i kāu mea mālama ola:

• Inā ʻoe a hāpai paha
• He aha nā lāʻau āu e lawe nei, a ʻo nā lāʻau paha, nā mea hoʻopili, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau

Hiki paha iā ʻoe ke mālama i ke koko i ka panakō koko no nā transfusions i ka wā a ma hope o kou ʻoki ʻana. E nīnau i kāu mea hāʻawi iā ʻoe a me nā lālā o kou ʻohana ke hāʻawi i ke koko.

Inā puhi ʻoe, pono ʻoe e hoʻokū. E noi i kāu mea hāʻawi mai i kōkua.

No ka manawa hebedoma 1 ma mua o ke kahakaha ʻana, e noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau e paʻakikī ai i ke kō ʻana o kou koko. Hiki paha i kēia ke hoʻonui i ke kahe i ka wā o ke ʻoki.

• ʻO kekahi o kēia mau lāʻau lapaʻau he aspirin, ibuprofen (Advil, Motrin), a me naproxen (Aleve, Naprosyn).
• Inā ʻoe e lawe ana i warfarin (Coumadin) a i ʻole clopidogrel (Plavix), e kamaʻilio me kāu kauka lā ma mua o ke kū a hoʻololi ʻana paha i kāu lawe ʻana i kēia mau lāʻau.

I nā lā ma mua o kou ʻoki kino:

• E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.
• E hoʻomaopopo mau i kāu mea hāʻawi inā loaʻa ʻoe i ke anu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe i ka manawa e kū mua i kāu ʻoki.

E hoʻomākaukau i kou hale no ka wā e hoʻi mai ana ʻoe mai ka haukapila.

E holoi a holoi i kou lauoho i ka lā ma mua o kou ʻoki ʻana. Pono ʻoe e holoi i kou kino holoʻokoʻa ma lalo o kou ʻāʻī me kahi kopa kūikawā. E ʻānai i kou umauma i 2 a i ʻole 3 mau manawa me kēia kopa.

I ka lā o kou ʻoki kino:

• E noi pinepine ʻia ʻoe mai inu a ʻai ʻole i kekahi mea ma hope o ke aumoe i ka pō ma mua o kou ʻoki kino ʻana. Pākuʻi ʻia kēia me ka hoʻohana ʻana i ka nau kamu a me nā mīkini hanu. E holoi i kou waha me ka wai inā maloʻo. E akahele o ale.
• E lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Manaʻo e lilo 4 a 7 mau lā i ka haukapila ma hope o ke kaha ʻana. E noho ʻoe i ka pō mua ma ka ICU a noho paha ma laila no 1 a 2 mau lā. E loaʻa he 2 a 3 mau paipu i kou umauma e hoʻokahe i ka wai mai a puni kou puʻuwai. Lawe pinepine ʻia kēia mau mea i 1 a 3 mau lā ma hope o ke kaha ʻana.

Loaʻa paha iā ʻoe kahi catheter (Tube Tube) i loko o kāu pēpē e hoʻokahe i ka mimi. Hiki paha iā ʻoe ke loaʻa i nā laina intravenous (IV) e hāʻawi i nā wai. E nānā pono nā kahu hānai i nā mea nānā e hōʻike i kāu mau hōʻailona koʻikoʻi (kou pulse, ka mahana, a me ka hanu).

E hoʻoneʻe ʻia ʻoe i kahi lumi hōkele maʻamau mai ka ICU. E kiaʻi ʻia kou puʻuwai a me nā hōʻailona koʻikoʻi a hoʻi ʻoe i kou home. E loaʻa iā ʻoe ka lāʻau ʻeha e kaohi ai i ka ʻeha a puni kāu ʻoki ʻoki.

E kōkua kāu kahu iā ʻoe e hoʻomau i kahi hana. E hoʻomaka paha ʻoe i kahi papahana e hoʻoikaika i kou puʻuwai a me kou kino.

Loaʻa paha iā ʻoe kahi pacemaker i kau ʻia i loko o kou puʻuwai inā e lohi loa kāu puʻuwai ma hope o ke kahakaha ʻana. Kūlohelohe a paʻa paha ia.

ʻAʻole hāʻule pinepine nā valves puʻuwai mīkini. Eia nō naʻe, hiki i nā kōkō koko ke hoʻomohala ma luna o lākou. Inā kū kahi kōpē koko, loaʻa paha ʻoe i ka maʻi hahau. Hiki ke hele i ke kahe ʻana, akā kākaʻikahi kēia.

ʻO nā valves biological i kahi makaʻu haʻahaʻa o ke kahe o ke koko, akā kūleʻa ʻole i kahi lōʻihi o ka manawa. No nā hualoaʻa maikaʻi loa, koho e loaʻa i kāu ʻoki aorta i kahi kikowaena e hana i kēia mau kaʻina hana.

Pani hakahaka Aortic; Valvuloplasty ʻaʻano; Hoʻoponopono hou kiwikā: Hoʻololi - aorta valve; AVR

• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• ʻO ka aspirin a me ka maʻi puʻuwai
• ʻO ke kīpoki puʻuwai puʻuwai - hoʻokuʻu
• ʻOki puʻuwai Pediatric - hoʻokuʻu
• Lawe iā warfarin (Coumadin)

ʻO Lindman BR, Bonow RO, Otto CM. Maʻi maʻi aorta. 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 68.

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.