ʻOki kino Mitral - wehe

Hoʻohana ʻia ke kahakaha mitral e hoʻoponopono a hoʻololi paha i ka pahu mitral i kou puʻuwai.

Ke kahe nei ke koko ma waena o nā keʻena ʻokoʻa i ka puʻuwai ma o nā kiwikā e hoʻopili ai i nā keʻena. ʻO kekahi o kēia ka mitral valve. Wehe ka mitral valve i hiki i ke koko ke kahe mai ka atrium hema a i ka ventricle hema. A laila pani ka pā, mālama i ke kahe o ke koko i hope.

I kēia ʻano ʻoki kino, hana ka mea ʻokiʻoki i kahi ʻoki nui i loko o kou umauma e hiki i ka puʻuwai. Hoʻohana nā ʻano ʻoki ʻē aʻe i kekahi mau ʻoki liʻiliʻi.

Ma mua o kou ʻoki ʻana, e loaʻa iā ʻoe ka anesthesia ākea.E hiamoe ʻoe a ʻaʻohe ʻeha i ka wā o ke kaʻina hana.

• E ʻokiʻoki kou kaukipala 10-ʻīniha ka lōʻihi (25.4 kenimika) ma ka waena o kou umauma.
• ʻO ka mea aʻe, e hoʻokaʻawale kāu kauka lāʻau i kou umauma i mea e ʻike ai i kou puʻuwai.
• Pili ka hapa nui o ka poʻe 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.
• Hana ʻia kahi ʻoki liʻiliʻi ma ka ʻaoʻao hema o kou puʻuwai i hiki i kāu kaukipō lōkō ke hoʻoponopono a hoʻololi paha i ka nohona mitral.

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

• Hoʻololi annuloplasty - Hoʻoponopono ke kahu lapaʻau i kahi ʻāpana e like me ke apo a puni ka paipū e ka humuhumu ʻana i ke apo o ka metala, ka lole, a i ʻole nā ​​mea a puni ka nohona.
• Hoʻoponopono Valve - Hoʻokiʻoki ke kahu lāʻau, nā kinona, a kūkulu hou paha i hoʻokahi a ʻoi paha o nā lapalapa ʻekolu (leaflets) o ka valve.

Inā hōʻino loa kāu pahu mitral e hoʻoponopono hou ʻia, pono ʻoe i kahi kiwikā hou. Kāhea ʻia kēia mea he keʻoki pani. E lawe aku kāu kauka lāʻau i kāu kiwikā mitral a humuhumu i kahi hou i kahi. Aia he ʻelua mau ʻano mitral valves:

• Mīkini, hana ʻia e nā mea hana a ke kanaka (synthetic), e like me ka titanium. ʻO ka lōʻihi loa o kēia mau valves. 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, i hana ʻia e nā kānaka a holoholona paha. ʻO kēia mau kiwikā e hala 10 a 12 mau makahiki. ʻAʻole paha ʻoe e pono e lawe i nā mea lahilahi o ke koko no ke ola.

Ke holo nei ka pahu hou a hoʻoponopono paha, e hana ana kāu 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 mau pule e hoʻōla ai ka iwi. E noho nā kaula i loko o kou kino.

Hiki paha iā ʻoe ke pili i ka manawa ʻole i pili i kou puʻuwai a hiki i kou hoʻi ʻana o ka puʻuwai maoli.

Lawe kēia ʻoki i 3 a 6 mau hola.

Pono ʻoe i ke ʻoki inā ʻaʻole holo pono kāu valve mitral.

• ʻO kahi kiwikā mitral ʻaʻole pani kokoke i nā ala āpau e ʻae i ke kahe o ke koko i ka atrium hema. Kapa ʻia kēia inoa registitation mitral.
• ʻO ka pahū mitral ʻaʻole wehe hāmama e kaohi i ke kahe o ke koko. Kapa ʻia kēia mitral stenosis.

Hiki paha iā ʻoe ke ʻoki puʻuwai puʻuwai hāmama no kēia mau kumu:

• ʻO nā loli i kāu kiwikā mitral ke kumu nei i nā ʻōuli nui o ka puʻuwai, e like me ka angina (ʻeha o ka umauma), ka hanu ʻana o ka hanu, nā ʻōpala maʻule (Synopeope), a i ʻole nā ​​puʻuwai puʻuwai.
• Hōʻike nā hoʻokolohua ʻo nā loli i kāu kiwikā o mitral e hoʻemi ana i kāu hana puʻuwai.
• Ke hana nei ʻoe i kahi kīʻaha puʻuwai hāmama no kekahi kumu ʻē aʻe, a pono paha i kāu kauka e pani a hoʻomaikaʻi i kāu kiwikā mitral i ka manawa like.
• Ua hōʻino ʻia kāu kiwikā puʻuwai e endocarditis (maʻi o ka puʻuwai puʻuwai).
• Ua loaʻa iā ʻoe he kiʻikuhi puʻuwai hou i ka wā i hala, a ʻaʻole maikaʻi maikaʻi.
• Loaʻa iā ʻoe nā pilikia e like me ke kahe o ke koko, maʻi, a i ʻole ke kahe ʻana o ke koko ma hope o ka loaʻa ʻana o kahi kiwikā puʻuwai hou.

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 puʻuwai.

• Ka hōʻeha puʻuwai a i ʻole hōʻeha.
• Nā pilikia puʻuwai puʻuwai.
• ʻO ka maʻi i loko o ke ʻoki (ʻoi aku paha e hiki i nā poʻe obese, loaʻa diabetes, a i ʻole ua loaʻa i kēia ʻoki).
• Ka nalowale ʻana o ka hoʻomanaʻo ʻana a me ka nalowale ʻana o ka mōakāka o ka noʻonoʻo, a i ʻole ka "noʻonoʻo fuzzy."
• ʻO ka maʻi post-pericardiotomy, kahi e loaʻa ai ka wela liʻiliʻi a me ka ʻeha o ka umauma. Hiki i kēia 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 noi i kāu mea hāʻawi inā hiki iā ʻoe a me nā lālā o kou ʻohana ke hāʻawi i ke koko.

Pono paha ʻoe e hōʻoki i ka lawe ʻana i nā lāʻau e ʻoi aku ka paʻakikī o kou kōkō ʻana no 2 mau pule ma mua o ka ʻoki ʻana. Hiki paha i kēia ke hoʻonui i ke kahe i ka wā o ke ʻoki.

• ʻO kekahi o kēia mau lāʻau he aspirin, ibuprofen (Advil, Motrin), a me naproxen (Aleve, Naprosyn).
• Inā ʻoe e lawe ana iā warfarin (Coumadin) a i ʻole clopidogrel (Plavix), e kamaʻilio me kāu mea hoʻolako ma mua o ka hoʻokū ʻana i kāu mau lāʻau a hoʻololi paha i kāu lawe ʻana iā lākou.

E hoʻomākaukau i kou hale ma mua o kou hele ʻana i ka haukapila i maʻalahi nā mea ke hoʻi ʻoe.

I ka lā ma mua o kou ʻoki ʻana, e ʻauʻau a holoi i kou lauoho. 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. Pono paha ʻoe e lawe i kahi lāʻau antibiotic e kiaʻi ai i ka maʻi.

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.
• Inā puhi ʻoe, pono ʻoe e hoʻokū. E noi i kāu mea hāʻawi mai i kōkua.
• E hoʻomaopopo mau i kāu mea hāʻawi inā loaʻa ʻoe i ke anu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe ma mua o kāu ʻoki.

I ka lā o ke kaha:

• E hāhai i nā ʻōlelo aʻoaʻo a kāu mea hoʻolako e pili ana i ka manawa e hōʻoki ai i ka ʻai ʻana a me ka inu ʻana.
• E lawe i nā lāʻau i haʻi ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Noho ka hapa nui o ka poʻe i 4 a 7 mau lā i ka haukapila ma hope o ke kaha ʻana.

E ala ʻoe i loko o ka keʻena mālama nui (ICU). E ola ʻoe ma laila no 1 a 2 mau lā. E loaʻa iā ʻoe he 2 a 3 mau paipu i kou umauma e hoʻokahe i ka wai mai a puni kou puʻuwai. Lawe pinepine ʻia nā paipu 1 a 3 mau lā ma hope o ke kaha ʻana.

Loaʻa paha iā ʻoe kahi paipu hikiwawe (catheter) i loko o kāu pēke e hoʻokahe i ka mimi. Hiki paha iā ʻoe ke loaʻa i nā laina intravenous (IV) e loaʻa ai nā wai. E nānā pono ʻia nā mākaʻi e hōʻike ana i nā hōʻailona koʻikoʻi (pulsa, 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 hoʻomaka lohi i ka hana. Hele paha ʻoe i kahi papahana hoʻoikaika kino e hoʻoikaika i kou puʻuwai a me kou kino.

ʻO nā valves puʻuwai mīkini i ke ola holoʻokoʻa. Eia nō naʻe, ulu paha ke kōkō koko ma luna o lākou. Hiki i kēia ke lilo i maʻi a pale ʻia paha. Inā kū kahi kōpē koko, loaʻa paha ʻoe i ka maʻi hahau.

Holo nā kiwikā i hana ʻia mai ke kino kanaka a holoholona paha i ka hala ʻana o ka manawa. He awelika ko lākou ola ʻana o 10 a 20 mau makahiki ma mua o ka pono e kūapo ʻia. Loaʻa iā lākou kahi haʻahaʻa haʻahaʻa o ke kahe o ke koko.

Mitral pani pani pani - hamama; Hoʻoponopono i ka nohona kiwikā - wehe; Mitral valvuloplasty

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

ʻO Goldstone AB, Woo YJ. Lapaʻau lapaʻau o ka mitral kiwikā. I: Sellke FW, del Nido PJ, Swanson SJ, eds. ʻO Sabiston lāua ʻo Spencer Surgery o ka umauma. 9th ed. Piladelapia, PA: Elsevier; 2016: chap 80.

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.

ʻO Thomas JD, Bonow RO. Maʻi maʻi mitral. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. I: ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 69.