Transcatheter aortic pani pani

Transcatheter aortic replacement replacement (TAVR) kahi hana i hoʻohana ʻia e pani ai i ka nohona aortic me ka wehe ʻole o ka pahu. Hoʻohana ʻia ia e mālama i nā mākua i lawa ʻole ke olakino no ke kaha ʻana o ka pahu maʻamau.

ʻO ke aorta kahi aʻa nui e lawe i ke koko mai kou puʻuwai a i ke koena o kou kino. Kahe ke koko mai kou puʻuwai a i loko o ke aorta ma o ka vaʻa. Kapa ʻia kēia kiwikā ʻo ke kiʻiona aorta. Wehe ʻia i hiki i ke kahe ke kahe i waho. Pani ia a laila, mālama i ke kahe o ke koko i hope.

ʻO kahi kiwikā aortic e hāmama ʻole e kaupalena i ke kahe o ke koko. Kapa ʻia kēia aortic stenosis. Inā he kulu pū kekahi, kapa ʻia ka regurgitation aortic. Hoʻololi ʻia ka hapanui o nā valves aortic no ka mea kaohi lākou i ke kahe i mua ma o ka aorta i ka lolo a me ke kino.

E hana ʻia ke kaʻina hana i kahi haukapila. Ma kahi o 2 a 4 mau hola paha.

• Ma mua o kou ʻoki ʻana, loaʻa iā ʻoe ke anesthesia ākea. E hoʻokau kēia iā ʻoe i kahi hiamoe ʻole ʻeha. ʻO ka pinepine, hana ʻia nā kaʻina hana me ʻoe i hoʻowalewale nui ʻia. ʻAʻole ʻoe hiamoe piha akā ʻaʻole ʻoe ʻeha. Kapa ʻia kēia he sedation kaulike.
• Inā hoʻohana ʻia ka anesthesia laulā, e hoʻokomo ʻoe i kahi paipu i lalo i kou ʻāʻī e pili ana i kahi mīkini e kōkua iā ʻoe e hanu. Wehe ʻia kēia ma hope o ke kaʻina hana. Inā hoʻohana ʻia ka hoʻohiamoe hoʻohaʻahaʻa, ʻaʻole pono ka puʻuwai hanu.
• E ʻokiʻoki ke kauka i kahi ʻoki (incision) i loko o ke aʻa i loko o kou aʻa a i ʻole i kou umauma kokoke i kou iwi umauma.
• Inā ʻaʻohe āu pacemaker, hiki i ke kauka ke hoʻokomo i hoʻokahi i loko. E ʻaahu ʻoe ia no 48 mau hola ma hope o ke kaha. Kōkua kahi pacemaker i kou puʻuwai e paʻi i kahi mele maʻamau.
• E wili ke kauka i kahi puʻupuʻu lahilahi i kapa ʻia he catheter ma o ke aʻa o kou puʻuwai a me ka kiwikā.
• E hoʻonui ʻia kahi pāluna liʻiliʻi ma ka hope o ka catheter i kāu kiwikā aortic. Kapa ʻia kēia ʻo valvuloplasty.
• A laila e alakaʻi ke kauka i kahi kiwikā aortic hou ma luna o ka catheter a me ka baluna a waiho i loko o kāu kiwikā aortic. Hoʻohana ʻia kahi kiwikā olaola no TAVR.
• E wehe ʻia ka kiwikā hou i loko o ka nohona kiwikā kahiko. E hana ia i ka hana o ka nohona kiwikā kahiko.
• E wehe ke kauka i ka catheter a pani i ka ʻoki me nā humuhumu a me ka lole.
• ʻAʻole pono ʻoe e noho ma ka mīkini puʻuwai puʻuwai no kēia kaʻina hana.

Hoʻohana ʻia ʻo TAVR no ka poʻe me nā stenosis aortic koʻikoʻi ʻaʻole lawa ke olakino e loaʻa i ka ʻoki ʻana o ka umauma hāmama e pani ai i ka nohona.

I nā mākua, ʻo ka stortosis aortic ka mea pinepine ma muli o nā waihona calcium e hoʻoliʻiliʻi ai ka pahu. Hoʻopili kēia i nā poʻe kahiko.

Hana ʻia ʻo TAVR no kēia mau kumu:

• Loaʻa iā ʻoe nā ʻōuli nui o ka puʻuwai, e like me ka ʻeha o ka umauma (angina), ka pōkole o ka hanu, nā wana maʻule (syncope), a i ʻole nā ​​puʻuwai puʻuwai.
• Hōʻike nā hoʻokolohua ke hoʻomaka nei nā loli i kāu kiwikā aortic e hōʻeha koʻikoʻi i ka maikaʻi o ka hana o kou puʻuwai.
• ʻAʻole hiki iā ʻoe ke hana i ka ʻoki o ka wili maʻamau no ka mea e hoʻoweliweli ia i kou olakino. (Kahakaha: Ke hana ʻia nei nā noiʻi e ʻike ai inā hiki ke kōkua ʻia i nā mea maʻi hou aʻe e ke ʻoki.)

He nui nā pono o kēia kaʻina hana. Aia ka liʻiliʻi o ka ʻeha, ke kahe o ke koko, a me ka makaʻu o ka maʻi. E ola wikiwiki nō hoʻi ʻoe ma mua o ke kahakaha o ka umauma hāmama.

Nā pilikia o kekahi anesthesia:

• Kahena
• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• 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 ʻē aʻe:

• Poino i nā kīʻaha koko
• Pono ʻoe e wehe i ke kīʻaha puʻuwai e hoʻoponopono i nā pilikia e ala aʻe i ke kaʻina hana
• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• ʻO ka maʻi o ka nohona hou
• Hewa ʻole nā ​​hakuʻala
• Kuʻi naʻau maʻamau
• Kahena
• Hoʻōla maikaʻi ʻole i ka ʻokiʻoki
• Make

E haʻi mau i kāu kauka a kahu hānai paha i nā lāʻau āu e lawe nei, e like me nā lāʻau laulau, nā mea hoʻopiha a i ʻole nā ​​mea kanu.

Pono ʻoe e ʻike i kāu kauka niho e ʻike pono ʻaʻohe maʻi i kou waha. Inā mālama ʻole ʻia, hoʻolaha paha kēia mau maʻi i kou puʻuwai a i ʻole ka puʻuwai puʻuwai hou.

No ka manawa o 2 mau pule 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 lākou 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 kāu kaʻina hana:

• E noi i kāu kauka i nā lāʻau e pono ai ʻoe e lawe i ka lā o kāu kaʻina hana.
• Inā puhi ʻoe, pono ʻoe e hoʻokū. E noi i kāu kauka no ke kōkua.
• E hoʻomaopopo mau i kāu kauka 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 kaʻina hana.
• I ka lā ma mua o kāu kaʻina hana, ʻauʻau a me ka shampoo maikaʻi. E noi ʻia 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. E noi ʻia paha ʻoe e lawe i kahi antibiotic e pale aku ai i ka maʻi.

I ka lā o kou ʻoki kino:

• E noi ʻia ʻoe ʻaʻole e inu a ʻai ʻole i kekahi mea ma hope o ke aumoe i ka pō ma mua o kāu kaʻina hana. Hoʻopili pū kēia me ka nau nau ʻana a me ka hoʻohana ʻana i nā mīkini hanu. E holoi i kou waha me ka wai inā e maloʻo, akā e akahele e ʻole e ale.
• E lawe i nā lāʻau a kāu kauka i haʻi aku ai iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi aku kāu kauka a kahu wahine paha iā ʻoe i ka wā e hōʻea ai i ka haukapila.

Hiki iā ʻoe ke hoʻolilo i 1 a 4 mau lā i ka haukapila.

E hoʻolilo ʻoe i ka pō mua ma kahi keʻena mālama nui (ICU). E nānā pono nā kahu hānai iā ʻoe. ʻO ka maʻamau ma waena o 24 mau hola, e hoʻoneʻe ʻia ʻoe i kahi lumi maʻamau a i kahi keʻena mālama hoʻololi i ka haukapila.

I ka lā ma hope o ke kaha ʻana, e kōkua ʻia ʻoe mai ka moena i hiki iā ʻoe ke ala aʻe a neʻe. E hoʻomaka paha ʻoe i kahi papahana e hoʻoikaika i kou puʻuwai a me kou kino.

E hōʻike kāu poʻe mālama ola iā ʻoe pehea e mālama ai iā ʻoe iho ma ka home. E aʻo ʻoe pehea e ʻauʻau ai iā ʻoe iho a mālama i ka ʻeha ʻoki. Hāʻawi ʻia ʻoe i nā ʻōkuhi no ka papaʻai a me ka hoʻoikaika kino. E mālama pono i nā lāʻau e like me ke kuhikuhi. Pono ʻoe e lawe i nā mea lahilahi o ke koko no ke koena o kou ola.

E kono kāu kauka iā ʻoe i loko no kahi manawa e ukali ai e hōʻoia i ka maikaʻi o ka nohona hou.

E haʻi pono aku i kekahi o kāu poʻe hāʻawi i loaʻa iā ʻoe kahi pani pani. E hana pono i kēia ma mua o ka loaʻa ʻana o nā kauka a me nā kaʻina hana niho.

ʻO ka loaʻa ʻana o kēia kaʻina hana hiki ke hoʻomaikaʻi i ka maikaʻi o kou ola a kōkua iā ʻoe e ola lōʻihi ma mua o ka ʻole me ke kaʻina hana. Hiki paha iā ʻoe ke hanu maʻalahi a ʻoi aku ka ikaika. Hiki paha iā ʻoe ke hana i nā mea hiki ʻole iā ʻoe ke hana ma mua no ka mea hiki i kou puʻuwai ke poma i ke koko momona o ka oxygen i ke koena o kou kino.

Maopopo ʻole i ka lōʻihi o ka hoʻomau o ka hana o ke kiwikā hou, no laila e ʻike pono i kāu kauka no nā koho maʻamau.

Valvuloplasty - aortic; TAVR; Transcatheter aortic valve implantation (TAVI)

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