He aha te pokanga pūtake aortic? Te Whāinga, te Hātepe me te Oranga

Ko te pokanga pūtake aortic he hātepe ngakau e whakatika ana, e whakakapi ana rānei i te pūtake o tō aorta, te uaua nui e kawe ana i te toto mai i tō ngakau ki te toenga o tō tinana. Ko te pūtake aortic he rite ki te tūāpapa o te kuaha putanga matua o tō ngakau, ā, ka pakaru, ka whānui rānei, ka taea e te pokanga te whakahoki mai i te rere toto tika me te tiaki i te mahi o tō ngakau.

Akene he nui te ahua o tēnei hātepe, engari he mano ngā tāngata e pokanga pūtake aortic ana i ia tau. Mā te māramatanga ki ngā mea e whai wāhi ana ka āwhina koe ki te whai wāhi atu me te māia ki te hātepe.

He aha te pokanga pūtake aortic?

Ko te pokanga pūtake aortic e whai wāhi ana ki te whakatika, ki te whakakapi rānei i te pūtake aortic, koinei te wāhanga e hono ana tō aorta ki tō ngakau. Kei roto i tēnei wāhanga te tātā aortic me te wāhanga tuatahi o te aorta ake.

Whakaarohia te pūtake aortic hei hononga nui e puta ai te toto i te rūma papu matua o tō ngakau. Ka pā te mate, te whānui, te pakaru rānei ki tēnei wāhanga, ka pā ki te pai o te papu o tō ngakau i te toto puta noa i tō tinana.

He maha ngā momo pokanga pūtake aortic. Ka taea e tō tākuta te whakatika i tō kiko o nāianei, te whakakapi i te tātā anake, te whakakapi rānei i te wāhanga pūtake katoa i runga i tō āhuatanga motuhake.

He aha te take e mahia ana te pokanga pūtake aortic?

Ka tūtohu tō tākuta i te pokanga pūtake aortic ka nui rawa te pūtake aortic, ka pakaru, ka mate rānei, kia kore ai e pai te mahi. Ka taea tēnei i runga i te maha o ngā āhuatanga e pā ana ki te kaha o tō ngakau ki te papu i te toto.

Ko te take tino noa he aortic root aneurysm, kei reira ngā pakitara o te aorta ka ngoikore, ka pupuhi ki waho rite ki te pōro. Ki te kore he rongoā, ka tūpono he mōrearea, he mōrearea pea te ora.

Koinei ngā āhuatanga matua e hiahia ana ki te pokanga pūtake aortic:

• Te puku o te pūkahukahu aortic (te whānui o te pūkahukahu aortic)
• Te mate o te tūāpapa aortic e pā ana ki te pūkahukahu e tata ana
• Te wehenga aortic (te haehae i te pakitara aortic)
• Te mate a Marfan, ētahi atu raruraru kiko hono rānei
• Te tūāpapa aortic bicuspid me te whānui o te pūkahukahu
• Te mate o te pūkahukahu aortic (endocarditis)
• Ngā hē o te ngākau i whānau mai e pā ana ki te pūkahukahu aortic

Ko ētahi āhuatanga onge pēnei i te mate a Loeys-Dietz, te mate a Ehlers-Danlos rānei, ka ngoikore hoki te pūkahukahu aortic i te roanga o te wā. Ka āta arotakehia tō āhuatanga e tō tākuta kia whakatau mēnā ko te pokanga te kōwhiringa pai mōu.

He aha te tikanga mō te pokanga pūkahukahu aortic?

Ka mahia te pokanga pūkahukahu aortic i raro i te rongoā whānui i roto i te rūma whakahaere o te hōhipera e tētahi tākuta ngākau. Ko te tikanga ka roa te 3 ki te 6 haora, i runga i te uaua o tō keehi.

Ka hanga e tō tākuta he tapahi i tō uma, ka whakamahi i te mīhini ngākau-pūkahukahu hei whakakapi i te mahi papu o tō ngākau i te wā o te mahi. Mā tēnei ka taea e tō tākuta te mahi i tō ngākau i te wā e tū ana.

Kei runga i te momo pokanga e hiahia ana koe ngā mahi motuhake:

1. Te whakakapi pūkahukahu aortic: Ka tangohia e tō tākuta te pūkahukahu kua pakaru, ka whakakapi ki te whakawhitinga, he mea hanga mai i te rauemi waihanga, i te kiko kararehe rānei
2. Te whakakapi pūkahukahu e tiaki ana i te tūāpapa: Ka tiakina te tūāpapa aortic hauora i te wā e whakakapi ana i te wāhanga pūkahukahu whānui anake
3. Te whakakapi whakawhitinga hiato: Ka whakakapi ngātahi te tūāpapa aortic me te pūkahukahu ki tētahi wae kotahi kei roto ngā wāhanga e rua
4. Te tikanga a Ross: Ka nekehia tō tūāpapa pūkahukahu ake hei whakakapi i te tūāpapa aortic me te pūkahukahu

I te wā o te pokanga, tērā pea me hono anō e tō tākuta ngā uaua coronary kia pai ai te rere o te toto ki tō uaua ngākau. He wāhanga tairongo tēnei engari he wāhanga o te tikanga.

Me pēhea te whakarite mō tō pokanga pūkahukahu aortic?

Ko te whakarite mō te pokanga pūtake aortic e whai ana i ētahi mahi nui hei āwhina i te whakatutuki i te hua pai rawa atu. Mā te rōpū tākuta e ārahi i a koe i roto i ia wāhanga whakarite i ngā wiki e arahina ana ki tō mahi.

Tuatahi, ka haere koe i roto i ngā whakamātautau whānui hei aromatawai i te mahi o tō ngākau me te hauora whānui. Ko te tikanga, kei roto i tēnei ngā whakamātautau toto, ngā hihi-X o te uma, ngā echocardiograms, ā, i ētahi wā, te whakauru katetaha ngākau, ngā karapa CT rānei.

Anei te mea ka taea e koe te tūmanako i te wā whakarite:

• Kati te kai paipa i te iti rawa 2 wiki i mua i te pokanga hei whakapai ake i te whakaora
• Whakarite, kati rānei i ētahi rongoā i runga i te tohutohu a tō tākuta
• Kia pai te akuaku niho me te rongoā i ngā raruraru niho
• Whaia ngā tohutohu kai i mua i te pokanga, te nuinga o te nohopuku i muri i te pō i mua i te pokanga
• Whakaritea tētahi tangata hei taraiwa i a koe ki te kāinga me te āwhina i te wā whakaora
• Whakaritea tō kāinga mō te whakaora me ngā nohoanga pai me ngā mea e ngāwari ana te toro atu

Ka tūtohu pea tō tākuta i te whakahou ngākau i mua i te pokanga mēnā he wā tō. Mā tēnei e āwhina i te whakakaha i tō ngākau me te whakapai ake i tō oranga tinana mō te mahi.

Me pēhea te pānui i ō ine pūtake aortic?

Ko ngā ine pūtake aortic te tikanga ka tangohia mā te whakamahi i te echocardiography, i ngā karapa CT rānei, ā, ka inea ki ngā mirimita. Ka whakataurite tō tākuta i ō ine ki ngā awhe noa i runga i te rahi o tō tinana me te tau.

Mō te nuinga o ngā pakeke, he 20-37 mirimita te ine o te pūtake aortic noa i tōna wāhi whānui. Heoi, ka tātai tō tākuta i te mea noa mō te rahi o tō tinana mā te whakamahi i tō teitei, te taumaha, me te rohe o te tinana.

Anei te pēhea e whakamārama ai ngā tākuta i ngā ine pūtake aortic:

• Noa: I roto i te awhe e tūmanakohia ana mō te rahi o tō tinana
• He iti te whānui: 40-45 mm (kei te hiahia aroturuki)
• He whānui ngāwari: 45-50 mm (e hiahiatia ana te aroturuki tata)
• He whānui rawa: Neke atu i te 50 mm (te nuinga o te wā ka tūtohu pokanga)

Ka whai whakaaro hoki tō tākuta ki te tere o te whānui haere o tō pūtake aortic i roto i te wā. Ahakoa ngā ine iti ake nei, tērā pea ka hiahiatia he pokanga mēnā e tere ana te tipu, mēnā rānei he momo ira tō.

Me pēhea te whakahaere i tō whakaora i muri i te pokanga pūtake aortic?

He tukanga haere haere te whakaora i te pokanga pūtake aortic, ā, he maha ngā marama ka pau. Ko te nuinga o te tangata e noho ana i te hōhipera mō te 5-7 rā i muri i te pokanga, ko ngā rā tuatahi e 1-2 i roto i te wāhi tiaki kaha mō te aroturuki tata.

I te wā o tō noho ki te hōhipera, ka āwhina tō rōpū hauora i a koe ki te tīmata ki te neke haere, ki ngā mahi manawa, me te whakanui haere i tō taumata mahi. Ka tīmata hoki koe ki te tango rongoā hei tiaki i tō ngākau me te ārai i ngā raruraru.

Ko te wā tika mō tō whakaora e whai ana i tēnei tauira:

• Ngā wiki tuatahi e 2: Okioki ki te kāinga, ngā haere poto, kaua e hiki i te taumaha neke atu i te 10 pauna
• 2-6 wiki: Whakanuia haere te tawhiti haere, ngā mahi māmā o te whare
• 6-12 wiki: Hoki ki te nuinga o ngā mahi noa, tērā pea ka hoki ki te mahi
• 3-6 marama: Te whakaora katoa, ka hoki ki ngā mahi katoa tae atu ki te whakakori tinana

Me tango koe i te rongoā whakaheke toto mēnā i whiwhi koe i tētahi tātā miihini, ā, ka whai koe i ngā whakaritenga whai-muri auau hei aroturuki i tō ahunga whakamua. Ko te nuinga o te tangata e pai ake ana i roto i ngā marama ruarua, ā, ka taea te hoki ki tō rātou oranga noa.

He aha te putanga pai rawa atu mō te pokanga pūtake aortic?

Ko te putanga pai rawa atu mō te pokanga pūtake aortic ko te wā e angitu ana te tikanga ki te ārai i ngā raruraru kino i te wā e tuku ana i a koe ki te hoki ki ō mahi noa me te pai ake o te mahi ngākau. He tino whakahihiri ngā reiti angitu mō te pokanga pūtake aortic, ā, ko te nuinga o te tangata e pā ana ki ngā hua pai i te wā roa.

He tino angitu te pokanga o te pūtake o te aorta i te wā hou, neke atu i te 95% o te hunga e ora ana i te mahi, ka haere tonu ki te noho i te oranga noa, te oranga kaha. Ko te pokanga e whakakore ana i te mōrearea o te pakaru o te aorta, ā, he maha ngā wā ka pai ake ngā tohu e pā ana ki a koe.

Ko ngā hua pai rawa atu i te wā roa ko:

• Te whakakorenga katoa o te mōrearea o te pakaru o te aneurysm
• Te pai ake o te kaha ki te whakakorikori tinana me te taumata pūngao
• Te whakawātea i ngā tohu pēnei i te mamae o te uma, te poto rānei o te manawa
• Te hoki ki ngā mahi o ia rā i roto i te 3-6 marama
• Ngā reiti oranga pai i te 10 tau (neke atu i te 90%)

Kei te whakawhirinaki te hua o tō ake ki ngā mea pēnei i tō tau, te hauora whānui, me te momo pokanga e hiahia ana koe. He maha ngā tāngata e miharo ana i te pai ake o te āhua i muri i te whakaoranga mai i te mahi.

He aha ngā āhuatanga mōrearea mō te hiahia pokanga o te pūtake o te aorta?

He maha ngā āhuatanga mōrearea ka whakanui i tō tūponotanga ki te whakawhanake i ngā raruraru o te pūtake o te aorta e hiahia ana ki te pokanga. Mā te māramatanga ki ēnei āhuatanga ka āwhina i a koe me tō tākuta ki te aroturuki i tō hauora ngākau.

Ko te āhuatanga mōrearea nui rawa atu ko te whai i tētahi āhuatanga ira e pā ana ki tō kiko honohono, pēnei i te mate Marfan, te pūwāhi aortic bicuspid rānei. He maha ngā wā ka riro ēnei āhuatanga i te whānau, ā, ka taea e rātou te whakanui i te pūtake o te aorta i te wā.

Ko ēnei ngā āhuatanga mōrearea matua hei mōhio:

• Te hītori o te whānau mō te aneurysms aortic, te mate ngākau ohorere rānei
• Te mate Marfan, ētahi atu raruraru kiko honohono rānei
• Pūwāhi aortic bicuspid (i whānau mai me ngā rau pūwāhi e rua, kaua ki te toru)
• Te toto tiketike, ina koa kāore i te pai te whakahaere
• Ngā mate pūwāhi ngākau o mua (endocarditis)
• Te wharanga o te uma, te pokanga ngākau o mua rānei
• Ētahi āhuatanga autoimmune

He mea nui ano te pakeke me te ira tangata, he nui ake nga raruraru o te pakiaka aortic i roto i nga tane me nga tangata neke atu i te 60 tau. Heoi, ka taea e nga ahuatanga ira te whakanui i te pakiaka aortic i nga tau katoa, koinei te take he mea nui te hitori o te whanau.

He pai ake te pokanga pakiaka aortic wawe, i te pokanga whakaroa ranei?

Ko te wa o te pokanga pakiaka aortic e whakawhirinaki ana ki te taurite i nga tupono o te tatari ki nga tupono o te pokanga ake. I te nuinga o nga wa, ka tūtohu te pokanga wawe ina tae ana nga inenga, nga tohu ranei ki etahi paepae, kaua ki te tatari mo tetahi ahuatanga ohorere.

He pai ake te pokanga wawe ina tae ana to pakiaka aortic ki nga paearu rahi motuhake, ki te pa ana ranei koe i nga tohu. Ko te tatari roa rawa ka nui ake te tupono o nga raruraru e raru ana i te oranga penei i te pakaru aortic, te wehenga ranei.

Ka tūtohu to taakuta kia pokanga wawe koe mena kei a koe:

• He nui ake te pakiaka aortic i te 50 mm te whanui
• Te tipu tere (neke atu i te 5 mm ia tau)
• Nga tohu penei i te mamae o te uma, te poto ranei o te manawa
• Te hitori o te whanau o te wehenga aortic
• Nga ahuatanga ira penei i te mate Marfan
• Nga mahere mo te haputanga (nga wahine whai pakiaka aortic whakanui)

Ko te pokanga whiriwhiri i mahia i mua i te puta o nga ahuatanga ohorere he pai ake nga hua me te iti ake o te tupono ka whakaritea ki nga tikanga ohorere. Ka taea e to roopu pokanga te whakamahere tupato, ka taea e koe te whakarite tinana me te kare-a-roto.

He aha nga raruraru ka puta mai i te whakanui i te pakiaka aortic kaore i rongoatia?

Ko te whakanui i te pakiaka aortic kaore i rongoatia ka arahi ki nga raruraru nui, ka raru pea i te oranga. Ko te tupono tino kino ko te wehenga aortic, te pakaru ranei, ka puta ohorere, me hiahia tonu te rongoa ohorere.

I te wa e whakanui ana te pakiaka aortic, ka angiangi, ka ngoikore nga pakitara, ka kaha ake te haehae. Ka puta tenei i te ohorere o te rongoa ka mate mena kaore i rongoatia tonu.

Ko nga raruraru tino nui ko:

• Te wehenga o te aorta (roimata i roto i te pakitara o te aorta)
• Te pakaru o te aorta (te pakaru katoa o te pakitara o te aorta)
• Te nui o te regurgitation o te vaolo aortic (te turuturu o te vaolo)
• Te korenga o te ngakau mai i te mahi vaolo kino
• Te hanga o nga toto toto i roto i te waahi whakanui
• Te kōpeketanga o nga hanganga ngakau tata

Ko etahi raruraru onge ko te kōpeketanga o nga uaua coronary, e tuku toto ana ki to uaua ngakau, te kōpeketanga ranei o nga hanganga tata penei i te vena cava superior. E hiahia ana enei ahuatanga kia aro tonu te rongoa.

Ko te rongo pai ko enei raruraru ka taea te aukati ma te pokanga i te wa tika. Ko te aroturuki i nga wa katoa me te whai i nga tohutohu a to taakuta ka awhina i te hopu i nga raru i mua i te kino.

He aha nga raruraru ka puta mai i te pokanga pakiaka aortic?

Pērā i te pokanga nui, he raruraru ano te pokanga pakiaka aortic, ahakoa he onge nga raruraru nui me nga roopu pokanga mohio. Ko te mohio ki enei take ka awhina koe ki te whakatau i tetahi whakatau mohio me te whakarite mo to whakaora.

Ko nga raruraru tino noa he wa poto, ka whakatauhia i te wa o to wa whakaora. Kei roto pea i enei ko nga manawataki ngakau koretake mo te wa poto, te pupuri wai, te mate ngawari ranei e pai ana te whakautu ki te maimoatanga.

Ko nga raruraru ka puta ko:

• Te toto ka hiahia pea ki te whakawhitinga toto
• Te mate i te waahi pokanga, i roto ranei i te toto
• Nga manawataki ngakau koretake (arrhythmias)
• Te whiu, nga raruraru neurological ranei
• Nga raruraru whatukuhu mai i te miihini ngakau-puku
• Nga raruraru me te whakatikatika pokanga e hiahia ana kia pokanga atu

Ko nga raruraru onge engari nui ko te whakaeke ngakau, te nui o te toto, nga raruraru ranei me te vaolo hou, te whakawhitinga ranei. Ka tino aroturukihia koe e to roopu pokanga ki te aukati me te rongoa tere i nga raruraru ka puta mai.

He iti te reeti raruraru whānui, ā, ka ora katoa te nuinga o te tangata, kāore he raruraru e mau tonu ana. Ka kōrero tō tākuta pokanga i ō āhuatanga tūpono takitahi, ā, ka whakautu i ngā āwangawanga motuhake kei a koe.

Āhea au e kite ai i te tākuta mō ngā āwangawanga pūtake aortic?

Me kite koe i te tākuta mēnā ka pā ki a koe ngā tohumate e tohu ana i ngā raruraru pūtake aortic, ina koa kei a koe ngā āhuatanga tūpono pēnei i te hītori whānau, i ngā āhuatanga ira rānei. Mā te kimi wawe me te aroturuki ka ārai i ngā raruraru nui.

Kaua e tatari mēnā ka pā ki a koe te mamae o te uma, ina koa he kaha, he ohorere, he horapa rānei ki tō tuara. Koinei pea ngā tohu o te wehenga aortic, e hiahia ana kia tere te rongoā ohorere.

Whakaritea he tūtakitanga ki tō tākuta mēnā kei a koe:

• Te mamae o te uma, te raru rānei, ina koa i te wā e mahi ana
• Te poto o te manawa i ngā mahi noa
• Te ngenge, te ngoikore rānei e pōro ana
• Ngā wā o te ngaro o te mahara, te tata rānei ki te ngaro o te mahara
• Ngā ngākau pā, ngā manawataki rerekē rānei
• Te hītori whānau o ngā raruraru aortic, te mate ohorere rānei o te ngākau

Mēnā kei a koe tētahi āhuatanga ira e mōhiotia ana pēnei i te mate Marfan, i te pūwāhi aortic bicuspid rānei, me whai koe i ngā arotake ngākau i ngā wā katoa ahakoa e pai ana koe. Mā te aroturuki wawe ka kite i ngā raruraru i mua i te pōro.

Waea atu ki te 911 ināianei tonu mēnā ka pā ki a koe te mamae ohorere, kaha o te uma e rite ana ki te haehae, ina koa ka neke ki tō tuara. Koinei pea te tohu o te wehenga aortic, he ohorere rongoā.

Ngā pātai e pātai pinepine ana mō te pokanga pūtake aortic

Q.1 He pai te pokanga pūtake aortic mō te pūwāhi aortic bicuspid?

Āe, ka whai hua te pokanga pūtake aortic mō ngā tāngata e whai ana i te pūwāhi aortic bicuspid ka whānui te pūtake aortic. Ko te pūwāhi aortic bicuspid he āhuatanga whānau noa e whānau ana koe me ngā rau pūwāhi e rua, kaua ki te toru.

He maha ngā tāngata e whai ana i te pūwāhi aortic bicuspid ka whanake te whānuitanga o te pūtake aortic i te roanga o te wā. Ka taea e te pokanga te whakatika i te raruraru o te pūwāhi me te whānuitanga o te pūtake, i runga i tō āhuatanga motuhake. I ētahi wā ko te pūtake anake e hiahia ana kia whakakapia, me te tiaki i tō pūwāhi.

Q.2 He mamae kei te uma te whānuitanga o te pūtake aortic?

Ka taea e te whānuitanga o te pūtake aortic te mamae kei te uma, ahakoa he maha ngā tāngata kāore e pā ana ki ngā tohu tae noa ki te wā ka nui ake te āhuatanga. Ka pērā te mamae me te pēhanga, te piri, te kore hāneanea rānei i tō uma.

Ko te mamae kei te uma te nuinga ka puta mai nā te mea ka pā te pūtake whānui ki te pai o te pūngao o tō ngākau i te toto, nā te mea rānei kāore te pūwāhi aortic e mahi tika ana. Ko ētahi tāngata ka pā ki te poto o te manawa, te ngenge rānei me te kore hāneanea o te uma.

Q.3 Ka taea e au te whakakori tinana i muri i te pokanga o te pūtake aortic?

Ka taea e te nuinga o ngā tāngata te hoki ki te whakakori tinana i muri i te whakaora katoa i te pokanga o te pūtake aortic, te nuinga i roto i te 3-6 marama. Ka hoatu e tō tākuta ngā aratohu motuhake i runga i tō momo pokanga me te ahunga whakamua o te whakaora.

Ka tīmata koe ki te hīkoi marie, ka piki haere tō taumata mahi. Ka taea e te nuinga o ngā tāngata te whai wāhi ki te whakakori tinana ngawari pērā i te kauhoe, te pahikara, te omaoma rānei. Ka tūtohu pea tō tākuta kia karo i ngā mahi tino kaha, i ngā hākinakina whakapā rānei.

Q.4 Kia pēhea te roa o te whakatikatika i te pūtake aortic?

Ko te whakatikatika i te pūtake aortic te nuinga ka roa ngā tau, he maha ngā tekau tau, ina koa ki ngā tikanga pokanga me ngā rauemi hou. Kei te whakawhirinaki te roa ki ngā āhuatanga pērā i tō tau, te momo whakatikatika, me te pai o tō whai i tō mahere tiaki i muri i te pokanga.

Ka taea e ngā pūwāhi mīhini te roa 20-30 tau, neke atu rānei, i te wā e roa ana ngā pūwāhi kiko 15-20 tau. Ka whiriwhiri tō tākuta i te kōwhiringa pai rawa atu i runga i tō tau, tō oranga, me ō hiahia mō te tango rongoā whakaheke toto.

Q.5 Me tango rongoā tonu au i muri i te pokanga o te pūtake aortic?

Ko ngā rongoā e hiahia ana koe i muri i te pokanga ka whakawhirinaki ki te momo whakatikatika ka whiwhi koe. Mēnā ka whiwhi koe i tētahi tūāwhiorangi mīhini, ka hiahia koe i ngā rongoā whakaheke toto mō te roanga o te oranga hei ārai i te hanganga o ngā pūhui i runga i te tūāwhiorangi.

Mēnā ka whiwhi koe i tētahi tūāwhiorangi kiko, i tētahi whakatikatika e tiaki ana i te tūāwhiorangi, tērā pea ka hiahia koe i ngā rongoā mō te wā poto i te wā o tō whakaoranga. He maha ngā tāngata ka tango noa i ngā rongoā hauora-ngākau pērā i te hunga e whakamahia ana hei whakahaere i te pēhanga toto, i te cholesterol rānei.