mahadhamani yokka punarujjeevaka endovascular beloon nirodham

mahadhamani (rebova) yokka punarujjeevana endovascular beloon nirodham anedi teevramgaa gayapadina gaayam rogula punarujjeevana samayamlo nirvahinche athi takkuva invasive prakriya. modata mahadhamani cross clampingtho atyavasara thoracotomici takkuva hanikara pratyamnaayamgaa abhivruddhi cheyabadindi, rebova anedi sampeedana kaani trunkle ledhaa junctional raktasraavaanni vaegamgaa niyantrinchadaaniki nirvahinchabadutundi. saadhaarana toda dhamani (cfa) kii praapyatanu saadhinchadam dwara mariyu mahadhamani lopala kaathetarnu munduku teesukelladam dwara modata rebova nirvahinchabadutundi. kaathetarnu vijayavantamgaa amarchina tarvaata, avarohana beloon avarohana thoracic mahadhamani (john 1) ledhaa paraaruna pottikadupu mahadhamani (john 3) lopala penchavacchu. rebova diguva raktasraavamnu taggistundi mariyu cardiac index, cerebral perfusion mariyu coronary perfusionnu meruguparustundi. rebova khachitamaina raktasraavam niyantrana avasaranni tolaginchanappatikii, idhi prarambha punarujjeevanam samayamlo taatkaalika charyaga upayogapadavachhu. rebova yokka prayojanaalu unnappatikee, gananeeyamaina sthaanika mariyu daihika ischemic pramaadaalu unnaayi. praamaanika rebova vidhaanaparamaina suuchanalanu erpaatu cheyadam mariyu ischemic gaayam pramaadaanni tagginchadam konasagutunna parisoedhanaku sambandhinchina amsaalu. eee saanketikata vayojana rogulalo vijayavantamgaa amalu cheyabadinappatiki, idhi inca pillalalo adhyayanam cheyabadaledu.
vaidya upayogaalu.
baadhaakaramaina gaayam.
mondem mariyu koodali praantaalaku ottidi cheyaleni baadhaakaramaina gaayam valla kalige teevramaina raktasraavam shock poura mariyu sainika gaayam baadhitulaloo maranaaniki pradhana kaaranamgaa undhi. oka anchuku gaayam valla kalige paridheeya raktasraavaaniki viruddhamgaa, mondem mariyu junctional praantaalaku baadhaakaramaina gayalu pratyaksha ottidi ledhaa tornicute applicationku savarinchabadavu. ottidi cheyaleni mondem raktasraavam bahya jokyalaku saricheyabadadu kabatti, eee gayalu raktasraavam chese maranaalalo sumaru 90 saatam varaku untaayi. teevramaina raktasraavam vascular embolisation ledhaa pottikadupu packing ledhaa anavasaramaina avayavaala tolagimpu vanti nashtam niyantrana shastrachikitsa paddhathulatho nirvahinchabadutundi. ayithe, hridayanaala pathanaaniki gurayye pramaadam unna teevramaina raktasraavam shock unna rogulalo, bruhaddhamani cross clampingtho atyavasara thoracotomy nirvahinchavacchu, ayithe phalitaalu saadhaaranamgaa paelavamgaa untaayi.
rebova vistarana.
bruhaddhamani cross-clampingtho atyavasara thoracotomici vaegamgaa moharinchadagina, athi takkuva invasive pratyamnaayamgaa rebova abhivruddhi cheyabadindi. eee prakriyaku oke suuchana pramaanam laenappatikee, idhi saadhaaranamgaa rakta utpatti punarujjeevanaaniki teevramaina raktasraavam vakreebhavanamtho moddubaarina ledhaa chochukupoye baadhaakaramaina gayalu unna rogulaku nirvahinchabadutundi. saadhaarana toda dhamani cherukovadam dwara mariyu mahadhamani lopala gaalitho nindina beloontho oka chinna endovascular kaathetarnu choppinchadam dwara rebova nirvahinchabadutundi. aagipoyina beloon dravyolbanam taruvaata, avarohana mahadhamani antataa rakta pravaham paakshikamgaa ledhaa puurtigaa addukuntundi, idhi taruvaata diguva raktasraavamnu addukuntundi. rebova parikaram yokka sardubaatu cheyagala catheter roopakalpana raktasraavam yokka anumaanita muulam aadhaaramgaa mahadhamani lopala aagipoye beloon yokka asthira sthaanaanni anumatistundi. avarohana thoracic mahaadhamaneelo john 1 sthaanam diaphragom krinda rakta pravahanni taggistundi mariyu udaram, pottikadupu mariyu diguva chivaralalo raktasraavam gananeeyamgaa taggistundi. pratyamnaayamgaa, pottikadupu mahadhamani loe infrarenal avarohanalo john 3 sthaanam pottikadupu lopala rakta sarafaraanu kaapaadutuu pottikadupu mariyu diguva chivaralalo raktasraavam taggistundi. rebova khachitamaina shastrachikitsa nirvahana avasaranni bharti cheyanappatiki, idhi mastishka mariyu myocardial perfusionnu kaapaadataaniki cardiac indexnu tatkalikamga penchadam dwara taatkaalika charyaga panichestundi. vijayavantamaina rebova vistarana taruvaata ventane, rogulanu atyavasara shastrachikitsa jokyam kosam pariganinchaali.
konasagutunna daryaaptu.
teevramaina raktasraavam shock chikitsalo rebova yokka bhadrata mariyu samarthatha anedi konasagutunna parisoedhanaloo oka rangam. prarambha adhyayanalu maranaaniki sambandhinchi viruddhamaina daetaanu nivedinchaayi mariyu bruhaddhamani cross clampingtho atyavasara thoracotometho polchinappudu rebova yokka spashtamaina prayojanaanni sthaapinchadamlo viphalamayyayi. ayithe, rebova parikaram yokka roopakalpana merugudalalu mariyu nirantaram abhivruddhi chendutunna roogi empika pramaanaalu taruvaata rebova phalitaalanu meruguparichayi. prastuta saahityam cardiopulmonary resussitation (cpr) avasaram laeni teevramaina raktasraavam shock unna rogulalo rebova vistarana yokka manugada prayojanaanni pradarsistundi. edemaina, hridayanaala pathanaaniki mundu moharinchinappudu rebova daani goppa saamarthyaanni pradarsinchinappatikii, iteevali dayta kooda (cpr) samayamlo moharinchinappudu vaagdaanam choopinchindi. bruhaddhamani cross clamping mariyu cardiac masaz thoo atyavasara thoracotometho polchinappudu, rebova parikaramtho closed cardiopulmonary compressions merugaina cardiac compression fraction mariyu end-tidalnu pradarsinchaayi. adanamgaa, konni kendraalu teevramaina raktasraavam shacku perige pramaadam unna hypotension unna rogulalo rebova vistarananu prothsahinchaayi, conny mahadhamani cross clampingtho atyavasara thoracotomici inca pramaanaalanu cherukoledu. rebova phalitaalalo vaividhyam anedi samsthaagata roogi empikalo vaividhyam mariyu konasagutunna moolyaankanam avasaranni highlight chese suuchikala pramaanaalanu pratibimbistumdi.
keelaka vidhaanaparamaina dasalu.
saadhaarana toda dhamani cherukovadam modata ultrasound guided, open ledhaa percutaneous tekniknu upayoginchi saadhinchabadutundi. aaa taruvaata, addupade beloon lavanheeyathatho penchabadataaniki mundu rebova parikaranni john 1 (avarohana thoracic mahadhamani) ledhaa john 3 (infrarenal abdominal mahadhamani) lopala unchutaaru. vijayavantamaina khachitamaina raktasraavam niyantrana taruvaata, aagipoyina beloon nemmadigaa tagginchabadutundi mariyu punaraavruta raktasraavam ledhaa jeevakriya lopam kosam roogi paryaveekshinchabadataadu. chivaraku, rebova sheet tolaginchabadutundi mariyu access sait samasyalu ledhaa sambhaavya ischemic samasyala kosam roogi paryaveekshinchabadataadu.
rebova vistarana yokka mukhya vidhaanaparamaina dasalu krindi pattikalo ivvabaddaayi
sambhaavya samasyalu.
rebova parikaram yokka athi takkuva hanikara swabhaavam unnappatikee, daani upayogamtho mudipadi unna gananeeyamaina pramaadaalu unnaayi. mahadhamani yokka nirodham cardiac mariyu coronary perfusionnu kaapaadataaniki cardiac indexnu tatkalikamga penchinappatikee, diguva ischemia yokka gananeeyamaina pramaadam undhi, idhi sthaanika ischemic maarpulu ledhaa daihika jeevakriya vaikalyaaniki daariteeyavachchu. avayava vichhedanam, jeevakriya aamlata mariyu teevramaina pratighatana gaayam vanti mukhyamaina samasyalu annee rebova vaadakamtho nivedinchabaddaayi mariyu konasagutunna parisoedhanaku sambandhinchinavi. vidyaasambandhamaina ledhaa shastrachikitsa sanghaalalo khachitamaina ekaabhipraayam laenappatikee, vaidyaparamgaa mukhyamaina ischemia pramaadaanni tagginchadaaniki aneka kendraalu sadhyamainappudalla 30 nimishala kante takkuva beloon moosiveta samayaalanu sifaarsu chestaayi. pratyamnaayamgaa, konni samsthalu diguva ischemia prabhavanni tagginchadaaniki pakshika bruhaddhamani avarodham ledhaa adapadadapa beloon apavitratanu sifaarsu chesaayi. adapadadapa beloon deflation nirvahinchadam saanketikamgaa takkuva kashtamgaa unnappatikee, mahadhamani yokka pakshika nirodham aniyantrita raktasraavam tagginchadaaniki, adhe samayamlo dhoora ischemianu parimitam cheyadaaniki mariyu surakshitamaina nirodha samayaalanu podiginchadaaniki niroopinchabadindi.
adanapu sambhaavya samasyalu krinda ivvabaddaayi

