Oluusi owulira ng’ossa obubi oba ng’owulira ng’ozitowa mu kifuba ng’okooye katono, oba ng’olinnya amadaala? Oboolyawo omusawo wo akubuulidde ku buzibu obuli mu vvaalu mu mutima gwo. Valiva y’omutima bw’etagguka bulungi n’ezibikira, tugiyita ‘stenosis’. Leero tugenda kwogera ku kulongoosa okw’enjawulo okukolebwa ng’obujjanjabi bw’embeera ng’eno. Okuva bwe kiri nti guno mulamwa mukulu nnyo, buli kimu tukitegeere mu ngeri ennyangu.
Mu ngeri ennyangu, ‘commissurotomy’ eno kye ki?
Okay, ka tusooke kino tukitegeere mu ngeri ennyangu. Omutima gwo gulina ebisenge bina ebikulu. Zilowoozeeko ng’ebisenge bina. Omusaayi okusobola okukulukuta okuva mu kisenge ekimu okudda mu kirala, enzigi eziri wakati waakyo zirina okugguka n’okuggalwa obulungi. Enzigi ezo ze tuyita valve z'omutima .
Commissurotomy nkola ekwata ku mitral valve mu mutima gwo. Kisangibwa wakati w’ebisenge ebibiri eby’omutima, omusuwa ogwa kkono n’omusuwa ogwa kkono. Luno lwe luggi wakati w’ebisenge byombi. Omulyango guno gulina ebiwaawaatiro bibiri.
Olw’embeera z’obujjanjabi ezimu naddala embeera eyitibwa ‘Mitral Valve Stenosis’ , enzigi zino ebbiri tezigguka bulungi. Kiringa oluggi olusibye. Kiki ekibaawo olwo? Okutambula kw’omusaayi okuva mu kisenge ekya waggulu okudda mu kisenge ekya wansi kukendeera. Kino kireetera omusaayi okudda emabega, ne kiteeka akazito kinene ku mutima n’amawuggwe. Ekiseera bwe kigenda kiyitawo, kino kiyinza okuvaako embeera ez’amaanyi ng’omutima okulemererwa .
‘Commissurotomy’ nkola ya kulongoosa erimu okusala akatundu akatono n’okwawula ebitundu (commissures) awali ebipapula bya vvaalu ezibiddwa, ne kisobozesa vvaalu okuddamu okugguka obulungi. Kino kisobozesa omusaayi okuddamu okuyita mu mutima mu ngeri ennyangu.
Ddala ani eyeetaaga okulongoosebwa kuno?
Okulongoosa kuno si kwa buli muntu. Waliwo ensonga enkulu eziwerako lwaki omusawo ayinza okukuwa amagezi okulongoosebwa kuno:
- Singa obujjanjabi obulala (nga eddagala) b’obadde oweereddwa tebufunye buwanguzi.
- Bw’oba tosaanira nkola eyitibwa ‘Balloon Valvuloplasty’, erimu okugaziya vvaalu n’akapiira.
- Bw’oba olongooseddwa omutima omulala, osobola okulongoosebwa kuno mu kiseera kye kimu.
Naye ekisinga obukulu nti obuwanguzi bw’okulongoosa kuno businziira ku kivaako okusannyalala kwo okwa mitral valve. Ka tulabe ebikulu ebibiri ebivaako embeera eno.
| Kiki ekivaako okugwa kwa mitral valve? | Ennyonyola n’okusaanira okulongoosa ‘commissarotomy’ |
|---|---|
| Obulwadde bw’omutima obw’enkizi | Okwonooneka kw’obusuwa bw’omutima olw’omusujja gw’enkizi mu buto. Okwonoonebwa kuno kubaawo oluvannyuma lw’emyaka. Wano ebipapula bya vvaalu we bifuuka ebiyungibwa wamu (fused commissures). Okulongoosa kwa ‘commissarotomy’ kusinga kukola bulungi mu mbeera eno. |
| Obulwadde bwa Mitral Stenosis obuvunda (Okukaddiwa) . | Abantu bwe bakaddiwa, ebitundu bya vvaalu byonooneka. Mu mbeera eno, ebitundu ebirala ebya vvaalu byonoonebwa okusinga ebipapula bya vvaalu okunywerera wamu. N’olwekyo, okulongoosa mu commissurotomy ebiseera ebisinga tekusaanira bantu bano. Beetaaga okuddaabiriza vvaalu endala oba okukyusa vvaalu mu bujjuvu (Mitral Valve Replacement) . |
Kitegeeza ki nga ebibikka ku vvaalu binyweredde?
Kino kyangu nnyo okutegeera. Kuba akafaananyi ng’omwenya mu maaso g’endabirwamu ng’ozibye emimwa. Tunuulira enkoona z’emimwa gyo egya waggulu n’egya wansi. Awo we wasisinkanira ebiwujjo ebibiri ebya mitral valve (commissures). Kati teebereza ng’omuntu akutte enkoona z’emimwa gyo n’engalo bbiri. Osobola okuggulawo akamwa ko obulungi? Nedda, tosobola? Ekyo kye kibaawo nga mitral valve ezibiddwa. ‘Commissurotomy’ nkola ya kulongoosa esumulula enkoona ezo ebbiri.
Oteekateeka otya nga tonnalongoosebwa?
Okuva bwe kiri nti kulongoosa kuno kunene, okwetegeka kutandika nga bukyali wiiki ntono. Ttiimu yo ey’abasawo (omusawo w’omutima, omusawo w’omutima) ejja kukukebera mu bujjuvu.
- Okukeberebwa omubiri mu bujjuvu
- Okukebera omusaayi
- Okwogera mu buwanvu ku bubonero bwo n’ebyafaayo by’obujjanjabi
Era ojja kukeberebwa okulaba oba waliwo ebizibikira mu mitral valve yo n’emisuwa emirala mu mutima gwo, gamba nga:
- Echocardiography - Eno ye sikaani y’omutima.
- Okukebera CT
- Okukebera emisuwa gy’omusaayi (Coronary Angiography).
Bw’oba olina ekibuuzo kyonna oba ekikweraliikiriza ku kulongoosebwa, byogere byonna n’omusawo era oteeke ebirowoozo byo.Bw’oba onywa sigala, kyetaagisa okumulekera ddala nga tonnalongoosebwa. Kino kiyinza okukendeeza ennyo ku bulabe obuli mu kulongoosebwa.
Okulongoosa kukolebwa kutya?
Kino kwe kulongoosa omutima oguggule. Wano waliwo ensengeka y’ebintu ebibaawo mu kisenge omulongoosebwa:
1. Ojja kuweebwa eddagala eribudamya okukusuza ddala.
2. Okutema kukolebwa wansi wakati mu ggumba ly’ekifuba (sternum).
3. Ojja kuyungibwa ku kyuma ekiyita ku mutima n'amawuggwe . Kino kikolebwa okuwa omubiri gwo omusaayi ne oxygen gwe gwetaaga ate ng’omutima gwo guyimiridde ng’olongoosebwa.
4. Omusawo alongoosa aggulawo ekitundu kya kkono eky’omutima n’akebera ekitundu ekiyitibwa mitral valve.
5. Ebitundu ebitonotono bikolebwa mu commissures za valve okubisumulula.
6. Olwo ojja kuggyibwa ku kyuma ky’omutima-amawuggwe era omutima gwo gujja kuddamu okutandika.
7. Mu kusembayo, bakola transesophageal echocardiogram okukakasa nti valve ekola bulungi.
Kiki ekibaawo oluvannyuma lw’okulongoosebwa?
Oluvannyuma lw’okulongoosebwa, ojja kwetaaga okumala wiiki nga emu mu ddwaaliro. Olunaku olusooka oba bbiri, ojja kukuumibwa mu kifo awajjanjabirwa abalwadde abayi (ICU) era ojja kulondoolwa nnyo.
Nga tonnava mu ddwaaliro, omusawo ajja kukubuulirira ku bino wammanga:
- Cardiac Rehab: Kino kiyamba nnyo mu kuddamu amaanyi n’okumanyiira obulamu obwa bulijjo oluvannyuma lw’okulongoosebwa.
- Engeri y’okulabirira ekifo ekisaliddwa: Kino kikulu nnyo okuziyiza obuwuka n’okuwona amangu ekiwundu.
- Ebikwata ku ddi lw'osobola okutandika okuvuga n'okuddamu okukola .
Ebivaamu, obulabe, ne ddi lw’olina okulaba omusawo
Open mitral commissurotomy erina obuwanguzi bungi nnyo. Alongoosa entambula y’omusaayi n’okukendeeza nnyo ku bubonero. Kyokka, si kya kugonjoola nsonga ya lubeerera. Abantu bangi abakola enkola eno bayinza okwetaaga okulongoosebwa okukyusa vvaalu mu kiseera ekimu mu biseera eby’omu maaso.
Nga bwe kiri ku buli kulongoosa, waliwo akabi akayinza okuvaamu.
- Okukulukuta kw’amazzi mu Mitral
- Okuvaamu omusaayi omungi
- Yinfekisoni
- Omutima obutakuba bulungi (Arrhythmia) .
- Storoko
Kyokka, akabi kano kakendeera mu ddwaaliro eddene eririmu abasawo abalina obumanyirivu mu kulongoosa. Bw’oba olina embeera z’obujjanjabi nga ssukaali, endwadde z’ekibumba oba omugejjo, akabi kayinza okuba akasingako katono. Yogerako n’omusawo wo ku nsonga eno.
Bw’ofuna obubonero buno, tegeeza omusawo mu bwangu:
- Omusujja
- Okumyuuka, okuzimba oba okusiiyibwa okumpi n’ekifo we batemye
- Obulumi mu kifuba oba okunyigirizibwa enfunda eziwera
Bw’ofuna obubonero bw’okulwala omutima okw’amangu (okulumwa ennyo mu kifuba, okukaluubirirwa okussa) oba obubonero bw’okusannyalala (okwogera obubi, okugwa ku ludda olumu olwa ffeesi), kuba ku ssimu ya 1990 amangu ddala ogende mu ddwaaliro ekikola ku bujjanjabi obw’amangu (ETU).
Obubaka Obutwala Awaka
- ‘Commissarotomy’ kwe kulongoosa omutima oguggule okukolebwa okuzzaawo emirimu emituufu ku mitral valve ezibiddwa.
- Ekisinga okuvaako embeera eno kwe kwonooneka kw’obusuwa bw’omutima olw’omusujja gw’enkizi mu buto.
- Wadde nga kuno kulongoosa kukola bulungi nnyo, emirundi mingi kuba kugonjoola kwa kaseera buseera era vvaalu eyinza okwetaaga okukyusibwa mu biseera eby’omu maaso.
- Enteekateeka z’okuddaabiriza omutima nkulu nnyo okusobola okuwona mu bujjuvu oluvannyuma lw’okulongoosebwa.
- Kikulu nnyo okubuuza omusawo wo ebibuuzo byonna by’oyinza okuba nabyo ku mbeera yo, okulongoosebwa n’akabi akayinza okuvaamu.
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