Kodi dokotala wanu wanena kuti mtsempha waukulu wamagazi womwe umanyamula magazi opangidwa ndi mpweya kuchokera mumtima mwanu m'thupi lanu wafooka ndipo wapanga chipolopolo chonga baluni pansi pake? Kapena mwina akunena kuti mungafunike opaleshoni pa izi? Ndizachibadwa kukhala ndi nkhawa mukamva izi, koma chonde dziwani kuti iyi ndi njira yofunika kwambiri yopulumutsira moyo wanu. Lero, tikambirana za momwe Aortic Root Replacement ilili, momwe imachitikira, ndi zina zonse zomwe muyenera kudziwa za njirayi ku Nirogi Lanka.
Mwachidule, kodi njira yosinthira mizu ya Aortic ndi chiyani?
Mtsempha wamagazi (aorta) ndi mtsempha waukulu komanso wofunikira kwambiri m'thupi lanu, wolumikizidwa mwachindunji ndi mtima wanu. Gawo loyamba lomwe mtsempha wamagazi umalumikizana ndi mtima wanu limadziwika kuti "Muzu wa Mtsempha wamagazi." Nthawi zina, khoma la gawoli limafooka ndikuyamba kuphulika ngati buluni. Ichi ndi chomwe timachitcha "Aneurysm."
Chiwopsezo chachikulu chokhala ndi aneurysm ndichakuti imatha kung'ambika (kuduladula) kapena kuphulika (kuphulika) nthawi iliyonse. Ngati izi zitachitika, zitha kuyambitsa kutuluka magazi mkati mwa thupi, komwe ndi vuto lalikulu lomwe lingawononge moyo.
Pa nthawi yosintha mizu ya mtsempha wamagazi, dokotala wanu amachotsa gawo lofooka la mtsempha wamagazi ndikuliyika m'malo mwake ndi cholumikizira chopangidwa. Njirayi imateteza bwino mavuto oopsa awa ndipo imathandiza kuteteza moyo wanu.
Kodi mitundu ikuluikulu ya opaleshoni iyi ndi iti?
Pali njira ziwiri zazikulu zochitira opaleshoniyi. Kutengera ndi matenda anu, dokotala wanu adzasankha njira yoyenera kwambiri yochiritsira.
| Mtundu wa Opaleshoni | Kufotokozera |
|---|---|
| Njira Yosinthira Mizu ya Aortic (ARR) / Bentall | Mu njira imeneyi, muzu wowonongeka wa mtsempha wanu wamagazi umasinthidwa pamodzi ndi valavu ya mtsempha pogwiritsa ntchito chogwirira chopangidwa ndi valavu yatsopano. Iyi ndi njira yabwino kwambiri ngati valavu yanu ya mtsempha wamagazi ikutuluka kapena ikusungunuka kwambiri. Ngati valavu yamakina ikugwiritsidwa ntchito, muyenera kumwa mankhwala oletsa magazi kuundana moyo wanu wonse kuti mupewe kuundana kwa magazi. |
| Kubwezeretsa Mizu Yosawononga Ma Vavu (VSRR) | Monga momwe dzinalo likusonyezera, njirayi imalowa m'malo mwa gawo lofooka la mtsempha wamagazi pomwe imasunga valavu yanu ya aortic yathanzi. Izi ndi zabwino kwa odwala achichepere kapena omwe ali ndi matenda olumikizana ndi minofu (monga Marfan syndrome) omwe ali ndi valavu yathanzi. Phindu lalikulu ndilakuti nthawi zambiri simufunikira mankhwala ochepetsa magazi omwe amasunga magazi kwa moyo wanu wonse. Pali njira ziwiri zazikulu: njira ya Yacoub ndi njira ya David. |
Mitundu ya VSRR
VSRR imachitika pogwiritsa ntchito njira imodzi mwa ziwiri zazikulu: njira ya Yacoub ndi David.
- Njira ya Yacoub: Izi zimaphatikizapo kukonzanso muzu wa aortic kuti ugwirizane ndi valavu yoyambirira. Nthawi zambiri imakhala yoyenera odwala okalamba kapena omwe aneurysm yawo siimachitika chifukwa cha majini.
- Njira ya David: Izi zimaphatikizapo kuyikanso valavu mkati mwa chogwirira chopangidwa. Ngakhale kuti ndi chovuta kwambiri, chimagwiritsidwa ntchito kwambiri ndipo chimalimbikitsidwa kwambiri kwa odwala achichepere omwe ali ndi matenda a majini monga Marfan syndrome.
Ndani Akufunika Opaleshoni Iyi Ndipo Liti?
Ngati muzu wa mtsempha wanu wakula, mukukumana ndi chiopsezo chophulika kapena kusweka kwa mtsempha, zomwe zimapangitsa kuti opaleshoni ikhale yofunika. Ngakhale izi zitha kuchitika chifukwa cha kukalamba, matenda a majini monga Marfan syndrome kapena Loeys-Dietz syndrome angayambitse aneurysms yoopsayi kukula msanga m'moyo.
Zisankho zokhudzana ndi opaleshoni zimadalira kukula kwa aneurysm ndi mbiri yanu yeniyeni ya chiopsezo:
- Ngati mulibe zoopsa za majini, opaleshoni nthawi zambiri imalimbikitsidwa pamene kukula kwake kufika pa 5.5 cm .
- Ngati muli ndi Marfan syndrome, nthawi zambiri mulingo wake umakhala 5.0 cm .
- Ngati muli ndi matenda a Marfan pamodzi ndi mbiri ya banja lanu ya aorta dissection, mapulani a mimba, kapena kukula mofulumira (kupitirira 3mm pachaka), opaleshoni ikhoza kulangizidwa pa 4.5 cm .
- Ngati muli ndi valavu ya bicuspid aortic ndi zinthu zina zoopsa monga kuthamanga kwa magazi kosalamulirika, nthawi zambiri kulowererapo kumaganiziridwa pa 5.0 cm .
Chofunika kwambiri, zisankhozi ndi zaumwini kwambiri. Dokotala wanu wa ku Nirogi Lanka adzasankha nthawi yoyenera yochitira opaleshoni yanu kutengera zaka zanu, thanzi lanu lonse, komanso mbiri yanu yachipatala.
Momwe Mungakonzekerere Opaleshoni Yanu
Popeza iyi ndi njira yofunika kwambiri, kukonzekera bwino n'kofunika kwambiri. Gulu lanu lachipatala lidzachita kafukufuku wathunthu:
- Kuyezetsa magazi: Kuyesa momwe impso zanu zimagwirira ntchito komanso momwe thupi lanu limagwirira ntchito.
- CT kapena Cardiac MRI: Kuti mupeze mapu atsatanetsatane a mtsempha wanu wonse.
- Coronary angiography: Kuonetsetsa kuti mitsempha ya mtima wanu ili bwino.
- Duplex ultrasound: Kuyang'ana thanzi la mitsempha yanu ya carotid m'khosi.
Muyenera kukambirana moona mtima ndi dokotala wanu za:
- Mankhwala onse: Izi zikuphatikizapo mavitamini, zowonjezera zitsamba, ndi mankhwala ogulitsidwa kunja kwa chipatala, ena mwa iwo angafunike kuyimitsidwa musanachite opaleshoni.
- Matenda omwe alipo: Matenda monga kuthamanga kwa magazi ayenera kuyang'aniridwa mosamala musanachite opaleshoni.
- Kusuta: Muyenera kusiya kusuta fodya osachepera mwezi umodzi musanachite opaleshoni. Chonde funsani gulu lanu la ku Nirogi Lanka ngati mukufuna thandizo kuti musiye kusuta.
Panthawi ndi Pambuyo pa Ndondomekoyi
Pa opaleshoni, mudzayikidwa pansi pa mankhwala oletsa ululu. Mudzalumikizidwa ndi makina oletsa kupweteka a mtima ndi mapapo , omwe amatenga ntchito ya mtima ndi mapapo anu kwakanthawi, zomwe zimathandiza dokotalayo kugwira ntchito pa mtima wokhazikika komanso wokhazikika.
Dokotala adzakudulani pachifuwa, kuchotsa gawo lofooka la mtsempha wamagazi, ndikuyikamo chogwirira chopangidwa. Kenako mitsempha ya mtima imalumikizidwanso ku chogwirira chisanatseke chogwiriracho. Nthawi zambiri njirayi imatenga maola 4 mpaka 6 .
Pambuyo pa opaleshoni, mudzakhala nthawi mu Intensive Care Unit (ICU) musanasamukire ku chipinda chochiritsira. Nthawi zambiri mumakhala kuchipatala kwa sabata imodzi, pomwe mudzayang'aniridwa mosamala ndikupatsidwa mankhwala ochepetsa ululu komanso mankhwala ofunikira.
Kodi Nthawi Yobwezeretsa Ndi Chiyani?
Kuchira kwathunthu pambuyo pa opaleshoni yayikuluyi nthawi zambiri kumatenga milungu 6 mpaka 12 , ndipo nthawi zina, miyezi ingapo. Thupi lanu limafunikira nthawi yochuluka komanso kuleza mtima kuti lichiritse bwino pambuyo pa opaleshoni yovuta ngati imeneyi.
- Kwa milungu 6 yoyambirira: Pewani kuyendetsa galimoto, kunyamula zinthu zolemera, kapena kuchita zinthu zolemetsa.
- Pa ntchito za pa desiki: Mutha kubwerera kuntchito pakatha milungu pafupifupi 6-8.
- Pa ntchito zovuta: Muyenera kudikira nthawi yayitali, monga momwe gulu lanu lazaumoyo limalangizira.
Kutsatira malangizo a dokotala wanu molondola komanso kutenga nawo mbali mu mapulogalamu obwezeretsa mtima kudzakuthandizani kwambiri kuti muchiritse mwachangu komanso mosavuta.
Nthawi Yoyenera Kupeza Chithandizo Chachipatala Mwamsanga
Mukabwerera kunyumba, ngati muwona zizindikiro zotsatirazi, funsani dokotala wanu nthawi yomweyo.
| Zizindikiro Zoyenera Kuzisamala | |
|---|---|
| Nkhawa Zokhudza Kuduladula kwa Opaleshoni: | |
| |
| Nkhawa Zina: | |
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Momwe Mungadziwire Zadzidzidzi
Ngati muli ndi aneurysm yomwe sinachiritsidwe, zizindikiro zotsatirazi zingasonyeze kuti ikuphulika kapena ikung'ambika. Ngati zili choncho, funani chithandizo chadzidzidzi mwachangu mwa kupita ku dipatimenti yadzidzidzi yapafupi kapena kuyimbira 911 (kapena ogwira ntchito zadzidzidzi apafupi).
- Kupweteka kwadzidzidzi komanso kosapiririka pachifuwa kapena kumbuyo kwa msana (nthawi zambiri kumatchedwa kung'ambika kapena kung'ambika).
- Thukuta lochuluka komanso khungu lozizira komanso lofewa.
- Kuvuta kupuma.
- Chizungulire kapena kukomoka.
- Kugunda kwa mtima mofulumira kapena kosasinthasintha.
Zinthu Zofunika Kwambiri (Nirogi Lanka)
- Kubwezeretsa Mizu ya Aortic ndi opaleshoni yopulumutsa moyo yomwe imachitidwa pa gawo loyambirira la aorta lofooka.
- Pali mitundu iwiri yoyambirira ya opaleshoni iyi: imodzi yomwe imalowa m'malo mwa valavu ya aortic (ARR) ndi ina yomwe imaisunga (VSRR). Dokotala wanu adzasankha njira yabwino kwambiri kwa inu.
- Ngakhale kuti kuchira kwathunthu kumatenga miyezi ingapo, chiwopsezo cha kupambana ndi kupulumuka kwa njirayi ndi chachikulu kwambiri (pafupifupi 98%-99%).
- Kutsatira malangizo a dokotala asanachite opaleshoni ndi pambuyo pake ndikofunikira kuti munthu achire bwino.
- Musazengereze kukambirana ndi dokotala wanu mafunso kapena nkhawa zilizonse. Ngakhale kuti njira imeneyi ndi yachizolowezi kwa akatswiri azachipatala, ndi yofunikira kwa inu, ndipo ndi zachilendo kukhala ndi nkhawa.
Kubwezeretsa Mizu ya Aortic, Aorta, Opaleshoni ya Mtima, Aneurysm, Njira ya Bentall, Marfan syndrome, Aortic valve, Matenda a Mtima, Opaleshoni ya Mtima
