Ndizachilendo kumva mantha pang'ono dokotala wanu akakuuzani kuti muli ndi vuto la valavu ya mtima. Makamaka akanena kuti muyenera kuchitidwa opaleshoni. Koma njira ya Ross yomwe tikambirane lero ndi njira yopambana kwambiri yochitira opaleshoni yomwe ingapereke moyo watsopano kwa anthu omwe ali ndi matenda a valavu ya mtima, makamaka achinyamata. Tiyeni tikambirane za izi mwachidule.
Mwachidule, kodi njira ya Ross ndi chiyani?
Uwu ndi opaleshoni ya mtima yovuta pang'ono, koma yaluso kwambiri. Imafuna kugwiritsa ntchito ziwalo za thupi lanu kukonza valavu ya mtima yodwala. Kunena zoona, imafuna njira ziwiri:
1. Valavu ya aorta yomwe ili ndi matenda a mtima wanu imachotsedwa ndikusinthidwa ndi valavu yanu ya m'mapapo yathanzi.
2. Kenako, valavu ya m'mapapo yochokera kwa wopereka wathanzi imayikidwa pamalo pomwe valavu ya m'mapapo yochotsedwayo inali.
Taganizirani ngati kugwiritsa ntchito gawo la thupi lanu kukonza vuto lalikulu. Izi zili ndi ubwino wambiri kuposa kuyika valavu yopangira.
N’chifukwa chiyani tikufunika opaleshoni imeneyi?
Valavu ya mtsempha wamagazi ili ngati chipata chofunikira kwambiri mumtima mwathu. Chipata ichi chimatseguka ndipo chimalola magazi oyera komanso odzaza ndi mpweya kuti ayende kuchokera mumtima kupita ku thupi lonse. Chimaletsanso magazi kuti asabwerere mumtima pakati pa kugunda kwa mtima, pamene valavu iyi ikutseka.
Koma nthawi zina valavu iyi imatha kukhala ndi matenda. Pali njira ziwiri zazikulu:
- Stenosis: Izi zimachitika pamene valavu siitseguka bwino ndipo imachepa. Izi zimalepheretsa thupi kupeza magazi okwanira.
- Kubwerera m'mimba: Apa ndi pamene valavu siitseka bwino ndipo imatuluka madzi, zomwe zimapangitsa kuti magazi abwerere mumtima.
Mavuto onsewa angayambitse zizindikiro monga kutopa ndi kupuma movutikira. Ngati sathandizidwa, akhoza kuwonjezera chiopsezo cha kulephera kwa mtima komanso matenda oopsa. Njira ya Ross imachotsa valavu yodwala ndikubwezeretsa ntchito ya mtima yabwinobwino.
Bwanji kusankha Pulmonary Valve m'malo mwa Aortic Valve?
Mwina mukudabwa chifukwa chake kusinthaku kukupangidwa, bwanji osangotenga valavu ina yopangira? Pali zifukwa zingapo zenizeni zomwe zimapangitsa izi.
- Kukana Kupanikizika: Valavu ya aorta imakhala ndi kupanikizika kwakukulu, kotero valavu yatsopano yomwe yayikidwamo iyenera kukhala yolimba komanso yolimba. Valavu yanu ya m'mapapo ndi yoyenera izi.
- Zoopsa za ma valve opangidwa: Pali chiopsezo cha magazi kuundana akaikidwa ma valve opangidwa. Chifukwa chake, muyenera kumwa mankhwala ochepetsa magazi moyo wanu wonse. Koma mukagwiritsa ntchito minofu yanu, chiopsezo chimenecho sichipezeka.
- Kuyika: Valavu ya m'mapapo ndi yofanana kwambiri ndi ya valavu ya aorta.
- Malo otsika mphamvu: Valavu yopereka mpweya imayikidwa pomwe valavu ya m'mapapo inali kale. Malo amenewo amakhala otsika mphamvu. Choncho ngakhale valavuyo ili yofooka pang'ono, sidzakhudza kwambiri.
Ndani woyenera komanso wosayenera opaleshoniyi?
Njira ya Ross si opaleshoni ya aliyense. Madokotala amasankha odwala chifukwa cha opaleshoniyi potengera zinthu zingapo.
| Omwe nthawi zambiri amakhala oyenera opaleshoni | Anthu omwe nthawi zambiri sali oyenerera opaleshoni |
|---|---|
| Anthu osakwana zaka 60. | Anthu omwe ali ndi matenda a autoimmune monga lupus ndi rheumatoid arthritis. |
| Anthu omwe ali ndi vuto la congenital aortic stenosis. | Anthu omwe ali ndi matenda olumikizana minofu monga Marfan syndrome . |
| Anthu omwe ali ndi matenda ena a aortic valve. | Anthu omwe ali ndi matenda a mitsempha ya mtima, omwe amatsekeka m'mitsempha yamagazi yoposa itatu mumtima. |
| Anthu omwe ali ndi matenda a aortic valve (aortic valve endocarditis). | Anthu omwe ali ndi matenda a pulmonary valve. |
Chofunika kwambiri ndichakuti dokotala wanu wa mtima apange chisankho chomaliza ngati opaleshoniyi ndi yoyenera kwa inu kapena ayi.
Momwe opaleshoni imachitikira sitepe ndi sitepe
Iyi ndi opaleshoni yokonzedwa bwino kwambiri yomwe imatenga maola angapo.
1. Mankhwala oletsa ululu:Choyamba, mudzapatsidwa mankhwala oletsa ululu. Choncho simudzamva chilichonse ndipo simudzakumbukira chilichonse cha opaleshoniyo.
2. Makina a mtima ndi mapapo: Kenako, mudzalumikizidwa ndi makina odulira mtima ndi mapapo . Makinawa amatenga ntchito ya mtima ndi mapapo anu kwakanthawi panthawi ya opaleshoni. Izi zimathandiza madokotala ochita opaleshoni kuchita opaleshoniyo mosatekeseka popanda kuletsa mtima wanu.
3. Kutsegula chifuwa: Madokotala opanga opaleshoni amadula pakati pa chifuwa, kudula fupa la m'mawere mbali zonse ziwiri (sternotomy) kuti afike pamtima.
4. Kuyesa ma valavu: Vavu ya m'mapapo imafufuzidwa mosamala kuti ione ngati ili ndi thanzi lokwanira lolowa m'malo mwa valavu ya m'mimba.
5. Kubwezeretsa ma valavu: Kenako, valavu ya aorta yowonongeka imachotsedwa ndipo valavu yanu ya m'mapapo imayikidwa mosamala pamalo pake.
6. Kuika valavu yopereka chithandizo: Kenako, valavu yotengedwa kuchokera kwa wopereka chithandizo wathanzi imayikidwa pamalo opanda kanthu pomwe valavu yopereka chithandizo cha m'mapapo inali.
7. Kubwezeretsa mtima: Pambuyo poti ma valve onse awiri aikidwa m'malo oyenera, mtima wanu umayambiranso kugwira ntchito ndipo pang'onopang'ono mumachotsedwa mu makina a mtima ndi mapapo. Ma valve onse awiri atsopano amawunikidwanso kuti atsimikizire kuti akugwira ntchito bwino.
8. Kumaliza opaleshoni: Pomaliza, sternum imalumikizidwanso ndi kumangidwa ndi mawaya, kudulako kumakulungidwa, ndikukutidwa ndi bandeji yoyera.
Ubwino ndi zoopsa zomwe zingachitike chifukwa cha opaleshoniyi
Monga opaleshoni ina iliyonse, njira ya Ross Procedure ili ndi ubwino ndi zoopsa zake. Zoopsa zake zitha kuchepetsedwa polandira chithandizo motsogozedwa ndi dokotala wodziwa bwino ntchito yake yemwe amachita izi nthawi zonse.
| Ubwino Waukulu | Zoopsa zomwe zingachitike |
|---|---|
| Mungathe kukhala ndi moyo wokangalika, kuphatikizapo kuchita masewera olimbitsa thupi komanso kuyendetsa galimoto. | Kutambasuka kwa mtsempha wamagazi pafupi ndi valavu yatsopano (Aortic autograft dilation). |
| Ngati akazi akufuna kutenga mimba, angathe kutero mosamala. | Kusakhazikika kwa kugunda kwa mtima (arrhythmia) . |
| Kuyenda bwino kwa magazi (hemodynamics) kumachitika m'thupi lonse. | Matenda amtima . |
| Simukuyenera kumwa mankhwala ochepetsa magazi kwa moyo wanu wonse. | Kutuluka magazi kwambiri (Kutuluka magazi) . |
| Zizindikiro zimachepa msanga. Wodwalayo amamva bwino atangomaliza opaleshoni. | Matenda . |
| Valavu yotuluka kapena yotsekeka. |
Nthawi yochira pambuyo pa opaleshoni ndi nthawi yoti muwone dokotala
Mukachita opaleshoni, mudzachira mu ICU ya mtima . Poyamba, mutha kulumikizidwa ndi chopumira kuti chikuthandizeni kupuma. Mudzakhala mu ICU kwa masiku pafupifupi asanu.
Zingatenge miyezi ingapo kuti munthu achire bwino akabwerera kunyumba. Panthawi imeneyi, kudzimbidwa, kusowa chilakolako cha chakudya, kusowa tulo, dzanzi ndi kutupa mozungulira malo odulidwawo ndi zofala.
Chofunika: Valavu ya m'mapapo yotengedwa kuchokera kwa wopereka siikhalitsa kwamuyaya. Nthawi zambiri imafunika kusinthidwa patatha zaka 15-20. Chifukwa chake, kuyezetsa ndi kuyang'anira matenda kwa moyo wonse ndikofunikira kwambiri.
Ngati mukukumana ndi zizindikiro zilizonse za mavuto mutachita opaleshoni, muyenera kudziwitsa dokotala wanu nthawi yomweyo . Dziwani bwino zizindikiro zotsatirazi:
- Kupweteka pachifuwa
- Malungo kapena kuzizira
- Chizungulire kapena kukomoka
- Kutsokomola magazi
- Kutupa kapena kutuluka magazi kosazolowereka
- Kusanza m'miyendo
- Kusanza
- Magazi mu ndowe (ofiira kwambiri)
Uthenga Wopita Nawo Kunyumba
- Njira ya Ross ndiyo njira yabwino kwambiri yothandizira anthu omwe ali ndi matenda aakulu a aortic valve, makamaka achinyamata.
- Izi zikuphatikizapo kutenga valavu yanu ya m'mapapo yathanzi ndikuiyika m'malo mwa valavu ya aortic yomwe yadwala.
- Popeza mumagwiritsa ntchito minofu yanu, simudzafunika kumwa mankhwala ochepetsa magazi kwa moyo wanu wonse. Muthanso kukhala ndi moyo wokangalika.
- Monga momwe zimakhalira ndi opaleshoni iliyonse, pali zoopsa zomwe zingachitike, koma zoopsazi zitha kuchepetsedwa polandira chithandizo motsogozedwa ndi dokotala wodziwa bwino ntchito yake.
- Ngati mukumva zizindikiro zachilendo mutachita opaleshoni, funsani dokotala nthawi yomweyo.











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