Tiyeni tiphunzire za opaleshoni ya valavu ya mtima (Surgical Mitral Commissurotomy) mwachidule.

Ganizirani mtima wanu ngati pampu yamadzi yomwe imagwira ntchito mosalekeza. Mkati mwa pampu iyi, muli ziwalo zinayi zazing'ono ngati chitseko zomwe zimathandiza kuyenda kwa magazi mbali imodzi yokha. M'mawu azachipatala, timatcha ma valve amtima awa. Ngati zitseko izi sizikutsegulidwa ndi kutsekedwa bwino, ndi vuto lalikulu, sichoncho? Mofananamo, lero tikulankhula za opaleshoni yapadera yomwe imachitika pamene valavu ya mitral, imodzi mwa ma valve ofunikira kwambiri mumtima mwathu, siikutsegulidwa bwino ndipo imakhala yopapatiza.

Kodi commissurotomy ndi chiyani?

Mwachidule, commissurotomy ndi opaleshoni yomwe imalola magazi kuyenda kudzera mu valavu ya mtima wanu. Kawirikawiri imachitidwa pa valavu ya mitral . Vavu ya mitral ili pakati pa chipinda chakumtunda chakumanzere (atrium yakumanzere) ndi chipinda chakumunsi chakumanzere (ventricle yakumanzere).

Tangoganizani kuti chitsekochi sichikutsegulidwa bwino ndipo chatsekedwa ndi kupapatiza. Tikuchitcha kuti mitral valve stenosis. Chomwe chimachitika ndichakuti njira yoti magazi atuluke kuchokera ku chipinda chapamwamba kupita ku chipinda chapansi yatsekedwa. Izi zimapangitsa kuti magazi abwerere m'mbuyo ndikuyika mphamvu zambiri pamtima ndi mapapo. Pakapita nthawi, izi zitha kubweretsa matenda akulu monga kulephera kwa mtima.

Opaleshoni ya commissurotomy iyi imagwiritsidwa ntchito ngati chithandizo cha magawo oyambirira a mitral valve stenosis. Koma kunena zoona, masiku ano siichitika kawirikawiri. Chifukwa nthawi zambiri imachitika ngati opaleshoni yotsegula mtima . Ili ndi zoopsa zina. Chifukwa chake, nthawi iliyonse ikatheka, madokotala amayesa kugwiritsa ntchito njira zosavuta komanso zosaopsa. Chimodzi mwa njira zazikulu zomwe zilipo pano ndi balloon valvuloplasty . Mu izi, chubu chopyapyala chimayikidwa ndipo china chake chonga balloon chimadzazidwa mkati mwa valavu yopapatiza, ndikuchikulitsa.

Komabe, kwa anthu ena, njira ya baluni siingachitike chifukwa cha malo a mtima wawo kapena zifukwa zina. Pazochitika zotere, opaleshoni ya commissurotomy ndiyo njira yabwino kwambiri.

Ndani kwenikweni amene akufunikira opaleshoni iyi?

Ngati muli ndi mitral stenosis ndipo pali chilichonse mwa izi, dokotala wanu angakulangizeni opaleshoni iyi:

• Ngati simunachiritsidwe ndi mankhwala ena.
• Ngati simungathe kuchitidwa opaleshoni ya baluni.

Kuphatikiza apo, ngati mudachitidwapo opaleshoni ina ya mtima, opaleshoniyi ikhoza kuchitidwa nthawi yomweyo.

Koma chinthu chimodzi chofunika kukumbukira ndi chakuti si aliyense amene ali ndi mitral valve stenosis amene angapatsidwe opaleshoniyi. Zimatengera chifukwa cha stenosis ya valve yanu.

Pali zifukwa ziwiri zazikulu:

1. Kuwonongeka komwe kumachitika chifukwa cha Matenda a Mtima Okhudzana ndi Nyamakazi:Matenda a nyamakazi, omwe amatsatira matenda a pakhosi ali mwana, amatha kuwononga ma valve a mtima patatha zaka zambiri.

2. Degenerative Mitral Stenosis: Pakapita nthawi, valavu imafooka pang'onopang'ono, imachepa, ndipo imakutidwa ndi calcium deposits.

Opaleshoni ya commissurotomy ndi yothandiza kwambiri kwa anthu omwe ali ndi matenda a mtima a nyamakazi . Pa vutoli, makona awiri a valavu komwe timapepala tiwiri timakumana, otchedwa commissures , amakhuthala ndipo nthawi zina amamatirana.

Mu opaleshoni ya commissurotomy, mabala ang'onoang'ono amapangidwa pamakona awiri a valavu ndipo amatulutsidwa. Kenako valavu imayamba kutseguka bwino. Komabe, mwa anthu omwe mavalavu atha chifukwa cha ukalamba, mavalavu nthawi zambiri sawonongeka. M'malo mwake, mbali zina za valavu ziyenera kukonzedwa. Chifukwa chake, opaleshoniyi si yoyenera kwa iwo. Adzayenera kukonzedwanso ndi mtundu wina wa valavu kapena kusinthidwa kwathunthu kwa valavu (mitral valve replacement).

Kodi chimachitika ndi chiyani opaleshoni isanachitike?

Kukonzekera kumayamba milungu ingapo, nthawi zina miyezi, tsiku lanu lisanafike opaleshoni. Gulu lanu lachipatala (dokotala wa banja lanu, katswiri wa mtima, ndi dokotala wa mtima) lidzakumana kuti likufufuzeni bwino.

Ngati muli ndi mafunso, mantha, kapena kukayikira za opaleshoniyi, lankhulani ndi dokotala wanu za iwo. Musabise chilichonse kwa inu nokha. Ndikofunikira kwambiri kudziwa chilichonse ndikuyamba opaleshoniyi ndi maganizo omasuka.

Dokotala wanu adzakupatsani malangizo a momwe mungakonzekere opaleshoni, kuphatikizapo nthawi yoti musiye kudya ndi kumwa musanachite opaleshoni, komanso kusintha kulikonse kwa mankhwala anu.

Kodi opaleshoniyi imachitidwa bwanji?

Mu chipinda chochitira opaleshoni, gulu lachipatala limatsatira njira izi:

1. Choyamba, mudzapatsidwa mankhwala oletsa ululu ndipo mudzagonekedwa mpaka opaleshoniyo itatha. Simudzamva kupweteka kulikonse.

2. Kenako, dokotala wa opaleshoni amadula pakati pa chifuwa chanu, pansi pa fupa la pachifuwa (sternum). Izi zimatchedwa median sternotomy .

3. Mudzalumikizidwa ndi makina odulira mtima ndi mapapo . Makinawa amatenga ntchito ya mtima ndi mapapo anu kwakanthawi panthawi ya opaleshoni. Izi zimathandiza dokotala kuchita opaleshoniyo muli chete, popanda kugunda kwa mtima wanu.

4. Malo olowera kumanzere a mtima amatsegulidwa ndipo valavu ya mitral imafufuzidwa.

5. Kenako, mabala odulidwa bwino kwambiri amapangidwa pamakona awiri (commissures) a valavu yomwe yakhala yolimba komanso yokhuthala, kuwalekanitsa ndi kuwamasula.

6. Ntchito ikatha, mudzachotsedwa mu makina olumikizirana mtima ndi mapapo ndipo mtima ndi mapapo anu adzayambanso kugwira ntchito.

7. Pomaliza, transesophageal echocardiogramKujambula kwapadera kumachitika kuti kutsimikizire ngati valavu ikugwira ntchito bwino komanso ngati chilichonse chikugwira ntchito bwino.

Nthawi zina, opaleshoni zina za mtima, monga kukonza ma valve ena a mtima (aortic valve kapena tricuspid valve), zitha kuchitidwa nthawi yomweyo ndi opaleshoni iyi. Ngati izi ndizofunikira, gulu lachipatala lidzakufotokozerani izi pasadakhale.

Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?

Mudzafunika kukhala m'chipatala kwa pafupifupi sabata imodzi mutachita opaleshoni. Kwa tsiku loyamba kapena awiri, mudzasungidwa m'chipinda chosamalira odwala kwambiri (ICU) ndipo mudzayang'aniridwa mosamala kwambiri. Izi zimathandiza kuzindikira mavuto aliwonse omwe angabwere mukachita opaleshoni mwamsanga.

Musanapite kunyumba kuchokera kuchipatala, dokotala wanu adzakupatsani zambiri zokhudza:

• Kubwezeretsa Mtima: Izi zimathandiza kwambiri anthu omwe akuchira opaleshoni ya mtima. Zimakuthandizani kuti mupezenso mphamvu ndikuyamba kuchita zinthu zachizolowezi.
• Momwe mungasamalire chodulidwacho: Ndikofunikira kwambiri kusunga chodulidwacho chili choyera kuti mupewe matenda ndikuchiritsa bala mwachangu.
• Zoletsa: Malangizo a nthawi yomwe mungadikire musanayambirenso kuchita zinthu monga kuyendetsa galimoto kapena kugwira ntchito zolemetsa.

Musanapite kunyumba, musaiwale kukonza zoti wina adzakutengeni.

Kodi ubwino ndi zoopsa za opaleshoniyi ndi ziti?

Ubwino

Opaleshoni iyi ingathandize kuchepetsa zizindikiro monga kupuma movutikira komanso kutopa komwe kumachitika chifukwa cha kuchepa kwa valavu ya mitral. Ingakutetezeninso ku mavuto akuluakulu omwe angabwere mtsogolo. Iyi ndi njira yabwino kwambiri yothandizira anthu omwe vuto lawo silili lalikulu mokwanira kuti alowe m'malo mwa valavu yonse komanso omwe sanachite bwino ndi mankhwala ena.

Zoopsa kapena Zovuta

Monga momwe zimakhalira ndi opaleshoni iliyonse, pali zoopsa. Vuto lofala kwambiri ndi mitral valve regurgitation .

Zoopsa zambirizi zitha kuchepetsedwa polandira chithandizo kuchipatala chachikulu chomwe chili ndi malo ochitira opaleshoni ya mtima komanso madokotala odziwa bwino ntchito yochita opaleshoni ya mtima.

Kodi chiyembekezo chili bwanji pambuyo pa opaleshoni?

Opaleshoni yotseguka ya commissurotomy imayenda bwino kwambiri. Opaleshoni imeneyi nthawi zambiri imakonza kuchepa kwa valavu ndikubwezeretsa kuyenda kwa magazi.

Dokotala wanu angakuuzeni bwino za thanzi lanu lamtsogolo. Aliyense amachira mosiyana. Zinthu zambiri zimakhudza izi, kuphatikizapo msinkhu wanu, thanzi lanu lonse, komanso kuchuluka kwa kuwonongeka kwa valavu yanu musanachite opaleshoni.

Kodi muyenera kukaonana ndi dokotala liti?

Ngati mukupeza zizindikiro zilizonse za matenda pamene mukuchira kunyumba mutachita opaleshoni, imbani dokotala nthawi yomweyo.

• Kupweteka pachifuwa, kulimba, kapena kusapeza bwino.
• Malungo.
• Kufiira kapena madzi ofanana ndi mafinya omwe akutuluka pamalo odulidwa.

Ngati mukukumana ndi zizindikiro zoopsa zotsatirazi, imbani nambala yanu yadzidzidzi yapafupi nthawi yomweyo kapena pitani ku Dipatimenti Yoona za Zadzidzidzi ya Chipatala (ETU) yapafupi:

• Zizindikiro za matenda a mtima (kupweteka kwambiri pachifuwa, kuvutika kupuma, kusanza, thukuta).
• Zizindikiro za ziwalo zopuwala (kuvutika kulankhula, kugwada mbali imodzi ya nkhope, kutayika kwa chiwalo).