Tiyeni tiphunzire za kukonza ma valve a Mitral m'njira yosavuta.

Kodi mumamvanso kupuma movutikira mukatopa pang'ono, mukumva kufooka mukakwera masitepe, kapena mukumva kulemera pachifuwa? Nthawi zina chifukwa cha zizindikirozi chingakhale vuto ndi kampata kakang'ono mumtima mwathu, valavu. Chifukwa chake lero tikambirana za valavu ya mitral mumtima ndi opaleshoni yokonzanso yomwe ingafunike chifukwa cha mavuto ake.

Kodi kukonza valve ya mitral n'chiyani?

Mwachidule, kukonza ma valve a mitral ndi opaleshoni yotsegula mtima yomwe imakonza mavuto a valvu ya mitral mumtima mwanu.

Taganizirani mtima wathu ngati nyumba yokhala ndi zipinda zinayi. Valavu ya mitral ndi chipata pakati pa chipinda chapamwamba kumanzere (atrium yakumanzere) ndi chipinda chapansi kumanzere (ventricle yakumanzere). Magazi oyera ochokera m'mapapo athu okhala ndi mpweya wambiri amayamba kulowa mu atrium yakumanzere. Kenako, magazi amenewo amalowa kudzera pachipata chotchedwa valvu ya mitral ndikupita ku ventricle yakumanzere. Kuchokera pamenepo, magazi amapopedwa kupita ku thupi lonse.

Choncho valavu iyi, valavu ya mitral, ikalephera kugwira ntchito bwino, imayambitsa vuto kuti mtima ugwire bwino ntchito. Pakapita nthawi, izi zitha kuwononga mtima ndi mapapo. Opaleshoniyi idapangidwa kuti ipewe kapena kuchedwetsa kuwonongekako.

Ngati muli ndi matenda aakulu a mitral valve, dokotala wanu angakulangizeni opaleshoni kuti akonze kapena kusintha valavu. Koma nthawi zambiri, makamaka ngati valavuyo ikutuluka magazi, madokotala amayesa kukonza valavuyo m'malo moisintha. Izi zili choncho chifukwa pali zabwino zambiri komanso zoopsa zochepa zosungira gawo la thupi lanu.

Kodi opaleshoniyi imachiza matenda otani?

Opaleshoni iyi imagwiritsidwa ntchito makamaka pochiza matenda awa:

Opaleshoni iyi ingakhale yofunikira ngati mbali yakumanzere ya mtima wanu sikupereka magazi okwanira m'thupi (kulephera kwa mtima kumbali yakumanzere) kapena ngati mtima wanu wakula. Komabe, ngati matendawa si aakulu, dokotala wanu akhoza kukupatsani mankhwala owongolera zizindikiro zanu. Komabe, muyenera kukhala ndi ma echocardiograms nthawi zonse kuti muwone momwe valavu yanu ilili. Ngati matendawa akupita patsogolo kapena mtima wanu wawonongeka, opaleshoni ingafunike pambuyo pake.

Kodi mumakonzekera bwanji musanachite opaleshoni?

Dokotala wanu ndi gulu lachipatala adzakuthandizani kukonzekera opaleshoni. Ndikofunikira kwambiri kuti mutsatire malangizo awo molondola.

• Mungapemphedwe kuti musiye kumwa mankhwala ena: Mungapemphedwe kuti musiye kumwa mankhwala ochepetsa magazi (anticoagulants) monga aspirin ndi warfarin milungu ingapo opaleshoni isanachitike.
• Zimakuthandizani kusiya kusuta: Ngati ndinu wosuta fodya, dokotala wanu angakuthandizeni kusiya kusuta.
• Gwiritsani ntchito sopo wopha tizilombo toyambitsa matenda: Mudzauzidwa kuti musambe thupi lanu ndi sopo wopha tizilombo toyambitsa matenda usiku wotsatira opaleshoni.
• Mankhwala oti mumwe patsiku la opaleshoni: Dokotala adzakuuzani mankhwala oti mumwe m'mawa wa tsiku limenelo.
• Kusala Kudya: Pa tsiku la opaleshoni, mumalangizidwa kuti musadye kapena kumwa chilichonse pakapita nthawi inayake.

Kodi chimachitika ndi chiyani panthawi ya opaleshoni?

Pa opaleshoni iyi, dokotala adzakonza vuto limodzi kapena angapo ndi valavu yanu. Izi ndi njira zomwe zimachitika nthawi zambiri pa opaleshoni.

1. Mankhwala oletsa ululu: Mudzapatsidwa mankhwala oletsa ululu kuti akugoneni tulo tofa nato, osadziwa kalikonse.

2. Kulumikizana ndi makina a mtima ndi mapapo:Pa opaleshoniyi, mudzalumikizidwa ndi makina apadera (cardiopulmonary bypass machine) omwe adzayang'anira ntchito ya mtima ndi mapapo anu.

3. Kuduladula: Kuduladuladula pachifuwa kumapangidwa. Kukula kwa kuduladulaku kumasiyana malinga ndi njira yochitira opaleshoni.

4. Mphete ya annuloplasty: Mphete yooneka ngati yotsukira yopangidwa ndi nsalu imayikidwa mozungulira valavu. Izi zimathandiza kuti valavuyo ibwererenso momwe inalili kale.

5. Kukonza ma valavu: Vavu ya mitral imakonzedwa pogwiritsa ntchito njira imodzi kapena zingapo zosiyana zochitira opaleshoni.

6. Kuyang'anira: Onetsetsani kuti valavu yakonzedwa bwino ndipo pangani zosintha zina ngati pakufunika kutero.

7. Kusiya kuyamwa: Mukamaliza opaleshoni, mudzachotsedwa mu makina. Kenako mtima ndi mapapo anu adzayambanso kugwira ntchito.

8. Kufufuza komaliza: Kuyesa kwapadera kwa echo (transesophageal echocardiogram) kumachitika kuti kutsimikizire ngati valavuyo yakonzedwa bwino.

Ndi njira ziti zochitira opaleshoni zomwe zimagwiritsidwa ntchito pa opaleshoniyi?

Madokotala amagwiritsa ntchito njira zosiyanasiyana pa opaleshoniyi. Lankhulani ndi dokotala wanu za njira yomwe imagwiritsidwa ntchito pa opaleshoni yanu.

Njira zodulira

• Kuchotsa sternotomy yonse: Kuduladula kwathunthu kumachitidwa molunjika pakati pa fupa la pachifuwa.
• Kudula pang'ono fupa la pachifuwa: Kudula gawo limodzi la fupa lapakati la pachifuwa.
• Kuchotsa chiwalo chakumanja: Kudula pang'ono kumachitika pakati pa nthiti ziwiri kumanja.
• Njira yothandizidwa ndi roboti: Opaleshoni imachitika pogwiritsa ntchito roboti pogwiritsa ntchito mabala ang'onoang'ono angapo m'nthiti.

Njira zina zochitira opaleshoni

• Kukonza ma valvu: Monga tafotokozera kale, izi zimaphatikizapo kuyika mphete mozungulira valavu. Izi nthawi zambiri zimachitika nthawi iliyonse yokonza valavu ya mitral.
• Kuchotsa valavu ya triangular kapena quadrangular: Gawo laling'ono la valavu yowonongeka limadulidwa ndikuchotsedwa, ndipo mbali zabwino zotsalazo zimasokedwa pamodzi.
• Kukonza ma khwaya: Ngati ulusi waung'ono wonga chingwe (chordae) womwe umasunga valavu pamalo pake wawonongeka, ziwalo zowonongekazo zimachotsedwa ndikusinthidwa ndi zopangidwa (zopangidwa kuchokera ku zinthu monga Gore-Tex®) kapena ndi ulusi wotengedwa kuchokera ku gawo lina la mtima lathanzi.

Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?

Pambuyo pa opaleshoni, mutha kuyembekezera zotsatirazi:

• Muyenera kukhala m'chipinda chosamalira odwala kwambiri (ICU) kwa tsiku limodzi kapena awiri, komwe gulu lachipatala lidzayang'anira kugunda kwa mtima wanu ndi kupuma kwanu.
• Pambuyo pake, muyenera kukhala m'chipinda chogona kwa masiku angapo.
• Ndikuuzani za chithandizo cha matenda a mtima .
• Mukapita kunyumba, mudzalangizidwa momwe mungasamalire bala la opaleshoni.

Anthu ambiri amakhala m'chipatala kwa pafupifupi sabata imodzi pambuyo pa opaleshoniyi.

Kodi ubwino wochita opaleshoniyi ndi wotani?

Pali ubwino wambiri wokonza valavu yomwe ilipo m'malo moisintha ndi yatsopano.

• Mwayi wochuluka wokhala ndi moyo wautali: Mwayi wokhala ndi moyo wautali komanso wathanzi pambuyo pa opaleshoni umawonjezeka.
• Chitetezo chabwino kwambiri pa ntchito ya mtima: Kuwonongeka kwa ntchito ya mtima ndi kochepa.
• Kuchepetsa chiopsezo cha mavuto: Pali kuchepa kwa chiopsezo cha mavuto monga sitiroko ndi endocarditis (matenda a valves a mtima).
• Palibe chifukwa chogwiritsa ntchito mankhwala ochepetsa magazi kwa nthawi yayitali: Nthawi zambiri, mankhwala ochepetsa magazi (anticoagulants) safunika kumwedwa kwa nthawi yayitali.

Kodi opaleshoniyi yayenda bwino bwanji? Kodi ndi mavuto otani omwe angakhalepo?

Opaleshoni iyi yayenda bwino kwambiri. Malinga ndi malipoti, ngakhale patatha zaka 10 opaleshoniyi itachitika, pafupifupi 94% ya odwala satuluka magazi ambiri.

Komabe, monga opaleshoni iliyonse, pali zoopsa ndi zovuta zomwe zingachitike.

• Kusakhazikika kwa kugunda kwa mtima (Arrhythmias)
• Kutuluka magazi
• Kutseka mtima
• Kulephera kwa mtima
• Matenda
• Stroke

Lankhulani ndi dokotala wanu za zoopsa izi ndi momwe mungachepetsere.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire?

Kawirikawiri zimatenga milungu inayi mpaka isanu ndi itatu kuti munthu achire bwino atachitidwa opaleshoniyi, ngakhale kuti anthu ena angatenge nthawi yayitali.

Nthawi yomwe imatenga kuti muchiritse imadalira zinthu zingapo:

• Kuopsa kwa matenda a mtima wanu musanachite opaleshoni: Ngati ntchito ya mtima wanu inali itasokonekera kale musanachite opaleshoni, zimatenga nthawi kuti mupezenso mphamvu.
• Thanzi lanu lonse musanachite opaleshoni: Izi zidzadalira ngati munali ndi matenda ena kapena matenda ena omwe adakupangitsani kukhala ovuta.
• Njira yogwiritsira ntchito opaleshoni:Ngati fupa lalikulu ladulidwa pakati pa chifuwa (median sternotomy), zimatenga milungu 6-8 kuti fupa lipole. Ngati opaleshoniyo ichitika kudzera m'mabala ang'onoang'ono, mabalawo adzachira msanga.

Kodi muyenera kupita kwa dokotala liti?

Ndi zachilendo kumva kupweteka pang'ono mutachita opaleshoni. Dokotala wanu adzakupatsani mankhwala ochepetsa ululu pa izi. Komabe, ngati mukukumana ndi zizindikiro zotsatirazi, musaganize kuti ndi zachilendo ndipo funsani dokotala nthawi yomweyo.

Nthawi zina simungadziwe ngati izi ndi gawo lachibadwa la kuchira kapena chinthu china chachikulu. Ngati mukukayikira, ndi bwino kuyimbira foni ndikufunsa dokotala wanu.