Tiyeni tiphunzire za chithandizo cha valvu ya mitral (TMVR) popanda opaleshoni.

Kodi inuyo kapena munthu amene mumamudziwa kapena mnzanu wapamtima mudauzidwapo ndi dokotala kuti muli ndi vuto ndi 'Mitral Valve' ya mtima wanu ndipo mukufunika opaleshoni? Tikamva mawu oti "opaleshoni ya mtima," ambiri aife timachita mantha pang'ono, eti? Zimenezo ndi zachilendo. Chifukwa tamvapo za opaleshoni yomwe imaphatikizapo kutsegula pachifuwa ndikuchita opaleshoni yayikulu. Koma kodi mukudziwa, sayansi ya zamankhwala yapita patsogolo kwambiri tsopano. Chifukwa chake, pali njira yatsopano yomwe ingalowe m'malo mwa valavu iyi popanda kutsegula pachifuwa komanso kudzera mu kudula pang'ono kwambiri. Lero, tikambirana za njira yothandizira yomwe yakhala yothandiza kwambiri kwa anthu ambiri, yotchedwa `Transcatheter Mitral Valve Replacement` kapena TMVR mwachidule.

Mwachidule, kodi TMVR ndi chiyani?

Chabwino, tiyeni tinene mwachidule. TMVR ndi njira yomwe imalowa m'malo mwa valavu ya mitral mumtima mwanu. Koma chinthu chapadera ndichakuti sichimachitika potsegula chifuwa chanu chonse monga opaleshoni yotsegula mtima. M'malo mwake, chubu chopyapyala (catheter) chimayikidwa kudzera mu kudula pang'ono kwambiri, ndipo valavu yatsopanoyo imayikidwa mumtima mwanu.

Tangoganizirani kuti m'malo mochotsa valavu yayikulu ndikuyiyika yatsopano, mumatenga ziwalo za valavu yatsopano kudzera m'bowo laling'ono ndikuzikonza mkati. Iyi ndi njira yosavuta kwambiri kuposa opaleshoni yayikulu. Vavu yatsopano yomwe imayikidwa motere ikhoza kukhala yopangidwa ndi anthu. Kapena ikhoza kukhala valavu yachilengedwe yopangidwa kuchokera ku minofu ya mtima wa ng'ombe, nkhumba, kapena munthu. Vavu yatsopanoyo ikayikidwa, imayamba kuchita chimodzimodzi ndi valavu yanu yakale, yodwala.

Ndani akufunikira chithandizo cha TMVR ichi?

Kuti timvetse izi, choyamba tiyeni tiwone chomwe 'valvu ya mitral' iyi ndi zomwe zimachitika nayo.

Mtima wathu uli ndi zipinda zinayi zazikulu. Ziwiri pamwamba ndi ziwiri pansi. Valavu ya mitral ili pakati pa atrium yakumanzere ndi ventricle yakumanzere. Ili ngati chitseko pakati pa zipinda ziwiri. Chitseko ichi chili ndi ma flap awiri (tipepala). Nthawi iliyonse mtima ukagunda, ma flap awa amatseguka ndi kutsekedwa. Izi zimathandiza kuti magazi aziyenda mbali imodzi yokha, kuchokera ku chipinda chapamwamba kupita ku chipinda chapansi. Ntchito yayikulu ya valavu iyi ndikuletsa magazi kuti asayende kumbuyo.

Koma nthawi zina, kaya kuyambira kubadwa kapena pambuyo pake, mavuto osiyanasiyana amatha kuchitika ndi valavu iyi. Pali mitundu iwiri ya mavuto makamaka.

Matendawa akakula kwambiri, angayambitse zizindikiro monga kupuma movutikira, kutopa, ndi kupweteka pachifuwa. Angayambitsenso matenda aakulu monga atrial fibrillation (kugunda kwa mtima kosasinthasintha), kuthamanga kwa magazi m'mapapo (kuthamanga kwa magazi m'mapapo), kapena kulephera kwa mtima.

Kodi TMVR ndi MitraClip ndi chinthu chimodzi?

Ayi. Ngakhale kuti zonsezi sizimakhudza kwambiri mavuto a mitral valve, pali kusiyana pakati pa ziwirizi.

• TMVR ndi njira yosinthira ma valavu onse .
• MitraClip™ ndi kukonza ma valavu. Zili ngati kuyika kachidutswa kakang'ono pakati pa ma flaps awiri a valavu yotuluka, ndikuletsa kutuluka kwa madzi.

Dokotala wanu wa mtima adzasankha chithandizo chomwe chili chabwino kwa inu.

Kodi chimachitika ndi chiyani chithandizo cha TMVR chisanachitike?

Musanayambe chithandizochi, gulu lanu lachipatala lidzakuyang'anirani mosamala. Izi zikuphatikizapo mayeso otsatirawa:

• Echocardiogram: Iyi ndi ultrasound scan ya mtima. Imatha kuona bwino momwe zipinda ndi ma valve a mtima akugwirira ntchito.
• Kujambula kwa CT: Izi zimatenga zithunzi za mbali zitatu (3D) za mtima ndi mitsempha yamagazi ndipo zimathandiza kukonzekera chithandizo.

Pogwiritsa ntchito mfundo zochokera mu mayesowa, gulu lachipatala limakonza kukula kwa valavu ndi njira yabwino kwambiri yochizira.

Kuphatikiza apo, dokotala wogonetsa anthu ogonetsa adzakambirana nanu ndikusankha mtundu wabwino kwambiri wa mankhwala ogonetsa kuti musamve ululu panthawi ya opaleshoni. Mutha kugonetsedwa mokwanira (anesthesia wamba), kapena mungagonekedwe osamva ululu (conscious sedation).

Masiku angapo musanalandire chithandizo, dokotala wanu adzakupatsani malangizo omveka bwino a momwe mungakonzekere. Izi zingaphatikizepo:

• Mankhwala ena, monga ochepetsa magazi, angafunike kuthetsedwa kwa masiku angapo.
• Pa tsiku la chithandizo, mudzapemphedwa kusala kudya (osadya kapena kumwa) kwa maola angapo.
• Pambuyo pa chithandizo, amapempha kuti akonze galimoto yoti ikutengereni kunyumba kuchokera kuchipatala.

Kodi chimachitika ndi chiyani panthawi ya chithandizo cha TMVR?

Njira yonseyi nthawi zambiri imatenga maola awiri kapena atatu ndipo imachitika ndi gulu lalikulu la madokotala, kuphatikizapo madokotala ochita opaleshoni ya mtima, akatswiri a mtima, akatswiri ojambula zithunzi, ndi akatswiri ogonetsa odwala.

Nayi njira yosavuta yofotokozera zomwe zimachitika panthawi ya chithandizo:

1. Choyamba, malo omwe adzadulidwe (nthawi zambiri m'chiuno kapena pang'ono pachifuwa) amatsukidwa ndipo tsitsi limachotsedwa ngati pakufunika kutero.

2. Kenako, kannula (mzere wa IV) idzaikidwa mumtsempha womwe uli m'dzanja lanu, womwe udzakupatsani mankhwala ndi madzi ofunikira.

3. Kenako, valavu yatsopano imalumikizidwa kumapeto kwa chubu chopyapyala komanso chosinthasintha chotchedwa catheter .

4. Tsopano, kudula pang'ono kwambiri kumapangidwa pamalo okonzedweratu m'mimba kapena pachifuwa, ndipo kudzera mu zimenezo, catheter iyi imalowetsedwa mu mtsempha wamagazi.

5. Pogwiritsa ntchito ukadaulo wapadera wojambulira zithunzi, monga X-ray, madokotala amatsogolera mosamala catheter iyi kudzera m'mitsempha yamagazi kupita ku valavu ya mitral mumtima.

6. Ikayikidwa pamalo pake, valavu yatsopano imayikidwa mkati mwa valavu yakale, yodwala.

7. Valavu yatsopano ikayikidwa bwino, catheter imachotsedwa mosamala ndipo chotupa chaching'ono chimatsekedwa.

Munthawi yonseyi, gulu lachipatala lipitiliza kuyang'anira chilichonse kuyambira kuthamanga kwa magazi anu ndi kuchuluka kwa mpweya m'magazi mpaka momwe mtima wanu ukugwirira ntchito pogwiritsa ntchito echocardiogram.

Kodi chimachitika ndi chiyani mukalandira chithandizo?

Mukamaliza kulandira chithandizo, mudzatengedwera ku chipinda chochiritsira. Gulu lachipatala lidzakusamalirani bwino mpaka mutachira ku opaleshoni yoletsa kupweteka. Anthu ena angafunike kukhala mu chipinda chosamalira odwala kwambiri (ICU) kwa kanthawi. Nthawi zambiri, muyenera kukhala kuchipatala kwa masiku angapo.

Musanapite kunyumba, madokotala adzakufotokozerani momveka bwino zomwe muyenera kuchita kenako.

• Kubwezeretsa mtima: Malangizo okhudza masewera olimbitsa thupi ndi kusintha moyo kuti athandize kulimbitsa mtima kachiwiri.
• Maulendo obwerezabwereza: Masiku omwe muyenera kukaonananso ndi dokotala.
• Mankhwala: Malangizo oyambira mankhwala atsopano kapena kuyambitsanso mankhwala akale.
• Ntchito yanthawi zonse: Kodi mungabwerere liti kuntchito ndikuyambiranso ntchito zanthawi zonse?

Kodi ubwino wa chithandizo cha TMVR ndi wotani?

Poyerekeza ndi opaleshoni ya mtima yotseguka, njira iyi ya catheter ili ndi zabwino zingapo.

• Matenda a mitral valve akhoza kukonzedwa.
• Kuchepetsa zizindikiro zoyambitsidwa ndi matendawa, monga kupuma movutikira komanso kutopa.
• Kuchepetsa chiopsezo cha mavuto aakulu azaumoyo.
• Amatha kuchira mwachangu kuposa opaleshoni yotseguka.
• Kuchepetsa mphamvu pa thupi ndi ululu.

Kodi pali zoopsa kapena zovuta zilizonse ndi chithandizochi?

Inde. Ngakhale kuti zoopsa zake n’zochepa poyerekeza ndi opaleshoni ya mtima yotseguka, monga momwe zimakhalira ndi njira ina iliyonse yachipatala, TMVR ikhoza kukhala ndi zoopsa ndi zovuta zina. Komabe, izi sizichitika kawirikawiri.

Izi ndi zina mwa zovuta zazikulu zomwe zingachitike:

• Magazi amaundana: Ngati magazi amaundanawa apita ku ubongo, sitiroko ikhoza kuchitika.
• Kuwonongeka kwa minofu: Khoma la mtima (kubowoka kwa ventricle yakumanzere) kapena mtsempha wamagazi womwe umapatsa magazi kumtima (mtsempha wa coronary) ukhoza kuvulala.
• Kutsekeka kwa njira yotulutsira magazi kuchokera kumanzere kwa ventricle: Valavu yatsopanoyi imatsekereza njira yotulutsira magazi kuchokera kumanzere kwa chipinda chapansi.
• Kusuntha kwa valavu: Kusuntha kwa valavu kuchokera pamalo ake okhazikika.

Mavuto ena angafunike chithandizo china kapena opaleshoni.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire?

Anthu ambiri amatha kubwerera ku ntchito zawo zachizolowezi ndikugwira ntchito mkati mwa milungu ingapo. Komabe, zingatenge miyezi iwiri kapena itatu kuti achire bwino . Chofunika kwambiri ndikutsatira malangizo a dokotala wanu mosamala. Musamafulumire kugwira ntchito yolemetsa kapena kuchita zinthu zolemetsa.

Ndi nthawi ziti zomwe muyenera kufunsa upangiri wa dokotala mukatha kulandira chithandizo?

Ichi ndi gawo lofunika kwambiri. Mukapita kunyumba mutalandira chithandizo, muyenera kusamala ndi kusintha kwa thupi lanu. Pali zizindikiro zina, ngati zikuwonekera, muyenera kufunsa upangiri wa dokotala nthawi yomweyo .

TMVR ndi njira yothandiza kwambiri yochizira anthu omwe ali ndi matenda a mitral valve omwe sangathe kuchitidwa opaleshoni ya mtima. Ngati muli ndi mafunso ena okhudza izi, chonde musazengereze kulankhula ndi dokotala wanu. Iye adzatha kukufotokozerani njira yabwino kwambiri yochizira.