Njira yatsopano yosinthira ma valve a mtima popanda kutsegula chifuwa (Transcatheter Pulmonary Valve Replacement - TPVR)

Nthawi zina mwina munamvapo za mwana amene anabadwa ndi vuto la mtima ali mwana. Mwina mwanayo anachitidwa opaleshoni panthawiyo ndipo vutolo linakonzedwa. Koma mwana wotere akakula pang'ono, akafika msinkhu wachinyamata, vuto la mtima lomwe linalipo paubwana wake likhoza kubwereranso mwanjira ina. Pankhaniyi, lero tikambirana za njira yofunika kwambiri yothandizira yomwe ingapereke mphamvu zambiri pa moyo.

Ndiye, kodi TPVR ndi chiyani?

Mwachidule, TPVR , kapena Transcatheter Pulmonary Valve Replacement , ndi njira yapadera yomwe imalowa m'malo mwa valavu ya m'mapapo yomwe sikugwira ntchito bwino mumtima mwanu, koma popanda kutsegula pachifuwa chanu. Izi zikumveka zodabwitsa, sichoncho? Nthawi zambiri, tikamaganiza zosintha valavu ya mtima, timaganiza za opaleshoni yotsegula mtima, yomwe imaphatikizapo kupanga kudula kwakukulu pakati pa pachifuwa. Komabe, mu njira iyi ya TPVR, dokotalayo amapanga kudula pang'ono kwambiri pakhungu la bere lanu ndipo amachita njira yonseyo.

Valavu ya m'mapapo ndi chipata chomwe chimalamulira njira yodutsa magazi kuchokera mumtima mwathu kupita ku mapapo athu. Ngati sichigwira ntchito bwino, kuyenda kwa magazi m'thupi lonse kudzasokonekera. Chifukwa chake kudzera mu njira iyi, mukasintha valavu yomwe sikugwira ntchito bwino ndi yatsopano, nthawi yanu yotsala komanso moyo wanu udzawonjezeka kwambiri. Komanso, zithandiza kuchedwetsa kapena kupewa kufunikira kwa opaleshoni yayikulu mobwerezabwereza.

Kodi chimachitika ndi chiyani ndi chithandizo cha TPVR ichi?

Taganizirani kuti mu opaleshoni yachikhalidwe yotsegula mtima, madokotala amadula fupa la pachifuwa ndikusamutsa kwakanthawi ntchito ya mtima kupita ku makina (makina odutsa mtima ndi mapapo), kenako amachotsa valavu yakale ndikuyika yatsopano. Izi zimatenga nthawi yayitali, zimatenga nthawi yayitali kuti zichiritsidwe, ndipo zingakhale zoopsa kwambiri kwa odwala ena kuti achite opaleshoni yayikulu yotereyi.

Koma njira ya TPVR ndi yosiyana kwambiri. Ndi njira yosalowerera kwambiri . Izi ndi zomwe zimachitika:

1. Dokotala wa mtima wothandiza anthu ovutika maganizo amadula pang'ono mtsempha waukulu wamagazi m'mimba mwanu (mtsempha wa femoral) ndikulowetsa chubu chopyapyala komanso chosinthasintha, chotchedwa catheter, kudzera mmenemo.

2. Mkati mwa catheter iyi muli valavu yatsopano, baluni yaying'ono yopindidwa.

3. Pogwiritsa ntchito njira zapadera monga X-ray, dokotala amatsogolera mosamala catheter iyi kudzera mu mtsempha wamagazi mpaka pomwe valavu ya m'mapapo ili mumtima.

4. Baluni ikangoyikidwa pamalo pake, imadzazidwa ndi mpweya. Vavu yatsopano, yomwe inapindidwa, imakula ndikulowa pamalo pomwe valavu yakale inali.

5. Kuyambira nthawi imeneyo, valavu yatsopano imayamba kugwira ntchito. Magazi ochokera mumtima kupita m'mapapo amabwerera m'malo abwinobwino.

Chimodzi mwa ubwino waukulu wa izi ndi chakuti anthu ambiri omwe adalandira chithandizochi amatha kupita kunyumba nthawi yomweyo. Nthawi yochira ndi yochepa kwambiri.

Ndiye, chimachitika ndi chiyani ngati valavu ya m'mapapo iyi sigwira ntchito bwino?

Pali mavuto awiri akuluakulu omwe angachitike ndi valavu ya m'mapapo.

Chifukwa cha matenda awiriwa, mutha kukhala ndi zizindikiro monga kupuma movutikira (kupuma movutikira) , kutupa kwa miyendo ndi mimba (kutupa) , kupweteka pachifuwa , komanso kugunda kwa mtima kosakhazikika . Zizindikirozi zidzachepa kwambiri mutalandira chithandizo cha TPVR.

Kodi chithandizochi ndi choyenera kwa ndani?

Ngati munabadwa ndi matenda a mtima obadwa nawo ndipo munachitidwa opaleshoni muli mwana, pali mwayi waukulu kuti chithandizochi chidzakuyenererani. Chifukwa valavu yomwe inayikidwa muubwana (nthawi zambiri homograft) imatha kuwonongeka pakapita nthawi. Kenako matenda omwe atchulidwa pamwambapa, monga stenosis kapena regurgitation, amatha kuwonekera muubwana. Ichi ndichifukwa chake madokotala amalimbikitsa njira ya TPVR kwa anthu otere.

Njira iyi imagwiritsidwa ntchito pochiza matenda otsatirawa a mtima wobadwa nawo:

• Tetralogy of Fallot: Kuphatikiza kwa zolakwika zinayi, kuphatikizapo mabowo mumtima, zomwe zimayambitsa kusakanikirana kwa magazi abwino ndi oipa.
• Kutsekeka kwa Mapafu: Vuto lomwe valavu ya m'mapapo siimapangidwira pobadwa.
• Truncus Arteriosus: Mitsempha ikuluikulu iwiri yamagazi yomwe imachokera kumtima (aorta ndi pulmonary artery) imalumikizidwa pamodzi kuti ipange umodzi.
• Kusintha kwa Mitsempha Yaikulu: Mitsempha iwiri ikuluikulu yamagazi imasinthidwa ndikulumikizidwa mbali zolakwika.

Kodi chimachitika ndi chiyani musanalandire chithandizo komanso mutalandira chithandizo?

Kukonzekera musanalandire chithandizo

Kuti aone ngati mungathe kuchita TPVR, dokotala wanu adzakuyang'anirani mosamala ndipo angachite mayeso ochepetsa nkhawa pakuchita masewera olimbitsa thupi. Kuphatikiza apo, mayeso otsatirawa angachitike:

• Angiogram
• Kujambula kwa mtima kwa CT
• MRI ya Mtima
• Echocardiogram
• Mayeso a ECG

Pambuyo poganizira zonsezi, dokotala adzasankha njira yabwino kwambiri yothetsera vutoli.

Pa nthawi ya chithandizo

Mudzapatsidwa mankhwala oletsa ululu musanayambe chithandizo, kotero simudzamva kupweteka kulikonse. Njira yonseyi imatenga pafupifupi maola awiri kapena atatu. Madokotala adzaika catheter, kuyika valavu, kuyang'ana momwe imagwirira ntchito, kenako n'kuchotsa catheter.

Pambuyo pa chithandizo

Mudzasungidwa m'chipatala usiku wonse kuti mukayang'aniridwe ndipo nthawi zambiri mudzatumizidwa kunyumba tsiku lotsatira. Mudzatha kuyambiranso ntchito zanu zachizolowezi patatha pafupifupi sabata imodzi.

Kodi ubwino ndi zoopsa zake ndi ziti?

Monga chithandizo chilichonse chamankhwala, ichi chili ndi ubwino ndi zoopsa zina.

Nthawi zambiri, mavuto aakulu monga matenda a mtima, sitiroko, kapena imfa amatha kuchitika. Chifukwa chake, ndikofunikira kukambirana zabwino ndi zoyipa za chithandizochi ndi dokotala musanapange chisankho.

Zinthu zina zofunika kudziwa

Kodi valavu yatsopano imatenga nthawi yayitali bwanji?

Izi zimadalira thanzi lanu lonse komanso momwe mtima wanu ulili. Anthu ena angafunike kuchitidwa opaleshoni ina pakapita nthawi. Koma nkhani yabwino ndi yakuti ngati pakufunika, mutha kusintha valavu ina ndi njira ya TPVR.

Kodi muyenera kusamala mukamachita chithandizo cha mano?

Inde, izi ndizofunikira kwambiri. Pazinthu monga kuchotsa mano ndi kutsuka mano, mabakiteriya mkamwa amatha kulowa m'magazi ndikuyendamo ndikuyambitsa matenda oopsa otchedwa endocarditis , matenda a valavu ya mtima yomwe yangobzalidwa kumene. Chifukwa chake, musanalandire chithandizo chilichonse cha mano, muyenera kudziwitsa dokotala wanu wa mano kuti mwalandirapo TPVR. Mungapemphedwe kuti mumwe mankhwala opha maantibayotiki musanalandire chithandizo.

Kodi pali vuto lililonse ndi chitetezo cha eyapoti?

Ayi. Kujambula zithunzi za X-ray ndi kufufuza chitetezo sikungakupwetekeni. Komabe, ngati mukuganiza zojambula zithunzi za MRI, kambiranani ndi dokotala wanu kaye.