Umutima wacu ni urugingo rutangaje. Ni nk'agasanduku gato gakora kadahagarara. Iyi pompe ifite ibice bine bifasha kohereza amaraso mu cyerekezo kimwe gusa, ibyo twita uturindantoki tw'umutima mu buvuzi. Tekereza uko byagenda iyo n'urugi rumwe muri izi rugomba kuba rwacitse, iyo rudafunguka cyangwa ngo rufunge neza. Urujya n'uruza rw'amaraso mu mubiri wose rwaba rwahungabanye, si byo se? Uyu munsi, turimo kuvuga ku gikorwa kigoye ariko cyagenze neza cyane gikorwa iyo uturindantoki tw'umutima, umwe mu turindantoki tw'ingenzi mu mutima, urwaye.
Mu magambo make, ni iki gikorwa cya Ross?
Ubu ni uburyo bwo kubaga budasanzwe. Abaganga babwita uburyo bwo kubaga ibihaha. Iki ni ikintu kidasanzwe cyane kibaho hano. Ubu buryo bwo kubaga bukoreshwa mu gice cy'umubiri wawe.
Mu magambo make, intambwe ebyiri z'ingenzi zibaho hano ni izi:
1. Valve yawe y'umuyoboro w'amaraso idakora neza irakurwaho igasimbuzwa valve yawe y'ibihaha imeze neza.
2. Hanyuma, valve y'ibihaha imeze neza (valve y'umutanga) yakuwe ku muntu wapfuye ishyirwa ahantu hadafite ikintu aho valve y'ibihaha yari iri.
Noneho ushobora kuba urimo gutekereza uti: "Kuki ubikora? Kuramo kimwe ukagishyiraho ikindi, hanyuma ugishyiraho ikindi hejuru yabyo, bisa nkaho bigoye, si byo se?" Yego, ni ukuri. Ariko hari impamvu nziza cyane yabyo. Reka tubirebe.
Kuki ubu buvuzi ari ingenzi? Kuki ukoresha valve yawe y'ibihaha?
Umutima wacu upompa amaraso meza kandi yuzuye ogisijeni mu mubiri wose unyuze muri vali yitwa vali y'umuyoboro w'amaraso. Iyi ni vali nyamukuru. Ni na vali ibuza amaraso gutembera inyuma mu gihe umutima utera.
Ariko rimwe na rimwe iyi valve ishobora kuziba idafungutse neza, ibyo twita stenosis . Cyangwa ntishobora gufunga neza amaraso ashobora kuva inyuma, ibyo twita regurgitation . Iyo ibi bibazo bikomeje, amahirwe yo kunanirwa k'umutima no kwandura aba menshi cyane.
Rero mu bihe bikomeye nk'ibi, valve yangiritse igomba gukurwaho hanyuma hagashyirwaho indi nshya.
None se, kuki wasimbuza valve yawe y'ibihaha n'iyakozwe mu buryo bw'ubukorano?
Hari impamvu nyinshi zibitera:
- Ihangane n'umuvuduko: Valve ya aorta iba iri munsi y'umuvuduko ukabije w'amaraso. Bityo valve ishyirwamo igomba kuba ikomeye cyane. Kubera ko valve yawe y'ibihaha ari urugingo ruzima, ishobora kwihanganira uyu muvuduko ukabije kandi ikamara igihe kirekire kurusha valve z'ubukorano.
- Ingaruka nke zo kuvura amaraso: Iyo bashyizemo utunyangingo tw’ubukorano, haba hari ibyago byinshi byo kuvura amaraso. Kubwibyo, bagomba gufata imiti igabanya amaraso ubuzima bwabo bwose. Ariko iyo bakoresheje ingirabuzimafatizo zabo, iyo ngaruka iba ntaho ihuriye.
- Aho valve y'ibihaha iherereye:Valve y'ibihaha iba iri munsi y'umuvuduko muke, bityo valve y'umuntu wapfuye ntizashira vuba. Nanone, valve y'imiyoboro y'amaraso n'valve y'ibihaha birasa cyane mu bunini no mu miterere.
Muri make, icyo abaganga b'inzobere mu kubaga bakora ni ugushyira umugozi ukomeye cyane mu gice cy'ingenzi cy'umutima, aho uremereye cyane, hanyuma ugashyira umugozi "utanga" mu gice gifite uburemere buke.
Ni nde ubu buvuzi bukwiriye, kandi ni nde butakwiriye?
Ubu buryo bwo kubaga ntibukwiriye buri wese. Abaganga basuzuma neza uko umurwayi amerewe hanyuma bagafata umwanzuro niba akwiriye cyangwa atabikwiriye. Reka turebere hamwe imbonerahamwe iri hepfo.
| Ni nde ukwiriye kubagwa? | Abantu badakwiriye kubagwa |
|---|---|
| Ubusanzwe ku bantu bakiri bato n'abari munsi y'imyaka 60 . | Abantu bafite indwara ziterwa n’ubwiyongere bw’umubiri nka lupus na rheumatoid arthritis. |
| Ku bafite ikibazo cyo kurwara indwara yo mu bwonko bw'imitsi itera aorta. | Abantu bafite indwara zo guhuza ingirangingo nka Marfan syndrome. |
| Ku barwaye izindi ndwara z'imitsi yo mu bwonko. | Ku bafite imbogamizi mu mitsi itatu cyangwa irenga y’amaraso ijyana amaraso ku mutima (indwara y’imitsi ifata amaraso). |
| Ku bafite indwara ya aortic valve endocarditis. | Ku bafite ikibazo cy'imitsi yo mu bihaha. |
Ni iki kibaho mu gihe cyo kubagwa?
Uburyo bwa Ross ni uburyo bworoshye kandi bwitondewe bufata amasaha menshi. Bukorwa n'itsinda ry'inzobere mu kubaga umutima. Reka turebe uko bigenda mu gihe cyo kubaga.
1. Anesthesia: Ubwa mbere, uzashyirwa munsi y'ikinyabutabire rusange. Ibi bivuze ko uzaba uri mu bitotsi byinshi kugeza igihe abaganga barangije kubaga, bityo ntuzumva ububabare. Nta kintu na kimwe uzibuka kuri iki gikorwa cyo kubaga.
2. Guhuza imashini ikoresha umutima n'ibihaha: Hanyuma, abaganga bazaguhuza n'imashini yihariye yitwa cardiopulmonary bypass machine. Iyi mashini ifata by'agateganyo akazi k'umutima n'ibihaha byawe mu gihe cyo kubaga. Ibi bituma abaganga babasha kubaga mu mutekano badahagaritse umutima wawe.
3. Gufungura igituza: Abaganga babaga batema igituza hagati mu gituza cyawe, bagatandukanya igufwa ry'ibere (sternum) mo kabiri kugira ngo bagere ku mutima. Ubu buryo bwitwa sternotomi .
4. Gusuzuma valve: Hanyuma, valve y'ibihaha irasuzumwa neza kugira ngo harebwe niba imeze neza kandi ikwiriye guterwa mu buryo bwo gusimbuza valve y'imiyoboro y'amaraso.
5. Gusimbuza valve: Niba byose bigenze neza, abaganga bazabakuramo valve ya aortic yangiritse bakayisimbuza valve yawe bwite y'ibihaha. Hanyuma, valve nzima y'ibihaha iva ku muntu wapfuye ishyirwa mu mwanya urimo ubusa aho valve ya mbere y'ibihaha yari iri.
6. Gusubiza umutima mu buryo bushya: Nyuma yo guterwa neza imiyoboro yombi mishya, abaganga bazabasha gutangiza umutima wawe. Hanyuma uzakurwa buhoro buhoro mu mashini ikoresha umutima n'ibihaha.
7. Igenzura rya nyuma n'ifungwa: Valve nshya zishyirwamo zongera gusuzumwa kugira ngo harebwe ko zikora neza. Iyo byose bigenze neza, igice cyo hagati cy'inyuma gishyirwaho insinga, hanyuma igice cyo hagati cy'igituza kigafungwa.
Ni izihe nyungu n'ingaruka zishobora guterwa n'ubu buvuzi?
Kimwe n'ubundi buryo bwose bwo kubaga, kubaga Ross bifite ibyiza n'ingaruka zabyo. Ingaruka zishobora kugabanuka cyane iyo ugiye kuvurwa n'umuganga w'inzobere ufite uburambe bwinshi muri ubu buryo bwo kubaga kandi akaba akora ubu buryo buri gihe.
| Ibyiza | Ingaruka |
|---|---|
| Ntabwo ukeneye gufata imiti igabanya amaraso ubuzima bwawe bwose. | Kwaguka kwa autograft y'imitsi (kwaguka kwa aorta hafi y'agace gashya kashyizwemo). |
| Ushobora kubaho ubuzima burangwa n'ibikorwa byinshi nta mbogamizi, ukora ibintu nko gukora imyitozo ngororamubiri no gutwara imodoka. | Ugutera kw'umutima kutumvikana neza (Arrhythmia). |
| Abagore bateganya gutwita bashobora kubyara umwana nta nkomyi. | Indwara y'umutima. |
| Amaraso atembera mu mubiri wose ari ku rwego rwiza cyane (Hemodynamics nziza cyane). | Kuva amaraso menshi (Kuva amaraso menshi). |
| Nyuma gato yo kubagwa, ibimenyetso biragabanuka maze utangira kumva ukize vuba . | Kwandura indwara. |
| Kubera ko ari ingirabuzimafatizo zayo, kuramba kwayo ni ku rwego rwo hejuru cyane. | Umuyoboro w'umutima uva. |
Igihe cyo gukira nyuma yo kubagwa kiba gite?
Nyuma yo kubagwa, uzabyukira muri ICU y'umutima. Mu masaha make ya mbere, ushobora gushyirwaho icyuma gifasha guhumeka. Imikorere y'umutima wawe izakurikiranwa buri gihe. Ubusanzwe uzaguma muri ICU iminsi igera kuri 5.
Bishobora gufata amezi menshi kugira ngo ukire neza nyuma yo gutaha. Muri iki gihe, ni ibisanzwe guhura n'ibintu nk'ibi:
- Impatwe
- Indwara zo mu mutwe nk'ihungabana
- Gusinzira nabi
- Gukunda kurya
- Kubura ibinya no kubyimba hafi y'aho bakorewe igikorwa cyo kubaga
Muri iki gihe, ni ngombwa cyane gukurikiza amabwiriza ya muganga wawe neza no kujya kwa muganga ku matariki yagenwe.
Ese bizakenerwa kuvurwa ubuzima bwose?
Yego. Nyuma yo kubagwa Ross, uzakenera kuba uri munsi y’ubugenzuzi bw’abaganga ubuzima bwawe bwose. Uzakenera gupimwa buri gihe kugira ngo urebe ko valve ebyiri zatewe zikora neza.
Wibuke ko gutera valve y'ibihaha yatanzwe n'umuterankunga ntabwo imara ubuzima bwose. Ishobora gukenera kongera gusimburwa, akenshi nyuma y'imyaka 15-20. Ariko ntugahangayike. Muri ibyo bihe, abaganga bakunze gusimbuza valve bakoresheje uburyo budakoresha uburyo bwinshi, badakoresheje incision nini. Kubwibyo, igihe cyo gukira kiba gito cyane.
Ni ryari ukwiye kujya kwa muganga?
Ni ingenzi cyane kumenya ibimenyetso byose by'ingorane iyo ugiye mu rugo nyuma yo kubagwa. Niba ubonye kimwe muri ibi bimenyetso bikurikira, hamagara muganga wawe vuba.
- Kubabara mu gatuza
- Niba wumva ufite umuriro cyangwa ufite ibicurane
- Niba wumva uzuzumwe cyangwa amaso yawe arimo guhinduka ubururu
- Niba urimo gukorora amaraso
- Niba ufite ibisebe bidasanzwe cyangwa kuva amaraso
- Iyo umuntu agize kuruka
- Niba amaguru yawe afite ibinya
- Niba intebe ari umutuku ukabije
Ubutumwa bwo kujyana mu rugo
- Kubaga Ross ni uburyo bwiza cyane bwo kuvura abantu bafite indwara ikomeye y’imitsi ifungana mu muyoboro w’amaraso.
- Kubera ko valve yawe y'ibihaha ikoreshwa hano, ibisubizo ni byiza cyane kandi biraramba.
- Kimwe mu byiza bikomeye by'ubu buvuzi ni uko udakenera gufata imiti igabanya amaraso ubuzima bwawe bwose.
- Nyuma yo kubagwa, uzabasha kubaho ubuzima burangwa n'imyitozo ngororamubiri nta mbogamizi.
- Kubera ko ubu buryo bwo kubaga bugoye cyane, ni ngombwa cyane gushaka abaganga b'inzobere mu kubaga bafite uburambe bwinshi muri uru rwego.
- Gukurikirana no gupima ubuzima bwose nyuma yo kubagwa birakenewe.
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