Reka twige ku bijyanye no kubaga imitsi y'umutima (Surgical Mitral Commissurotomy) mu magambo yoroheje.

Tekereza umutima wawe nk'ipompe y'amazi ikora idahagarara. Muri iyi pompe, hari ibice bine bito bisa n'umuryango bifasha amaraso gutembera mu cyerekezo kimwe gusa. Mu buvuzi, tuyita utu tugari tw'umutima. Iyo izi nzugi zidafunguka kandi ntizifungwe neza, ni ikibazo gikomeye, si byo se? Mu buryo nk'ubwo, uyu munsi turimo kuvuga ku kubagwa kwihariye gukorwa iyo uruti rwa mitral, rumwe mu tugari tw'ingenzi mu mutima wacu, rudafungutse neza kandi rugacika ruto.

Komissurotomy ni iki?

Muri make, commissurotomy ni igikorwa cyo kubaga gifasha amaraso gutembera mu mugozi uri mu mutima wawe. Akenshi gikorerwa kuri mitral valve . Valve ya mitral iherereye hagati y'icyumba cyo hejuru ibumoso (atrium y'ibumoso) n'icyumba cyo hasi ibumoso (ventricle y'ibumoso).

Tekereza ko uru rugi rudafunguka neza kandi rugafatana kandi rugafunganye. Ibi tubyita mitral valve stenosis. Icyaba gihari ni uko inzira y'amaraso ava mu cyumba cyo hejuru ajya mu cyumba cyo hasi ifunze. Ibi bituma amaraso asubira inyuma kandi bigatera umutwaro mwinshi ku mutima no mu bihaha. Uko igihe kigenda gihita, ibi bishobora no gutera indwara zikomeye nko kunanirwa k'umutima.

Ubu buryo bwo kubaga bwa commissurotomy bukoreshwa mu kuvura ibyiciro bya mbere bya stenosis ya mitral valve. Ariko mu by'ukuri, muri iki gihe ntabwo bikorwa kenshi cyane. Kubera ko akenshi bikorwa nk'uburyo bwo kubaga umutima ufunguye . Bufite ingaruka zimwe na zimwe. Kubwibyo, igihe cyose bishoboka, abaganga bagerageza gukoresha uburyo bworoshye kandi budatera akaga. Bumwe mu buryo bw'ingenzi buboneka ubu ni valvuloplasty ya balloon . Muri ubwo buryo, hashyirwamo umuyoboro muto hanyuma ikintu kimeze nk'umupira w'amaguru gishyirwamo umwuka imbere muri valve yagabanutse, kikayigura.

Ariko, kuri bamwe, uburyo bwo kubaga balune ntibushobora gukorwa bitewe n'aho umutima wabo uhagaze cyangwa izindi mpamvu. Muri ibyo bihe, kubaga commissurotomy ni bwo buryo bwiza.

Ni nde koko ukeneye ubu bubagwa?

Niba ufite stenosis ya mitral kandi kimwe muri ibi bikurikira kikureba, muganga wawe ashobora kukugira inama yo kubagwa:

• Niba utarakira hakoreshejwe ubundi buryo bwo kuvura.
• Niba udashobora gukorerwa isuzuma rya balloon valvuloplasty.

Byongeye kandi, niba warigeze kubagwa umutima ukundi, ubu buvuzi bushobora gukorwa icyarimwe.

Ariko ikintu kimwe ni ngombwa kwibuka. Si abantu bose bafite stenosis ya mitral valve bashobora kubagwa. Biterwa n'icyateye stenosis ya valve yawe.

Hari impamvu ebyiri z'ingenzi:

1. Kwangirika guterwa n'indwara y'umutima ya rubagimpande:Umuriro uterwa na rubagimpande, ukurikira indwara yo mu muhogo mu bwana, ushobora kwangiza imiyoboro y'umutima nyuma y'imyaka myinshi.

2. Degenerative Mitral Stenosis: Uko igihe kigenda gihita, valve iracika intege buhoro buhoro, iragabanuka, kandi igatwikirwa n'ibice bya kalisiyumu.

Kubaga commissurotomy bifasha cyane cyane abantu bafite indwara y'umutima ya rubagimpande . Muri iki kibazo, impande ebyiri z'agace k'imitsi aho udupapuro tubiri duhurira, twitwa commissures , birakomera kandi rimwe na rimwe birafatana.

Mu kubaga hakoreshejwe uburyo bwa commissurotomy, hakorwa uduce duto ku mpande ebyiri z'agapira hanyuma kakarekurwa. Hanyuma agapira gatangira gufungura neza. Ariko, ku bantu bafite agapira gashaje bitewe n'imyaka, agapira gakunze kuba kadangiritse. Ahubwo, ibindi bice bya gapira bigomba gusanwa. Kubwibyo, ubu buryo bwo kubaga ntibubakwiriye. Bazagomba gusanwa ubundi bwoko bwa gapira cyangwa gusimburwa burundu (mitral valve replacement).

Ni iki kibaho mbere yo kubagwa?

Imyiteguro itangira ibyumweru, rimwe na rimwe amezi, mbere y'umunsi wo kubagwa kwawe. Itsinda ry'abaganga bawe (umuganga w'umuryango wawe, inzobere mu by'umutima, n'umuganga w'umutima) bazahurira hamwe kugira ngo bagupime neza.

Niba ufite ikibazo, ubwoba, cyangwa gushidikanya ku kubagwa, vugana na muganga wawe kuri byo. Ntugire icyo uhisha. Ni ngombwa cyane kumenya byose no kujya kubagwa ufite umutima utuje.

Muganga wawe azaguha amabwiriza y'uko wakwitegura kubagwa, harimo igihe cyo kureka kurya no kunywa mbere yo kubagwa, hamwe n'impinduka zose ku miti yawe.

Kubagwa bikorwa gute?

Mu cyumba cyo kubaga, itsinda ry’abaganga rikurikiza izi ntambwe:

1. Ubwa mbere, uzahabwa ikinya cyo gusinziriza hanyuma usinzire kugeza igihe abaganga barangije kubaga. Nta bubabare uzumva.

2. Hanyuma, umuganga ubaga agukata hagati mu gituza, hepfo mu igufwa ry'ibere (sternum). Ibi byitwa median sternotomy .

3. Uzaba uhujwe n'imashini ikoresha umutima n'ibihaha . Iyi mashini ifata by'agateganyo akazi k'umutima n'ibihaha byawe mu gihe cyo kubagwa. Ibi bituma muganga abakorera kubaga ukiri muzima, umutima wawe udatemba.

4. Atriyumu y'ibumoso y'umutima irafungurwa hanyuma valve ya mitral irasuzumwa.

5. Hanyuma, hakorwa icyuho gito cyane ku mfuruka ebyiri (commissures) z'agace k'ingufu kamaze gufatana kandi kakagira ubugari, kakavanwa hagati yabyo hanyuma kakarekurwa.

6. Nyuma y'akazi, uzakurwa ku mashini ikoresha umutima n'ibihaha maze umutima n'ibihaha byawe bizongera gukora.

7. Amaherezo, echocardiogram ya transesophagealHakorwa isuzuma ryihariye kugira ngo hemezwe niba valve ikora neza kandi niba byose bikora neza.

Hari igihe ubundi buryo bwo kubaga umutima, nko gusana izindi valve z'umutima (valve aortic cyangwa tricuspid valve), bushobora gukorwa icyarimwe n'ubu buryo bwo kubaga. Niba bibaye ngombwa, itsinda ry'abaganga rizabigusobanurira mbere y'igihe.

Ni iki kibaho nyuma yo kubagwa?

Uzakenera kumara icyumweru kimwe mu bitaro nyuma yo kubagwa. Ku munsi wa mbere cyangwa ibiri, uzaguma mu cyumba cy’indembe (ICU) kandi ukurikiranwe neza cyane. Ibi ni ukugira ngo bigufashe kubona ingorane zishobora kuvuka nyuma yo kubagwa vuba bishoboka.

Mbere yuko uva mu bitaro, muganga wawe azaguha amakuru yerekeye:

• Ivuriro ry'umutima: Ibi ni ingirakamaro cyane ku bantu bakize nyuma yo kubagwa umutima. Bigufasha kugarura imbaraga no gutangira gukora imirimo isanzwe.
• Uko wakwita ku icibwa: Ni ngombwa cyane kugira ngo icyuho gisukure kugira ngo hirindwe kwandura no gukiza igisebe vuba.
• Amabwiriza: Inama ku gihe ugomba gutegereza mbere yo gusubira mu bikorwa nko gutwara imodoka cyangwa gukora imirimo iremereye.

Mbere yo gutaha, ntukibagirwe gutegura umuntu uza kugutwara.

Ni izihe nyungu n'ingaruka z'ubu buvuzi?

Ibyiza

Uku kubagwa gushobora kugabanya ibimenyetso nko kubura umwuka no kunanirwa guterwa no kugabanya umugozi wa mitral. Bishobora kandi kukurinda ingorane zikomeye zishobora kubaho mu gihe kizaza. Ubu ni uburyo bwiza cyane bwo kuvura abantu bafite ikibazo kidakomeye bihagije cyo gusimbuza umugozi burundu kandi batabashije kuvura neza ubundi buryo.

Ingaruka cyangwa ingorane

Kimwe no kubagwa kose, hari ibyago. Ingorane ikunze kugaragara ni ugusubirana kwa valve ya mitral .

Ingaruka nyinshi muri izi zishobora kugabanuka iyo umuntu avuriwe mu bitaro bikuru bifite ibigo n'abaganga b'inararibonye mu kubaga umutima.

Ni iki kizabaho nyuma yo kubagwa?

Gufungura commissurotomy bifite igipimo cyo hejuru cyane cyo gukora neza. Ubusanzwe ubu buryo bukosora igabanuka ry'agapira k'amaraso no gusubiza amaraso mu buryo.

Muganga wawe ashobora kukubwira neza ubuzima bwawe bw'ejo hazaza. Buri wese akira mu buryo butandukanye. Hari ibintu byinshi bigira ingaruka kuri ibi, harimo imyaka yawe, ubuzima muri rusange, ndetse n'urugero rwangiritsemo mu muyoboro wawe w'amaraso mbere yo kubagwa.

Ni ryari ugomba kujya kwa muganga?

Niba ugaragaje ibimenyetso by'ubwandu mu gihe uri gukira uri mu rugo nyuma yo kubagwa, hamagara muganga wawe ako kanya.

• Kubabara mu gituza, gufungana, cyangwa kumererwa nabi.
• Umuriro.
• Udukoko cyangwa amazi asa n'ibibyimba ava aho yaciwe.

Niba ubonye kimwe muri ibi bimenyetso bikomeye bikurikira, hita uhamagara inomero y'ubutabazi bw'ibanze yo mu gace utuyemo cyangwa ujye ku bitaro bikuru byita ku butabazi bw'ibanze (ETU) biri hafi yawe:

• Ibimenyetso by'indwara y'umutima (kubabara cyane mu gatuza, guhumeka nabi, kuruka, kubira ibyuya).
• Ibimenyetso by'ubumuga (kunanirwa kuvuga, kunama k'uruhande rumwe rw'isura, kubura ibyiyumvo mu kuboko cyangwa ukuguru).