Umuti wo kuvura amaraso mu mutima? (Ibumoso bwo gufunga igice cy'amaraso mu mutima) Reka tubyige mu buryo bworoshye!

Ese muganga wawe yaba yarakubwiye ko ufite Atrial Fibrillation, umutima wihuta cyane? Ushobora kuba uzi ko abantu bafite iyi ndwara bafite amahirwe menshi yo kurwara stroke inshuro eshatu cyangwa eshanu kurusha abandi. Impamvu nyamukuru ibi ni amaraso afungana mu mutima. Uyu munsi rero turimo kuvuga ku buryo bwihariye bwazanye ihumure rikomeye ku bantu benshi kandi bukoreshwa mu kugabanya iyi ngaruka mbi.

Mu magambo make, ifungwa ry'igice cy'ibumoso cya Atrial ni iki?

Yego, iri zina rishobora kumvikana nk'irigoye, ariko inkuru irasobanutse neza. Tekereza ku gice cyo hejuru cy'umutima wacu, icyumba cyo hejuru cy'umutima wacu. Hari igice gito gisa n'agafuka gituruka ku rukuta rw'iki cyumba. Ibyo ni byo abaganga bita Left Atrial Appendage (LAA) .

Ubusanzwe, iyo umutima utera neza, amaraso atembera muri uyu mufuka hanyuma akongera agasohoka. Ariko ku muntu ufite Atrial Fibrillation (Afib), icyumba cyo hejuru cy'umutima ntigifata neza, ahubwo gihita kinyeganyega. Hanyuma, amaraso yirundanya muri uwo mufuka witwa LAA, maze amaraso agatangira kuzura. 90% by'amaraso atera stroke ku bantu bafite Afib agaragara muri uyu mufuka muto witwa LAA.

Igishimishije ni uko gufunga iki gice cya LAA bitagira ingaruka ku mikorere y'umutima. Umutima ushobora gukora neza udafite.

Ni nde ukeneye ubu buvuzi?

Ubu buryo bwo kuvura bugirwa inama cyane cyane ku bantu bafite ikibazo cyo kugabanuka k'amaraso mu maraso (Afib) bafite ibyago byinshi byo kurwara indwara yo mu bwonko. Ni igisubizo cyiza cyane cyane ku bafite ibibazo byo kugabanya amaraso.

Abaganga bakunze gutanga imiti igabanya amaraso nka warfarin (Coumadin®) kugira ngo bagabanye ibyago byo kurwara indwara yo mu bwonko. Ariko hari abantu bagira ibibazo kuri iyi miti:

• Gupima amaraso buri gihe: Ugomba gupimwa amaraso buri gihe kugira ngo umenye neza ko ufata ingano ikwiye y'imiti.
• Kugenzura indyo: Hari ibiryo bimwe na bimwe, nk'imboga zirimo vitamine K, bishobora kuba ngombwa ko bigabanuka.
• Ingaruka zo kuva amaraso: Uyu muti ushobora kugabanya kuva amaraso ndetse no mu gihe hari imvune nto. Ibi ni bibi ku muntu ugwa kenshi cyangwa ufite ibyago byo kuva amaraso mu mara.
• Uyu muti ntukora kuri bamwe.

Apixaban (Eliquis®), rivaroxaban (Xarelto®) idafite warfarinNubwo hari imiti mishya nk'iyi, ntabwo ikora kuri buri wese. Irahenze kuri bamwe, kandi ifite ibyago byo kuva amaraso.

Rero, ku bantu bagorwa no gukomeza gufata imiti igabanya amaraso kubera impamvu nk'izi, mushobora kuvugana na muganga wanyu ku bijyanye n'uburyo bwo kuvura bwitwa LAA Closure.

Ni ubuhe buryo bukoreshwa mu gufunga LAA?

Hari uburyo butandukanye n'ibikoresho byo gufunga iki gice cya LAA. Bimwe muri ibi ni:

Kwitegura no gukora ubuvuzi

Mbere yo kuvurwa

Mbere yuko uhabwa ubu buvuzi, muganga wawe azasuzuma umutima wawe akoresheje Transesophageal Echocardiogram (TEE).Isuzuma ryitwa TEE cyangwa CT scan y'umutima rikorwa. Isuzuma rikubiyemo gushyira kamera nto mu muhogo kugira ngo hamenyekane imiterere n'ingano nyayo ya LAA mu mutima. Ibi biterwa nuko LAA ya buri wese atari imwe. LAA za bamwe zimeze nk'ibaba ry'inkoko, mu gihe LAA z'abandi zimeze nk'ikinyugunyugu. Iri suzuma rikoreshwa mu guhitamo igikoresho n'ingano ikubereye.

Byongeye kandi, uzagirwa inama yo kureka kurya no kunywa (kwiyiriza ubusa) amasaha make mbere yo kuvurwa.

Mu gihe cyo kuvurwa

Hari uburyo bubiri bw'ingenzi bwo kubikora.

1. Kubikora icyarimwe n'abandi babazwe umutima: Niba ugiye kubagwa umutima mu bundi buryo bukomeye, nko kubagwa bypass, umuganga ashobora gukata no gukuraho iki gice cya LAA icyarimwe, cyangwa akagipfuka.

2. Gutera mu buryo budakunze kugaragara: Ubu ni bwo buryo bukunze gukoreshwa cyane. Nta gukata gukomeye gukorerwa hano. Dore uko bigenda:

• Hakorwa akato gato ku ruhu hafi y'ikibuno, hanyuma umuyoboro muto witwa catheter unyuzwa mu mitsi y'amaraso ijya mu mutima.
• Uyu muyoboro ushyirwa mu gice cy'iburyo cy'umutima ujya mu gice cy'ibumoso, unyuze mu mwobo muto uri mu rukuta ruri hagati y'ibyumba bibiri. (Ntugahangayike, uyu mwobo ukunze kwifunga wonyine mu mezi 6).
• Hanyuma umuyoboro ushyirwa kuri LAA, maze igikoresho cyatoranyijwe mbere kigafungwa umunwa wa LAA.
• Ibi byose bikorwa urebye imbere ukoresheje scan nka Fluoroscopy (videwo ya X-ray) na TEE .
• Iyo akazi karangiye, kateri irakurwamo.

Bigenda bite nyuma yo kuvurwa?

Niba ubu buvuzi bukozwe binyuze mu gukata gato, ushobora kumara ijoro rimwe gusa mu bitaro hanyuma ukabasha gutaha umunsi ukurikiyeho.

Gahunda y'imiti izahinduka gato nyuma yo gutaha.

• Ubusanzwe, mu minsi 45 ya mbere , uzabwirwa gufata umuti ugabanya amaraso hamwe na aspirine. Muri icyo gihe, uruhu ruzaba rukikije igikoresho, rukifunga neza.
• Iyo isuzuma rya TEE nyuma y'iminsi 45 ryemeza ko LAA ifunze burundu, ushobora guhagarika gufata imiti igabanya amaraso. Hanyuma uzahabwa clopidogrel (Plavix®) na aspirine mu gihe cy'amezi 6 .
• Hari igihe muganga agira inama yo gufata aspirine igihe kirekire.

Ni izihe nyungu n'ingaruka byagira?

Nkuko bigenda ku buvuzi ubwo aribwo bwose, hari ibyiza n'ingaruka ntoya. Muganga wawe azagusobanurira ibi byose.

Ni ryari ugomba kuvugana na muganga?

Niba ubonye kimwe muri ibi bimenyetso bikurikira nyuma yo gusubira mu rugo nyuma yo kuvurwa, bimenyeshe muganga wawe ako kanya.

• Umuriro cyangwa ibindi bimenyetso by'ubwandu (kubyimba, gutukura kw'aho hafatiwe).
• Umutima utari usanzwe, kumva urimo utera cyane mu gituza.
• Kubabara cyane mu gituza.
• Kugorwa no guhumeka.

Kubana na Afib bishobora kugutera imihangayiko, cyane cyane iyo ufite ibibazo by’imiti igabanya amaraso. Gufunga kwa LAA si ibya buri wese, ariko bishobora kuba amahitamo kuri wewe. Bityo rero, vugana n’umuganga w’indwara z’umutima, ubaze ibibazo byawe, hanyuma ufate icyemezo kikubereye.