Menya uburyo bwo kuvura LAA Closure (Left Atrial Appendage Closure) bugabanya ibyago byo kurwara stroke.

Ushobora kuba warumvise ibyerekeye Atrial Fibrillation (Afib), indwara aho umutima wawe utera mu buryo butunguranye kandi bwihuse. Wenda wowe cyangwa umuntu wo mu muryango wawe ufite iyi ndwara. Ingaruka zikomeye zo kurwara Afib ni ukwiyongera kw'ibyago byo kurwara stroke. Nk'igisubizo kuri ibi, abaganga bakunze kwandika imiti igabanya amaraso. Ariko gufata iyi miti igihe kirekire si byoroshye kuri buri wese. Ku bantu nk'abo, turimo kuvuga uburyo bwihariye bwo kuvura bushobora kugabanya ibyago byo kurwara stroke.

Mu magambo make, gufunga igice cy'ibumoso cy'atrial (LAA) ni iki?

Kugira ngo tubisobanukirwe, reka tubanze twige ku gice gito cy'umutima wacu. Mu cyumba cyo hejuru ibumoso cy'umutima wacu, cyitwa Left Atrium, hari agace gato kameze nk'agafuka. Ibi ni byo twita Left Atrial Appendage (LAA) .

Ubusanzwe, iyo umutima utera mu buryo butunguranye, amaraso ari muri iyi LAA ashyirwa mu gice cy'umutima. Ariko, ku muntu urwaye Atrial Fibrillation (Afib) , umutima utera mu buryo butunguranye, bityo amaraso ari muri iyi sakoshi yitwa LAA ntatera neza maze agatangira kwihuza. Uku kwihuza kw'amaraso amaherezo bishobora guhinduka ibibyimba by'amaraso .

Ikibabaje ni uko iyo iki gipfundikizo cy’amaraso kivuyemo kigafata umuyoboro w’amaraso ugana mu bwonko, gishobora gutera indwara yo gucika kw’amaraso . Hafi 90% by’indwara yo gucika kw’amaraso ku bantu barwaye Afib biterwa n’uko ibipfundikizo by’amaraso biba muri LAA.

Rero, muri ubu buryo bwo kuvura bwitwa LAA Closure, agapfunyika kitwa LAA aho amaraso apfutse, haba mu kubagwa cyangwa mu gukata gato cyane. Nyuma yo gufunga, nubwo amaraso yapfutse, ntashobora kwinjira mu maraso. Kubwibyo, ibyago byo kurwara indwara yo gucika kw'imitsi biragabanuka cyane.

Ni nde ubu buryo bwiza bwo kuvura? Kuki tudakoresha imiti igabanya amaraso gusa?

Gufunga kwa LAA si uburyo bwo kuvura abantu bose bafite ibyago byinshi byo kurwara indwara yo mu bwonko iterwa na Afib. By'umwihariko, byitabwaho ku bantu bafite:

• Ku badashaka gufata imiti igabanya amaraso igihe kirekire.
• Abantu bagwa kenshi bityo bakaba bafite ibyago byinshi byo kuva amaraso (kuko n'igikomere gito gishobora gutera kuva amaraso menshi iyo ufashe imiti igabanya amaraso).
• Ku bantu bagira izindi ngaruka mbi zikomoka ku miti igabanya amaraso.
• Ku bantu badashobora kwishyura imiti ihendutse yo kugabanya amaraso.

Abantu benshi bahura n'ingorane zitandukanye iyo bafata imiti ishaje yo kugabanya amaraso nka Warfarin.

Nubwo hari imiti mishya nka Apixaban na Rivaroxaban, ibiciro byayo biri hejuru ndetse n'ibyago byo kuva amaraso bikomeje ni ibibazo kuri bamwe. Ugomba kuvugana n'umuganga w'indwara z'umutima kugira ngo agufashe guhitamo uburyo bwiza bwo kuvura.

Ni ubuhe buryo bukoreshwa mu gufunga iyi LAA?

Hari uburyo butandukanye n'ibikoresho bikoreshwa muri ibi. Tekereza nko gufunga umunwa w'icupa ry'amazi, iki gikoresho gikoreshwa mu gufunga umunwa w'iki gikapu cyitwa LAA.

• Ibikoresho byo kuziba imbere: Ibi bimeze nk'umutaka muto. Bishyirwa mu mutima hakoreshejwe catheter kandi bikoreshwa mu gufunga umwobo wa LAA imbere. WATCHMAN™ na Amulet™ ni ibikoresho bikunzwe cyane muri ubwo bwoko.
• Ibikoresho byo gufunga inyuma: Hari igihe, mu gihe cy'ubundi buryo bwo kubaga umutima, LAA ishobora gufungwa inyuma hakoreshejwe agapira (`AtriClip™`) cyangwa hakoreshejwe umugozi wihariye (`Lariat™`).

Uburyo bukubereye butorwa nyuma y'ikiganiro hagati yawe na muganga wawe.

Kwitegura kuvurwa n'uko ubuvuzi bukorwa

Mbere yo kuvurwa...

Mbere y'ubu buryo bwo kuvura, muganga wawe azakenera gupima ingano nyayo n'imiterere ya LAA yawe. LAA ya buri wese si imwe. Hari abavuga ko ifite ishusho nk'ibaba ry'inkoko, cactus, cyangwa cauliflower. Ibi bizasaba gupimwa Echocardiogram ya Transesophageal Echocardiogram (TEE) (gupima umutima binyuze mu muyoboro witwa larynx) cyangwa gupimwa Cardiac CT . Uzasabwa kandi kwiyiriza ubusa (kudarya cyangwa kunywa) amasaha make mbere yo gukora ubu buryo.

Mu gihe cyo kuvurwa...

Ibi bishobora gukorwa mu buryo bubiri bw'ingenzi:

1. Mu bundi buryo bwo kubaga umutima:Niba urimo kubagwa umutima mu bundi buryo bukomeye, nko kubagwa bypass, umuganga ashobora no gukuraho cyangwa kudoda LAA icyarimwe.

2. Gutera amaraso make: Ubu buryo ni bwo bukoreshwa cyane. Aha, umuyoboro muto, witwa catheter, ushyirwa mu kibuno cyawe unyuze mu mutsi hanyuma ukagezwa ku mutima wawe. Hanyuma, igikoresho cyatoranijwe gishyirwa mu mwenge wa LAA hanyuma kigafungwa kugira ngo amaraso adasohoka. Ubu buryo bwose bukorwa hifashishijwe ikoranabuhanga rya X-ray (Fluoroscopy) na scan (TEE/Intracardiac Ultrasound).

Nyuma yo kuvurwa ...

• Ubusanzwe ugomba kurara mu bitaro ijoro ryose.
• Isuzuma rya TEE rizongera gukorwa mu minsi igera kuri 45 kugira ngo harebwe niba ubuvuzi bwagenze neza.
• Uzahabwa umuti wo kugabanya amaraso na aspirine kugira ngo unywe kugeza igihe ingingo z'umubiri zizakurira hafi y'iki gikoresho, ibyo bikaba bifata ukwezi n'igice.
• Nyuma y'ibyo, uzagomba guhagarika gufata imiti igabanya amaraso hanyuma ufate Clopidogrel na aspirine mu gihe cy'amezi agera kuri 6. Ushobora no gufata aspirine ubuzima bwawe bwose. Ibi byose bizakorwa ku nama za muganga wawe.

Ni izihe nyungu n'ingaruka z'ubu buvuzi?

Nk’uko bigenda ku buvuzi ubwo aribwo bwose, ubu buvuzi bufite ibyiza n’ibyago.

Ubu buryo bwo kuvura bufite akamaro cyane. Dukurikije ubushakashatsi bumwe na bumwe, ubu buryo bushobora kugabanya ibyago byo kurwara indwara yo gucika intege ku kigero cya 80%. Ariko ibuka ko ari ngombwa kubiganiraho na muganga wawe mbere yo gufata icyemezo niba ari byiza kuri wewe.

Ni ryari ngomba kubonana na muganga?

Uretse kujya mu nama zawe zo gukurikirana, menyesha muganga wawe ako kanya niba ubonye ibimenyetso bikurikira:

• Ibimenyetso by'umuriro cyangwa ubundi bwandu
• Umutima utari umeze neza
• Kubabara mu gatuza
• Guhumeka bigoranye

Niba ubonye kimwe muri ibi bimenyetso, jya ku bitaro bikuru by’ubutabazi bw’ibanze (ETU) by’ibitaro biri hafi yawe vuba.