Reka twige ku kuvura valve ya mitral (TMVR) nta kubagwa.

Ese wowe cyangwa umuntu uzi cyangwa inshuti yawe ya hafi wigeze ubwirwa na muganga ko ufite ikibazo cya 'Mitral Valve' y'umutima wawe kandi ko ukeneye kubagwa? Iyo twumvise ijambo "kubagwa umutima," benshi muri twe bagira ubwoba gato, si byo se? Ibyo ni ibisanzwe. Kuko twumvise ibyerekeye kubagwa bikubiyemo gufungura igituza no kubagwa bikomeye. Ariko wari uzi ko siyansi y'ubuvuzi yateye imbere cyane ubu. Kubwibyo, hari uburyo bushya bushobora gusimbura ubu buryo bwo gufungura igituza no guca mu kantu gato cyane. Uyu munsi, tugiye kuvuga ku buryo bwo kuvura bwabaye ihumure rikomeye ku bantu benshi, bwitwa 'Transcatheter Mitral Valve Replacement' cyangwa TMVR mu magambo ahinnye.

Mu magambo make, TMVR ni iki?

Reka tubivuge mu buryo bworoshye. TMVR ni uburyo busimbura valve ya mitral mu mutima wawe. Ariko ikintu cyihariye kuri yo ni uko idakorwa ufungura igituza cyawe cyose nk'uko bikorwa mu kubaga umutima. Ahubwo, umuyoboro muto (catheter) ushyirwamo unyuze mu kantu gato cyane, hanyuma valve nshya igashyirwa mu mutima wawe.

Tekereza ko aho gukuraho valve nini ukayisimbuza nshya, ufata ibice bya valve nshya ukabinyuza mu mwobo muto ukabishyira imbere. Ubu buryo ni uburyo budakunze kugaragara cyane nk'ububaji bukomeye. Valve nshya ishyirwa muri ubu buryo ishobora kuba iy'ubukorano. Cyangwa ishobora kuba valve y'ibinyabuzima ikozwe mu nka, ingurube, cyangwa inyama z'umutima w'umuntu. Iyo valve nshya imaze gushyirwamo, itangira gukora kimwe neza n'uko valve yawe ishaje, irwaye, yakoraga.

Ni nde ukeneye ubu buryo bwo kuvurwa na TMVR?

Kugira ngo tubisobanukirwe neza, reka tubanze turebe icyo iyi 'valve ya mitral' ari cyo n'uko ibaho.

Umutima wacu ufite ibyumba bine by'ingenzi. Bibiri hejuru na bibiri hasi. Valve ya mitral iherereye hagati ya atrium y'ibumoso na ventricle y'ibumoso. Ni nk'urugi ruri hagati y'ibyumba bibiri. Uru rugi rufite udupapuro tubiri (udupapuro). Igihe cyose umutima ukubita, utu dupapuro turafunguka kandi tugafunga. Ibi bituma amaraso atembera mu cyerekezo kimwe gusa, kuva mu cyumba cyo hejuru kugera mu cyumba cyo hasi. Akamaro k'ingenzi k'iyi valve ni ukubuza amaraso gutembera inyuma.

Ariko rimwe na rimwe, haba kuva umwana avutse cyangwa nyuma yaho, ibibazo bitandukanye bishobora kuvuka kuri iyi valve. Hari ubwoko bubiri bw'ibibazo.

Iyo izi ndwara zibaye zikomeye, zishobora gutera ibimenyetso nko kubura umwuka, umunaniro, no kubabara mu gatuza. Zishobora kandi gutera indwara zikomeye nko gutera umutima mu buryo budasanzwe (umutima utari umeze neza), umuvuduko ukabije w’amaraso mu bihaha (umuvuduko ukabije w’amaraso mu bihaha), cyangwa umutima unanirwa gukora neza.

Ese TMVR na MitraClip ni kimwe?

Oya. Nubwo byombi ari uburyo bwo kuvura ibibazo bya mitral valves bidakunze kugaragara, hari itandukaniro hagati yabyo byombi.

• TMVR ni uburyo bwo gusimbuza valve yose .
• MitraClip™ ni uburyo bwo gusana valve. Ni nko gushyira agace gato hagati y'uduce tubiri tw'agace kavamo valve, ugahagarika amazi avamo.

Umuganga w'indwara z'umutima ni we uzagena uburyo bwiza bwo kuvura.

Ni iki kibaho mbere yo kuvurwa na TMVR?

Mbere y'ubu buvuzi, itsinda ry'abaganga bazagusuzuma neza. Ibi bizaba bikubiyemo ahanini ibi bikurikira:

• Echocardiogram: Iyi ni scan ya ultrasound y'umutima. Ishobora kwerekana neza uko ibyumba by'umutima n'udupira tw'umutima bikora.
• CT Scan: Iyi mashini ifata amashusho y’umutima n’imitsi y’amaraso mu buryo bwa 3D kandi igafasha mu gutegura uburyo bwo kuvura.

Ikoresheje amakuru aturuka muri ibi bizamini, itsinda ry’abaganga ritegura ingano nziza y’ingufu n’uburyo bwiza bwo kuvura.

Byongeye kandi, umuganga w’inzobere mu by’imiti azavugana nawe maze agufashe icyemezo cy’ubwoko bwiza bw’inzobere mu kugufasha kwirinda kubabara mu gihe cyo kubagwa. Ushobora gusinzira burundu (anesthesia rusange), cyangwa ushobora gusinzira ntugire ububabare (conscious sedation).

Iminsi mike mbere y'uko uvurwa, muganga wawe azaguha amabwiriza asobanutse neza y'uko wakwitegura. Muri ayo mabwiriza hashobora kuba harimo:

• Imiti imwe n'imwe, nk'imiti igabanya amaraso, ishobora gusaba guhagarika gukoresha mu minsi mike.
• Ku munsi wo kuvurwa, uzasabwa kwiyiriza ubusa (utarya cyangwa ngo unywe) mu gihe cy'amasaha make.
• Nyuma yo kuvurwa, basaba ko bagutegurira imodoka yo kugutwara iwawe uvuye kwa muganga.

Ni iki kibaho mu gihe cyo kuvurwa na TMVR?

Ubusanzwe igikorwa cyose kimara amasaha abiri kugeza kuri atatu kandi gikorwa n'itsinda rinini ry'abaganga, barimo abaganga b'umutima, abaganga b'indwara z'umutima, abahanga mu gufata amashusho, n'abaganga b'inzobere mu gutera ikinya.

Dore isesengura ryoroheje ry'ibiba mu gihe cyo kuvurwa:

1. Ubwa mbere, agace kazakorerwamo icyuho (akenshi mu kibuno cyangwa agace gato ku gituza) karasukurwa kandi umusatsi ugakurwaho bibaye ngombwa.

2. Hanyuma, kanula (umurongo wa IV) izashyirwa mu mutsi uri mu kuboko kwawe, aho uzanyuzwamo imiti n'amazi akenewe.

3. Hanyuma, valve nshya ihambirwa ku mpera y'umuyoboro muto kandi woroshye witwa catheter .

4. Noneho, hakorwa icyuho gito cyane ahantu runaka mu kibuno cyangwa mu gituza, kandi binyuze muri ibyo, iyi catheter ishyirwa mu mitsi y'amaraso.

5. Bakoresheje ikoranabuhanga ryihariye ryo gufata amashusho, nka X-rays, abaganga bayobora neza iyi catheter mu mitsi y'amaraso bakayigeza kuri valve ya mitral mu mutima.

6. Iyo imaze gushyirwa mu mwanya wayo, valve nshya ishyirwa mu valve ishaje kandi irwaye.

7. Iyo valve nshya imaze gushyirwa mu mwanya wayo neza, catheter ikurwaho witonze hanyuma agace gato kagafungwa.

Muri iki gihe cyose, itsinda ry’abaganga rizakomeza gukurikirana ibintu byose kuva ku muvuduko w’amaraso yawe n’urugero rwa ogisijeni mu maraso kugeza ku mikorere y’umutima wawe hakoreshejwe echocardiogram.

Bigenda bite nyuma yo kuvurwa?

Nyuma yo kuvurwa, uzajyanwa mu cyumba cyo gukira. Itsinda ry'abaganga rizakwitaho neza kugeza ukize ikinya. Hari abantu bashobora gukenera kumara igihe mu cyumba cy'indembe (ICU). Ubusanzwe, ugomba kumara iminsi mike mu bitaro.

Mbere yo gutaha, abaganga bazagusobanurira neza icyo ugomba gukora nyuma yaho.

• Kuvugurura umutima: Inama ku myitozo ngororamubiri no guhindura imibereho kugira ngo bifashe kongera gukomeza umutima.
• Gahunda zo gukurikirana: Iminsi ugomba kongera kubonana na muganga.
• Imiti: Inama ku miti mishya yo gutangira cyangwa imiti ishaje yo gutangira.
• Akazi gasanzwe: Ni ryari ushobora gusubira ku kazi ugasubira mu mirimo isanzwe?

Ni izihe nyungu zo kuvura TMVR?

Ugereranyije no kubaga umutima ufunguye, ubu buryo bwa catheter bufite ibyiza byinshi.

• Indwara ya Mitral valve irashobora gukosorwa.
• Kugabanya ibimenyetso biterwa n'iyi ndwara, nko kubura umwuka no kunanirwa.
• Kugabanya ibyago bikomeye by'ubuzima.
• Ishobora gukira vuba kurusha kubagwa mu buryo bwihuse.
• Ingaruka ku mubiri no ku bubabare bigabanuka.

Ese hari ingaruka cyangwa ingorane ziterwa n'ubu buvuzi?

Yego. Nubwo ingaruka ziba nke ugereranije no kubagwa umutima, kimwe no ku buvuzi ubwo aribwo bwose, TMVR ishobora kugira ingaruka zimwe na zimwe. Ariko, izi ni nke cyane.

Izi ni zimwe mu ngorane zikomeye zishobora kubaho:

• Amaraso apfutse: Iyo ayo maraso apfutse ajya mu bwonko, indwara yo gucika kw'imitsi ishobora kubaho.
• Kwangirika kw'uturemangingo: Urukuta rw'umutima (gutobora kw'imitsi y'ibumoso) cyangwa umuyoboro w'amaraso utanga amaraso ku mutima (imitsi y'umutima) bishobora gukomereka.
• Kuziba kw'inzira yo gusohora amaraso mu gice cy'ibumoso: Umugozi mushya ubuza inzira amaraso ava mu cyumba cyo hasi cy'ibumoso.
• Uburyo valve igenda: Uburyo valve igenda iva aho ihagaze.

Ingorane zimwe na zimwe zishobora gusaba ubundi buvuzi cyangwa kubagwa.

Bifata igihe kingana iki kugira ngo umuntu akire?

Abantu benshi bashobora gusubira mu mirimo yabo isanzwe bagakora mu byumweru bike. Ariko, bishobora gufata amezi abiri cyangwa atatu kugira ngo bakire neza . Icy'ingenzi ni ugukurikiza amabwiriza ya muganga witonze. Ntukihutire gukora imirimo iremereye cyangwa imirimo ivunanye.

Ni mu bihe ibihe ugomba gushaka inama kwa muganga nyuma yo kuvurwa?

Iki ni ingenzi cyane. Iyo ugiye mu rugo nyuma yo kuvurwa, ugomba kwitondera impinduka mu mubiri wawe. Hari ibimenyetso bimwe na bimwe, nibigaragara, ugomba gushaka inama kwa muganga vuba .

TMVR ni uburyo bw'ingirakamaro cyane bwo kuvura abantu bafite indwara ya mitral valve badashobora kubagwa umutima. Niba ufite ibindi bibazo kuri ibi, nyamuneka vugana na muganga wawe. Azashobora kugusobanurira uburyo bwiza bwo kuvura.