Reka twige uburyo bugezweho bwo gusimbuza valve udafunguye umutima (Transcatheter Mitral Valve Replacement - TMVR)!

Umutima wacu ni urugingo rutangaje rukora nta guhagarara. Muri uyu mutima, hari uturindantoki tune dukora nk'amarembo ane kugira ngo tugenzure neza urujya n'uruza rw'amaraso. Uturindantoki twemerera amaraso gutembera mu cyerekezo kimwe gusa. Imwe muri utu turindantoki yitwa 'valve ya Mitral'. Iyi iherereye ibumoso bw'umutima hagati y'icyumba cyo hejuru (atrium y'ibumoso) n'icyumba cyo hasi (ventricle y'ibumoso). Ariko rimwe na rimwe iyi valve ya mitral ishobora kurwara. Ibyo bivuze ko amaraso ashobora kuva inyuma adafunze neza, cyangwa agafungwa adafunguye neza. Muri iki gihe rero, iyo valve igomba gusimburwa.

None se TMVR ni iki?

Mu magambo make, TMVR (Transcatheter Mitral Valve Replacement) ni uburyo bugezweho bwo kuvura busimbura valve ya mitral yangiritse n'ivali nshya hatabayeho kubagwa umutima cyane.

Tekereza, aho kubagwa cyane bikubiyemo gufungura igituza no guhagarika umutima, umuyoboro muto (catheter) unyuzwa mu kantu gato cyane mu gituza cyangwa mu gituza, ku muyoboro w'amaraso, ukajya mu mutima, hanyuma agace gashya kagashyirwamo agace gashyirwa mu mwanya w'agace gashaje gafite indwara. Aka gace gashya gashobora kuba agace gakozwe n'abantu, cyangwa gashobora gukorwa mu nyamaswa z'inyamaswa (inka, ingurube). Muri ubu buryo, agace gashaje ntigakurwaho, ahubwo gashyirwamo agashya kagashyirwamo kagakosorwa.

Ni nde koko ukeneye ubu buvuzi?

Hari ubwoko bubiri bw'ingenzi bw'indwara ya mitral valve:

1. Gusubirana kwa valve ya Mitral: Iki ni igihe utwo duce tubiri tw'iyi valve tudafunga neza, bigatuma amaraso amwe asumwa n'umutima ava inyuma. Ni nk'amazi ava mu robine yamenetse.

2. Guhagarika imikorere y'imitsi yo mu bwoko bwa Mitral: Ibi bibaho iyo icyuma gifunganye kandi ntigifunguke neza. Ibi bigabanya ingano y'amaraso ashobora gutembera imbere. Nk'uko iyo umuyoboro ufunze, amazi agenda aragabanuka.

Iyo ibi bibazo byombi bikomeye, ibimenyetso bikomeye nko kubura umwuka, kuribwa mu mitsi, umuvuduko ukabije w’amaraso mu bihaha, no kunanirwa k’umutima bishobora kubaho.

Ese TMVR na MitraClip ni kimwe?

Oya. Nubwo ubwo buryo bwombi ari uburyo bwo kuvura bukorwa hatabayeho gufungura umutima, ni uburyo bubiri butandukanye.

• MitraClip™: Ibi bikubiyemo gusana valve irimo kuva. Ibi bikubiyemo gushyira agakoresho gato kameze nk'agace k'inyuma hagati y'udupapuro tubiri tw'iyi valve kugira ngo amaraso adasohoka.
• TMVR:Ibi si ugusana, ahubwo hashyizweho valve nshya rwose.

Ni iki kibaho mbere yo kuvurwa na TMVR?

Nyuma yo gufata icyemezo cyo kuguha ubu buvuzi, itsinda ry’abaganga rizagusuzuma neza.

• Ibizamini: Hakorwa ibizamini byinshi, nko "Echocardiogram" kugira ngo harebwe imikorere y'umutima na "CT scan" kugira ngo harebwe imiterere y'umutima. Ibi bikoreshwa mu gutegura uburyo bwo kuvura.
• Kuvuga ku bijyanye n'ikinyabutabire: Inzobere izakubwira ubwoko bw'ikinyabutabire uzahabwa kugira ngo wirinde ububabare mu gihe cyo kuvurwa. Icyemezo kizafatwa hashingiwe ku ndwara yawe, niba uzahabwa ikinyabutabire rusange cyangwa ikinyabutabire cyo kuruhuka utazi.
• Amabwiriza: Muganga azaguha amabwiriza yihariye.
• Imiti imwe (cyane cyane imiti igabanya amaraso) ishobora gusaba guhagarika kuyikoresha mu minsi mike.
• Uzasabwa kwiyiriza ubusa amasaha make ku munsi wo kuvurwa.
• Uzamenyeshwa kuzana umuntu mu rugo nyuma yo kuvurwa.

Ni iki kibaho mu gihe cyo kuvurwa?

Ubu buvuzi busanzwe bumara amasaha abiri cyangwa atatu. Itsinda ry'inzobere, barimo abaganga b'umutima, abaganga b'indwara z'umutima, n'abaganga b'inzobere mu gutera ikinya, nibo babigizemo uruhare.

Muri make, ibi ni byo bibaho.

1. Aho hakorewe isuku (umuhogo cyangwa igituza) hasukurwa kandi hagategurwa.

2. Kanula (umurongo wa IV) ishyirwa mu mutsi uri mu kuboko, aho imiti n'amazi bikenewe bitangwa.

3. Valve nshya ifatanye n'umuyoboro muto (catheter).

4. Uyu muyoboro ushyirwa mu mitsi y'amaraso binyuze mu gukata gato gakorerwa mu kibuno cyangwa mu gituza.

5. Hakoreshejwe ikoranabuhanga ryihariye ryo gufata amashusho, uyu muyoboro uyoborwa ku mugozi wa mitral w'umutima.

6. Valve nshya ishyirwa muri valve ishaje, ishyizwe mu mwanya wayo neza, hanyuma igashyirwamo.

7. Hanyuma umuyoboro urakurwaho hanyuma aho gukata hagafungwa.

Ikipe y'abaganga irimo gukurikirana ibintu byose, harimo n'umuvuduko w'amaraso yawe n'urugero rwa ogisijeni, muri iki gihe cyose.

Ni iki kibaho nyuma ya TMVR?

Nyuma yo kuvurwa, uzajyanwa mu cyumba cyo gukira. Uzakurikiranirwa hafi kugeza igihe uzakira ikinya. Hari abantu bashobora gukenera kuguma mu cyumba cy’indembe (ICU) umunsi umwe cyangwa ibiri. Ubusanzwe, uzakenera kuguma mu bitaro iminsi mike.

Ugiye mu rugo, muganga wawe azakugira inama kuri ibi bikurikira:

• Uburyo bwo kwitabira gahunda zo kuvura indwara z'umutima.
• Gahunda zo gukurikirana.
• Ku bijyanye n'imiti yo gutangira bundi bushya n'imiti mishya yo gufata.
• Ni ryari nshobora gusubira mu mirimo isanzwe n'akazi?

Ibyiza n'ingaruka zo kuvurwa na TMVR

Nkuko bigenda ku buvuzi ubwo aribwo bwose, hari ibyiza ndetse n'ingaruka. Reka tubirebe.

Ni ryari ugomba gushaka inama zihutirwa ku buvuzi?

Iyo ugiye mu rugo nyuma yo kuvurwa, ugomba kwitondera cyane ibimenyetso bimwe na bimwe. Niba ubonye ibimenyetso bikurikira , jya mu cyumba cy’ubuvuzi bwihutirwa (ETU) cy’ibitaro vuba.