Ese ushobora kwiyumvisha gusimbuza umugozi w'umutima udafunguye igituza burundu? Yego, ubu ni ukuri. Uyu munsi turimo kuvuga kuri iri koranabuhanga ryazanye icyizere gishya ku bantu benshi bafite ibibazo by'imigozi y'ibihaha bitewe n'indwara z'umutima bavukanye. Reka dutangire ibi n'ikiganiro cyoroshye kandi cy'inshuti.
Mu magambo make, TPVR ni iki?
TPVR, bisobanura Transcatheter Pulmonary Valve Replacement , ni ukubaga gusimbuza valve y'ibihaha idakora neza mu mutima wawe n'imashini nshya binyuze mu gukata gato cyane. Ubusanzwe, iyo dutekereje kubaga umutima, dutekereza kubaga gukata igice kinini hagati mu gituza no gufungura igituza. Ariko, muri ubu buryo, gukata igice kinini nk'icyo ntigukorwa.
Ahubwo, abaganga baca umwobo muto mu ruhu rw'ikibuno cyawe maze bakawukoresha. Uyu muyoboro w'ibihaha, ukora nk'irembo ryohereza amaraso ava mu mutima wawe ajya mu bihaha byawe, ni ingenzi cyane. Abantu bavukana indwara z'umutima bavukanye bashobora kugira ibibazo by'uyu muyoboro uko bagenda bakura nyuma yo kubagwa bakiri abana. Rero, gusimbuza uwo muyoboro ubu buryo bishobora gutuma ubuzima bwawe n'imibereho yawe birushaho kuba byiza, kandi birinda kubagwa kenshi.
Ni iki mu by'ukuri kibaho muri sisitemu ya TPVR?
Mu kubaga umutima usanzwe, igufwa ry'igituza riracibwa, umurwayi agahuzwa n'imashini ikoresha umutima n'ibihaha, agakuramo valve ishaje, hanyuma agashyirwamo indi nshya. Ibi bifata igihe kirekire, bigafata igihe kirekire kugira ngo bikire, kandi kuri bamwe, ubu buvuzi ni ikintu kibi.
Ariko si ko bimeze kuri TPVR. Umuganga w’indwara z’umutima yinjiza umuyoboro muto (catheter) anyuze mu mutsi uri mu gituza cyawe maze akayobora umuyoboro mushya unyuze muri uwo muyoboro ujya mu mutima wawe. Ibi byose bikorwa hifashishijwe ikoranabuhanga nka X-rays. Iyo umaze kugera ahantu heza, umuyoboro mushya ushyirwamo umwuka ukoresheje umupira hanyuma ugashyirwa ahantu heza.
Ibi ni nko gushyira urugi rushya mu rugi rushaje utarinze kurukuraho.
Nyuma y'ibi, amaraso ava mu mutima ajya mu bihaha asubizwa mu buzima bwiza. Umushahara ku mutima uragabanuka, kandi umubiri ubona ogisijeni nziza. Kenshi na kenshi, umuntu wakorewe ubu bubagwa ashobora gutaha uwo munsi .
Bigenda bite iyo valve yanjye y'ibihaha idakora neza?
Hari ibibazo bibiri by'ingenzi bigaragara mu muyoboro w'ibihaha. Reka tubisuzume muri make.
| Indwara | Mu magambo make ... |
|---|---|
| Stenose y'ibihaha | Umuyoboro w'amaraso uba muto kandi ntufunguke neza, ibyo bigatuma amaraso ava mu mutima ajya mu bihaha atembera nabi. Ibi bitera imbaraga nyinshi ku ruhande rw'iburyo rw'umutima. Uko igihe kigenda gihita, igice cy'iburyo cy'umutima gishobora no kunanirwa. |
| Gusubira kw'amaraso mu mitsi y'ibihaha (amaraso ava mu mitsi y'ibihaha) | Kubera ko valve idafunga neza, amwe mu maraso ajyanwa mu bihaha asubira mu mutima. Ibi kandi bigabanya ingano y'amaraso ajya mu mutima, byongera umuvuduko ku ruhande rw'iburyo rw'umutima kandi bishobora gutera umutima guhagarara nabi. |
Muri izi ndwara zombi, ushobora kugira ibimenyetso nk'ibi:
- Guhumeka bigoranye (dyspnea)
- Kubyimba inda n'amaguru (edema)
- Kubabara mu gatuza
- Kumva umutima wawe urimo gutera cyane (gutera cyane)
Ibi bimenyetso biterwa no kudakora neza k'umutima cyangwa gutera k'umutima mu buryo butunguranye (arrhythmias). Ibi bimenyetso akenshi biragenda neza nyuma yo kubagwa TPVR.
Ni nde ukwiriye kubagwa muri TPVR?
Niba waravutse ufite ikibazo kigira ingaruka ku mitsi y'umutima wawe, ushobora kungukirwa n'ubu buryo bwo kubagwa. By'umwihariko,
- Abantu babazwe imitsi y'ibihaha bakiri abana.
- Abantu bakuru n'urubyiruko bagize iyo valve baraziba cyangwa bakavamo amazi uko igihe kigenda gihita.
- Akenshi, abaganga batekereza ku buryo bwa TPVR ku bantu bahawe homograft (guterwa valve) n'undi muntu bakiri abana, iyo iyo valve igabanutse uko igihe kigenda gihita.
Zimwe mu ndwara z'ingenzi zivurwa n'ubu buvuzi ni izi:
- Kugwa kw'ibihaha: Indwara aho umuyoboro w'ibihaha udakora igihe cyo kuvuka.
- Ingufu y'ibihaha ikora neza: Indwara aho amaraso asubira inyuma anyuze muri iyo nyufu.
- Tetralogy of Fallot: Indwara aho amaraso meza n'amabi yivanga bitewe n'ubusembwa bune bw'umutima.
- Truncus Arteriosus: Indwara aho imitsi ibiri y'amaraso iva mu mutima ihuzwa.
- Guhindura imitsi minini y'amaraso: Ni indwara aho imitsi ibiri y'amaraso y'umutima ihinduka kandi igahuzwa.
Kubaga TPVR byatanze umusaruro mwiza cyane mu kuvura bene ibyo bibazo.
Ni iki kibaho mbere, mu gihe cyo kubagwa na nyuma yaho?
Kwitegura mbere yo kubagwa
Kugira ngo amenye niba ubu buryo bwo kubaga bukubereye, muganga wawe azabanza kugusuzuma neza. Ashobora gukora ibizamini byinshi, urugero:
- Angiogramu
- Isuzuma rya CT ry'umutima
- MRI y'umutima
- Echocardiogram
- Isuzuma ry'umutima (Electrocardiogram) (ECG)
Hashingiwe ku bisubizo by'ibi bizamini, muganga wawe azagusaba kubagwa TPVR cyangwa agafata icyemezo cyo gukurikirana uburwayi bwawe igihe runaka. Azakugira inama kandi ku byo kurya n'imiti ugomba kureka gufata (cyane cyane imiti igabanya amaraso) mbere yo kubagwa. Ntukibagirwe kubwira muganga wawe ibyerekeye ubwivumbure ubwo aribwo bwose ushobora kuba ufite.
Mu gihe cyo kubaga
Mbere yuko ubagwa utangira, uzahabwa ikinya kugira ngo utazagira ububabare. Icyo gihe ni bwo inzobere izatangira gukora.
1. Ubwa mbere, hakorwa akato gato mu kibuno cyawe (umutsi wo mu kibuno) cyangwa wenda mu ijosi ryawe (umutsi wo mu kibuno) hanyuma umuyoboro (catheter) ugashyirwamo.
2. Hanyuma, hakoreshejwe ikoranabuhanga nka X-rays, valve nshya iyoborwa binyuze muri wa muyoboro no ku nsinga ikagera ahantu nyaho mu mutima. Iyi valve ipfundikirwa hejuru y'umupira.
3. Iyo igeze aho ihagaze neza, agapira karashyuha. Agapira gashya karakura kagafata neza imbere muri ka karito gashaje. Kuva icyo gihe, karito gashya gatangira gukora.
4. Hanyuma, reba neza ko valve ikora neza hanyuma ukureho imiyoboro yose yashyizwemo.
Ubusanzwe iki gikorwa cyose kimara amasaha abiri cyangwa atatu .
Nyuma yo kubagwa
Nyuma yo kubagwa, uzarara mu bitaro kugira ngo ukurikiranwe. Niba byose bigenze neza, uzabasha gutaha mu gitondo gitaha . Muganga wawe azaguha amabwiriza yo gukurikiza igihe uzaba ugiye mu rugo. Kenshi na kenshi , uzabasha gukomeza imirimo yawe isanzwe mu minsi irindwi .
Ni izihe nyungu n'ingaruka z'uburyo bwa TPVR?
Nkuko bigenda ku buvuzi ubwo aribwo bwose, hari ibyiza n'ingaruka ntoya. Reka tubimenye byombi.
| Ibyiza | Ingaruka/Ingorane |
|---|---|
| Igihe cyo gukira ni gito. | Ububabare, gukomereka, cyangwa kubyimba aho umuyoboro washyizwe. |
| Ingaruka zo kwandura ni nke. | Amaraso apfutse. |
| Igihe cyo kumara mu bitaro ni gito. | Kwangirika kw'imitsi y'amaraso. |
| Nta nkovu nini zibaho, ni udusebe duto gusa. | Indwara zandurira mu mutima (cyane cyane indwara zo mu gice cy'imbere cy'umutima - Endocarditis). |
| Ingaruka mbi ni nkeya nko kubagwa umutima. | Ugutera kw'umutima kutumvikana neza (Arrhythmia). |
Ni gake cyane, ingorane zikomeye nk'indwara y'umutima, gucika kw'imitsi, cyangwa urupfu zishobora kubaho. Ariko ibi ni gake cyane. Muganga wawe azakubwira ibi byose mu buryo burambuye.
Hari ibindi bibazo ushobora kuba ufite
Iyi valve nshya izamara igihe kingana iki?
Biterwa n'ibintu byinshi, nko ubuzima bwawe muri rusange n'imikorere y'umutima. Hari abantu bashobora gukenera kongera kubagwa muri ubu bwoko nyuma y'igihe runaka.
Ese ngomba gukora ikintu kidasanzwe mbere yo kuvurwa amenyo?
Yego, ibi ni ingenzi cyane. Mu gihe cyo kuvurwa amenyo, bagiteri zo mu kanwa kawe zishobora kwinjira mu maraso zigatera ubwandu bw'umuyoboro mushya w'umutima (endocarditis). Kubwibyo, iyo ugiye kwa muganga w'amenyo, ugomba kumubwira mbere y'igihe ko wasimbuwe umuyoboro w'umutima. Ushobora kandi gukenera gufata imiti yica udukoko mbere yuko iryinyo rikurwamo.
Ese nshobora kugenzura umutekano ku kibuga cy'indege?
Yego, nta kibazo. Imirasire ya X na scanner z'umutekano ku kibuga cy'indege ntabwo byangiza valve yawe. Ariko, ugomba kuvugana na muganga mbere yo gupimwa na MRI.
Ubutumwa bwo kujyana mu rugo
- TPVR ni uburyo bugezweho bwo kubaga busimbura umuyoboro w'umutima w'ibihaha binyuze mu gukata gato mu kibuno, hatabayeho gufungura igituza.
- Ibi birakwiriye cyane cyane abantu bafite ibibazo by'imitsi y'ibihaha bitewe n'indwara z'umutima bavukanye.
- Ifite igihe gito cyo gukira, ibyago bike, kandi iguma mu bitaro igihe gito ugereranije no kubagwa umutima.
- Ushobora gusubira mu buzima busanzwe mu minsi mike nyuma y'uku kubagwa.
- Niba ufite ikibazo nk'iki, vugana n'umuganga w'indwara z'umutima ku bijyanye n'ubu buryo bwo kuvura kugira ngo arebe niba bukubereye.
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