Hari igihe ushobora kuba warumvise iby'umwana wavutse afite ikibazo cy'umutima akiri muto. Wenda uwo mwana yabazwe icyo gihe maze ikibazo kigakosorwa. Ariko iyo umwana nk'uwo akuze gato, iyo ageze mu bwana, ikibazo cy'umutima cyariho muri ubwo bwana gishobora kongera kugaragara mu bundi buryo. Muri icyo gihe, uyu munsi tugiye kuvuga ku buryo bw'ingenzi cyane bwo kuvura bushobora guha imbaraga nyinshi ubuzima.
None se, TPVR ni iki?
Mu magambo make, TPVR , cyangwa Transcatheter Pulmonary Valve Replacement , ni uburyo bwihariye busimbura valve y'ibihaha idakora neza mu mutima wawe, ariko idafunguye igituza cyawe. Ibi bisa n'ibitangaje, si byo se? Ubusanzwe, iyo dutekereje gusimbuza valve y'umutima, dutekereza kubagwa umutima ufunguye, bikubiyemo gukata igice kinini hagati mu gituza. Ariko, muri ubu buryo bwa TPVR, umuganga ubaga akata igice gito cyane mu ruhu rw'ikibuno cyawe maze akagikora cyose muri ubwo buryo.
Umugozi w'ibihaha ni irembo rigenga inzira amaraso ava mu mutima wacu ajya mu bihaha byacu. Iyo udakoze neza, inzira y'amaraso igera ku mubiri wose izahungabana. Bityo rero, binyuze muri ubu buryo, iyo usimbuje umugozi utari umeze neza n'undi mushya, igihe cyawe cyo kubaho n'ubwiza bw'ubuzima bizazamuka cyane. Nanone, bizafasha gutinza cyangwa kwirinda burundu gukenera kubagwa inshuro nyinshi.
Ni iki mu by'ukuri kibaho kuri ubu buryo bwo kuvura bwa TPVR?
Tekereza ko mu kubaga umutima mu buryo busanzwe, abaganga baca igufwa ryo mu gituza maze bakimura by'agateganyo imikorere y'umutima bakayishyira mu mashini (imashini ikoresha umutima n'ibihaha), hanyuma bagakuramo valve ishaje bagashyiramo nshya. Ibi bifata igihe kirekire, bigafata igihe kirekire kugira ngo bikire, kandi bishobora guteza akaga ku barwayi bamwe na bamwe kubagwa bikomeye nk'ibyo.
Ariko uburyo bwa TPVR buratandukanye cyane. Ni uburyo butagira ingaruka nyinshi . Dore uko bigenda:
1. Umuganga w’indwara z’umutima akuramo agace gato k’umutsi munini w’amaraso mu kibuno cyawe (umutsi wo mu kibuno) maze agashyiramo umuyoboro muto kandi woroshye witwa catheter .
2. Muri iyi katheteri harimo valve nshya, agapira gato kapfunyitse.
3. Akoresheje uburyo bwihariye nka X-rays, muganga ayobora neza iyi catheter mu mitsi y'amaraso kugeza aho valve y'ibihaha iri mu mutima.
4. Iyo igeze aho, agapira karashyuha. Agapira gashya, kari karapfundikiwe, karakura kagahita gafata aho agapira gashaje kari kari.
5. Kuva icyo gihe, umugozi mushya utangira gukora. Amaraso ava mu mutima ajya mu bihaha asubira ku murongo.
Kimwe mu byiza bikomeye by'ibi ni uko abantu benshi bavuwe ubu buryo bashobora guhita basubira mu rugo. Igihe cyo gukira ni gito cyane.
None se, bigenda bite iyo iyi valve y'ibihaha idakora neza?
Hari ibibazo bibiri by'ingenzi bishobora kubaho ku mugozi w'ibihaha.
| Indwara | Mu magambo make ... |
|---|---|
| Stenose y'ibihaha | Kubera ko valve idafunguka neza, bigabanya ingano y'amaraso ashobora gutemberamo akagera mu bihaha. Ibi bitera umuvuduko mwinshi ku ruhande rw'iburyo rw'umutima, ibyo bikaba byatuma icyo gice kinanirwa gukora. |
| Gusubira kw'ibihaha mu maraso | Kubera ko valve idafunga neza, amaraso ajyanwa mu bihaha asubira mu mutima. Ibi bishobora guteza imihangayiko myinshi ku mutima bigatuma uruhande rw'iburyo runanirwa. |
Bitewe n'izi ndwara ebyiri, ushobora kugira ibimenyetso nko kubura umwuka (dyspnea) , kubyimba amaguru n'inda (edema) , kubabara mu gituza , no gutera k'umutima mu buryo budasanzwe . Ibi bimenyetso bizagabanuka cyane nyuma yo kuvurwa na TPVR.
Ni nde ubu buvuzi bukwiriye kurusha ubundi?
Niba waravutse ufite indwara y'umutima kandi ukabagwa ukiri umwana, hari amahirwe menshi ko ubu buryo buzagukwira. Kubera ko agakoresho k'umutima kashyizwemo mu bwana (akenshi gaterwa na homograft) gashobora kwangirika uko igihe kigenda gihita. Hanyuma indwara zavuzwe haruguru, nko gutemba cyangwa gusubiranamo, zishobora kugaragara mu bwana. Niyo mpamvu abaganga basaba abantu nk'abo gukoresha uburyo bwa TPVR.
Ubu buryo bukoreshwa mu kuvura indwara z'umutima zivukana zikurikira:
- Tetralogy of Fallot: Uruvange rw'inenge enye, harimo imyobo mu mutima, bigatuma amaraso meza n'amabi bivangavanga.
- Kugwa kw'ibihaha: Indwara aho umuyoboro w'ibihaha udakora igihe cyo kuvuka.
- Truncus Arteriosus: Imitsi ibiri y'ingenzi y'amaraso ikomoka ku mutima (aorta n'imitsi y'ibihaha) irahuzwa kugira ngo ikore umwe.
- Guhindura imitsi minini y'amaraso: Imitsi ibiri minini y'amaraso irahinduka kandi ihuzwa ku mpande zitari zo.
Igikuru ni uko muganga wawe azagena niba ubu buryo bw'ubuvuzi bukubereye, hashingiwe ku mateka y'ubuzima bwawe, imiterere y'ubuzima bwawe, n'ibizamini byinshi byihariye wakorewe.
Ni iki kibaho mbere na nyuma yo kuvurwa?
Kwitegura mbere yo kuvurwa
Kugira ngo arebe niba ushobora gukora TPVR, muganga wawe azagusuzuma neza kandi ashobora gukora ikizamini cy'umuvuduko w'imyitozo ngororamubiri. Byongeye kandi, ibizamini bikurikira bishobora gukorwa:
- Angiogramu
- Isuzuma rya CT ry'umutima
- MRI y'umutima
- Echocardiogram
- Ikizamini cya ECG
Nyuma yo gusuzuma ibi byose, muganga azaguhitiramo igisubizo cyiza kuri wewe.
Mu gihe cyo kuvurwa
Uzaterwa ikinya mbere yuko ubuvuzi butangira, bityo ntuzumva ububabare. Igikorwa cyose kimara amasaha abiri cyangwa atatu. Abaganga bazashyiramo catheter, bashyire valve, barebe imikorere yayo, hanyuma bakuremo catheter.
Nyuma yo kuvurwa
Uzaguma mu bitaro kugira ngo ukurikiranwe ijoro ryose, kandi akenshi uzahita woherezwa mu rugo umunsi ukurikiyeho. Uzashobora gukomeza imirimo yawe isanzwe mu cyumweru kimwe.
Ni izihe nyungu n'ingaruka byagira?
Nk’uko bigenda kuri buri buryo bwose bwo kuvura, ubu buryo bufite ibyiza n’ingaruka zimwe na zimwe.
| Ibyiza | Ingaruka |
|---|---|
| Igihe cyo gukira ni gito. | Amaraso apfutse. |
| Ingaruka zo kwandura ni nke. | Kwangirika kw'imitsi y'amaraso. |
| Igihe cyo kumara mu bitaro ni gito. | Umutima utari umeze neza (Arrhythmia). |
| Nta nkovu zikomeye zizabaho. | Indwara z'umutima (Endocarditis). |
| Ububabare buragabanuka. | Kuva amaraso mu buryo butunguranye. |
Ni gake cyane hashobora kubaho ingorane zikomeye nko kurwara umutima, gucika imitsi, cyangwa urupfu. Kubwibyo, ni ngombwa kuganira na muganga wawe ku byiza n'ibibi by'ubu buryo bwo kuvura mbere yo gufata icyemezo.
Hari ibindi bintu by'ingenzi ugomba kumenya
Valve nshya imara igihe kingana iki?
Ibi biterwa n'ubuzima bwawe muri rusange n'imiterere y'umutima wawe. Hari abantu bashobora gukenera kubagwa bundi bushya nyuma y'igihe runaka. Ariko inkuru nziza ni uko nibiba ngombwa, ushobora gusimbuza indi valve n'uburyo bwa TPVR.
Ese ugomba kwitonda mu gihe cyo kuvurwa amenyo?
Yego, ibi ni ingenzi cyane. Mu gihe cyo gukura amenyo no gusukura amenyo, bagiteri zo mu kanwa zishobora kwinjira mu maraso zikayanyuramo bigatera indwara ikomeye yitwa endocarditis , indwara yandurira mu muyoboro w'umutima washyizwemo. Kubwibyo, mbere yo kuvurwa amenyo, ugomba kumenyesha muganga w'amenyo ko wafashe TPVR. Ushobora gusabwa gufata imiti yica udukoko mbere yo kuvurwa.
Ese hari ikibazo kiri mu mutekano w'ikibuga cy'indege?
Oya. Gupima X-rays ku kibuga cy'indege no kugenzura umutekano nta cyo bizagutwara. Ariko, niba urimo gutekereza gupima MRI, banza uganire na muganga wawe.
Ubutumwa bwo kujyana mu rugo
- TPVR ni uburyo bugezweho bwo kuvura bukoresha uburyo bworoshye bwo gusimbuza umuyoboro w'ibihaha by'umutima binyuze mu gukata gato, udafunguye igituza.
- Iki ni igisubizo cyiza ku bibazo by'imitsi ifungana bibaho bakiri bato, cyane cyane ku babazwe bakiri abana kubera indwara z'umutima bavukanye.
- Hari igihe gito cyo gukira, igihe cyo kurara mu bitaro ni gito, kandi ububabare buragabanuka ugereranyije no kubagwa umutima mu buryo busanzwe.
- Nkuko bigenda ku buryo bwose bwo kuvura, hari ingaruka mbi, bityo rero ugomba kubiganiraho na muganga wawe mbere yo gufata umwanzuro niba bikubereye.
- Ni ingenzi cyane kugira ngo ubuzima bwawe burusheho kuba bwiza gukurikiza amabwiriza ya muganga wawe nyuma yo kuvurwa no kubonana na muganga wawe ku matariki yagenwe.
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