Ese umuganga wawe yakubwiye ko umuzi w'umutima wawe wagutse gato kandi ko ukeneye kubagwa? Ni ibisanzwe kumva ufite ubwoba no guhangayika iyo ubyumvise. Ni nde udakunda ijambo "kubagwa umutima"? Ariko ntugahangayike. Ikoranabuhanga ryateye imbere cyane uyu munsi. Uyu munsi, tugiye kuvuga ku kubagwa kwihariye kandi kwagenze neza cyane, gukemuye iki kibazo tudakuyeho igice cy'agaciro k'umutima wawe, ari cyo 'valve' yawe bwite.
Gusimbuza imizi ya Aortic yo mu bwoko bwa Valve-Saring Aortic ni iki?
Kugira ngo tubisobanukirwe neza, reka tubanze turebe uko umutima ukora. Tekereza umutima wawe nk'ipompo y'amazi mu rugo rwawe. Iyi pompe ipompa amaraso mu mubiri wawe wose.
- Aorta: Uyu ni wo muyoboro munini kandi munini usohoka mu mutima. Utwara amaraso mu mubiri wose.
- Umuzi w'imitsi: Iki ni cyo gice cya mbere cy'umutsi mukuru uhuza umutima. Ni nk'aho ushyira umuyoboro kuri moteri.
- Valve y'imitsi: Iki ni cyo gice cy'ingenzi cyane cy'inkuru. Aho ihuriye n'umutima, hari igice gikora nk'urugi. Iyo umutima upompa amaraso, uru rugi rurakinguka, rusohora amaraso. Hanyuma uru rugi rurafunga kugira ngo amaraso adasubira mu mutima. Iki ni cyo twita `(valve y'imitsi)`.
Noneho, muri bamwe, umuzi w'uyu mutsi munini uhuza umutima, `(Umuzi wa Aortic),` uba ufite intege nke gato ugatangira kubyimba no gukomera nk'umupira. Ibi tubyita `(Aortic Root Aneurysm)`. Iyo bikuze gutya, uwo muryango, iyo valve, ntufunga neza. Hanyuma amaraso atangira kuva inyuma, `(Aortic Regurgitation)`.
Mu bihe byashize, iyo ubwoko bw'ikibazo bwavukaga, abaganga babaga bakuraho umuzi wa aortic na valve ya aortic, bakabisimbuza umuzi wa aortic na valve y'ubukorano. Ubu buryo bwo kubaga bwitwa Bentall procedure .
Ariko ubu, niba valve yawe imeze neza, bivuze ko itangiritse cyane, aho gukuraho valve karemano y'agaciro, `(Umuzi wa Aortic)` wangiritse ni wo wonyine ukurwaho, umuyoboro mushya w'ubukorano (`graft`), hanyuma valve yawe ubwayo ikongera gushyirwaho. Mu magambo make, ibi byitwa Valve-Sparing Aortic Root Replacement .
Ni izihe ndwara zivurwa muri ubu buvuzi?
Ubu buryo bwo kubaga bukorerwa ahanini indwara yitwa `(Aortic Root Aneurysm)`. Ibi bivuze ko umuzi w'umuyoboro w'amaraso wabyimbye nk'ibara ry'umupira. Ibi bishobora guteza akaga, kuko iyo urenze urugero runaka, ushobora guturika (gucika) cyangwa gucika (aortic dissection).
Hari abantu bafite indwara zo mu mitsi ihuza imiterere y’uturemangingo, nka Marfan syndrome. Abantu bafite izi ndwara baba bafite ibyago byinshi byo kurwara aortic root aneurysm.
Ni nde ukwiriye kubagwa?
Muganga wawe azakora ibizamini bitandukanye kugira ngo amenye niba uri umukandida mwiza kuri ubu buvuzi. Muri rusange, ushobora kuba umukandida mwiza kuri ubu buvuzi.
- Niba Valve yawe ya Aortic ifite calcium nke cyane cyangwa nta na calcium ifite.
- Keretse niba valve yangiritse cyane.
- Niba valve ikora neza, cyangwa ishobora gukosorwa hakoreshejwe gusana gato.
- Ubu buryo bwo kubaga bugirwa inama cyane cyane ku bantu bari munsi y'imyaka 75 ndetse n'abafite indwara zikomoka ku ngirabuzimafatizo.
Witegura ute mbere yo kubagwa?
Kubera ko iki ari igikorwa gikomeye cyo kubaga, ni ngombwa cyane kugitegura neza. Umuganga wawe azaguha amabwiriza asobanutse neza kuri iki gikorwa.
- Imiti: Ugomba kubwira muganga wawe imiti iyo ari yo yose ufata ubu. Ashobora kugusaba guhagarika cyangwa guhindura imiti imwe n'imwe (cyane cyane imiti igabanya amaraso) mbere yo kubagwa.
- Kwiyiriza ubusa: Uzasabwa kutarya cyangwa ngo unywe ikintu icyo ari cyo cyose nyuma ya saa sita z'ijoro mbere y'uko ubagwa. Ntukanywe n'amazi.
- Ibizamini: Muganga azategeka ibizamini byinshi kugira ngo ateganye kubagwa.
- Echocardiogram (isuzuma ry'umutima)
- Gupima amaraso
- Isuzuma rya CT rigenzurwa na EKG
- MRI y'umutima
- Angiogramu y'umutima
- Kunywa itabi: Niba unywa itabi, ni ngombwa ko ureka kunywa itabi burundu nibura ukwezi kumwe mbere yo kubagwa.
- Baza ibibazo: Vugana na muganga wawe nta guhishanya ku mpungenge cyangwa ubwoba ufite. Bizaba byiza cyane kumenya byose neza.
Kubagwa bikorwa gute?
Ubusanzwe ubu buvuzi bumara amasaha ari hagati ya 4 na 6. Iyo bukozwe n'umuganga w'inararibonye, umutima uhagarara igihe gito, hafi isaha imwe. Intambwe zikoreshwa muri iki gikorwa ni izi zikurikira.
1. Anesthesia: Ubwa mbere, uzahabwa anesthesia kugira ngo usinzire cyane. Bityo ntuzumva ububabare ubwo aribwo bwose.
2. Gufungura igituza: Muganga atema igituza hagati mu gituza (median sternotomy) kugira ngo agere ku mutima.
3. Imashini ikoresha umutima n'ibihaha: Hanyuma, uzahuzwa n'imashini ikoresha umutima n'ibihaha (cardiopulmonary bypass machine). Iyi mashini izakora akazi k'umutima n'ibihaha byawe mu gihe cyo kubagwa. Izaguha kandi imiti yo guhagarika umutima wawe by'agateganyo.
4. Gutandukanya valve: Umuganga uzabaga azatandukanya neza valve yawe ya aorta n'ingingo ziyikikije.
5. Gusana:Iyo hari ikintu cyangiritse gato ku migozi y'imashini, gihita gikosorwa.
6. Gukuraho igice cyangiritse: Igice cyabyimbye kandi cyangiritse cy'`(Umuzi w'Aortic)` kiracibwa kikavanwaho.
7. Gutera imiyoboro y'ubukorano: Ahubwo, umuyoboro w'ubukorano "graft" ukozwe mu mwenda wihariye urafatwa, ugakorwa ku bunini bukubereye, hanyuma ugashyirwa aho hantu.
8. Gufata valve: Hanyuma , valve yawe karemano , yakuweho witonze, ishyirwa mu muyoboro mushya watewemo hanyuma igashyirwa hamwe (kongera kuyishyiramo).
9. Kugenzura: Reba niba byose bimeze neza, niba valve ifunguka kandi igafunga neza, ndetse niba hari aho amazi yavuye.
10. Gufunga: Imitsi y'umutima itanga amaraso mu mutima ihita ihuzwa n'agace gashya. Ukurwa mu mashini ikoresha umutima n'ibihaha, maze iyo umutima wawe wongeye gukora, igisebe cyo mu gituza cyawe kiba gifunze.
11. Isuzuma rya nyuma: Mbere yo gusohoka mu cyumba cyo kubaga, hakorwa "echocardiogram ya transesophageal echocardiogram" kugira ngo hemezwe ko kubaga byagenze neza.
Iterambere rigezweho mu kubaga
Uko igihe cyagiye gihita, abaganga bongeyeho ubuhanga bushya kugira ngo ubu buryo bwo kubaga burusheho kugira icyo bugeraho.
- Kugabanya imisemburo: Muri make, igice cy'ishingiro gifata valve (aortic annulus) gishyirwa ku mubiri wawe. Ibi bizarinda amaraso kuva muri valve mu gihe kizaza.
- Kurema Sinuses Nshya za Aortic (Neosinuses): Umuzi wa aorta karemano ufite utuntu duto. Kubera ko graft nshya ari umuyoboro ugororotse, inatera utuntu duto. Ibi bituma amaraso atembera neza kandi bigabanya kwangirika kw'udupapuro tw'amaraso.
Ni izihe nyungu z'ubu buvuzi?
Ubu buryo bwo kubaga bufite inyungu nyinshi zikomeye ugereranyije n'uburyo busanzwe bwo kubaga bwa Bentall (bukubiyemo gusimbuza valve hamwe na valve).
| Akamaro | Kubaga hakoreshejwe uburyo bwo kugabanya imvange y'amaraso | Kubaga Bentall (ukoresheje valve ya mechanical) |
|---|---|---|
| Imiti igabanya amaraso ubuzima bwose | Ntabwo ari ngombwa kuyifata. | Imiti nka Coumadin (Warfarin) igomba gufatwa ubuzima bwose. |
| Amaraso afungana, ibyago byo gucika imitsi | Hasi cyane. | Birenzeho cyane . |
| Ibyago byo kwandura imitsi yo mu bwonko (endocarditis) | Hasi cyane. | Byarenze urugero . |
| Hakenewe kubagwa imvange y'amashanyarazi | Ni nke cyane. 95% by'abantu ntibazayikenera mu gihe cy'imyaka 10. | Bishobora kuba ngombwa uko igihe kigenda gihita. |
Bifata igihe kingana iki kugira ngo umuntu akire nyuma yo kubagwa?
Nyuma yo kubagwa, uzaguma mu cyumba cy’indembe (ICU) umunsi umwe cyangwa ibiri, hanyuma wimurwe mu cyumba gisanzwe. Ubusanzwe ushobora gutaha uvuye mu bitaro mu minsi 4 kugeza kuri 7.
Bifata ibyumweru bigera kuri 6 kugira ngo umuntu akire neza kandi asubire mu bikorwa bisanzwe.
Muri iki gihe,
- Kwitabira gahunda yo kuvura indwara z'umutima ni igitekerezo cyiza. Bizagufasha gukira vuba no gukomera.
- Muganga avuga ko ntagomba gukora ikintu icyo ari cyo cyose nko guterura ibyuma cyangwa gutwara imodoka mu gihe cy'ibyumweru bigera kuri bitandatu.
- Gukurikirana gahunda zo kwivuza: Ushobora gutekereza ko udakeneye kongera kubonana na muganga wawe nyuma yo gukira. Ariko ni ngombwa kubikora . Ni ngombwa gukomeza kwisuzumisha indwara z'umutima wawe buri gihe.
Igihe cyo guhamagara muganga ako kanya
Umaze gusubira mu rugo, niba ugaragaje kimwe muri ibi bikurikira, hamagara muganga wawe ako kanya cyangwa ujye mu ishami rishinzwe ubutabazi bw’ibanze (ETU) ry’ibitaro biri hafi yawe.
| Ibimenyetso | Icyo ugomba kwitaho |
|---|---|
| Impinduka mu nzira yo gucamo | Utukura, kubyimba, ububabare bukabije, ubushyuhe, n'amabyi y'umuhondo cyangwa icyatsi kibisi hafi y'aho hafatiwe. |
| Kubabara mu gatuza | Kubabara mu gatuza bitunguranye cyangwa bikomeye. |
| Guhumeka bigoranye | Guhumeka nabi mu buryo butunguranye. |
| Kubyimba amaguru | Kubyimba amaguru cyangwa kudashobora kwimura amaguru. |
| Kuzungera cyangwa gucika intege | Kuzungera cyane, gucika intege, cyangwa umunaniro ukabije. |
| Umuriro cyangwa ibicurane | Umuriro urimo ubukonje, amatembabuzi y'umuhondo cyangwa icyatsi kibisi. |
Ni ibisanzwe kumva ufite ubwoba mbere yo kubagwa ikintu cyose gikomeye. Ariko ibuka ko ubu bubagwa burimo gukorwa kugira ngo burokore ubuzima bwawe kandi bugufashe kugira ubuzima bwiza igihe kirekire. Ganira n'umuryango wawe n'inshuti kuri ibi. Inkunga yabo izagukomeza cyane muri iki gihe.
Ubutumwa bwo kujyana mu rugo
- Gusimbuza imizi y'imitsi ya Aortic mu buryo bworoshye ni uburyo bwo kubaga bugezweho butuma valve yawe ya aortic ikora neza kandi bugafasha mu kwaguka kw'imitsi ya aortic.
- Akamaro gakomeye k'ibi ni uko udakenera gufata imiti igabanya amaraso ubuzima bwawe bwose, nk'uko wabikora ukoresheje valve ya mechanical.
- Ubu buvuzi bushobora gukorwa buyobowe n'umuganga w'inararibonye mu bitaro bifite ibikoresho byiza kandi bifite igipimo cyo gutsinda kiri hejuru cyane (kirenga 99%).
- Bifata ibyumweru bigera kuri 6 kugira ngo umuntu akire neza nyuma yo kubagwa. Muri icyo gihe, ni ngombwa cyane gukurikiza amabwiriza ya muganga.
- Ntutinye kuvugana na muganga wawe ku kibazo cyangwa impungenge ushobora kuba ufite. Ni imbaraga zikomeye kuri wewe kumenya amakuru yose mbere yo kujya kubagwa.
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