Ese muganga yakubwiye ko ukeneye kubagwa umutima? Ni ibisanzwe kumva ufite ubwoba gato iyo avuze ibyo. Ariko muri iki gihe, ubuvuzi bwateye imbere cyane. Hari uburyo bumwe bwo kubaga bugerageza kurinda ibice byinshi by'umubiri wawe uko bishoboka kose. Uyu munsi tugiye kuvuga ku bundi buryo budasanzwe bwo kubaga. Ni ukuvuga, umugozi w'umutima, ari wo ubagwa urinda umugozi.
Renal function (eGFR)
Measure kidney function based on creatinine value
Mu magambo make, kubaga Valve-Sparing ni iki?
Kugira ngo tubisobanukirwe neza, reka tubanze twige ku gice gito cy'umutima wacu. Icyumba kinini cyo gupompa cy'umutima wacu (ventricle y'ibumoso) gihuza n'umuyoboro munini w'amaraso mu mubiri wacu, aorta. Iyi sano tuyita 'Umuzi w'Aorta'. Ni nk'umuzi w'igiti. Imbere muri uyu 'Muzi w'Aorta' hari irembo ry'ingenzi cyane, 'Aorta Valve'.
Igihe cyose umutima utera, iyi "Aortic Valve" irakingura ikanapompa amaraso mu mubiri, hanyuma igafunga. Uku gufunga bibuza amaraso gusubira mu mutima.
Noneho tekereza, muri bamwe, 'Umuzi w'Aortic', ni ukuvuga igice cy'irembo gisa n'irembo, cyacitse intege, cyabyimbye, kandi kikaba kinini. Bimeze nk'ibara ry'umuhondo ririmo kwiyongera. Ibi tubyita 'Aneurysm y'Umuzi w'Aortic'. Iyo iri rembo ribaye rinini, urugi rurimo, ni ukuvuga 'Aortic Valve', ntirufunga neza. Hanyuma amaraso atangira kuva mu mutima. Ibi byitwa 'Aortic Regurgitation'.
Mu kubaga gakondo (uburyo bwa Bentall), abaganga babakuramo Umuzi w'Aortic na Aortic Valve byombi bibyimba hanyuma bagashyiramo ebyiri nshya z'ubukorano.
Ariko muri ubu buryo bwo kubaga Valve-Sparing, hari ikintu kidasanzwe kibaho . Ikigaragara hano ni uko "Umuzi wa Aortic" wabyimbye ari wo wonyine ukurwaho, "Aortic Valve" yawe nzima igasigara uko iri, maze igashyirwa ku "Muzi wa Aortic" mushya. Mu magambo make, ni nko guhindura igice cy'umuryango gusa ugashyiraho urugi rwawe rwa kera.
Akamaro gakomeye k'ibi ni uko ushobora kugumana valve yawe bwite, bityo ntugomba gufata imiti igabanya amaraso ubuzima bwawe bwose (nka Coumadin) nk'uko wabikora ukoresheje valve ya mechanical.
Ni izihe ndwara ubu buvuzi buvura?
Uku kubagwa bikorwa cyane cyane mu bihe bikurikira:
- Aneurysm y'imitsi y'amaraso: Nkuko nabivuze mbere, iki ni ikibyimba kidasanzwe mu mizi y'imitsi y'amaraso gihuza n'umutima. Iyo kibaye kinini cyane, gishobora guturika mu buryo butunguranye (Aortic Dissection cyangwa Gucika). Ni akaga gakomeye ku buzima.
- Aneurysm yo kuzamuka kw'imitsi y'amaraso hamwe n'imyanya y'amaraso y'amaraso yagutse: Aho umwanya muto usanzwe mu mizi y'amaraso y'amaraso ('imyanya y'amaraso y'amaraso y'amaraso') urushaho kwaguka, hamwe n'ibyimbirwa mu gice cy'amaraso y'amaraso cy'amaraso kizamuka.
Abantu bafite indwara zimwe na zimwe zo mu mubiri zishingiye ku maraso, nka Marfan syndrome, baba bafite ibyago byinshi byo kurwara aortic root aneurysm. Kubwibyo, abaganga babaga basuzuma neza uko umurwayi ameze kandi bagapima ibyiza n'ingaruka zo kubagwa mbere yo gufata icyemezo niba bikwiye.
Ese ukwiriye kubagwa?
Niba valve yawe y'umuyoboro w'amaraso ifite ibi bimenyetso, ushobora kuba umukandida muri ubu bubagwa:
- Iyo hari calcium nke cyane cyangwa nta calcium irimo muri valve.
- Keretse niba valve yangiritse cyane.
- Niba valve ikora neza cyangwa ishobora gusanwa hakoreshejwe uburyo buke bwo kuyisana.
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Check Availability →Witegura ute mbere yo kubagwa?
Umuganga wawe azagusobanurira ibyo ukeneye gukora byose mbere yo kubagwa. Ni ngombwa cyane gukurikiza ayo mabwiriza neza. Ubusanzwe, ibi ni byo uzakenera gukora.
| Igice kigomba gutegurwa | Icyo gukora |
|---|---|
| Imiti | Bwira muganga wawe imiti usanzwe ufata. Ntugahagarike cyangwa ngo uhindure imiti iyo ari yo yose utabanje kugisha inama. |
| Ibyokurya n'amazi | Ntukarye cyangwa ngo unywe ikintu icyo ari cyo cyose (ndetse n'amazi) nyuma ya saa sita z'ijoro mbere y'uko ubagwa. |
| Kunywa itabi | Kunywa itabi n'ibikomoka ku itabi bigomba guhagarikwa burundu byibuze ukwezi kumwe mbere yo kubagwa. |
| Umuntu wo gufasha | Teganya ko hari umuntu uzaguherekeza mu bitaro no mu rugo. |
Byongeye kandi, muganga azakora ibizamini byinshi kugira ngo ateganye kubagwa, urugero:
- Echocardiogram (gupima umutima)
- Gupima amaraso
- Indwara ya CT scan irinda umutima n'igituza
- Angiogramu y'umutima
- Gupima amaraso ya genetiki niba hakekwa indwara y'uruhererekane
Ni iki kibaho mu gihe cyo kubagwa?
Ubusanzwe ubu buvuzi bumara amasaha ari hagati ya 4 na 6. Iyo umuganga w’inzobere akoze ubu buvuzi, umutima ugomba guhagarara mu gihe cy’isaha imwe. Ntugahangayike, muri icyo gihe, imashini izakora akazi k’umutima n’ibihaha.
Dore uko bigenda intambwe ku yindi:
1. Anesthesia: Ubwa mbere, uzasinzira burundu. Bityo ntuzumva ububabare ubwo aribwo bwose.
2. Gufungura igituza: Umuganga ubaga atema igituza hagati mu gituza ('median sternotomy') kugira ngo agere ku mutima.
3. Guhuza n'imashini ikoresha umutima n'ibihaha: Uzahuzwa n'imashini ikoresha umutima n'ibihaha. Iyi mashini izafata imikorere y'umutima n'ibihaha byawe mu gihe cyo kubagwa. Muri iki gihe, umuti witwa 'solution ya cardioplegia' uzatangwa kugira ngo uhagarike umutima wawe by'agateganyo.
4. Gusohora Valve: Umuganga ubaga atandukanya neza valve yawe ya aorta n'ingingo ziyikikije.
5. Gukuraho ibice byangiritse: Umuzi wa Aortic wabyimbye n'ibindi bice byangiritse biracibwa bigakurwaho.
6. Uduce duto: Umuyoboro w'ubukorano (graft) ushyirwa mu mwanya w'igice cyakuweho. Uyu ukozwe mu mwenda wihariye (polyester).
7. Guteranya valve: Valve yawe ya aortic irafatwa, hagashyirwamo agace gashya, hanyuma gashyirwamo umugozi.
8. Gusuzuma Valve: Kugira ngo umenye neza ko byose bimeze neza, amazi anyura muri 'Graft' kugira ngo urebe niba valve ikora neza, ifunguka kandi igafunga.
9. Intambwe ya nyuma: Imitsi y'umutima ijyana n'umutima ihujwe na 'Graft' nshya. Hanyuma ukuwe muri 'Heart-Hang Machine' maze umutima wawe ukemererwa kongera gukora. Hanyuma igituza gifunga.
Uburyo bugezweho bwo kubaga (Guteranya abaganga mu buryo bwahinduwe)
Uko igihe cyagiye gihita, abaganga b'inzobere mu kubaga bongeyeho uburyo bushya bwo gutuma iki gikorwa kirushaho kugira ingaruka nziza. Urugero:
- Kurema Sinuses nshya za Aortic (Neosinuses): Ubusanzwe, Graft ni umuyoboro ugororotse. Ariko Umuzi wa Aortic karemano ufite umwanya muto (sinuses). Muri ubwo buryo bushya, umwanya nk'uwo ukorwa mu buryo bw'ubukorano muri Graft. Ibi bituma amaraso atembera neza, kandi kwangirika kwa valve kukagabanuka.
- Ingano y'agace ka Aortic Annulus: Ingano y'igice gisa n'impeta iyo valve ihagazeho (aortic annulus) irahindurwa kugira ngo ihuze n'ingano y'umubiri wawe. Ibi bigabanya ibyago byo kuva amaraso muri valve mu gihe kizaza.
Ni iki kibaho nyuma yo kubagwa? Kandi bifata igihe kingana iki kugira ngo umuntu akire?
Nyuma yo kubagwa, uzaguma mu cyumba cy’indembe (ICU) umunsi umwe cyangwa ibiri, hanyuma wimurwe mu cyumba gisanzwe. Ubusanzwe ushobora gutaha mu minsi 4 kugeza kuri 7.
Bifata ibyumweru bigera kuri 6 kugira ngo umuntu akire neza. Ntukihutire ibintu muri iki gihe. Ugomba kuba maso ugasubira mu buzima busanzwe.
Nubwo waba ufite uruhushya rwo gutwara ibinyabiziga, ntugatware imodoka kugeza igihe muganga wawe aguhaye uruhushya. Uzakenera gutegereza nibura ibyumweru 6 mbere yo gukora ikintu icyo ari cyo cyose nko guterura ibyuma cyangwa kujya ku kazi.
Kwitabira gahunda yo kuvura indwara z'umutima (cardiac rehab) bizagufasha gukira vuba. Nanone, menya neza ko ujya kwa muganga wawe mu gihe cyo gukurikirana. Bazakomeza gukurikirana imiterere y'umutima wawe.
Ni izihe ngaruka n'inyungu z'ubu buvuzi?
Kimwe n'ubundi buryo bwose bwo kubaga bunini, hari ingaruka zimwe na zimwe zishobora kubaho. Ariko, iyo umuganga w'inzobere mu kubaga mu bitaro bifite ibikoresho byiza, izo ngaruka ziba nke .
Ibyiza by'ingenzi:
- Ntabwo ari ngombwa gufata imiti igabanya amaraso ubuzima bwawe bwose.
- Ibyago byo kubyimba kw'amaraso, gucika imitsi, no kwandura imitsi yo mu bwonko (endocarditis) biragabanuka.
- Amahirwe yo kubagwa kugira ngo wongere usimbuze valve mu gihe kiri imbere ni make cyane.
Ubushakashatsi bwagaragaje ko igipimo cy'intsinzi y'ubu buvuzi kirenga 99%. Nubwo nyuma y'imyaka 10, abantu bagera kuri 95% bamaze kubagwa ntibazongera gukenera ubundi buvuzi.
| Igihe cyo guhamagara muganga nyuma yo kubagwa | |
|---|---|
| Impinduka mu nzira yo gucamo | Gutukura, ububabare, kubyimba, amabyi cyangwa andi mazi ava mu gice cy'igisebe. |
| Kubabara mu gituza cyangwa kugorwa no guhumeka | Kubabara mu gatuza cyangwa guhumeka bigoranye. |
| Ibindi biranga umubiri | Kubyimba amaguru, umunaniro ukabije, gucika intege, umuriro, amaraso mu gitereko. |
| Inkorora | Inkorora ifite ibisebe by'umuhondo cyangwa icyatsi cyangwa inkorora izana amaraso. |
Niba ufite kimwe muri ibi bimenyetso, hamagara muganga wawe ako kanya cyangwa ujye mu ishami rishinzwe ubutabazi bwihuse (ETU) ry’ibitaro biri hafi yawe.
Ubutumwa bwo kujyana mu rugo
- Gusimbuza imizi y'imitsi ya Aortic mu buryo bworoshye ni uburyo bwo kubaga bugezweho busimbura imizi y'imitsi ya aortic yangiritse gusa, bugatuma valve yawe ya aortic ikomeza kuba nzima.
- Akamaro gakomeye k'ibi ni uko utagomba gufata imiti igabanya amaraso mu buzima bwawe bwose kandi ibyago byo kongera kubagwa mu gihe kiri imbere biragabanuka.
- Ubu buryo bwo kubaga ntibukwiriye buri wese. Umuganga wawe ni we uzagena niba bukwiriye ikibazo cyawe.
- Bifata ibyumweru bigera kuri 6 kugira ngo umuntu akire neza nyuma yo kubagwa. Muri iki gihe, kurikiza amabwiriza ya muganga neza.
- Niba ufite ikibazo icyo ari cyo cyose, ntutinye kubaza muganga wawe. Inkunga y'umuryango wawe nayo ni ingirakamaro cyane muri iki gihe.
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