Chiremba akakuudza here kuti tsinga huru yeropa inotakura ropa kubva pamoyo wako kuenda kumuviri wako wese yave isina simba uye ine bundu pasi? Kana kuti akakuudza here kuti unoda kuvhiyiwa? Zvakajairika kuti unzwe kutya zvishoma paunonzwa chimwe chinhu chakadai. Asi uku kuvhiyiwa kwakakosha zvikuru kunogona kuponesa hupenyu hwako. Nhasi, tichataura nezvekuti kuvhiyiwa uku kweAortic Root Replacement chii, kuti kunoitwa sei, uye zvese zvaunoda kuziva nezvazvo.
Zvichitaurwa zviri nyore, chii chinonzi Aortic Root Replacement?
Tsinga yeropa yakakura uye inonyanya kukosha mumuviri, aorta, yakabatana nemoyo wedu. Chikamu chekutanga cheaorta iyi painobatanidza nemoyo chinonzi mudzi weaortic. Dzimwe nguva madziro echikamu ichi anova asina simba uye otanga kuputira sebharumu. Izvi zvinonzi aneurysm.
Njodzi yekuve ne aneurysm yakaita seiyi ndeyekuti inogona "kupatsanura" kana "kuputika" chero nguva. Kana izvozvo zvikaitika, zvinogona kukonzera kubuda ropa kwakanyanya mumuviri uye zvinogona kutoisa upenyu panjodzi.
Saka, kuvhiyiwa kwe `Aortic Root Replacement` kunosanganisira kubvisa mudzi we aorta usina simba uye wakazvimba woutsiva ne artificial channel (graft). Izvi zvinogona kudzivirira mamiriro ezvinhu ane njodzi andataura uye kuponesa hupenyu hwako.
Ndedzipi mhando huru dzekuvhiyiwa uku?
Pane nzira mbiri huru dzekuita kuvhiyiwa uku. Chiremba wako achasarudza nzira yakakunakira zvichienderana nemamiriro ako ezvinhu.
| Rudzi rwekuvhiyiwa | Tsananguro |
|---|---|
| Maitiro ekutsiva Aortic Root (ARR) kana Bentall | Mukuita uku, mudzi weaortic nevharuvhu yeaortic yakabatana nayo zvinobviswa uye imwe itsva yekugadzirwa inoiswa. Maitiro aya anonyanya kunaka kana vharuvhu yako yeaortic isina simba (inodonhedza mvura) kana kuti yakakora (calcification). Kana vharuvhu yemechanical ikaiswa, uchafanira kutora mishonga inorwisa ropa kweupenyu hwako hwese. |
| Kutsiva Mudzi Unochengetedza Mavharuvhu (VSRR) | Sezvinoratidzwa nezita racho, nzira iyi inosanganisira kungotsiva chikamu chisina simba chevharuvhu yako yeropa pasina kuikuvadza. Nzira iyi yakanakira vanhu vanovhiyiwa vachiri vadiki, kunyanya kana vharuvhu yako iri mumamiriro akanaka, kunyanya avo vane zvirwere zvemajini (zvakadai seMarfan syndrome). Chinhu chikuru ndechekuti haufanirwe kutora mushonga unoomesa ropa kweupenyu hwako hwese. Kune mhando mbiri dzenzira iyi : nzira yeYacoub uye nzira yeDavid. |
Zvikamu zveVSRR surgery
Kuvhiyiwa kweVSRR kwakakamurwazve kuita nzira mbiri: nzira dzaYacoub naDavid.
- Maitiro eYacoub: Izvi zvinosanganisira kugadzirisa vharuvhu yeaortic. Izvi zvinonyanya kukodzera vanhu vakwegura vane aneurysm nekuda kwezvikonzero zvisiri zvemajini.
- Maitiro aDavid: Izvi zvinosanganisira kuiswazve kwevharuvhu yeaortic. Izvi zvakaoma kupfuura maitiro aYacoub, asi zvinonyanya kushandiswa. Inonyanya kukodzera vechidiki vane zvirwere zvemajini zvakaita se 'Marfan syndrome'.
Ndiani anoda kuvhiyiwa uku uye riini?
Munhu wese ane mudzi weaortic wakazvimba uye ari panjodzi yekubvaruka kana kubvaruka angada kuvhiyiwa uku. Dzimwe nguva chirwere ichi chinoitika nekuda kwekuchinja kunoitika nekukura. Zvakare, zvirwere zvemajini zvakaita seMarfan syndrome neLoeys-Dietz syndrome zvinogona kukonzera aneurysm iyi ine njodzi achiri mudiki.
Kuvhiyiwa kunowanzo kurudzirwa zvichienderana nehukuru hwe aneurysm nezvimwe zvinhu zvine njodzi.
- Kana pasina zvimwe zvirwere zvemajini kana zvinhu zvinoisa njodzi, dhayamita yeaneurysm inodarika 5.5 centimeters .
- Kana uine Marfan syndrome, dhayamita yacho inodarika 5.0 centimeters .
- Kana uine Marfan syndrome, nhoroondo yemhuri yerudzi urwu rwe aneurysm, uri kuronga kuva nepamuviri, kana kana aneurysm iri kukura nekukurumidza kupfuura mamirimita matatu pagore, kuvhiyiwa kunogona kukurudzirwa kunyangwe iri 4.5 centimeters mudhayamita.
- Kana uine bicuspid aortic valve (ma cusps maviri chete) nezvimwe zvinhu zvinogona kukonzera njodzi, zvakaita seBP yakakwira, kuvhiyiwa kunogona kukurudzirwa pa dhayamita ye 5.0 centimeters .
Chinhu chakakosha ndechekuti sarudzo idzi hadzina kufanana kune wese munhu. Chiremba wako ndiye achasarudza nguva yakanakisa yekuvhiyiwa zvichienderana nezera rako, hutano hwako, nezvimwe zvirwere.
Unogadzirira sei usati wavhiyiwa?
Sezvo uku kuri kuvhiyiwa kukuru, kunoda kugadzirira nokungwarira. Chiremba wako achakuongorora zvakakwana uye achakuraira bvunzo dzinoverengeka dzinodiwa.
- Kuongororwa kweropa: Kuongorora mashandiro eitsvo.
- Kuongororwa kwemwoyo neCT kana MRI: Ongorora zvikamu zvese zveaorta.
- Coronary angiography: Ona mamiriro etsinga dzemwoyo dzinopa ropa kumoyo.
- Duplex ultrasound: Tarisa hutano hwetsinga dziri mumutsipa (carotid arteries).
Uyewo, unofanira kutaura nachiremba wako nezvezvinhu izvi:
- Nezvemishonga yese yaunotora: Izvi zvinosanganisira mavhitamini uye kunyange mishonga yemiti. Mimwe mishonga ingada kuti urege kuitora usati wavhiyiwa.
- Nezvezvimwe zvirwere zvaunazvo: Zvinhu zvakaita seBP inofanira kudzorwa zvakanaka usati wavhiyiwa.
- Kana uchisvuta: Unofanira kurega kusvuta zvachose mwedzi mumwe chete usati wavhiyiwa. Bvunza chiremba wako kuti akubatsire neizvi.
Chii chinoitika panguva yekuvhiyiwa uye mushure mekuvhiyiwa?
Munguva yekuvhiyiwa, uchaiswa pasi peanesthesia uye ucharara zvachose. Zvadaro uchabatanidzwa nemuchina wemwoyo nemapapu (cardiopulmonary bypass) . Muchina uyu uchaita basa remwoyo nemapapu ako panguva yekuvhiyiwa.
Chiremba anochera pakati pechipfuva chako, osvika pamwoyo wako, obvisa chikamu chetsinga chisina simba, ochitsiva negwara idzva rekugadzira (graft). Mitsipa yeropa inopa ropa kumoyo wako inobva yabatanidzwa kune gwara idzva uye gwara racho rinosonerwa. Kuvhiya uku kunowanzotora pakati pemaawa mana kusvika matanhatu .
Mushure mekuvhiyiwa, muchafanira kugara muchikamu chevarwere vane chirwere chakanyanya (ICU) kwemazuva mashoma. Zvadaro muchaendeswa kuchipatara chemazuva ese. Kugara muchipatara kwese kunogona kutora vhiki imwe chete. Munguva iyi, muchapihwa mishonga inoderedza marwadzo, mishonga inobvisa ropa rakawanda, uye mimwe mishonga inodiwa.
Zvinotora nguva yakareba sei kuti munhu apore?
Zvinogona kutora mavhiki matanhatu kusvika gumi nemaviri , kana mwedzi miviri kusvika mitatu, kuti unyatsopora kubva pakuvhiyiwa uku. Uku kuvhiyiwa kukuru, saka unofanira kupa muviri wako nguva yekupora.
- Kwemavhiki matanhatu: Usatyaira kana kusimudza zvinhu zvinorema.
- Pabasa remuhofisi: Uchakwanisa kudzoka mumavhiki angangoita matanhatu kusvika masere.
- Kubasa rinoda simba: Unofanira kumirira kwenguva yakareba.
Kutevedzera mirairo yachiremba wako nemazvo uye kutora chikamu muzvirongwa zvekurapa mwoyo zvichabatsira zvikuru kuti munhu apore nekukurumidza.
Nguva yekuona chiremba nekukasika
Kana wadzokera kumba, kana ukaona chimwe chezviratidzo zvinotevera , fonera chiremba wako nekukasika.
| Zviratidzo zvekuchenjerera | |
|---|---|
| Matambudziko ane chekuita nekuchekwa kweganda: | |
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| Dzimwe nyaya: | |
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Nzira yekuziva sei dambudziko rekukurumidza?
Kana uine aneurysm isina kurapwa, zviratidzo zvinotevera zvinogona kuva chiratidzo chekutsemuka kana kuputika. Kana zvakadaro , enda kuchipatara chiri pedyo neEmergency Department (ETU) kana kufonera ambulensi ye1990.
- Kurwadziwa kusingatarisirwi muchipfuva kana kumusana wekumusoro (kunzwa sekunge pane chiri kubvarurwa mukati memuviri).
- Kudikitira uye kunzwa kutonhora.
- Kutadza kufema zvakanaka.
- Dzungu kana kufenda.
- Kurova kwemoyo nekukurumidza.
Mharidzo Yekuenda Nayo Kumba
- Kutsiva Midzi yeAortic kuvhiyiwa kukuru, kunogona kuponesa hupenyu kunoitwa pamudzi weaorta usina simba.
- Kune mhando mbiri huru dzekuvhiyiwa uku; imwe inotsivawo aortic valve (ARR) uye imwe inongobvisa vharuvhu (VSRR). Chiremba wako ndiye achasarudza kuti ndeipi nzira yakakunakira.
- Kunyangwe zvichitora mwedzi yakati wandei kuti munhu apore zvizere kubva pakuvhiyiwa uku, kubudirira uye mwero wekurarama kwekuvhiyiwa kwacho wakakwira zvikuru (anenge 98%-99%).
- Kunyatsotevedzera mirayiridzo yekurapa usati wavhiyiwa uye mushure mekuvhiyiwa kwakakosha kuti munhu aporeswe nekukurumidza.
- Usanyara kukurukura chero zvinokunetsa kana zvaunotya nachiremba wako. Kunyange zvazvo kuvhiyiwa uku kwakajairika kuvanachiremba, zvakajairika kuti uve nezvinokunetsa nekuti chiitiko chitsva.

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