Mhinduro yekugwamba kweropa mumoyo? (Kuruboshwe kweAtrial Appendage Closure) Ngatidzidzei nezvazvo zviri nyore!

Wakamboudzwa nachiremba wako here kuti une Atrial Fibrillation, kurova kwemoyo kunokurumidza zvisingawanzoitiki? Pamwe unoziva kuti vanhu vane chirwere ichi vane mukana wekurohwa nesitiroko kakapetwa katatu kusvika kashanu kupfuura vamwe. Chikonzero chikuru cheizvi kuumbwa kweropa mukati memoyo. Saka nhasi tiri kutaura nezvekurapa kwakakosha kwakaunza zororo guru kuvanhu vazhinji uye kunoshandiswa kuderedza njodzi iyi ine njodzi.

Zvichitaurwa zviri nyore, chii chinonzi Left Atrial Appendage Closure?

Zvakanaka, izvi zvinganzwika sezita rakaoma, asi nyaya yacho iri nyore kwazvo. Funga nezve atrium yekuruboshwe, imba yepamusoro yemoyo yedu. Kune chikamu chidiki chakaita sehomwe chinobuda pamadziro eimba iyi. Ndizvo zvinonzi navanachiremba Left Atrial Appendage (LAA) .

Kazhinji, kana mwoyo uchirova zvakanaka, ropa rinoyerera mubhegi iri rozobuda zvakare. Asi mumunhu ane Atrial Fibrillation (Afib), makamuri epamusoro emoyo haagumbuke zvakanaka, asi anodedera. Zvadaro, ropa rinoungana mubhegi iroro rinonzi LAA, uye mavanga eropa anotanga kuumbwa. 90% yemavanga eropa anokonzera sitiroko muvanhu vane Afib anoumbwa mubhegi iri diki rinonzi LAA.

Chinhu chakanakisa ndechekuti kuvhara chikamu ichi cheLAA hakukanganisi mashandiro emoyo. Mwoyo unogona kushanda zvakanaka usina.

Ndiani anoda kurapwa uku?

Kurapa uku kunokurudzirwa zvikuru kuvanhu vane Atrial Fibrillation (Afib) vari panjodzi huru yekubatwa nestroke. Imhinduro yakanaka zvikuru kune avo vane matambudziko ekuderedza ropa.

Vanachiremba vanowanzo nyora mishonga inodzikisa ropa yakaita sewarfarin (Coumadin®) kuderedza njodzi yekurohwa nesitiroko. Asi vamwe vanhu vane matambudziko nemishonga iyi:

• Kuongororwa ropa nguva dzose: Unofanira kuongororwa ropa nguva dzose kuti uve nechokwadi chekuti uri kutora mushonga wakakodzera.
• Kudzora kudya: Zvimwe zvekudya, zvakaita semiriwo ine vhitamini K, zvingada kuderedzwa.
• Njodzi yekubuda ropa: Mushonga uyu unogona kunonotsa kubuda ropa kunyangwe kana munhu akakuvara zvishoma. Izvi zvine njodzi kumunhu anowa kakawanda kana kuti ari panjodzi yekubuda ropa kubva mudumbu.
• Mushonga uyu haushandi kune vamwe vanhu.

Apixaban (Eliquis®), rivaroxaban (Xarelto®) isina warfarinKunyangwe paine mishonga mitsva yakaita seiyi, haishandi kune wese munhu. Inodhura kune vamwe vanhu, uye ine njodzi yekubuda ropa.

Saka, kune avo vanoomerwa nekuramba vachitora mishonga inodzikisa ropa nekuda kwezvikonzero zvakaita seizvi, munogona kutaura nachiremba wenyu nezvemushonga unonzi LAA Closure.

Ndedzipi nzira dzinoshandiswa kuvhara LAA?

Kune nzira dzakasiyana siyana uye zvishandiso zvekuvhara chikamu ichi cheLAA. Dzimwe dzacho ndeidzi:

Kugadzirira uye kuita kurapwa

Usati warapwa

Usati watanga kurapwa uku, chiremba wako achaongorora moyo wako neTransesophageal Echocardiogram (TEE).Kuongororwa kunonzi TEE kana kuti cardiac CT scan kunoitwa. Kuongororwa kunosanganisira kuisa kamera diki pasi pegurokuro kuti uzive chimiro chaicho nehukuru hweLAA mumoyo. Izvi zvinodaro nekuti LAA yemunhu wese haisi yakafanana. LAA dzevamwe vanhu dzakaita sebapiro rehuku, nepo LAA dzevamwe dzakaita seshavishavi. Kuongororwa uku kunoshandiswa kusarudza mudziyo wakakunakira uye saizi.

Pamusoro pezvo, uchakurudzirwa kurega kudya nekunwa (kutsanya) kwemaawa mashoma usati watanga kurapwa.

Panguva yekurapwa

Pane nzira mbiri huru dzekuita izvi.

1. Kuzviita panguva imwe chete nekuvhiyiwa kwemoyo: Kana uri kuvhiyiwa kwemoyo kukuru, kwakadai sekuvhiyiwa kwe bypass, chiremba anogona kucheka nekubvisa chikamu ichi cheLAA panguva imwe chete, kana kuchisonesa chakavharwa.

2. Kupinza zvishoma: Iyi ndiyo nzira inonyanya kushandiswa. Hapana kucheka kukuru pano. Izvi ndizvo zvinoitika:

• Kuchekwa kudiki kunoitwa paganda riri pedyo nepahudyu, uye chubhu diki inonzi catheter inopfuudzwa nemutsinga yeropa ipapo ichienda kumoyo.
• Chubhu iyi inopinzwa kubva paatrium yekurudyi yemoyo ichienda kuatrium yekuruboshwe, nepaburi diki riri pamadziro ari pakati pemakamuri maviri. (Musazvidya moyo, buri iri rinowanzo vhara roga mukati memwedzi mitanhatu).
• Chubhu yacho inobva yaendeswa kuLAA, uye mudziyo wakasarudzwa kare unomanikidzwa kuvhara muromo weLAA.
• Zvese izvi zvinoitwa nekutarisa mukati uchishandisa ma scan akaita seFluoroscopy (X-ray video) uye TEE .
• Kana basa rapera, catheter inobviswa.

Chii chinoitika mushure mekurapwa?

Kana kurapwa uku kuchiitwa nekucheka kadiki, ungangofanira kugara muchipatara kwehusiku humwe chete uye uchakwanisa kuenda kumba mangwana acho.

Chirongwa chemishonga chichachinja zvishoma mushure mekunge waenda kumba.

• Kazhinji, kwemazuva makumi mana nemashanu ekutanga , uchaudzwa kuti utore mushonga unorwisa ropa rinopwanya ropa neaspirin. Munguva iyoyo, nyama yeganda inoumbwa yakakomberedza mudziyo, ichiivhara zvakasimba.
• Kana TEE scan yangopera mazuva makumi mana nemashanu yaratidza kuti LAA yavharwa zvachose, unogona kurega kutora mishonga inobvisa ropa. Uchapihwa clopidogrel (Plavix®) neaspirin kwemwedzi mitanhatu .
• Dzimwe nguva chiremba anokurudzira kutora aspirin kwenguva yakareba.

Ndezvipi zvakanakira uye njodzi dzacho?

Sezvinongoita chero kurapwa kupi zvako, kune zvakanakira uye njodzi diki. Chiremba wako achakutsanangurira zvese izvi.

Unofanira kutaura nachiremba rini?

Kana ukaona chimwe chezviratidzo zvinotevera mushure mekudzokera kumba mushure mekurapwa, zivisa chiremba wako nekukasika.

• Fivha kana zvimwe zviratidzo zvehutachiona (kuzvimba, kutsvuka kweganda rakachekwa).
• Kurova kwemoyo kusina kujairika, kunzwa sekunge munhu ari kubhururuka muchipfuva.
• Kurwadziwa kwakanyanya pachipfuva.
• Kutadza kufema zvakanaka.

Kugara neAfib kunogona kukunetsa, kunyanya kana uine matambudziko nemishonga yako yekuderedza ropa. LAA Closure haisi yemunhu wese, asi inogona kunge iri sarudzo yako. Saka taura pachena nezvazvo nachiremba wemwoyo wako, bvunza mibvunzo yako, uye ita sarudzo yakakunakira.