Iwe kana mumwe munhu waunoziva kana shamwari yepedyo wakamboudzwa nachiremba kuti une dambudziko ne'Mitral Valve' yemoyo wako uye kuti unoda kuvhiyiwa here? Patinonzwa izwi rekuti "kuvhiyiwa kwemoyo," vazhinji vedu tinotya zvishoma, handiti? Izvozvo zvakajairika. Nekuti takanzwa nezvekuvhiyiwa kunosanganisira kuvhura chipfuva uye kuita maoparesheni makuru. Asi waizviziva here, sainzi yezvekurapa yafambira mberi zvakanyanya ikozvino. Saka, kune nzira itsva inogona kutsiva vharuvhu iyi pasina kuvhura chipfuva uye kuburikidza nekucheka kudiki. Nhasi, tichataura nezvenzira yekurapa yave iri zororo guru kuvanhu vazhinji, inonzi `Transcatheter Mitral Valve Replacement` kana TMVR muchidimbu.
Zvichitaurwa zviri nyore, chii chinonzi TMVR?
Zvakanaka, ngatizvitaure zviri nyore. TMVR inzira inotsiva vharuvhu yemitral iri mumoyo mako. Asi chinhu chakakosha nezvayo ndechekuti haiitwe nekuvhura chipfuva chako chose sekuvhiyiwa kwemoyo wakavhurika. Pane kudaro, chubhu yakatetepa (catheter) inopinzwa nepaburi diki, uye vharuvhu itsva inopinzwa mumoyo mako.
Fungidzira kuti pachinzvimbo chekubvisa vharuvhu hombe woitsiva neimwe itsva, unotora zvikamu zvevharuvhu itsva nepaburi diki wozvigadzirisa mukati. Iyi inzira isinganyanyi kupindira pane kuvhiyiwa kukuru. Vharuvhu itsva inoiswa nenzira iyi inogona kunge yakagadzirwa. Kana kuti inogona kunge iri vharuvhu yemuviri yakagadzirwa nenyama yemombe, yenguruve, kana yemwoyo wemunhu. Mushure mekunge vharuvhu itsva yaiswa, inotanga kuita zvakafanana nevharuvhu yako yekare, ine chirwere.
Ndiani anoda kurapwa uku kweTMVR?
Kuti tinzwisise izvi, ngatitangei tatarisa kuti iyi 'mitral valve' chii uye kuti chii chinoitika kwairi.
Mwoyo wedu une makamuri makuru mana. Maviri pamusoro uye maviri pasi. Vharuvhu yemitral iri pakati peatrium yekuruboshwe neventricle yekuruboshwe. Yakaita semusuwo uri pakati pemakamuri maviri. Gonhi iri rine maflaps maviri (mapepa). Nguva imwe neimwe moyo paunorova, maflaps aya anovhurika uye anovharika. Izvi zvinobvumira ropa kuti riyerere nenzira imwe chete, kubva mukamuri repamusoro kuenda mukamuri repasi. Basa guru revharuvhu iyi nderekudzivirira ropa kuti risayerere richidzokera kumashure.
Asi dzimwe nguva, kungave kubva pakuzvarwa kana gare gare, matambudziko akasiyana-siyana anogona kuitika nevharuvhu iyi. Kune mhando mbiri dzematambudziko.
| Mamiriro evharuvhu | Zvichitaurwa zviri nyore, chii chinoitika? |
|---|---|
| Kudzoreredza vharuvhu yeMitral | Chinoitika pano ndechekuti vharuvhu harivharike zvakanaka. Zvakaita sekuti mashizha maviri emusuwo haavharike zvakanaka uye pane kamukana kadiki. Ipapo ropa rinobuda richidzokera kumashure, richipinda mukamuri repamusoro. |
| Kuvhiyiwa kweMitral valve stenosis | Chinoitika pano ndechekuti vharuvhu inova diki kana kuti yakavharwa. Izvi zvinoreva kuti gonhi harivhurike zvachose. Ipapo huwandu hweropa rinoda kuyerera mberi hunovharika. |
Kana zvirwere izvi zvikanyanya kuipa, zvinogona kukonzera zviratidzo zvakaita sekushaya mweya, kuneta, uye kurwadziwa pachipfuva. Zvinogonawo kukonzera zvirwere zvakakomba zvakaita seatrial fibrillation (kurova kwemoyo kusina kurongeka), pulmonary BP (BP yakakwira mumapapu), kana kutadza kushanda kwemoyo.
Nzira iyi yekurapa, inonzi TMVR, inowanzova sarudzo yakanaka kune vanhu vakwegura uye vane mamwe matambudziko ehutano uye vasingakwanise kushivirira kuvhiyiwa kukuru kwemoyo.
TMVR neMitraClip zvakafanana here?
Kwete. Kunyangwe zvese zviri zviviri zvisinganyanyi kupindira mukurapa matambudziko e mitral valve, pane musiyano pakati pezviviri izvi.
- TMVR inotsiva vharuvhu zvachose .
- MitraClip™ igadziriso yevharuvhu. Zvakafanana nekuisa kachidimbu kadiki pakati pemaflaps maviri evharuvhu iri kudonha, uchimisa kudonha kwevharuvhu.
Chiremba wemwoyo wako ndiye achasarudza kuti ndeipi nzira yekurapa yakakunakira.
Chii chinoitika kurapwa kweTMVR kusati kwaitwa?
Usati watanga kurapwa uku, timu yako yezvekurapa ichakuongorora nokungwarira. Izvi zvinosanganisira bvunzo dzinotevera:
- Echocardiogram: Uku kuongorora kwemoyo ne ultrasound. Kunogona kuona zvakajeka mashandiro ari kuita makamuri emoyo nemavharuvhu.
- CT Scan: Izvi zvinotora mifananidzo yemoyo netsinga dzeropa ine mativi matatu (3D) uye zvinobatsira kuronga kurapwa.
Vachishandisa ruzivo rwunobva mubvunzo idzi, timu yezvekurapa inoronga saizi yevharuvhu yakanakisa uye nzira yekurapa nayo.
Pamusoro pezvo, chiremba weanesthesia achataura newe osarudza rudzi rwakanakisisa rweanesthesia kuti usanzwa kurwadziwa panguva yekuvhiyiwa. Unogona kurara zvachose (general anesthesia), kana kuti unogona kurara usinganzwe kurwadziwa (conscious sedation).
Mazuva mashoma usati warapwa, chiremba wako achakupa mirairo yakajeka yekuti ungagadzirira sei. Izvi zvinogona kusanganisira:
- Mimwe mishonga, yakaita semishonga inobvisa ropa rakawanda, ingada kuregwa kwemazuva mashoma.
- Pazuva rekurapwa, uchakumbirwa kutsanya (usina kudya kana kunwa) kwemaawa mashoma.
- Mushure mekurapwa, vanokumbira kuti varonge mota yekukutorera kumba kubva kuchipatara.
Chii chinoitika panguva yekurapwa kweTMVR?
Maitiro ese anowanzo tora maawa maviri kusvika matatu uye anoitwa nechikwata chikuru chevanachiremba, kusanganisira vanachiremba vemwoyo, vanachiremba vemwoyo, nyanzvi dzemifananidzo, uye vanachiremba vanokonzeresa kurwadziwa.
Heino kupatsanurwa kuri nyore kwezvinoitika panguva yekurapwa:
1. Kutanga, nzvimbo ichachekwa (kazhinji pahudyu kana nzvimbo diki pachipfuva) inocheneswa uye bvudzi rinobviswa kana zvichidikanwa.
2. Zvadaro, cannula (mutsara wemutsinga) ichaiswa mutsinga iri muruoko rwako, iyo inokupa mishonga nemvura zvinodiwa.
3. Tevere, vharuvhu itsva inonamirwa kumagumo kwechubhu yakatetepa, inochinjika inonzi catheter .
4. Zvino, kucheka kudiki kunogadzirwa panzvimbo yakatarwa muhudyu kana pachipfuva, uye kuburikidza nazvo, catheter iyi inopinzwa mutsinga yeropa.
5. Vachishandisa tekinoroji yekufungidzira, yakadai seX-rays, vanachiremba vanonyatso tungamira catheter iyi kuburikidza netsinga dzeropa kuenda kuvharuvhu yemitral iri mumoyo.
6. Kana yangoiswa panzvimbo, vharuvhu itsva inoiswa mukati mevharuvhu yekare, ine chirwere.
7. Kana vharuvhu itsva yaiswa panzvimbo yayo zvakanaka, catheter inobviswa nokungwarira uye kucheka kudiki kunovharwa.
Munguva iyi yese, timu yezvekurapa icharamba ichitarisa zvese kubva paBP yako uye mwero weokisijeni muropa kusvika pakushanda kwemoyo wako vachishandisa echocardiogram.
Chii chinoitika mushure mekurapwa?
Kana kurapwa kwapera, uchaendeswa kukamuri revanopora. Chikwata chevanachiremba chichakutarisira zvakanaka kusvika wapora kubva pakushandisa mushonga weanesthesia. Vamwe vanhu vangangoda kugara muchikamu chevanorwara zvakanyanya (ICU) kwenguva yakati. Kazhinji, uchafanira kugara muchipatara kwemazuva mashoma.
Usati waenda kumba, vanachiremba vachakutsanangurira zvakajeka zvaunofanira kuita.
- Kugadzirisa mwoyo: Mazano ekurovedza muviri nekuchinja mararamiro ekubatsira kusimbisa moyo zvakare.
- Nguva dzekuonana nachiremba zvakare: Mazuva aunofanirwa kuonana nachiremba zvakare.
- Mishonga: Mazano emishonga mitsva yekutanga kana mishonga yekare yekutangazve.
- Basa remazuva ose: Ungadzokera kubasa riini wotangazve mabasa ako emazuva ose?
Ndezvipi zvakanakira kurapwa neTMVR?
Kana tichienzanisa nekuvhiyiwa kwemoyo kwakavhurika, nzira iyi ye catheter ine zvakanakira zvakawanda.
- Chirwere cheMitral valve chinogona kugadziriswa.
- Kuderera kwezviratidzo zvinokonzerwa nechirwere ichi, zvakaita sekushaya mweya uye kuneta.
- Kuderedzwa kwenjodzi yematambudziko makuru ehutano.
- Kukwanisa kupora nekukurumidza kupfuura kuvhiyiwa kwepanze.
- Kuderedza kukanganiswa kwemuviri nekurwadziwa.
Pane njodzi kana matambudziko here nekurapwa uku?
Ehe. Kunyangwe njodzi dziri shoma pane kuvhiyiwa kwemoyo kwakavhurika, sezvinoitwa chero nzira dzekurapa, TMVR inogona kuva nematambudziko. Zvisinei, izvi hazviwanzoitiki.
Chinonyanya kukosha ndechekuti, kana paine dambudziko guru panguva yekurapwa, timu yezvekurapa yakagadzirira kuchinja kuita operation yemoyo nekukurumidza kana zvichidikanwa.
Aya ndiwo mamwe ematambudziko makuru anogona kuitika:
- Kugwamba kweropa: Kana magwamba aya eropa achienda kuuropi, sitiroko inogona kuitika.
- Kukuvara kwenyama: Madziro emwoyo (kuboorwa kwetsinga yekuruboshwe) kana tsinga yeropa inopa ropa kumoyo (coronary artery) anogona kukuvara.
- Kuvharika kwenzira yekubuda kweropa kuruboshwe: Vharuvhu itsva inovhara nzira yekubuda kweropa kubva mukamuri rezasi rekuruboshwe.
- Kufamba kwevharuvhu: Kufamba kwevharuvhu kubva panzvimbo yayo yakatarwa.
Mamwe matambudziko angada kurapwa kwakawedzerwa kana kuvhiyiwa.
Zvinotora nguva yakareba sei kuti munhu apore?
Vanhu vazhinji vanogona kudzokera kumabasa avo enguva dzose voshanda mukati memavhiki mashoma. Zvisinei, zvinogona kutora mwedzi miviri kusvika mitatu kuti vanyatsopora . Chinhu chakakosha ndechekutevera mirairo yachiremba wako nokungwarira. Usamhanye kuita basa rinorema kana kuita zvinhu zvinorema.
Muzviitiko zvipi zvaunofanira kutsvaga mazano echiremba mushure mekurapwa?
Ichi chikamu chakakosha zvikuru. Paunodzokera kumba mushure mekurapwa, unofanira kutarisisa shanduko dziri kuitika mumuviri wako. Pane zvimwe zviratidzo, kana zvikaonekwa, unofanira kutsvaga rubatsiro rwechiremba nekukurumidza .
| Njodzi: Kana uine zviratidzo izvi, enda kuchipatara cheEmergency Department (ETU) nekukasika! | |
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| Zviratidzo zvestroke zvinogona kusanganisira: | |
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| Zviratidzo zvechirwere chemwoyo zvinogona kusanganisira: | |
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| Zvimwe zvinhu zvekuchenjerera: Taura nachiremba wako kana uine izvi. | |
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TMVR inzira inobatsira zvikuru yekurapa vanhu vane chirwere chemitral valve vasingakwanise kuvhiyiwa mwoyo. Kana muine mimwe mibvunzo nezveizvi, ndapota inzwa wakasununguka kutaura nachiremba wenyu. Iye achakwanisa kutsanangura nzira yakanakira yekurapa.
Mharidzo Yekuenda Nayo Kumba
- TMVR inzira yemazuva ano yekurapa inotsiva vharuvhu yemitral yemoyo kuburikidza nekucheka kudiki, pasina kuvhura chipfuva.
- Izvi zvinonyanya kukodzera varwere vane dambudziko rekushivirira kuvhiyiwa kwemoyo kwakavhurika.
- Kupora kunokurumidza uye migumisiro yemuviri hainyanyi kukosha pane yekuvhiyiwa kwakavhurika.
- Sezvinongoita mishonga yese, kune dzimwe njodzi, uye zvakakosha kukurukura izvi nachiremba wako.
- Mushure mekurapwa, kana zviratidzo zvestroke kana chirwere chemwoyo zvikaonekwa, unofanira kuenda kuchipatara nekukasika.
- Chiremba wemwoyo wako chete ndiye anogona kukupa mazano akanyatsonaka ekurapa kwakanakira iwe.
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