Mwoyo wedu inhengo inoshamisa inoshanda isingamiri. Mukati memoyo uyu, mune mavharuvhu mana anoshanda semagedhi mana ekudzora kufamba kweropa. Aya anobvumira ropa kufamba nenzira imwe chete. Rimwe remavharuvhu aya rinonzi 'Mitral valve'. Iri riri kuruboshwe rwemoyo pakati pekamuri repamusoro (atrium yekuruboshwe) nekamuri repasi (ventricle yekuruboshwe). Asi dzimwe nguva vharuvhu iyi yemitral inogona kurwara. Izvi zvinoreva kuti ropa rinogona kubuda richidzokera shure risina kuvhara zvakanaka, kana kuti rinogona kuvharika risina kuvhurwa zvakanaka. Saka muchiitiko ichi, vharuvhu iyoyo inofanira kutsiviwa.
Saka chii chinonzi TMVR?
Zvichitaurwa zviri nyore, TMVR (Transcatheter Mitral Valve Replacement) inzira yemazuva ano yekurapa inotsiva valvu yemitral yakakuvara nevharuvhu itsva pasina kuvhiyiwa kwemoyo kwakakura.
Fungidzira, pachinzvimbo chekuvhiyiwa kukuru kunosanganisira kuvhura chipfuva nekumisa moyo, chubhu yakatetepa (catheter) inopfuudzwa nepaburi diki mudumbu kana pachipfuva, pamwe chete netsinga yeropa, ichipinda mumoyo, uye vharuvhu itsva inopinzwa nepaburi uye inoiswa panzvimbo pevharuvhu yekare, ine chirwere. Vharuvhu itsva iyi inogona kunge iri vharuvhu yakagadzirwa nevanhu, kana kuti inogona kugadzirwa nenyama yemhuka (mombe, nguruve). Mukuita uku, vharuvhu yekare haibviswi, asi panzvimbo pezvo itsva inoiswa mukati mayo uye inogadziriswa.
Ndiani anoda kurapwa uku?
Kune marudzi maviri makuru echirwere chemitral valve:
1. Kudzoreredza vharuvhu yeMitral: Apa ndipo apo maburi maviri evharuvhu asingavharike zvakanaka, zvichiita kuti rimwe ropa rinopombwa nemoyo ridonhe kumashure. Zvakafanana nemvura iri kubuda mupombi yakapwanyika.
2. Mitral valve stenosis: Apa ndipo apo vharuvhu inova diki uye isingavhurike zvakanaka. Izvi zvinoderedza huwandu hweropa rinogona kuyerera mberi. Sekunge kana pombi yavharwa, kuyerera kwemvura kunoderera.
Kana zvirwere izvi zvese zvikanyanya, zviratidzo zvakakomba zvakaita sekushaya mweya, atrial fibrillation, pulmonary BP, uye kutadza kushanda zvakanaka kwemoyo zvinogona kuitika.
Kazhinji, kuvhiyiwa kwemoyo kunoitwa muzviitiko zvakaita seizvi. Zvisinei, TMVR isarudzo yakanaka kune avo vakwegura, vane mamwe matambudziko ehutano, uye vasingakwanise kubhadhara njodzi dzekuvhiyiwa kukuru kwakadaro.
TMVR neMitraClip zvakafanana here?
Kwete. Kunyangwe zvese izvi zviri kurapwa kunoitwa pasina kuvhura moyo, inzira mbiri.
- MitraClip™: Izvi zvinosanganisira kugadzirisa vharuvhu rinodonhedza mvura. Izvi zvinosanganisira kuisa kamuchina kadiki kakaita seclip pakati pemapepa maviri evharuvhu kuti ropa risadonhedze.
- TMVR:Uku hakusi kugadziriswa, asi vharuvhu itsva zvachose yaiswa.
Chii chinoitika kurapwa kweTMVR kusati kwaitwa?
Mushure mekusarudza kukupa mushonga uyu, timu yezvekurapa ichakuongorora nokungwarira.
- Miedzo: Miedzo yakati wandei inoitwa, yakadai se "Echocardiogram" yekutarisa mashandiro emwoyo uye "CT scan" yekutarisa chimiro chemwoyo. Izvi zvinoshandiswa kuronga kurapwa.
- Kutaura nezve anesthesia: Nyanzvi ichataura newe nezverudzi rweanesthesia yauchapihwa kudzivirira kurwadziwa panguva yekurapwa. Sarudzo ichaitwa zvichienderana nemamiriro ako ezvinhu, kana uchapihwa anesthesia yakajairika kana kuti sedation isingazivi.
- Mirayiridzo: Chiremba achakupa mimwe mirairo yakakosha.
- Mimwe mishonga (kunyanya mishonga inoderedza ropa) ingada kuregwa kwemazuva mashoma.
- Uchakumbirwa kutsanya kwemaawa mashoma pazuva rekurapwa.
- Uchaziviswa kuti uuye nemumwe munhu kumba mushure mekurapwa.
Chii chinoitika panguva yekurapwa?
Kurapwa uku kunowanzotora maawa maviri kusvika matatu. Chikwata chenyanzvi, kusanganisira vanachiremba vemwoyo, vanachiremba vemwoyo, uye vanachiremba vanokonzeresa kurwadziwa, vanobatanidzwa mune izvi.
Muchidimbu, izvi ndizvo zvinoitika.
1. Nzvimbo yakachekwa (pahuro kana pachipfuva) inocheneswa uye inogadzirwa.
2. Cannula (mutsara wemutsinga) inoiswa mutsinga iri muruoko, umo mishonga nemvura zvinodiwa zvinopihwa.
3. Vharuvhu itsva yakabatanidzwa kumagumo kwechubhu yakatetepa (catheter).
4. Chubhu iyi inopinzwa mutsinga yeropa kuburikidza nekucheka kudiki kunoitirwa pahudyu kana pachipfuva.
5. Uchishandisa tekinoroji yakakosha yekufungidzira, chubhu iyi inotungamirwa kuvharuvhu yemitral yemoyo.
6. Vharuvhu itsva inopinzwa muvharuvhu yekare, ine chirwere, yoiswa zvakanaka, yoiswa.
7. Chubhu inobviswa uye kucheka kwacho kunovharwa.
Chikwata chekurapa chiri kutarisa zvese, kusanganisira BP yako uye mwero weokisijeni, munguva yese iyi.
Chii chinoitika mushure meTMVR?
Mushure mekurapwa, muchaendeswa kukamuri revanopora. Muchatariswa zvakanyanya kusvika mapora kubva muanesthesia. Vamwe vanhu vangangoda kugara muchikamu chevanorwara zvakanyanya (ICU) kwezuva rimwe kana maviri. Kazhinji, muchafanira kugara muchipatara kwemazuva mashoma.
Kana wadzokera kumba, chiremba wako achakupa mazano anotevera:
- Maitiro ekutora chikamu muzvirongwa zvekuvandudza hutano hwemwoyo.
- Kugadzwa kwekutevera.
- Nezvemishonga yekutanga patsva uye mishonga mitsva yekunwa.
- Ndingadzokera rini kumabasa angu enguva dzose?
Mabhenefiti nenjodzi dzekurapa kweTMVR
Sekune mamwe marapirwo ekurapa, kune zvakanakira pamwe nenjodzi. Ngatizvitarisei.
| Zvakanakira | Njodzi & Matambudziko |
|---|---|
| Chirwere cheMitral valve chinogadziriswa. | Pane njodzi yekuti ropa riungane richienda kuuropi, zvichikonzera sitiroko. |
| Kuderera kunoonekwa kwezviratidzo (zvakadai sekushaya mweya). | Kukuvadzwa kwenyama yemwoyo. Semuenzaniso: Kuboorwa kwetsinga yekuruboshwe. |
| Kupora nekukurumidza kupfuura kuvhiyiwa kwemoyo kwakavhurika. | Kuvharika kwenzira yekubuda kwemhepo kuruboshwe. |
| Hapana vanga guru uye kurwadziwa kushoma. | Vharuvhu yakaisirwa inogona kufamba kana kusuduruka kubva panzvimbo yayo. |
Chinhu chakakosha ndechekuti njodzi idzi hadziwanzowaniki, uye kana paine matambudziko akamuka, timu yezvekurapa yakagadzirira kuchinja ipapo ipapo kuita open surgery kana kutora mamwe matanho akakodzera.
Unofanira kutsvaga rubatsiro rwekukurumidzira riini?
Paunodzokera kumba mushure mekurapwa, unofanira kungwarira zvakanyanya nezvezvimwe zviratidzo. Kana ukaona zviratidzo zvinotevera , enda kuEmergency Treatment Unit (ETU) yechipatara nekukasika.
| Enda kuETU nekukasika! | |
|---|---|
| Zviratidzo zvestroke |
|
| Zviratidzo zvechirwere chemwoyo | |
| Kana uine zviratidzo izvi, zivisa chiremba wako. | |
| Matambudziko ane chekuita nekuchekwa | Matinji anobuda, achibuda ropa kubva paronda. |
| Zviratidzo zvehutachiona | Marwadzo, kutsvuka, urwa kana kubuda kwemvura, fivha panzvimbo yeronda. |
| Zviratidzo zvekugwamba kweropa | Kurwadziwa, kuzvimba, uye kuchinja ruvara munzvimbo dzakadai sepahudyu, pabvi, kana patsoka. |
| Zvimwe zviratidzo zvechirwere chemwoyo | Kuwedzera uremu kamwe kamwe, kuzvimba kwemakumbo netsoka. |
Mharidzo Yekuenda Nayo Kumba
- TMVR inzira yemazuva ano yekurapa inotsiva vharuvhu yemitral isina kuvhura moyo, ine njodzi shoma uye inopora nekukurumidza.
- Iyi isarudzo yakanaka, kunyanya kune vakwegura kana vane zvimwe zvirwere zvinoita kuti zviomere kuvhiyiwa kukuru.
- Kana iwe kana mumwe munhu ari pedyo newe aine chirwere chemitral valve, taura nachiremba wemwoyo nezvesarudzo iyi yekurapa. Iye ndiye achasarudza kuti ndeipi nzira yekurapa yakakunakira.
- Mushure mekurapwa, kutevedzera mirairo yachiremba wako nemazvo kwakakosha kuti ukurumidze kupora. Gara uchiziva zviratidzo zvekunyevera.
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