Chiremba wako akakuudza here kuti mudzi wetsinga yako yeropa wakakura zvishoma uye kuti unoda kuvhiyiwa? Zvakajairika kuti unzwe kutya uye kunetseka zvishoma paunonzwa izvozvo. Ndiani asingade shoko rekuti "kuvhiyiwa kwemoyo"? Asi usazvidya moyo. Tekinoroji yafambira mberi zvikuru nhasi. Nhasi, tichataura nezvekuvhiyiwa kwakabudirira zvikuru, kwakakosha kunogadzirisa dambudziko iri pasina kubvisa chikamu chakakosha chemoyo wako, icho chiri 'vharuvhu' yako yechisikigo.
Chii chinonzi Valve-Saring Aortic Root Replacement?
Kuti tinzwisise izvi, ngatitangei tatarisa mashandiro anoita moyo. Funga nezvemoyo wako sepombi yemvura mumba mako. Pombi iyi inopomba ropa mumuviri wako wese.
- Aorta: Iyi ndiyo chubhu huru, yakakura kwazvo inobuda mumoyo. Inotakura ropa kumuviri wese.
- Mudzi weAortic: Ichi chikamu chekutanga chetsinga huru inobatanidza nemoyo. Zvakafanana nepaunosungirira chubhu kune mota.
- Vharuvhu yeAortic: Ichi ndicho chikamu chakakosha munyaya. Painobatanidza nemoyo, pane chikamu chinoshanda semusuwo. Kana moyo uchipomba ropa, suo iri rinovhurika, roburitsa ropa. Ipapo suo iri rinovharwa kudzivirira ropa kuti risadzokere mumoyo. Izvi ndizvo zvatinodaidza kuti `(Vharuvhu yeAortic)`.
Zvino, mune vamwe vanhu, mudzi wetsinga huru iyi inobatanidza nemoyo, `(Mudzi weAortic),` unova usina simba wotanga kuzvimba wokura sebharumu. Tinoti izvi `(Aortic Root Aneurysm)`. Kana yakura seizvi, gonhi iroro, vharuvhu iyoyo, harivharike zvakanaka. Ipapo ropa rinotanga kudonha richidzokera kumashure, `(Aortic Regurgitation)`.
Kare, paimuka dambudziko rerudzi urwu, vanachiremba vaibvisa midzi yeaortic nevharuvhu yeaortic, vozvitsiva nemidzi yeaortic nevharuvhu. Kuvhiya uku kunonzi Bentall procedure .
Asi ikozvino, kana vharuvhu yako iri mumamiriro akanaka, zvichireva kuti haina kukuvara zvakanyanya, pachinzvimbo chekubvisa vharuvhu iyoyo yechisikigo inokosha, `(Mudzi weAortic)` wakakuvara chete ndiwo unobviswa, chubhu itsva yekugadzira (`graft`) inoiswa, uye vharuvhu yako pachayo inosungirirwa pairi zvakare. Zvichitaurwa zviri nyore, izvi zvinonzi Valve-Sparing Aortic Root Replacement .
Ndezvipi zvirwere zvinorapwa nekuvhiyiwa uku?
Kuvhiyiwa uku kunonyanya kuitwa pachirwere chinonzi `(Aortic Root Aneurysm)`. Izvi zvinoreva kana mudzi weaorta wakazvimba sebharumu. Izvi zvinogona kuva nengozi, nekuti kana ukanyanya kukura kupfuura muganho wakati, unogona kuputika (kuputika) kana kubvaruka (aortic dissection).
Vamwe vanhu vane zvirwere zvemajini zvinobatanidza tsinga, zvakaita seMarfan syndrome. Vanhu vane zvirwere izvi vari panjodzi huru yekuve neaortic root aneurysm.
Ndiani akakodzera kuvhiyiwa uku?
Chiremba wako achaita bvunzo dzakasiyana-siyana kuti aone kana uri munhu akakodzera kuvhiyiwa uku. Kazhinji, unogona kunge uri munhu akakodzera kuvhiyiwa uku.
- Kana Aortic Valve yako isina calcium yakawanda kana kuti isina calcium yakakwana.
- Kunze kwekunge vharuvhu yakakuvara zvakanyanya.
- Kana vharuvhu iri kushanda zvakanaka, kana kuti inogona kugadziriswa nekugadziriswa kudiki.
- Kuvhiyiwa uku kunokurudzirwa zvikuru kune vanhu vari pasi pemakore makumi manomwe nemashanu uye avo vane zvirwere zvemajini.
Unogadzirira sei usati wavhiyiwa?
Sezvo uku kuri kuvhiyiwa kukuru, zvakakosha zvikuru kugadzirira zvakanaka. Chiremba wako achakupa mirayiridzo yakajeka nezveizvi.
- Mishonga: Unofanira kuudza chiremba wako nezvemishonga yauri kutora parizvino. Anogona kukukumbira kuti urege kana kuchinja mimwe mishonga (kunyanya mishonga inobvisa ropa) usati wavhiyiwa.
- Kutsanya: Uchakumbirwa kusadya kana kunwa chero chinhu mushure mehusiku husiku hwakatangira kuvhiyiwa. Usatombonwa mvura.
- Miedzo: Chiremba acharaira miedzo yakati wandei kuti aronge kuvhiyiwa.
- Echocardiogram (kuongorora kwemoyo)
- Kuongororwa kweropa
- Kuongororwa kweCT neECG
- MRI yemoyo
- Angiogram yeCoronary
- Kusvuta: Kana uri munhu anosvuta, zvakakosha kuti urege kusvuta zvachose mwedzi mumwe chete usati wavhiyiwa.
- Bvunza mibvunzo: Taura pachena nachiremba wako nezvezvinokunetsa kana zvaunotya. Zvichava zororo guru kuziva zvese zvakajeka.
Kuvhiyiwa uku kunoitwa sei?
Kuvhiyiwa uku kunowanzotora maawa ari pakati pe4 ne6. Kana kuchiitwa nemaoko nachiremba ane ruzivo, moyo unomira kwenguva pfupi, inenge awa imwe chete. Matanho anobatanidzwa mukuita uku ndeaya anotevera.
1. Anesthesia: Kutanga, uchapihwa anesthesia yekukurara hope dzakadzika. Saka hauzonzwi kurwadziwa.
2. Kuvhura chipfuva: Chiremba anoita cheko pakati pechipfuva (median sternotomy) kuti asvike pamoyo.
3. Muchina wemwoyo nemapapu: Tevere, uchabatanidzwa nemuchina wemwoyo nemapapu (cardiopulmonary bypass machine). Muchina uyu uchaita basa remwoyo nemapapu ako panguva yekuvhiyiwa. Uchakupawo mushonga wekumisa moyo wako kwechinguva.
4. Kupatsanurwa kwemavharuvhu: Chiremba anovhiya achanyatsopatsanura vharuvhu yako yeaortic kubva munyama yakaipoteredza.
5. Kugadzirisa:Kana paine kukuvara kudiki pamavharuvhu, anogadziriswa nekukasika.
6. Kubvisa chikamu chakakuvara: Chikamu chakazvimba uye chakakuvara che`(Aortic Root)` chinochekwa uye chinobviswa.
7. Kuisirwa chubhu yekugadzirwa: Pane kudaro, chubhu yekugadzirwa yakagadzirwa nejira rakakosha inotorwa, yogadzirwa saizi yakakodzera iwe, yoiswa panzvimbo iyoyo.
8. Kubatanidzazve vharuvhu: Zvadaro , vharuvhu yako yechisikigo , iyo yakabviswa nokungwarira, inoiswa mukati mechubhu ichangobva kuiswa uye inosonerwa pamwe chete (kuiswazve).
9. Kuongorora: Tarisa kuti zvinhu zvese zvakanaka here, kana vharuvhu ichivhurika uye ichivhara zvakanaka, uye kana paine maburi ari kubuda.
10. Kuvhara: Mitsipa yeropa inoendesa ropa kumoyo inobva yabatanidzwa negraft itsva. Unobviswa mumuchina wemoyo nemapapu uye kana moyo wako watanga kushanda zvakare, kucheka kuri muchipfuva chako kunovharwa.
11. Kuongororwa kwekupedzisira: Usati waburitswa muimba yekuvhiyiwa, ``transesophageal echocardiogram'' inoitiswa kuratidza kubudirira kwekuvhiyiwa.
Kuvandudzwa kwemazuva ano mukuvhiya
Nekufamba kwenguva, vanachiremba vakawedzera nzira itsva dzekuita kuti kuvhiyiwa uku kubudirire.
- Kuderedzwa kweAnnulus: Zvichitaurwa zviri nyore, hwaro hunobata vharuvhu (aortic annulus) hunomanikidzwa kuti hukwane mumuviri wako. Izvi zvinodzivirira ropa kuti risabude kubva muvharuvhu mune ramangwana.
- Kugadzira Sinuses Itsva dzeAortic (Neosinuses): Mudzi weaorta yechisikigo une kuzununguka kudiki. Sezvo graft itsva iri chubhu yakatwasuka, inogadzirawo kuzununguka kudiki. Izvi zvinoita kuti kuyerera kweropa kuve kwechisikigo uye zvinoderedza kukuvara kwemapepa evharuvhu.
Ndezvipi zvakanakira kuvhiyiwa uku?
Kuvhiyiwa uku kune zvakanakira zvakawanda pane kuvhiyiwa kwechinyakare kweBentall (kunosanganisira kutsiva vharuvhu pamwe chete nevharuvhu).
| Zvakanakira | Kuvhiya Kunochengetedza Mavharuvhu | Kuvhiyiwa kweBentall (nevharuvhu yemuchina) |
|---|---|---|
| Mishonga inoomesa ropa kweupenyu hwese | Hamufanirwe kuitora. | Mishonga yakaita seCoumadin (Warfarin) inofanira kutorwa kweupenyu hwese. |
| Kugwamba kweropa, njodzi yekurohwa nesitiroko | Zvakaderera zvikuru. | Zvinonyanya kukosha . |
| Njodzi yehutachiona hwevharuvhu (endocarditis) | Zvakaderera zvikuru. | Zvakawandisa . |
| Kudiwa kwekuvhiyiwa kwekutsiva vharuvhu | Yakaderera zvikuru. Vanhu 95% havazoida kwemakore gumi. | Zvingave zvichidikanwa nekufamba kwenguva. |
Zvinotora nguva yakareba sei kuti munhu apore mushure mekuvhiyiwa?
Mushure mekuvhiyiwa, uchachengetwa mukamuri rekutarisirwa zvakanyanya (ICU) kwezuva rimwe kana maviri, wozoendeswa kukamuri rekugara. Kazhinji unogona kudzokera kumba kubva kuchipatara mukati memazuva mana kusvika manomwe.
Zvinotora mavhiki matanhatu kuti munhu apore zvakakwana uye adzokere kumabasa ake enguva dzose.
Munguva iyi,
- Kupinda muchirongwa chekurapa mwoyo ipfungwa yakanaka. Zvichakubatsira kuti upore nekukurumidza uye uve nesimba.
- Chiremba anoti musaite chero chinhu chakadai sekusimudza masimbi kana kutyaira mota kwemavhiki angangoita matanhatu.
- Kuongororwa kwekutevera: Ungasafunga kuti unofanira kuona chiremba wako zvakare kana wapora. Asi zvakakosha kuita izvozvo . Zvakakosha kuti mwoyo wako ugare uchiongororwa nguva nenguva.
Nguva yekufonera chiremba nekukasika
Mushure mekudzokera kumba, kana ukaona chimwe chezviratidzo zvinotevera, fonera chiremba wako nekukasika kana kuenda kuEmergency Department (ETU) yechipatara chiri pedyo.
| Chiratidzo | Zvekuteerera |
|---|---|
| Kuchinja munzira yekucheka | Kutsvuka, kuzvimba, kurwadziwa kwakanyanya, kudziya, uye hurwa hweyero kana girini hwakatenderedza nzvimbo yakachekwa. |
| Kurwadziwa kwechipfuva | Kurwadziwa kwechipfuva kamwe kamwe kana kwakanyanya. |
| Kuoma kufema | Kufema zvishoma nezvishoma. |
| Kuzvimba kwemakumbo | Kuzvimba kwemakumbo kana kutadza kufambisa makumbo. |
| Dzungu kana kupera simba | Dzungu rakanyanya, kupera simba, kana kuneta zvakanyanya. |
| Fivha kana dzihwa | Fivha ine dzihwa, kubuda kwemvura ine manyoka eyero kana girini. |
Zvakajairika kuti unzwe kutya usati wavhiyiwa chero kupi zvako kukuru. Asi yeuka, kuvhiyiwa uku kuri kuitwa kuti uponese hupenyu hwako uye kuti ugare uine hutano kwenguva yakareba. Taura nemhuri yako neshamwari nezveizvi. Rutsigiro rwavo ruchakusimbisa zvikuru panguva ino.
Mharidzo Yekuenda Nayo Kumba
- Kutsiva Midzi yeAortic Inochengetedza Valve inzira yepamusoro yekuvhiya inochengetedza vharuvhu yako yeaortic yechisikigo uye inorapa kukura kwemidzi yeaortic.
- Chinhu chikuru chakanakira izvi ndechekuti haufanirwe kutora mushonga unodzikisa ropa kweupenyu hwako hwese, sezvaungaita nevharuvhu yemuchina.
- Kuvhiyiwa uku kunogona kuitwa pasi pekutarisirwa kwachiremba ane ruzivo muchipatara chine nzvimbo dzakanaka uye kune mwero wekubudirira kwakanyanya (kupfuura 99%).
- Zvinotora mavhiki matanhatu kuti munhu apore zvizere kubva pakuvhiyiwa. Munguva iyoyo, zvakakosha zvikuru kutevedzera mirairo yachiremba.
- Usatya kutaura nachiremba wako nezvemibvunzo kana zvinokunetsa. Isimba guru kuti uzive zvizere usati waenda kuvhiyiwa.
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