Ngatidzidzei nezvekuvhiyiwa kwazvino kwakachengetedza vharuvhu yemoyo (Valve-Sparing Aortic Root Replacement).

Chiremba akakuudza here kuti unoda kuvhiyiwa kwemoyo? Zvakajairika kuti unzwe kutya zvishoma paanotaura izvozvo. Asi nhasi uno, mushonga wafambira mberi zvikuru. Kune mamwe maoparesheni anoedza kuchengetedza nhengo dzakawanda dzemuviri wako sezvinobvira. Nhasi tichataura nezveimwe nzira yakakosha yekuvhiyiwa. Kureva, vharuvhu yemoyo, inova nzira yekuvhiyiwa inodzivirira vharuvhu.

Zvichitaurwa zviri nyore, chii chinonzi Valve-Sparing surgery?

Zvakanaka, kuti tinzwisise izvi, ngatitangei tadzidza nezvechikamu chidiki chemwoyo wedu. Kamuri guru rekupomba remwoyo wedu (ventricle yekuruboshwe) rinobatana netsinga huru yeropa mumuviri wedu, aorta. Tinodana kubatana uku kuti 'Mudzi weAortic'. Kwakafanana nemudzi wemuti. Mukati me'Mudzi weAortic' uyu mune gedhi rakakosha zvikuru, 'Aortic Valve'.

Nguva imwe neimwe mwoyo paunorova, iyi 'Aortic Valve' inovhura uye inopomba ropa mumuviri, yobva yavhara. Kuvhara uku kunomisa ropa kuti risadzokere mumoyo.

Zvino fungidzira, mune vamwe vanhu, `Mudzi weAortic`, kureva kuti, chikamu chegedhi chakaita segedhi, chapera simba, chakazvimba, uye chakakura. Zvakaita sebharumu riri kufuridzirwa. Tinoti izvi `Aortic Root Aneurysm`. Gedhi iri parinokura, gonhi riri mariri, kureva `Aortic Valve`, harivharike zvakanaka. Ipapo ropa rinotanga kudonhedza mvura richidzokera mumoyo. Izvi zvinonzi `Aortic Regurgitation`.

Mukuvhiya kwechinyakare (nzira ye "Bentall"), vanachiremba vanobvisa `Aortic Root` ne`Aortic Valve` zviri kuburitsa tsinga voisa maviri matsva ekugadzira.

Chinhu chikuru chakanakira izvi ndechekuti unogona kuchengetedza vharuvhu yako wega, saka haufanirwe kutora mushonga wekudzivirira ropa kubva muropa hupenyu hwako hwese (seCoumadin) sezvaungaita nevharuvhu yemuchina.

Kuvhiyiwa uku kunorapa zvirwere zvipi?

Kuvhiyiwa uku kunonyanya kuitwa munyaya dzinotevera:

• Aortic Root Aneurysm: Sezvandambotaura, uku kuzvimba kusingawanzoitiki mumudzi weaorta kunobatanidza nemoyo. Kana izvi zvikanyanya kukura, zvinogona kuputika kamwe kamwe (`Aortic Dissection` kana kuti Rupture). Zvine njodzi huru kuhupenyu.
• Kukwira kweAortic Aneurysm ine Dilated Aortic Sinuses: Zviitiko apo nzvimbo diki dzechisikigo dziri mu'Aortic Root' ('Aortic Sinuses') dzinokura zvishoma, nekuputika muchikamu chinokwira cheaorta.

Vanhu vane zvimwe zvirwere zvema connective tissue zvakagarwa nhaka, zvakaita seMarfan syndrome, vari panjodzi huru yekubatwa ne aortic root aneurysm. Saka, vanachiremba vanoongorora mamiriro emurwere nokungwarira uye vanoyera mabhenefiti nenjodzi dzekuvhiyiwa vasati vasarudza kana zvakakodzera.

Wakakodzera kuvhiyiwa uku here?

Kana vharuvhu yako yeaortic ine hunhu uhu, unogona kunge uri munhu anofanirwa kuvhiyiwa uku:

• Kana paine calcium deposits shoma kana kuti pasina calcium deposits (calcification) muvharuvhu.
• Kunze kwekunge vharuvhu yakakuvara zvakanyanya.
• Kana vharuvhu iri kushanda zvakanaka kana kuti ichigona kugadziriswa nekugadzirwa kudiki.

Unogadzirira sei usati wavhiyiwa?

Chiremba wako achakutsanangurira zvese zvaunoda kuita usati wavhiyiwa. Zvakakosha kutevedzera mirairo iyoyo nemazvo. Kazhinji, izvi ndizvo zvaunofanira kuita.

Pamusoro pezvo, chiremba achaita bvunzo dzakasiyana-siyana kuti aronge kuvhiyiwa, dzakadai se:

• Echocardiogram (kuongorora kwemoyo)
• Kuongororwa kweropa
• `Kuongororwa kweCT nemwoyo nechipfuva neEKG`
• Angiogram yeCoronary
• Kuongororwa kweropa remajini kana paine chinofungidzirwa kuti une chirwere chenhaka

Chii chinoitika panguva yekuvhiyiwa?

Kuvhiya uku kunowanzotora maawa mana kusvika matanhatu. Kana chiremba ane ruzivo akaita kuvhiya uku, moyo unofanirwa kumira kweinenge awa. Usazvidya moyo, munguva iyoyo, muchina uchaita basa remwoyo nemapapu.

Hezvino zvinoitika nhanho nhanho:

1. Anesthesia: Kutanga, ucharara zvachose. Saka hauzonzwi kurwadziwa.

2. Kuvhura chipfuva: Chiremba anovhiya anoita cheko pakati pechipfuva ('median sternotomy') kuti asvike pamoyo.

3. Kubatanidza Muchina weMoyo neMapapu: Uchabatanidzwa nemuchina we'Cardiopulmonary Bypass'. Muchina uyu uchatora basa remoyo nemapapu ako panguva yekuvhiyiwa. Panguva ino, mushonga unonzi 'cardioplegia solution' uchapihwa kuti umise moyo wako kwechinguva.

4. Kusunungura Vharuvhu: Chiremba anovhiya achanyatsoparadzanisa vharuvhu yako yeaortic kubva munyama yakaipoteredza.

5. Kubviswa kwezvikamu zvakakuvara: `Mudzi weAortic` wakazvimba pamwe nezvimwe zvikamu zvakakuvara zvinochekwa zvobviswa.

6. Graft: Chubhu yekugadzira ('graft') inoiswa panzvimbo pechikamu chakabviswa. Iyi yakagadzirwa nejira rakasiyana ('polyester').

7. Kuiswazve kwevharuvhu: Vharuvhu yako yeaortic inotorwa, gwaro idzva rinoiswa, uye rinosungirirwa panzvimbo yaro.

8. Kuongorora Vharuvhu: Kuti zvive pachena kuti zvese zvakanaka, mvura inopfuudzwa ne'Graft' kuti ione kana vharuvhu iri kushanda nemazvo, ichivhurika uye ichivhara.

9. Danho rekupedzisira: Mitsipa yemwoyo yakabatana ne'Graft' itsva. Wobva wabviswa mu'Moyo-Mapapu' uye moyo wako unobvumirwa kushanda zvakare. Wobva wavhara chipfuva.

Maitiro ekuvhiya emazuva ano (Kuisazve mwana mudumbu)

Nekufamba kwenguva, vanachiremba vakaisa nzira itsva dzekuita kuti kuvhiyiwa uku kubudirire. Semuenzaniso:

• Kugadzira Sinuses Itsva dzeAortic (`Neosinuses`): Kazhinji, `Graft` ichubhu yakatwasuka. Asi `Mudzi weAortic` wechisikigo une nzvimbo diki (`sinuses`). Munzira itsva, nzvimbo dzakadaro dzinogadzirwa zvechisikigo mu`Graft`. Izvi zvinoita kuti kufamba kweropa kuve kwechisikigo, uye kukuvara kwevharuvhu kunoderedzwa.
• Saizi yeAortic Annulus: Saizi yechikamu chakaita serin'i icho vharuvhu inogara pairi ('aortic annulus') inogadziriswa kuti ienderane nehukuru hwemuviri wako. Izvi zvinoderedza njodzi yekubuda kweropa kubva muvharuvhu mune ramangwana.

Chii chinoitika mushure mekuvhiyiwa? Uye zvinotora nguva yakareba sei kuti munhu apore?

Mushure mekuvhiyiwa, uchachengetwa mukamuri rekuchengetwa kwakanyanya (ICU) kwezuva rimwe kana maviri, wobva waendeswa kukamuri rekugara. Kazhinji unogona kudzokera kumba mumazuva mana kusvika manomwe.

Kunyangwe uine rezinesi rekutyaira, usatyaira kusvika chiremba wako akubvumidza. Uchafanira kumirira kwemavhiki matanhatu usati waita chero chinhu chakadai sekusimudza zvinorema kana kuenda kubasa.

Kupinda muchirongwa chekurapa mwoyo ('cardiac rehab') kuchakubatsira kuti upore nekukurumidza. Uyewo, iva nechokwadi chekuenda kunoona chiremba wako nguva yekutevera. Vacharamba vachiongorora mamiriro emwoyo wako.

Ndezvipi njodzi uye mabhenefiti ekuvhiyiwa uku?

Kufanana nekuvhiyiwa kupi zvako kukuru, kune dzimwe njodzi dzinobatanidzwa. Zvisinei, kana ichiitwa nachiremba ane ruzivo muchipatara chine nzvimbo dzakanaka, njodzi idzi hadzina kunyanya kuipa .

Zvakanakira zvikuru:

• Hamufanirwe kutora mushonga wekuderedza ropa kweupenyu hwenyu hwese.
• Njodzi yekugwamba kweropa, sitiroko, uye hutachiona hwevharuvhu (endocarditis) inoderedzwa.
• Mikana yekuti munhu avhiyiwe kuti atsive vharuvhu zvakare mune ramangwana yakaderera zvikuru.

Tsvagiridzo yakaratidza kuti mwero wekubudirira kwekuvhiyiwa uku unodarika 99%. Kunyangwe mushure memakore gumi, vanhu vanosvika 95% vakavhiyiwa uku havazodi kuvhiyiwa zvakare.

Kana uine chimwe chezviratidzo izvi, fonera chiremba wako nekukasika kana kuenda kuEmergency Department (ETU) yechipatara chiri pedyo.