Uncedo lwentliziyo yakho: Yintoni i-cardiology yokungenelela?

Ngaba wakha weva ngegama elithi "Interventional Cardiology"? Mhlawumbi ugqirha wakho ukhe walikhankanya, okanye mhlawumbi ujonge kulo kuba unengxaki yentliziyo. Nokuba kunjalo, eli licandelo elibaluleke kakhulu kwezonyango. Masithethe ngalo ngokufutshane, akunjalo?

Yintoni i-Interventional Cardiology? Kulula kakhulu!

Ngamafutshane, i-interventional cardiology yinkqubo ekhethekileyo esebenzisa ityhubhu encinci kakhulu , eguquguqukayo ebizwa ngokuba yi-"catheter" ukuxilonga nokunyanga izifo zentliziyo kunye nemithambo yegazi . Cinga ngayo njenge-cannula encinci esiyisebenzisayo xa sifaka i-saline engalweni yethu, kodwa le "catheter" yityhubhu ecolekileyo nangakumbi. Le ifakwa ngomnye wemithambo yegazi yakho. Ke ngoko, akukho mfuneko yokwenza utyando olukhulu eluswini. Le yeyona nzuzo inkulu yale ndlela.

Oogqirha kweli candelo (sibabiza ngokuba ziingcali zentliziyo ezisebenzisanayo) banceda abantu abanesifo sentliziyo kunye nesifo semithambo yegazi. Bakwanyanga iintsana, abantwana abancinci, kunye nabantu abadala abaneziphene zentliziyo, ezifana neziphene zevalvu yentliziyo okanye isifo sentliziyo sokuzalwa, ezifana neziphene zeseptal.

Yintoni umahluko phakathi kwe-Interventional Cardiology kunye ne-Cardiothoracic Surgery?

Nangona zombini ezi zinto zinxulumene nentliziyo, kukho umahluko omncinci.

Ingcali yentliziyo engenelelayo yenza unyango lwe-"Minimally Invasive"`, endilukhankanyileyo ngaphambili, isebenzisa i-`(Catheter)``, ngaphandle kokusikwa okukhulu, ngomngxuma omncinci. Oko kukuthi, abenzi `` utyando lwentliziyo evulekileyo`` , olubandakanya ukwenza isilonda esikhulu esiphakathini sesifuba (``Sternotomy``).

Nangona kunjalo, ugqirha wentliziyo ngumntu owenza utyando kumalungu esifubeni, njengentliziyo, imiphunga, kunye nomqala. Benza utyando lwentliziyo evulekileyo. Ngamanye amaxesha basebenzisa nezigcawu ezininzi ezincinci endaweni yesigcawu esinye esikhulu.

Eyona nto ibalulekileyo kukuba, kwiimeko ezininzi, zombini ezi ngcali zisebenzisana ukugqiba ukuba loluphi unyango olufanelekileyo kuwe.

Yintoni kanye kanye eyenziwa yingcali yentliziyo engenelelayo?

Aba gqirha bagxile ekusebenziseni loo "catheter" ukuxilonga nokunyanga izifo zentliziyo kunye nemithambo yegazi. Ezinye iindlela zisetyenziswa ukufumanisa ukuba siyintoni kanye kanye esi sifo, ngelixa ezinye zisetyenziswa ukunyanga esi sifo.

Zeziphi iimvavanyo eziyalelwa yingcali yentliziyo engenelelayo?

Kule ntsimi ikakhuluIjonga ukuba ukujikeleza kwegazi emzimbeni wakho kusebenza kakuhle na. Ijonga iingxaki eziphazamisa ukuhamba kwegazi kwaye izama ukuzisombulula. Umzekelo, ijonga ukuhamba kwegazi kunye noxinzelelo kwimithambo yegazi ehambisa igazi entliziyweni yakho (i-"Coronary Arteries"`) kunye nangaphakathi kwamagumbi entliziyo.

Ezinye zeemvavanyo ezenziweyo zoku zezi:

• I-CT scan yemithambo yegazi yentliziyo (i-computed tomography (CT) yeCoronary Arteries).
• I-echocardiogram (i-echocardiogram yangaphakathi kwentliziyo).
• I-MRI yentliziyo.
• I-X-ray yesifuba .

Yintoni iNkqubo yoNyango lwentliziyo?

Le yindlela yokunyanga intliziyo kusetyenziswa i-`(Catheter)` kuphela, ngaphandle kokusikwa ulusu okanye ukwenza utyando. Umzekelo, ukuba ukutshintsha ivalvu yentliziyo okanye ukulungisa ivalvu yentliziyo kwenziwa kusetyenziswa i-`(Catheter)`, lunyango lwentliziyo olungenelelayo.

Zeziphi iindlela zonyango ezenziwa yingcali yentliziyo engenelelayo?

Zininzi iindlela zonyango ezenziwa ngaba gqirha. Usenokuba ukhe weva ngezinye zazo.

• Ukufakwa kwe-catheter kwintliziyo: Ukuhlolwa kwentliziyo ngokufaka i-catheter kuyo.
• I-Angiogram (`Angiogram` - `I-Peripheral` okanye `I-Coronary`): Ulwelo olukhethekileyo lufakwa kwimithambo yegazi kwaye kuthathwa ii-X-ray ukuze kufunyaniswe ukuba zikuphi na izithintelo.
• I-Angioplasty: Ukuvula kwakhona umthambo wegazi ovalekileyo ngokuwufutha ngesixhobo esincinci esifana nebhaluni.
• Ukususwa kweCoronary Atherectomy: Ukususwa kweendawo ezinamafutha (i-plaque) kwimithambo yegazi .
• Umlinganiselo weFractional Flow Reserve (FFR): Umlinganiselo wokuba ingakanani i-blood flow evalekileyo ngenxa yokuvaleka kwemithambo yegazi.
• I-Intravascular Ultrasound (IVUS): Inkqubo apho kufakwa isixhobo esincinci se-ultrasound kumthambo wegazi.
• I-Optical Coherence Tomography (OCT): Indlela esebenzisa ukukhanya ukubona ingaphakathi lemithambo yegazi ngokucacileyo.
• Ukubekwa kweStent: Umbhobho omncinci ofakwe kumthambo wegazi ovalekileyo ovulwe yi-angioplasty ukuze ungavaleki kwakhona. Oku kudla ngokwenziwa ngesinyithi.
• Ukutshintshwa kunye nokulungiswa kweValve yeNtliziyo: Oku kungenziwa ngoku nge-catheter.
• Ukuvalwa kwe-Atrial Appendage yasekhohlo.
• Ukuvala umngxuma eludongeni phakathi kwe-atria (`Atrial Septal Defect Closure`).
• Utywala lweSeptal Ablation.
• Ukuvalwa kwePatent Foramen Ovale.
• Ukususwa kwezintso: Unyango olujolise kwimithambo-luvo ukuya kwizintso ukuze kuncitshiswe uxinzelelo lwegazi oluphezulu.
• I-Thrombolysis: Ukunyibilikisa amahlwili egazi.

Yeyiphi indlela yonyango eqhelekileyo eyenziwa ziingcali zentliziyo ezingenelelayo?

Eyona nkqubo ixhaphakileyo eyenziwa ngaba gqirha yi -angioplasty kunye nokufakwa kwe-stent kwimithambo yegazi yentliziyo. Oku kubandakanya ukusebenzisa i-catheter ukufumana ukuvaleka kwemithambo yegazi entliziyweni. Emva koko, ngesixhobo esincinci esifana nebhaluni, ukuvaleka (oko kukuthi, i-plaque eyenziwe yi-cholesterol deposits) kucinezelwa eludongeni lwemithambo yegazi, kudala indlela yokuhamba kwegazi. Emva koko, ukuba kuyimfuneko, kubekwa ityhubhu ye-mesh ebizwa ngokuba yi-stent apho ukuthintela indlela ukuba ingavaleki kwakhona. Olu lunyango olusindisa ubomi kumntu oye waba nesifo sentliziyo.

Zeziphi izifo kunye neemeko ezinyangwa yi-cardiology yokungenelela?

Le ndlela inokunyanga izifo ezininzi ezichaphazela intliziyo nemithambo yegazi. Nazi imizekelo embalwa:

• Isifo seValve yeNtliziyo
• I-atherosclerosis
• Ukuhlaselwa yintliziyo
• Isifo seCarotid Artery (esi sisixhobo esikhulu segazi entanyeni)
• Isifo seMitha yeCoronary
• I-Hypertrophic Cardiomyopathy (ukuqina kwemisipha yentliziyo)
• I-Coronary Artery Fistula (Unxibelelwano olungaqhelekanga phakathi komthambo wegazi entliziyweni nomnye umthambo wegazi okanye inxalenye yentliziyo)
• Isifo semithambo yegazi ejikeleze umzimba (ukuvaleka kwemithambo yegazi emalungeni)
• Isifo seMingxunya esingapheliyo (iVein)
• I-Aortic Valve Stenosis
• Izifo zokuqunjelwa kwegazi (`Isifo seThromboembolic`)
• I-Aneurysm
• Imingxunya eludongeni phakathi kwe-atria (`Atrial Septal Defect`)
• Imingxunya eludongeni phakathi kweeventricle (`Ventricular Septal Defect`)

Ngaba ndifuna ingcebiso yokubona ugqirha wentliziyo ongenelelayo?

Ewe, uya kufuna ukuthunyelwa komnye ugqirha ukuze ubone ugqirha wentliziyo ongenelelayo. Oku kungenxa yokuba ezi ngcali ziqeqeshwe ukwenza uvavanyo oluthile okanye unyango olufunayo.

Basebenza phi aba gqirha bentliziyo abangenelelayo?

Iingcali zentliziyo ezisebenza ngokungenelela zisebenza kwizibhedlele, kumaziko ezonyango abucala, nakwizikolo zonyango. Abanye babandakanyeka kuphando nasekufundiseni abafundi bezonyango ngelixa bebonelela ngonyango.

Amaxesha amaninzi, aba gqirha badla ngokubakho ukuze banyange imeko engxamisekileyo, umzekelo, umntu onesifo sentliziyo.

Luluphi uqeqesho olufunekayo kwi-cardiology yokungenelela?

Ukusebenza kweli candelo kufuna iminyaka yoqeqesho. Emva kwesikolo sezonyango (iminyaka emi-4), abo balandela olu qeqesho bagqiba iminyaka emithathu yoqeqesho lokuhlala kwi-Internal Medicine, kulandele eminye iminyaka emithathu yoqeqesho olukhethekileyo kwi-General Cardiology.

Emva koko, uza kufumana ubuncinane omnye unyaka woqeqesho olukhethekileyo lwe-interventional cardiology (`Fellowship`) kwiindlela ezisetyenziswayo ukusebenzisa ``Catheter``. Kulapho ke kuphela apho uza kufumana ``Certification`` kwibhodi yezonyango.

Abanye oogqirha bentliziyo abangenelelayo bangamalungu emibutho efana ne-Society for Cardiovascular Angiography and Interventions (SCAI) okanye banobulungu obukhethekileyo ("Fellow"). "Fellow" ngumntu owenze iinkqubo ezingaphezu kwe-1,000. Oku kuthetha ukuba unyangwa ngumntu ofumene uqeqesho oluphezulu kakhulu.

Yintoni onokuyilindela ngexesha lokuqeshwa kwe-cardiologist yokungenelela?

Ngaphandle kokuba yingxamiseko, ingcali yentliziyo engenelelayo iya kuthetha nawe ngeengxaki zakho zentliziyo okanye zemithambo yegazi. Baza kukubuza ngeempawu zakho kunye nokuba unexesha elingakanani unazo. Kubalulekile ukuzisa uluhlu lwamayeza onke owathathayo (abhalwe ngugqirha, athengiswa ngaphandle kwemvume kagqirha, iivithamini, kwanezongezo).

Ugqirha uza kumamela intliziyo yakho. Uza kukubuza nokuba usebenzisa icuba okanye usela utywala na. Uza kukubuza nokuba kukho umntu kusapho lwakho oye waba nesifo sentliziyo okanye iingxaki zemithambo yegazi. Angenza novavanyo olulula apho, njengokujonga uxinzelelo lwakho lwegazi.

Ukuba ufuna uvavanyo lokuxilonga kunye/okanye unyango, kuya kufuneka ucwangcise idinga elahlukileyo ngaloo mini. Ugqirha wakho uza kukuchazela unyango olungenelelayo abacinga ukuba lufanelekile kuwe, kunye neenzuzo kunye neengozi. Baza kukuxelela nendlela yokulungiselela unyango. Umzekelo, ungacelwa ukuba ungatyi okanye ungaseli iiyure ezisibhozo ngaphambi kovavanyo okanye unyango.

Kuqhelekile ukuba novalo nokukhathazeka xa uxelelwa ukuba uza kwenziwa utyando lwentliziyo. Kodwa khumbula, xa une-cardiology yokungenelela, unyanyekelwa yingcali eqeqeshwe kakhulu. Banokuqokelela ulwazi abaludingayo ukuze baxilonge imeko baze bayinyange ngaphandle kokwenza utyando lwentliziyo evulekileyo.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ngoko ke, i-cardiology yokungenelela yintsimi yezonyango ephucukileyo kakhulu kwaye inobuhlobo nesigulane.

• Akukho kusikwa okukhulu: Eyona nzuzo kukuba iingxaki ezininzi zentliziyo nemithambo yegazi zinokunyangwa kusetyenziswa i-catheter encinci kuphela, ngaphandle kokwenza naluphi na ukusikwa okukhulu.
• Ukuchacha ngokukhawuleza: Ekubeni kungekho tyando lukhulu lwenziwayo, ixesha lokuhlala esibhedlele lifutshane, kwaye ungachacha ngokukhawuleza kwaye ubuyele kubomi bakho besiqhelo.
• Ubuchule: Olu nyango lwenziwa ngoogqirha abafumene uqeqesho olukhethekileyo ngale njongo.
• Musa ukoyika: Ukuba unikwe unyango olunjalo, thetha nogqirha wakho ngalo kakuhle uze ufumane iinkcukacha. Ukwazi ulwazi oluchanekileyo kuya kukunceda uphephe uloyiko olungeyomfuneko.

Ukuba uneengxaki zentliziyo, ungalibali ukubona ugqirha ukuze akunike ingcebiso. Intliziyo ephilileyo ithetha ubomi obusempilweni!

Isifo sentliziyo , i-interventional cardiology, i-catheter, i-angioplasty, i-stent, utyando lwentliziyo, impilo yentliziyo