Ngaba ugqirha wakho uthe umthambo wegazi oyintloko othwala igazi elineoksijini elisuka entliziyweni yakho emzimbeni wakho uye waba buthathaka waza wavelisa iqhubu elifana nebhaluni ezantsi kwawo? Okanye mhlawumbi bacebise ukuba unokufuna utyando ngenxa yoku? Kungokwemvelo ukuba nexhala xa usiva oku, kodwa nceda wazi ukuba le yinkqubo ebalulekileyo eyenzelwe ukusindisa ubomi bakho. Namhlanje, siza kuxoxa ngokuba yintoni kanye i-Aortic Root Replacement, yenziwa njani, kunye nayo yonke into ekufuneka uyazi ngale nkqubo eNirogi Lanka.
Ngamafutshane, yintoni i-Aortic Root Replacement?
I-aorta yeyona mthambo wegazi mkhulu nobaluleke kakhulu emzimbeni wakho, iqhagamshelwe ngqo entliziyweni yakho. Inxalenye yokuqala apho i-aorta inamathela khona entliziyweni yakho yaziwa ngokuba yi-"Aortic Root." Ngamanye amaxesha, udonga lwale nxalenye luyabuthathaka luze luqale ukudumba njengebhaluni. Oku sikubiza ngokuba yi-"Aneurysm."
Umngcipheko oyintloko wokuba ne-aneurysm kukuba inokukrazuka (iqhekeze) okanye iqhume (iqhekeke) nangaliphi na ixesha. Ukuba oku kuyenzeka, kunokukhokelela ekopheni okukhulu kwangaphakathi, nto leyo eyingozi kakhulu ebomini.
Ngexesha lokutshintshwa kweengcambu ze-Aortic, ugqirha wakho ususa icandelo le-aorta elibuthathaka nelivuvukileyo aze alifake i-graft yokwenziwa. Le nkqubo ithintela ngempumelelo ezi ngxaki ziyingozi kwaye inceda ukukhusela ubomi bakho.
Ziziphi iintlobo eziphambili zolu tyando?
Zimbini iindlela eziphambili zokwenza olu tyando. Ngokusekelwe kwimeko yakho yempilo, ugqirha wakho uya kugqiba eyona ndlela ifanelekileyo yokuchacha.
| Uhlobo lotyando | Inkcazo |
|---|---|
| Inkqubo yoTshintsho lweNgcambu ye-Aortic (ARR) / Bentall | Kule nkqubo, ingcambu eyonakeleyo ye-aorta yakho itshintshwa kunye nevalvu ye-aorta kusetyenziswa i-graft yokwenziwa kunye nevalvu entsha. Le yindlela efanelekileyo ukuba ivalvu yakho ye-aorta ivuza okanye inyibilike kakhulu. Ukuba kusetyenziswa ivalvu yomatshini, kuya kufuneka uthathe amayeza okubulala igazi ubomi bakho bonke ukuthintela ukuqhekeka kwegazi. |
| Ukutshintshwa kweengcambu zeValve-Sparing (VSRR) | Njengoko igama lisitsho, le nkqubo ithatha indawo yenxalenye ebuthathaka yomthambo wemithambo yegazi ngelixa igcina ivalvu yakho ye-aortic esempilweni. Oku kulungele izigulana ezincinci okanye abo baneengxaki zezicubu ezidibeneyo (ezifana neMarfan syndrome) abanevalvu ezisempilweni. Inzuzo enkulu kukuba awudingi amayeza okunciphisa igazi ubomi bonke. Kukho iindlela ezimbini eziphambili: inkqubo kaYacoub kunye nenkqubo kaDavid. |
Iintlobo ezincinci ze-VSRR
I-VSRR yenziwa kusetyenziswa enye yeendlela ezimbini eziphambili: inkqubo kaYacoub nokaDavid.
- Inkqubo kaYacoub: Oku kuquka ukuhlaziya ingcambu ye-aortic ukuze ilingane nevalvu yokuqala. Idla ngokuba yeyokufaneleka kakhulu kwizigulane ezindala okanye abo bane-aneurysm engabangelwa ziimeko zemfuza.
- Inkqubo kaDavid: Oku kubandakanya ukufakelwa kwakhona kwevalvu ngaphakathi kwi-graft yokwenziwa. Nangona iyinkimbinkimbi ngakumbi ngobuchwephesha, isetyenziswa kakhulu kwaye icetyiswa kakhulu kwizigulane ezincinci ezineemeko zemfuza ezifana ne-Marfan syndrome.
Ngubani Ofuna Olu Ngqesho Kwaye Nini?
Ukuba ingcambu ye-aorta yakho ikhulisiwe, ujongene nomngcipheko onokubakho wokuqhekeka okanye ukuqhekeka, nto leyo eyenza utyando lube yimfuneko. Nangona oku kunokwenzeka ngenxa yokuguga, iimeko zemfuza ezifana ne-Marfan syndrome okanye i-Loeys-Dietz syndrome zinokubangela ukuba ezi aneurysms ziyingozi zikhule kwangethuba ebomini.
Izigqibo malunga notyando zisekelwe kubungakanani be-aneurysm kunye neprofayili yakho yomngcipheko:
- Ukuba awunazo iingozi zemfuza ezifihlakeleyo, utyando lucetyiswa ngokubanzi xa ububanzi bufikelela kwi -5.5 cm .
- Ukuba une-Marfan syndrome, umda udla ngokuba yi -5.0 cm .
- Ukuba une-Marfan syndrome edibene nembali yosapho yokuqhekeka kwe-aorta, izicwangciso zokukhulelwa, okanye ukukhula ngokukhawuleza (ngaphezulu kwe-3mm ngonyaka), utyando lunokucetyiswa kwi -4.5 cm .
- Ukuba une-aortic valve ene-bicuspid kunye nezinye izinto ezinobungozi ezifana noxinzelelo lwegazi oluphezulu olungalawulekiyo, ukungenelela kudla ngokuqwalaselwa kwi -5.0 cm .
Okubaluleke kakhulu, ezi zigqibo zenziwe ngendlela eyenzelwe wena kuphela. Ugqirha wakho waseNirogi Lanka uza kugqiba ixesha elifanelekileyo lotyando lwakho ngokusekwe kwiminyaka yakho, impilo yakho iyonke, kunye nembali yakho yezonyango.
Indlela Yokulungiselela Utyando Lwakho
Ngenxa yokuba le yinkqubo ebalulekileyo, ukulungiselela kakuhle kubalulekile. Iqela lakho lezonyango liza kuqhuba uvavanyo olupheleleyo:
- Uvavanyo lwegazi: Ukuvavanya ukusebenza kwezintso zakho kunye nokusebenza kwenkqubo yomzimba iyonke.
- I-CT okanye i-Cardiac MRI: Ukufumana imephu eneenkcukacha ze-aorta yakho yonke.
- I-Coronary angiography: Ukuqinisekisa ukuba imithambo yegazi enika intliziyo yakho iphilile.
- I-Duplex ultrasound: Ukujonga impilo yemithambo yakho ye-carotid entanyeni.
Kufuneka ube nengxoxo ecacileyo nogqirha wakho malunga noku:
- Onke amayeza: Oku kuquka iivithamini, izongezo zemifuno, kunye namayeza athengiswa ngaphandle kwemvume kagqirha, amanye awo anokufuna ukuyeka ngaphambi kotyando.
- Iimeko zempilo ezikhoyo: Iimeko ezifana noxinzelelo lwegazi oluphezulu kufuneka zilawulwe ngokungqongqo ngaphambi kotyando.
- Ukutshaya: Kufuneka uyeke ukutshaya ubuncinane inyanga enye ngaphambi kotyando. Nceda ubuze iqela lakho laseNirogi Lanka ukuba ufuna inkxaso yokuyeka.
Ngexesha nasemva kwenkqubo
Ngexesha lotyando, uza kufakwa phantsi kwe-anesthesia eqhelekileyo. Uza kuqhagamshelwa kumatshini we-cardiopulmonary bypass , othatha okwethutyana umsebenzi wentliziyo yakho kunye nemiphunga, okuvumela ugqirha ukuba asebenze kwintliziyo ezinzileyo, engashukumiyo.
Ugqirha uza kwenza utyando esifubeni sakho, asuse icandelo le-aorta elibuthathaka, aze alifake i-graft yokwenziwa. Emva koko imithambo yentliziyo iphinda inamathele kwi-graft ngaphambi kokuba i-incision ivalwe. Inkqubo idla ngokuthatha iiyure ezi-4 ukuya kwezi-6 .
Emva kotyando, uza kuchitha ixesha kwiYunithi yoKhathalelo oluPhezulu (ICU) ngaphambi kokuba uye kwigumbi lokuchacha eliqhelekileyo. Ixesha elipheleleyo lokuhlala esibhedlele lidla ngokuba malunga neveki enye, apho uza kuhlolwa ngononophelo kwaye unikwe ulawulo lweentlungu kunye namayeza afunekayo.
Lithini Ixesha Lokubuyisela?
Ukuchacha ngokupheleleyo emva kwale nkqubo inkulu kudla ngokuthatha iiveki ezi-6 ukuya kwezi-12 , kwaye kwezinye iimeko, iinyanga ezininzi. Umzimba wakho udinga ixesha elininzi kunye nomonde ukuze uphile ngokufanelekileyo emva kotyando olunzima kangaka.
- Kwiiveki ezi-6 zokuqala: Kuphephe ukuqhuba, ukuphakamisa izinto ezinzima, okanye ukwenza imisebenzi enzima.
- Kwimisebenzi yedesika: Usenokukwazi ukubuyela emsebenzini kwiiveki ezimalunga nezi-6-8.
- Kwimisebenzi enzima emzimbeni: Kuya kufuneka ulinde ixesha elide, njengoko kucetyisiwe liqela lakho lezempilo.
Ukulandela imiyalelo kagqirha wakho ngokuchanekileyo kunye nokuthatha inxaxheba kwiinkqubo zokulungisa intliziyo kuya kukunceda kakhulu ukuba uphumelele ngokukhawuleza nangokulula.
Ixesha Lokufuna Unyango Ngokukhawuleza
Emva kokuba ubuyele ekhaya, ukuba ubona naziphi na iimpawu ezilandelayo, qhagamshelana nogqirha wakho ngoko nangoko.
| Iimpawu Okufanele Uzijonge | |
|---|---|
| Iingxaki Zokusikwa Ngotyando: | |
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| Ezinye izinto ezixhalabisayo: | |
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Indlela Yokuqonda Ingxamiseko
Ukuba une-aneurysm enganyangwanga, ezi mpawu zilandelayo zinokubonisa ukuba iyaqhekeka okanye iyakrazuka. Kwimeko enjalo, funa unyango olungxamisekileyo ngokukhawuleza ngokuya kwicandelo elikufutshane okanye utsalele umnxeba ku-911 (okanye iinkonzo zongxamiseko zasekuhlaleni).
- Intlungu enganyamezelekiyo esifubeni okanye emqolo ongasentla (edla ngokuchazwa njengokukrazula okanye ukukrazula).
- Ukubila kakhulu nolusu olubandayo noluthambileyo.
- Ubunzima bokuphefumla.
- Ukudinwa okanye ukuquleka.
- Ukubetha kwentliziyo okukhawulezayo okanye okungahambelaniyo.
Izinto ezibalulekileyo ekufuneka uzithathe (eNirogi Lanka)
- Ukutshintshwa kweengcambu ze-Aortic yinkqubo yotyando olusindisa ubomi eyenziwa kwicandelo lokuqala elibuthathaka le-aorta.
- Kukho iintlobo ezimbini eziphambili zolu tyando: olunye oluthatha indawo yevalvu ye-aortic (ARR) kunye nolunye oluyigcinayo (VSRR). Ugqirha wakho uya kugqiba eyona ndlela ifanelekileyo kuwe.
- Nangona ukuchacha ngokupheleleyo kuthatha iinyanga ezininzi, amazinga empumelelo kunye nokusinda kwale nkqubo aphezulu kakhulu (malunga ne-98%-99%).
- Ukunamathela ngokungqongqo kwizikhokelo zonyango zangaphambi kotyando nasemva kotyando kubalulekile ukuze uphile kakuhle.
- Musa ukuthandabuza ukuxoxa ngayo nayiphi na imibuzo okanye uloyiko nogqirha wakho. Nangona le nkqubo iqhelekile kwiingcali zonyango, ngamava abalulekileyo kuwe, kwaye kuyinto eqhelekileyo ukuba neenkxalabo.
Ukutshintshwa kweengcambu ze-Aortic, i-Aorta, utyando lwentliziyo, i-Aneurysm, inkqubo ye-Bentall, i-Marfan syndrome, i-Aortic valve, isifo sentliziyo, utyando lwentliziyo
