Xa ugqirha wakho ekuxelela ukuba kufuneka wenze utyando lokutshintsha ivalvu yakho ye-aortic kuba ayisebenzi kakuhle, ungaziva usoyika kwaye unexhala. Yinto eqhelekileyo leyo. Kodwa olu lutyando abantu abaninzi abalwenzayo kwaye luneziphumo eziphumelelayo. Ngoko ke namhlanje, masithethe ngolu tyando, olubizwa ngokuba yi-Surgical Aortic Valve Replacement (SAVR), ngendlela elula kakhulu eya kususa onke amathandabuzo akho.
Yintoni kanye kanye i-aortic valve replacement surgery (SAVR)?
Ngamafutshane, i-SAVR iyenzeka xa ivalvu ye-aorta entliziyweni yakho yonakele kangangokuba ayisasebenzi kakuhle, kwaye kufakelwa ivalvu entsha endaweni yayo ngotyando.
Khawuthelekelele ukuba ivalvu ye-aorta 'ngumnyango' apho umthambo wegazi oyintloko emzimbeni wakho (esiwubiza ngokuba yi-aorta) uqhagamshela khona nentliziyo yakho. Ngalo lonke ixesha intliziyo yakho ibetha, olu cango luyavuleka luze lupompe igazi emzimbeni wakho. Emva koko, ucango luyavalwa.
Ngamanye amaxesha, ngenxa yobudala okanye ezinye izizathu, iingxaki zinokuvela ngolu cango.
- Iingcango azivuleki kakuhle: Njenge-hinge yomnyango onomhlwa, le valve isenokungavuleki ngokupheleleyo. Ngokwezonyango, oku kubizwa ngokuba yi-aortic stenosis . Emva koko, nangona intliziyo ibetha, igazi elaneleyo likhutshwa emzimbeni.
- Ucango aluvaleki kakuhle: Njengocango oludala lweplanga olungavaleki kakuhle, le valve inokungaphumeleli ukuvala ngokupheleleyo. Oku kubizwa ngokuba yi-aortic regurgitation . Oku kubangela ukuba inxalenye yegazi elimpontshelwa emzimbeni liphinde lingene entliziyweni.
Xa ivalvu ingasebenzi kakuhle, intliziyo yakho kufuneka isebenze nzima kunesiqhelo ukupompa igazi elifunekayo emzimbeni wakho. Kufana nepompo yamanzi ezama ukupompa amanzi ngepayipi evalekileyo. Lo mzamo wongezelelweyo ungonakalisa intliziyo yakho ngokuhamba kwexesha. Usenokubona neempawu ezifana nentlungu yesifuba kunye nobunzima bokuphefumla. Ukuba ayinyangwa, le meko inokuba yingozi ebomini ngokuhamba kwexesha.
Ngoko ke xa ufumana ivalvu entsha, umthwalo osentliziyweni yakho uyakhululeka kwaye uqala ukuziva ungcono kakhulu. Intliziyo yakho ikhuselekile kwaye unethuba lokuphila ubomi obusempilweni kakhulu.
I-SAVR lutyando oluvulelekileyo. Oku kuthetha ukuba ugqirha wenza i-incision esifubeni sakho ukuze afikelele entliziyweni yakho. Ekubeni olu lutyando olukhulu, kukho iingozi ezithile. Nangona kunjalo, ugqirha wakho uza kukuchazela ngokucacileyo iingenelo kunye neengozi zolu tyando ngokusekelwe kwimeko yakho.
Kwenzeka ntoni ngaphambi kotyando?
Kuya kufuneka wenze uvavanyo oluninzi ngaphambi kotyando. Oku kuya kunceda iqela lakho lezempilo ukuba lihlole kakuhle imeko yentliziyo yakho kwaye ligqibe ukuba loluphi utyando olulungele wena. Umzekelo, baya kugqiba ukuba ngaba utyando lwe-SAVR okanye utyando oluncinci olubizwa ngokuba yi-TAVR lulungele wena.
Nazi ezinye iimvavanyo onokuthi ufune ukuziqwalasela:
- Ukucoca Intliziyo
- I-X-reyi yesifuba
- Iskena se-CT
- I-Echocardiogram (i-Echocardiogram - i-Echo)
- I-ECG (i-Electrocardiogram - EKG)
- Uvavanyo lwegazi nomchamo
Konke oku kwenziwa ukuqinisekisa ukuba ulungele ngokupheleleyo utyando kwaye umzimba wakho unako ukuluphatha. Emva koko, uya kunikwa imiyalelo ecacileyo yendlela yokulungiselela usuku lotyando.
- Kuthatha ixesha elingakanani ngaphambi kotyando kufuneka ndiyeke ukutya nokusela?
- Ngaba kufuneka uyeke okwethutyana naliphi na iyeza olisebenzisayo ngoku?
- Lifikile ixesha lokuza esibhedlele.
- Izinto omawuziphathe xa ufika esibhedlele nezinto omawuzishiye ekhaya.
Ukuba kukho into engacacanga ngale miyalelo, ungathandabuzi ukubuza ugqirha okanye umongikazi wakho. Ukuba ungumntu otshayayo, ukuyeka ngokukhawuleza ngaphambi kotyando kunokunciphisa kakhulu umngcipheko weengxaki.
Ukukhetha ivalvu yokufakelwa: Ziziphi iindlela onokukhetha kuzo?
Esinye sezona zigqibo zibalulekileyo oza kuzenza xa ulungiselela utyando lwe-SAVR kukuba loluphi uhlobo lwevalvu oza kuyifakela. Kukho iintlobo ezimbini eziphambili zevalvu. Makhe sijonge izinto ezilungileyo nezingalunganga nganye ukuze sikuncede uziqonde ngcono.
| Uhlobo lweValve | Inkcazo | Eyona nto ibalulekileyo / eyona nto ibalulekileyo |
|---|---|---|
| Iivalvu zebhayoloji/ze-Bioprosthetic | Ezi zenziwe ngenyama yehagu, yenkomo, okanye (engafane yenzeke) yomntu. Zisenokuba nezinto ezenziwe ngokwenziwa ezongeziweyo kuzo. | Ukuba le valve ifakiwe, akuyi kufuneka usele amayeza okunciphisa ukugabha kwegazi ubomi bakho bonke.Kodwa ezi zinokuguga ngokuhamba kwexesha (malunga neminyaka eli-10-20), uze emva koko kufuneke ukuba wenze olunye utyando. |
| Iivalvu zoomatshini | Ezi zenziwe ngezinto ezihlala ixesha elide ezifana nekhabhoni nentsimbi. | Ezi valve zihlala ixesha elide. Nangona kunjalo, ukuba zifakwe, kukho umngcipheko wokuqhekeka kwegazi, ngoko ke ukuthintela oku, kuya kufuneka uthathe i-anticoagulant efana neWarfarin ubomi bakho bonke . |
Ugqirha wakho uza kuxoxa nawe ngazo zombini iindlela aze akucebise ngevalvu efanelekileyo kuwe ngokusekwe kwiminyaka yakho, impilo yakho, nendlela ophila ngayo. Ngokwesiqhelo, ivalvu yoomatshini iyacetyiswa kubantu abangaphantsi kweminyaka engama-50, kwaye ivalvu yendalo iyacetyiswa kubantu abangaphezu kweminyaka engama-65. Kwabo baphakathi, ungakhetha enye ngokusekwe kwizinto ozikhethayo neemfuno zakho.
Kwenzeka ntoni ngexesha lotyando?
Utyando lwe-SAVR ludla ngokuthatha malunga neeyure ezimbini ukuya kwezine. Awuyi kuva nto ngeli xesha. Amanyathelo abandakanyekayo kolu tyando ngala alandelayo:
1. I-Anesthesia: Okokuqala, iqela lakho lokhathalelo liza kukunika i-anesthesia. Oku kuza kukwenza ulale ubuthongo obunzulu. Awuyi kuva ntlungu ngexesha lotyando okanye ukhumbule nantoni na eyenzekayo.
2. Ukudibanisa nomatshini wentliziyo nemiphunga: Okulandelayo, uza kudityaniswa nomatshini wentliziyo nemiphunga. Oku kuthetha ukuba igazi lakho aliyi entliziyweni nakwimiphunga yakho ngexesha lotyando, kodwa endaweni yoko lidlula kulo matshini, apho licocwa lize libuyiselwe emzimbeni wakho. Oku kufana nokunika intliziyo nemiphunga yakho ikhefu elincinci. Lo matshini ukwamisa intliziyo yakho okwethutyana. Oku kuvumela ugqirha ukuba enze utyando ngokukhuselekileyo kwintliziyo engayibethiyo.
3. Ukusika: Ugqirha wenza ukusika okuthe nkqo (sternotomy) malunga ne-intshi ezi-1.5 ubude phakathi kwesifuba sakho, ecaleni kwethambo lesifuba.
4. Ukutshintshwa kwevalvu: Emva koko, ivalvu ye-aortic endala eyonakeleyo iyasuswa, ithatyathelwe indawo yivalvu entsha ize ithungwe kakuhle.
5. Ukuvalwa kwesifuba: Okulandelayo, iindawo ezimbini ezahluliweyo ze-sternum zixhunyaniswa kwakhona kusetyenziswa iintambo. Ezi ntambo zihlala zishiywa endaweni yazo ubomi bonke. Ekugqibeleni, ulusu luthungwa luvalwe.
Iinketho ezingafunekiyo kakhulu
Kwezinye iimeko, oogqirha benza olu tyando besebenzisa imingxunya emincinci. Ugqirha wakho uza kukuxelela okungakumbi malunga nokuba oku kulungile na kuwe.
Kwenzeka ntoni emva kotyando? Linjani ixesha lokuchacha?
Emva kotyando, kuya kufuneka uhlale esibhedlele kangangeentsuku ezintlanu. Ngeli xesha, iqela lezonyango liza kujonga impilo yakho. Baza kukunceda ukuba uqhele ukuhamba kancinci yonke imihla kwaye ubuyele kwimisebenzi yakho yesiqhelo.
Kungathatha iiveki ezine ukuya kwezisibhozo ukuze uphile ngokupheleleyo emva kokuba ubuyele ekhaya. Kuqhelekile ukuziva udiniwe ngeli xesha. Umzimba wakho udinga ukuphumla. Ngoko ke ungakhawulezi ubuyele kwimisebenzi yakho yakudala. Landela imiyalelo kagqirha wakho ngokuchanekileyo.
Wakuba uphilile ngokupheleleyo (emva kweeveki ezi-6-8), ugqirha wakho unokucebisa ukuba wenze i-cardiac rehab rehab. Le yinkqubo ejongiweyo ekunceda ukuba ubuyele kancinci kancinci kwaye ngokukhuselekileyo ekuzilolongeni. Uya kunikwa nesikhokelo malunga notshintsho kwindlela yokuphila, njengokulandela ukutya okunempilo kwentliziyo kunye nokuyeka ukutshaya.
Zithini iingenelo, iingozi, kunye namazinga empumelelo yolu tyando?
Ukutshintsha ivalvu engasebenzi kakuhle kunokusindisa ubomi. Le meko inokuba yingozi ukuba ayinyangwa.
Kubantu abaninzi, umngcipheko weengxaki ezinzima ezifana nokufa okanye isifo sohlangothi uphantsi kakhulu. Oko kungaphantsi kwe-1% ukuya kwi-2%. Lo mngcipheko unokwahluka ngokuxhomekeke kwizinto ezifana neminyaka yakho kunye nempilo yakho iyonke. Ugqirha wakho uza kukuchazela ngenqanaba lakho lomngcipheko.
Njengakwezinye iintlobo zotyando, kunokubakho iingxaki ezithile.
- Ukungahambi kakuhle kwentliziyo (i-Arrhythmia)
- Ukufuna ukufakwa kwe-pacemaker esisigxina
- Ukopha
- Iintsholongwane
- Istroke
- Ukufa
Ezi ngozi azifani kuye wonke umntu. Ziyahluka ngokuxhomekeke kwiminyaka yakho kunye nezinye iimeko zempilo. Ugqirha wakho uya kwenza konke okusemandleni akhe ukunciphisa ezi ngozi.
Ufanele uthethe nini nogqirha?
Ngelixa ululama ekhaya, kubaluleke kakhulu ukwazisa ugqirha wakho ngokukhawuleza ukuba ubonakalisa naziphi na iimpawu zomngcipheko. Qaphela ngakumbi ezi mpawu zilandelayo:
| Iimpawu eziyingozi - Ukuba unazo ezi, yazisa ugqirha wakho ngoko nangoko! | |
|---|---|
| - Intlungu yesifuba okanye ukuxinana | - Ubomvu okanye ulwelo oluphuma kwi-incision yotyando |
| - Umkhuhlane okanye ukubanda | - Ukudumba, ukuba bomvu, okanye intlungu ebuhlungu ejikeleze inxeba |
| - Ukudumba kwemilenze okanye iinyawo (i-Edema) | - Ukuziva ukubetha kwentliziyo okungaqhelekanga (njengokuba isifuba sakho sibetha ngamandla) |
| - Ukunyuka kobunzima obungaphezulu kwe-1.5 kg (ngaphezulu kwe-3 lbs) kwiveki. | |
Kuqhelekile ukuziva usoyika xa ufumanisa ukuba kufuneka utshintshe ivalvu yentliziyo. Kodwa khumbula, le yinkqubo enceda intliziyo yakho, njengokulungisa into ephukileyo ekhayeni lakho. Emva kolu tyando, intliziyo yakho iya kukwazi ukusebenza lula, kwaye uya kuziva ungcono. Ukuba unemibuzo malunga noku, ungathandabuzi ukuthetha nogqirha wakho kwaye ukhululeke.
Umyalezo Wokuya Ekhaya
- I-SAVR lutyando oluthatha indawo yevalvu ye-aortic eyonakeleyo ngentsha, kwaye ineziphumo eziphumeleleyo kakhulu.
- Ugqirha wakho uza kuxoxa nawe ukuba uza kufumana ivalvu yebhayoloji okanye ye-mechanical aze akhethe uhlobo olufaneleyo kuwe.
- Kuthatha iiveki ezininzi ukuba umntu aphile ngokupheleleyo emva kotyando, kwaye kubaluleke kakhulu ukuphumla nokulandela iingcebiso zonyango ngelo xesha.
- Ukuba ubona naziphi na iimpawu ezinobungozi ngexesha lokuchacha kwakho, ezinje ngomkhuhlane, ukudumba kwesilonda, okanye iintlungu eziqatha esifubeni, tsalela umnxeba ugqirha wakho ngoko nangoko.
- Olu tyando lunciphisa umthwalo entliziyweni yakho, lukunceda uphile ubomi obusempilweni nobude.
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