Kuqhelekile ukuziva usoyika kancinci xa ugqirha wakho ekuxelela ukuba unengxaki ngevalvu yentliziyo. Ingakumbi xa esithi kufuneka wenze utyando ngenxa yayo. Kodwa inkqubo kaRoss esiza kuthetha ngayo namhlanje yinkqubo yotyando ephumelele kakhulu enokunika ubomi obutsha kubantu abanezifo zevalvu yentliziyo, ingakumbi abantu abaselula. Ngoko masithethe ngale nto kanye, ngokulula.
Ngamafutshane, yintoni iNkqubo kaRoss?
Olu lutyando lwentliziyo oluntsonkothileyo, kodwa olunobuchule kakhulu. Lubandakanya ukusebenzisa amalungu omzimba wakho ukulungisa ivalvu yentliziyo enesifo. Ukuchaneka, lubandakanya amanyathelo amabini:
1. Ivalvu ye-aortic yentliziyo yakho enesifo iyasuswa ize ithatyathelwe indawo yivalvu yakho yepulmonary esempilweni.
2. Emva koko, ivalvu yemiphunga evela kumntu ophilileyo iyafakwa kwindawo apho ivalvu yemiphunga yayikhona.
Cinga ngayo njengokusebenzisa inxalenye yomzimba wakho ukulungisa isiphene esikhulu. Oku kuneenzuzo ezininzi kunokufaka ivalvu yokwenziwa.
Kutheni sidinga olu tyando?
Ivalvu ye-aorta ifana nesango elibaluleke kakhulu entliziyweni yethu. Eli sango liyavuleka kwaye livumela igazi elicocekileyo nelicebileyo ngeoksijini ukuba liphume entliziyweni liye emzimbeni wonke. Likwathintela igazi ukuba libuyele entliziyweni phakathi kokubetha kwentliziyo, njengoko le valve ivala.
Kodwa ngamanye amaxesha le valve inokuba nesifo. Kukho iindlela ezimbini eziphambili:
- I-Stenosis: Oku kwenzeka xa ivalvu ingavuli kakuhle ize inciphe. Oku kuthintela umzimba ekufumaneni igazi elaneleyo.
- Ukubuyela esiqhelweni: Oku kwenzeka xa ivalvu ingavaleki kakuhle kwaye ivuza, nto leyo evumela igazi ukuba libuyele entliziyweni.
Zombini ezi ngxaki zinokubangela iimpawu ezifana nokudinwa kunye nokuphefumla kancinci. Ukuba azinyangwa, zinokunyusa umngcipheko wokusilela kwentliziyo kunye nosulelo olunzima. Inkqubo kaRoss isusa ivalvu enesifo kwaye ibuyisele ukusebenza kwentliziyo okuqhelekileyo.
Kutheni ukhetha iPulmonary Valve endaweni yeAortic Valve?
Usenokuba uzibuza ukuba kutheni kwenziwa olu tshintsho, kutheni ungafumani enye ivalvu yokwenziwa? Kukho izizathu ezahlukeneyo zoku.
- Ukumelana noxinzelelo: Ivalvu ye-aorta iphantsi koxinzelelo olukhulu, ngoko ke ivalvu entsha efakwe kuyo kufuneka ihlale ixesha elide kwaye yomelele. Ivalvu yakho yepulmonary ifanelekile koku.
- Iingozi zeevalvu zokwenziwa: Kukho umngcipheko wokuqhekeka kwegazi xa kufakwa iivalvu zokwenziwa. Ngoko ke, kufuneka uthathe amayeza okunciphisa igazi ubomi bakho bonke. Kodwa xa usebenzisa izicwili zakho, loo mngcipheko awukho.
- Ukufakela: Ivalvu yepulmonary ifana kakhulu ngobukhulu kunye nokuma kwevalvu ye-aortic.
- Indawo enoxinzelelo oluphantsi: Ivalvu yomnikelo ibekwa apho ivalvu yemiphunga yayikhona ngaphambili. Loo ndawo iphantsi koxinzelelo oluphantsi. Ngoko ke nokuba loo valve ibuthathaka kancinci, ayizukuba nampembelelo ingako.
Ngubani ofanelekileyo nongafanelekanga kolu tyando?
Inkqubo kaRoss ayilotyando lomntu wonke. Oogqirha bakhetha izigulane ngenxa yezizathu ezahlukeneyo.
| Abo baqhele ukwenziwa utyando ngokubanzi | Abantu abangafanelekanga utyando ngokubanzi |
|---|---|
| Abantu abangaphantsi kweminyaka engama-60 ubudala. | Abantu abanezifo zokuzikhusela komzimba ezifana ne-lupus kunye ne-rheumatoid arthritis. |
| Abantu abane-aortic stenosis yokuzalwa. | Abantu abaneengxaki zezicubu ezidityanisiweyo ezifana neMarfan syndrome . |
| Abantu abanezinye izifo ze-aortic valve. | Abantu abanesifo semithambo yegazi yentliziyo, esibangela ukuvaleka kwemithambo yegazi engaphezu kwemithathu entliziyweni. |
| Abantu abane-aortic valve infection (i-aortic valve endocarditis). | Abantu abanesifo se-pulmonary valve. |
Eyona nto ibalulekileyo kukuba ugqirha wakho wentliziyo enze isigqibo sokugqibela sokuba olu tyando lukulungele okanye alukufanelanga.
Indlela olu tyando lwenziwa ngayo inyathelo ngenyathelo
Olu lutyando olucwangcisiweyo kakhulu oluthatha iiyure ezininzi.
1. I-Anesthesia:Okokuqala, uza kufakwa phantsi kwe-anesthesia eqhelekileyo. Ngoko awuyi kuva nto kwaye awuyi kuba nankumbulo yotyando.
2. Umatshini wentliziyo nemiphunga: Okulandelayo, uza kuqhagamshelwa kumatshini wentliziyo nemiphunga . Lo matshini uthatha okwethutyana umsebenzi wentliziyo nemiphunga yakho ngexesha lotyando. Oku kuvumela oogqirha botyando ukuba benze utyando ngokukhuselekileyo ngaphandle kokumisa intliziyo yakho.
3. Ukuvula isifuba: Oogqirha benza utyando phakathi kwesifuba, besika isifuba kumacala omabini (sternotomy) ukuze bafikelele entliziyweni.
4. Ukuhlolwa kwevalvu: Ivalvu yemiphunga ihlolwa ngononophelo ukuze kubonwe ukuba iphilile ngokwaneleyo na ukuba ingatshintsha ivalvu ye-aortic.
5. Ukutshintshwa kwevalvu: Emva koko, ivalvu ye-aortic eyonakeleyo iyasuswa kwaye ivalvu yakho yepulmonary ityalwe ngononophelo endaweni yayo.
6. Ukufakelwa kwevalvu yomnikelo: Okulandelayo, ivalvu ethathwe kumntu ophilileyo ifakwa kwindawo engenanto apho ivalvu yemiphunga yayikhona.
7. Ukuvuselelwa kwentliziyo: Emva kokuba zombini iivalvu zifakwe kwiindawo ezifanelekileyo, intliziyo yakho iyaqalwa kwakhona kwaye ukhutshwa kancinci kancinci kumatshini wentliziyo-imiphunga. Zombini iivalvu ezintsha nazo ziyajongwa ukuqinisekisa ukuba zisebenza kakuhle.
8. Ukugqitywa kotyando: Ekugqibeleni, i-sternum ibotshelelwe kwakhona kwaye iqiniswe ngeengcingo, i-incision iyathungwa, kwaye igqunywe ngebhandishi ecocekileyo.
Iingenelo kunye neengozi ezinokubakho zolu tyando
Njengalo naluphi na utyando, inkqubo kaRoss ineenzuzo kunye neengozi. Iingozi zingancitshiswa ngokwenziwa unyango phantsi kweliso logqirha onamava owenza ezi nkqubo rhoqo.
| Iingenelo eziphambili | Iingozi ezinokubakho |
|---|---|
| Ungaphila ubomi obuxakekileyo, kuquka ukuzilolonga nokuqhuba imoto. | Ukwandiswa komthambo wegazi kufutshane nevalvu entsha (i-Aortic autograft dilation). |
| Ukuba abafazi bafuna ukukhulelwa, bangakwenza oko ngokukhuselekileyo. | Ukuphazamiseka kwentliziyo (i-Arrhythmia) . |
| Ukujikeleza kwegazi okugqwesileyo (i-hemodynamics) kufezekiswa kuwo wonke umzimba. | Ukuhlaselwa yintliziyo . |
| Akunyanzelekanga ukuba usele amayeza okunciphisa igazi ubomi bakho bonke. | Ukopha kakhulu (Ukopha igazi) . |
| Iimpawu ziphela ngokukhawuleza. Isigulana siziva singcono emva nje kotyando. | Usulelo . |
| Ivalvu evuzayo okanye ebambekileyo. |
Ixesha lokuchacha emva kotyando kunye nexesha lokubona ugqirha
Emva kotyando, uza kubuyela ezingqondweni kwiCardiac ICU . Ekuqaleni, ungaqhagamshelwa kwi- ventilator ukukunceda uphefumle. Uza kuhlala kwi-ICU kangangeentsuku ezintlanu.
Kungathatha iinyanga ezininzi ukuba umntu aphile ngokupheleleyo emva kokubuyela ekhaya. Ngeli xesha, ukuqhinwa, ukuphelelwa ngumdla wokutya, ukungalali, ukungaziva mnandi kunye nokudumba okujikeleze inxeba zizinto eziqhelekileyo.
Kubalulekile: Ivalvu yemiphunga efunyenwe kumntu onikelayo ayihlali ixesha elide. Idla ngokufuna ukutshintshwa emva kweminyaka eli-15-20. Ke ngoko, uhlolo lwezonyango kunye nokubeka iliso ubomi bonke kubaluleke kakhulu.
Ukuba ufumana naziphi na iimpawu zeengxaki emva kotyando, kufuneka wazise ugqirha wakho ngoko nangoko . Qaphela ngakumbi ezi mpawu zilandelayo:
- Iintlungu zesifuba
- Umkhuhlane okanye ukubanda
- Ukudinwa okanye ukuquleka
- Ukukhohlela igazi
- Ukutyumza okanye ukopha okungaqhelekanga
- Ukungabi nangqondo kwamalungu
- Ukuhlanza
- Igazi elikwisitulo (elibomvu ngokuqaqambileyo)
Umyalezo Wokuya Ekhaya
- Inkqubo kaRoss lolona nyango lubalaseleyo kubantu abanesifo se-aortic valve esinzima, ingakumbi abantu abaselula.
- Oku kuquka ukuthatha ivalvu yakho yemiphunga esempilweni uze uyifake kwenye indawo ukuze ithathe indawo yevalvu ye-aortic enesifo.
- Ngenxa yokuba usebenzisa izicubu zakho, akuyi kufuneka usele amayeza okunciphisa igazi ubomi bakho bonke. Ungaphila ubomi obuxakekileyo.
- Njengakwezinye iintlobo zotyando, kukho iingozi ezibandakanyekileyo, kodwa ezi ngozi zingancitshiswa ngonyango phantsi kweliso logqirha onamava.
- Ukuba ufumana naziphi na iimpawu ezingaqhelekanga emva kotyando, qhagamshelana nogqirha wakho ngoko nangoko.
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