Usenokuba ukhe weva nge-Atrial Fibrillation (Afib), imeko apho intliziyo yakho ibetha ngokungacwangciswanga nangokukhawuleza. Mhlawumbi wena okanye umntu kusapho lwakho unale meko. Umngcipheko omkhulu we-Afib kukwanda komngcipheko we-stroke. Njengesisombululo soku, oogqirha badla ngokunika amayeza okunciphisa igazi. Kodwa ukuthatha la mayeza ixesha elide akulula kuye wonke umntu. Kubantu abanjalo, sithetha ngendlela ekhethekileyo yonyango enokunciphisa umngcipheko we-stroke.
Ngamafutshane, yintoni iLeft Atrial Appendage Closure (LAA Closure)?
Ukuze sikuqonde oku, masiqale sifunde ngenxalenye encinci yentliziyo yethu. Kwigumbi eliphezulu lasekhohlo lentliziyo yethu, elibizwa ngokuba yi-Left Atrium, kukho i-protrusion encinci efana nengxowa. Le yinto esiyibiza ngokuba yi-Left Atrial Appendage (LAA) .
Ngokwesiqhelo, xa intliziyo ibetha ngesingqisho, igazi elingaphakathi kweli LAA liphonswa liye kwinxalenye yentliziyo. Nangona kunjalo, kumntu one- Atrial Fibrillation (Afib) , intliziyo ibetha ngokungacwangciswanga, ngoko ke igazi elingaphakathi kweli bhegi elibizwa ngokuba yi LAA aliphonswa kakuhle lize liqale ukudibana. Oku kudibana kwegazi ekugqibeleni kunokujika kube ngamahlwili egazi .
Ngelishwa, ukuba eli hlwili liyaphuma lize libambeke kwimithambo yegazi eya engqondweni, linokubangela isifo sohlangothi . Malunga nama-90% ezihluli kubantu abane-Afib zibangelwa kukwakheka kwamahlwili kwi-LAA.
Ngoko ke, kolu nyango lubizwa ngokuba yi-LAA Closure, ibhegi ibizwa ngokuba yi-LAA apho amahlwili egazi enziwa khona, nokuba kungotyando okanye ngokusikwa okuncinci kakhulu. Emva kokuba oku kuvaliwe, nokuba amahlwili egazi enziwa, awakwazi ukungena egazini. Ke ngoko, umngcipheko wesifo sohlangothi uyancipha kakhulu.
Into ebalulekileyo kukuba olu nyango alunyangi i-Afib, kodwa lunciphisa kakhulu umngcipheko we-stroke obangelwa yiyo.
Ngubani olona nyango lufanelekileyo? Kutheni ungasebenzisi nje izinto zokunciphisa igazi?
Ukuvalwa kwe-LAA akulonyango lomntu wonke osengozini enkulu yokuba nesifo sohlangothi ngenxa ye-Afib. Kuqwalaselwa ngakumbi kubantu aba:
- Kwabo bangafuni ukuthatha amayeza okunciphisa igazi ixesha elide.
- Abantu abawa rhoqo ngoko ke basengozini enkulu yokopha (kuba nokuba yingozi encinci inokubangela ukopha okukhulu xa bethatha amayeza okunciphisa igazi).
- Kwabo bafumana ezinye iziphumo ebezingalindelekanga ezivela kumayeza okunciphisa igazi.
- Kwabo bangenakukwazi ukuhlawula amaxabiso aphezulu amayeza okunciphisa igazi.
Abantu abaninzi bajongene nobunzima obahlukeneyo xa bethatha amayeza amadala okunciphisa igazi afana neWarfarin.
| Iingxaki zokusebenzisa amayeza afana neWarfarin |
|---|
| - Kufuneka uye esibhedlele rhoqo ukuze uhlolwe igazi lakho ukuqinisekisa ukuba umthamo wamayeza uchanekile. |
| - Ezinye ukutya ezinevithamini K (ezifana nesipinatshi) kufuneka zincitshiswe. |
| - Umngcipheko wokopha uphezulu kakhulu. |
| - Imizimba yabanye abantu ayinakukwazi ukuyinyamezela le yeza. |
Nangona kukho amayeza amatsha afana ne-Apixaban kunye ne-Rivaroxaban, ixabiso lawo liphezulu kunye nomngcipheko wokuqhubeka nokopha zizinto ezixhalabisa abanye abantu. Ngokuqinisekileyo kuya kufuneka uthethe nogqirha wakho wentliziyo ukuze agqibe ukuba loluphi unyango olulungele wena.
Zeziphi iindlela ezisetyenziswayo ukuvala le LAA?
Kukho iindlela ezahlukeneyo kunye nezixhobo zokwenza oku. Cinga nje ngokuvala umlomo webhotile yamanzi, esi sixhobo sisetyenziselwa ukuvala umlomo wale ngxowa ebizwa ngokuba yi-LAA.
- Izixhobo zokuvalela ngaphakathi: Ezi zifana nesambrela esincinci. Zifakwa entliziyweni kusetyenziswa i-catheter kwaye zisetyenziselwa ukuvala ukuvulwa kwe-LAA ngaphakathi. I-WATCHMAN™ kunye ne-Amulet™ zizixhobo ezidumileyo zolu hlobo.
- Izixhobo zokuvala zangaphandle: Ngamanye amaxesha, ngexesha lotyando lwentliziyo, i-LAA ingavalwa ngaphandle nge-clip (`AtriClip™`) okanye nge-suture ekhethekileyo (`Lariat™`).
Indlela efanelekileyo kuwe ikhethwa emva kwengxoxo phakathi kwakho nogqirha wakho.
Ukulungiselela unyango kunye nendlela oluqhutywa ngayo unyango
Ngaphambi konyango...
Ngaphambi kwale nkqubo, ugqirha wakho kuya kufuneka alinganise ubungakanani kunye nokuma kwe-LAA yakho. Ayingomntu wonke ofana ne-LAA. Abanye bathi imile njengephiko lenkukhu, i-cactus, okanye i-cauliflower. Oku kuya kubandakanya i-Transesophageal Echocardiogram (TEE) (i-scan yentliziyo eyenziwa ngetyhubhu ebizwa ngokuba yi-larynx) okanye i -Cardiac CT scan. Uya kuyalelwa nokuba uzile ukutya (ungatyi okanye usele) iiyure ezimbalwa ngaphambi kwenkqubo.
Ngexesha lonyango...
Oku kungenziwa ngeendlela ezimbini eziphambili:
1. Ngolunye utyando lwentliziyo:Ukuba wenza olunye utyando olukhulu lwentliziyo, olufana notyando lwe-bypass, ugqirha angasusa okanye athunge i-LAA ivaliwe ngaxeshanye.
2. Ayingeni kakhulu: Le yindlela esetyenziswa kakhulu. Apha, ityhubhu encinci, ebizwa ngokuba yi-catheter, ifakwa nge-groin yakho iye emthanjeni ize ihanjiswe ukuya entliziyweni yakho. Emva koko, isixhobo esikhethiweyo sifakwa kwindawo evulekileyo ye-LAA kwaye sivalwe ukuthintela ukuba amahlwili egazi angaphumi. Le nkqubo yonke yenziwa phantsi kwesikhokelo setekhnoloji ekhethekileyo ye-X-ray (Fluoroscopy) kunye ne-scan (TEE/Intracardiac Ultrasound).
Emva konyango...
- Ngokwesiqhelo kufuneka uhlale esibhedlele ubusuku bonke.
- I-TEE scan iza kuphinda yenziwe kwisithuba seentsuku ezingama-45 ukuze kubonwe ukuba unyango luphumelele na.
- Uza kunikwa isithambisi segazi kunye ne-aspirin ukuze uyithathe de izicubu zomzimba zikhule zijikeleze esi sixhobo, nto leyo ethatha malunga nenyanga enesiqingatha.
- Emva koko, kuya kufuneka uyeke ukuthatha i-blood thinner uze uthathe iClopidogrel kunye ne-aspirin kangangeenyanga ezi-6. Kusenokufuneka uthathe i-aspirin ubomi bakho bonke. Konke oku kuya kwenziwa ngokwengcebiso kagqirha wakho.
Ziziphi iingenelo kunye neengozi zale ndlela yonyango?
Njengalo naluphi na unyango lwezonyango, olu lunezibonelelo kunye neengozi.
| Iinzuzo | Iingozi/Iingxaki |
|---|---|
| Umngcipheko we-stroke uncitshiswe kakhulu. | Ingxaki ngesixhobo sokufakela. |
| Ukukwazi ukukhululeka ekuthatheni amayeza okunciphisa igazi ixesha elide (i-anticoagulants). | Impendulo engalunganga kwi-anesthesia. |
| Ukubuyela esimeni esilungileyo kuba kwenzeka ngokusikwa okuncinci. | Ukopha. |
| Ukuphucula umgangatho wobomi. | Intlungu yesifuba, usulelo. |
| Ukuqokelelana kolwelo olujikeleze intliziyo (i-pericardial effusion). | |
| Imeko engaqhelekanga efana nestroke. |
Olu nyango lusebenza kakhulu. Ngokwezinye izifundo, le ndlela inokunciphisa umngcipheko westroke malunga ne-80%. Kodwa khumbula, kubalulekile ukuxoxa ngako konke oku nogqirha wakho ngaphambi kokuba ugqibe ekubeni oku kulungile na kuwe.
Ndifanele ndimbone nini ugqirha?
Ukongeza kokuya kwiindibano zakho zokulandelela ezicwangcisiweyo, yazisa ugqirha wakho ngoko nangoko ukuba ufumana ezi mpawu zilandelayo:
- Iimpawu zomkhuhlane okanye olunye usulelo
- Ukubetha kwentliziyo okungaqhelekanga
- Iintlungu zesifuba
- Ubunzima bokuphefumla
Ukuba ufumana naziphi na kwezi mpawu, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko.
Umyalezo Wokuya Ekhaya
- Ukuvalwa kwe-LAA lunyango lwabantu abane-Atrial Fibrillation (Afib) ukunciphisa umngcipheko we-stroke.
- Oku kusebenza ngokuvala ingxowa encinci entliziyweni ebizwa ngokuba yi-LAA, ukuthintela amahlwili egazi aphuma apho ukuba angangeni emzimbeni.
- Olu nyango lolunye unyango olufanelekileyo kwabo bangenako ukuthatha amayeza okunciphisa igazi ixesha elide.
- Oku akuyi kuyinyanga i-Afib, kodwa kunokuthintela ingozi enkulu, eyi-stroke.
- Yenza isigqibo emva kokuthetha nogqirha wakho wentliziyo malunga nokuba olu nyango lukulungele na kwaye zithini izibonelelo kunye neengozi zalo.
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