Ngaba ukhe uzive uphelelwa ngumphefumlo xa udiniwe kancinci, uzive ubuthathaka xa unyuka izinyuko, okanye uzive unzima esifubeni sakho? Ngamanye amaxesha unobangela wezi mpawu unokuba yingxaki enomgodi omncinci entliziyweni yethu, ivalvu. Ngoko ke namhlanje siza kuthetha ngevalvu ye-mitral entliziyweni kunye notyando lokulungisa olunokufuneka ngenxa yeengxaki ngayo.
Yintoni ukulungiswa kwevalvu ye-mitral?
Ngamafutshane, ukulungiswa kwevalvu ye-mitral lutyando lwentliziyo oluvulayo olulungisa iingxaki zevalvu ye-mitral entliziyweni yakho.
Cinga ngentliziyo yethu njengendlu enamagumbi amane. Ivalvu ye-mitral lisango eliphakathi kwegumbi eliphezulu ngasekhohlo (atrium yasekhohlo) kunye negumbi elisezantsi ngasekhohlo (ventricle yasekhohlo). Igazi elicocekileyo nelicebileyo ngeoksijini elivela emiphungeni yethu liqala lingene kwi-atrium yasekhohlo. Emva koko, elo gazi lingena ngesango elibizwa ngokuba yivalvu ye-mitral lize liye kwi-ventricle yasekhohlo. Ukusuka apho, igazi liphonswa emzimbeni wonke.
Ngoko ke xa le valve, ivalvu ye-mitral, ingasebenzi kakuhle, xa igula, yenza kube nzima ukuba intliziyo isebenze kakuhle. Ekuhambeni kwexesha, oku kunokubangela umonakalo entliziyweni nasemiphungeni. Olu tyando lwenzelwe ukuthintela okanye ukulibazisa loo monakalo.
Ukuba unesifo esibi se-mitral valve, ugqirha wakho usenokucebisa ukuba utyando lulungiswe okanye lutshintshwe ivalvu. Kodwa kwiimeko ezininzi, ingakumbi ukuba ivalvu ivuza igazi, oogqirha baya kuzama ukulungisa ivalvu endaweni yokuyitshintsha. Kungenxa yokuba zininzi iingenelo kunye neengozi ezimbalwa zokugcina inxalenye yomzimba wakho.
Zeziphi iimeko ezinyangwa lolu tyando?
Olu tyando lusetyenziswa kakhulu ukunyanga ezi meko zilandelayo:
| Imeko yezonyango | Icacisiwe ngokulula |
|---|---|
| Ukuvuselelwa kwevalvu ye-Mitral | Iiflaps ezimbini zevalvu azivaleki kakuhle, nto leyo evumela ukuba igazi livuza kwicala elingalunganga, oko kukuthi, ngasemva. Ukuba oku kuvuza kukhulu okanye kubangela iimpawu, kunokufuneka utyando. |
| I-Mitral valve stenosis | Ukuvulwa kwevalvu kuyancitshiswa, nto leyo ethintela igazi elaneleyo ukuba lingaphumi kuyo. Ukuba iimpawu zinzima okanye ivalvu incinci kakhulu, kunokufuneka utyando. |
| Ukuncipha kwevalvu ye-Mitral | Iincwadana ezimbini zevalvu ziba buthathaka kwaye zikhululeke. Kwenziwa utyando lwevalvu ye-mitral ezintandathu kwezili-10 ukuthintela ukuvuza kwegazi ngenxa yesi simo. |
Olu tyando lunokuba yimfuneko ukuba icala lasekhohlo lentliziyo yakho alimpompeli igazi elaneleyo emzimbeni (ukusilela kwentliziyo kwicala lasekhohlo) okanye ukuba intliziyo yakho ikhulisiwe. Nangona kunjalo, ukuba isifo asibi kakhulu, ugqirha wakho unokukunika amayeza okulawula iimpawu zakho. Nangona kunjalo, kufuneka uhlale une -echocardiograms rhoqo ukujonga imeko yevalvu yakho. Ukuba isifo siyaqhubeka okanye intliziyo yakho yonakele, utyando lunokufuneka kamva.
Uzilungiselela njani ngaphambi kotyando?
Ugqirha wakho kunye neqela lezonyango baya kukunceda ulungiselele utyando. Kubaluleke kakhulu ukuba ulandele imiyalelo yabo ngokuchanekileyo.
- Usenokucelwa ukuba uyeke ukusebenzisa amayeza athile: Usenokucelwa ukuba uyeke ukusebenzisa amayeza okunciphisa igazi (i-anticoagulants) afana ne-aspirin kunye ne-warfarin kwiiveki ezimbalwa ngaphambi kotyando.
- Ikunceda uyeke ukutshaya: Ukuba ungumntu otshayayo, ugqirha wakho anokukunceda uyeke ukutshaya.
- Sebenzisa isepha yokubulala iintsholongwane: Uza kuxelelwa ukuba uhlambe umzimba wakho ngesepha yokubulala iintsholongwane ngobusuku bangaphambi kotyando.
- Amayeza omawuwasebenzise ngosuku lotyando: Ugqirha uza kukuxelela ukuba zeziphi amayeza omawuwasebenzise kusasa ngaloo mini.
- Ukuzila Ukutya: Ngomhla wotyando, uyacetyiswa ukuba ungatyi okanye ungaseli nto emva kwexesha elithile.
Kwenzeka ntoni ngexesha lotyando?
Ngexesha lotyando, ugqirha uza kulungisa ingxaki enye okanye ezingaphezulu kwivalvu yakho. La ngamanyathelo adla ngokwenzeka ngexesha lotyando.
1. I-Anesthesia: Uza kunikwa amayeza okubulala iintlungu ukuze ulale ubuthongo obunzulu, ungazi nto.
2. Uqhagamshelo kumatshini wentliziyo nemiphunga:Ngexesha lotyando, uza kuqhagamshelwa kumatshini okhethekileyo (umatshini we-cardiopulmonary bypass) oza kuthatha umsebenzi wentliziyo yakho nemiphunga.
3. Ukwenza i-incision: Kwenziwa i-incision esifubeni. Ubungakanani beli candelo buyahluka ngokuxhomekeke kwinkqubo yotyando.
4. Indandatho ye-Annuloplasty: Indandatho efana ne-washer eyenziwe ngelaphu ibekwa ijikeleze ivalvu. Oku kunika inkxaso kwivalvu kwaye kuyinceda ukuba ibuyele kwimo yayo yesiqhelo.
5. Ukulungiswa kwevalvu: Ivalvu ye-mitral ilungiswa kusetyenziswa indlela enye okanye ezininzi ezahlukeneyo zotyando.
6. Ukuhlolwa: Jonga ukuba ivalvu ilungisiwe kakuhle kwaye wenze uhlengahlengiso olongezelelweyo ukuba kuyimfuneko.
7. Ukulumla umntwana: Emva kotyando, uza kususwa ematshinini. Emva koko intliziyo yakho nemiphunga yakho iza kuqala ukusebenza kwakhona.
8. Uvavanyo lokugqibela: Uvavanyo olukhethekileyo lwe-echo (i-transesophageal echocardiogram) lwenziwa ukuqinisekisa ukuba ivalvu ilungisiwe ngempumelelo na.
Zeziphi iindlela zotyando ezisetyenziswayo kolu tyando?
Oogqirha basebenzisa iindlela ezahlukeneyo kolu tyando. Thetha nogqirha wakho malunga nendlela esetyenziswayo kutyando lwakho.
Iindlela zokufaka iziqwenga
- Utyando olupheleleyo lwe-sternotomy: Ukusika okupheleleyo kwenziwa ngqo embindini wesifuba.
- Ukususwa kwesisu esincinci: Ukusika inxalenye yethambo eliphakathi lesifuba kuphela.
- Utyando lwesifuba sasekunene: Kwenziwa umngxuma omncinci phakathi kweembambo ezimbini kwicala lasekunene.
- Indlela yokuncedisa iRobhothi: Utyando lwenziwe kusetyenziswa irobhothi kusetyenziswa imingxunya embalwa emincinci kakhulu kwiimbambo.
Ezinye iinkqubo zotyando
- I-Annuloplasty: Njengoko besitshilo ngaphambili, oku kubandakanya ukubeka iringi ejikeleze ivalvu. Oku kudla ngokwenziwa rhoqo ngexesha lokulungiswa kwevalvu ye-mitral.
- Ukususwa kwe-triangular okanye i-quadrangular: Inxalenye encinci yevalvu eyonakeleyo iyasikwa ize isuswe, kwaye ezinye iindawo ezilungileyo ziyathungwa kunye.
- Ukulungiswa kweChordal: Ukuba iifayibha ezincinci ezifana nentambo (i-chordae) ezibambe ivalvu endaweni yazo zonakele, iindawo ezonakeleyo ziyasuswa kwaye zitshintshwe zezokwenziwa (ezenziwe ngezinto ezifana neGore-Tex®) okanye ngeefayibha ezithathwe kwenye indawo ephilileyo yentliziyo.
Kwenzeka ntoni emva kotyando?
Emva kotyando, ungalindela oku kulandelayo:
- Kuya kufuneka uhlale kwigumbi lokhathalelo oluphezulu (ICU) usuku olunye okanye ezimbini, apho iqela lezonyango liza kujonga ukubetha kwentliziyo yakho kunye nokuphefumla kwakho.
- Emva koko, kuya kufuneka uhlale kwigumbi eliqhelekileyo kangangeentsuku ezimbalwa.
- Ndiza kukuxelela ngonyango lwentliziyo .
- Emva kokuba ubuyele ekhaya, uza kufundiswa indlela yokunyamekela inxeba lotyando.
Uninzi lwabantu kufuneka bahlale esibhedlele kangangeveki emva kolu tyando.
Zithini iingenelo zokwenza olu tyando?
Kukho iingenelo ezininzi zokulungisa ivalvu ekhoyo endaweni yokuyitshintsha ngentsha.
- Amathuba okuphila ubomi obude nobunempilo emva kotyando ayanda.
- Ukhuseleko olufanelekileyo lokusebenza kwentliziyo: Umonakalo ekusebenzeni kwentliziyo uncinci.
- Umngcipheko onciphileyo weengxaki: Kukho umngcipheko onciphileyo weengxaki ezifana nestroke kunye ne-endocarditis (usulelo lweevalvu zentliziyo).
- Akukho mfuneko yokusebenzisa amayeza okunciphisa igazi ixesha elide: Kwiimeko ezininzi, amayeza okunciphisa igazi (ama-anticoagulants) akufuneki athathwe ixesha elide.
Nanini na xa kunokwenzeka, oogqirha bazama ukulungisa ivalvu endaweni yokuyitshintsha, kuba leyo yeyona ndlela ilungileyo kwizigulane ezininzi.
Luphumelele kangakanani olu tyando? Ziziphi iingxaki ezinokubakho?
Olu tyando luphumelele kakhulu. Ngokweengxelo, nokuba kudlule iminyaka eli-10 emva kotyando, malunga nama-94% ezigulana aziphumi igazi elininzi.
Nangona kunjalo, njengalo naluphi na utyando, kukho iingozi kunye neengxaki ezinokwenzeka.
- Ukungaqheleki kwentliziyo (iiArrhythmias)
- Ukopha
- Ibhloko yentliziyo
- Ukumelwa yintliziyo
- Usulelo
- Istroke
Thetha nogqirha wakho ngale mingcipheko kunye nendlela onokuyinciphisa ngayo.
Kuthatha ixesha elingakanani ukuchacha?
Ngokuqhelekileyo kuthatha malunga neeveki ezine ukuya kwezisibhozo ukuba umntu aphile ngokupheleleyo kolu tyando, nangona abanye abantu banokuthatha ixesha elide.
Eyona nto ibalulekileyo kukuba, musa ukuthelekisa inkqubo yakho yokuchacha neyomnye umntu. Ukuba nje ummelwane wakho uphilile ngenyanga akuthethi ukuba ufanele ukwenze oko. Umzimba womntu wonke wahlukile. Ukuba kuthatha ixesha elide, oko kuqhelekile. Musa ukuzinyanzela ukuba uphile ngokukhawuleza.
Ixesha elithathayo ukuze ululame lixhomekeke kwizinto ezininzi:
- Ubunzima besifo sentliziyo yakho ngaphambi kotyando: Ukuba ukusebenza kwentliziyo yakho bekusele kuphazamisekile ngaphambi kotyando, kuya kuthatha ixesha elide ukuze ubuyisele amandla.
- Impilo yakho ngokubanzi ngaphambi kotyando: Oku kuya kuxhomekeka ekubeni ubusebenza okanye unezinye iimeko zempilo ezikwenze kwaba nzima.
- Indlela yotyando esetyenzisiweyo:Ukuba kwenziwe umsikelo omkhulu phakathi kwesifuba (median sternotomy), kuya kuthatha malunga neeveki ezi-6-8 ukuba ithambo liphole. Ukuba utyando lwenziwa ngokusikwa okuncinci, amanxeba aya kuphola ngokukhawuleza.
Ufanele uye nini kugqirha?
Kuqhelekile ukuba ube nengxaki emva kotyando. Ugqirha wakho uza kukunika amayeza okudambisa iintlungu ngenxa yoku. Nangona kunjalo, ukuba ufumana naziphi na iimpawu ezilandelayo, musa ukucinga ukuba ziqhelekile kwaye qhagamshelana nogqirha wakho ngoko nangoko.
| Iimpawu zesilumkiso ekufuneka uziqaphele | |
|---|---|
| Umkhuhlane, ukubanda | Ukukhohlela igazi okanye i-mucus etyheli/eluhlaza |
| Iintlungu zesifuba | Ubunzima bokuphefumla |
| Ubomvu, ukudumba, ubomvu, okanye intlungu ejikeleze inxeba lotyando | Isicaphucaphu nokuhlanza |
| Intloko ebuhlungu kakhulu, isiyezi, ukulahlekelwa zingqondo | Ubunzima bokuthetha, ukuthintitha (iimpawu zestroke) |
| Ukubetha kwentliziyo okungaqhelekanga (okukhawulezayo kakhulu okanye okucothayo kakhulu) | Intlungu, ubomvu, okanye ukudumba emlenzeni ongezantsi |
Ngamanye amaxesha usenokungazi ukuba le yinto eqhelekileyo yokuchacha okanye yinto enzulu. Ukuba unamathandabuzo, kungcono ukufowunela ugqirha wakho.
Umyalezo Wokuya Ekhaya
- Ukulungiswa kwevalvu yeMitral lutyando oluphumelele kakhulu kwisifo sentliziyo. Akukho mfuneko yokoyika oku.
- Kwiimeko ezininzi, kuluncedo kakhulu ukulungisa ivalvu kunokuyifaka entsha.
- Kuthatha ixesha ukuchacha emva kotyando, ngoko ke mamela umzimba wakho kwaye ube nomonde.
- Landela imiyalelo kagqirha wakho ngokuchanekileyo. Ukuba unamathandabuzo okanye ufumana naziphi na iimpawu ezingaqhelekanga, yazisa ugqirha wakho ngoko nangoko.
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