Oko kufuneka ukwazi malunga nenkqubo ye-TAVR (Transcatheter Aortic Valve Replacement), ethatha indawo yevalvu ngaphandle kokuvula intliziyo

Xa usiva igama elithi "utyando lwentliziyo," yintoni efika engqondweni? Uninzi lwexesha, sicinga ngotyando olukhulu olubandakanya ukuvula isifuba, akunjalo? Kodwa ngokuhambela phambili kwesayensi yezonyango, ngoku kukho unyango olulula kakhulu nolungenabungozi kwiingxaki ezithile zentliziyo. Namhlanje, siza kuthetha ngonyango olutsha noluphumeleleyo.

Yintoni i-TAVR? Masiyiqonde ngokulula.

Intsingiselo epheleleyo ye-TAVR yiTranscatheter Aortic Valve Replacement . Ngamanye amaxesha ikwabizwa ngokuba yi-TAVI (Transcatheter Aortic Valve Implantation). Omabini la magama abhekisa kwindlela efanayo yonyango.

Ngamafutshane, i-TAVR yindlela yokutshintsha ivalvu ye-aorta yentliziyo ngomngxunya omncinci kakhulu, ngaphandle kokuvula isifuba.

Cinga ngentliziyo yethu njengempompo yamanzi endlwini. Le mpompo ithumela igazi emzimbeni wonke ngepayipi ephambili. Le mbhobho iphambili ibizwa ngokuba yi-aorta. Xa igazi lisuka entliziyweni liye kule aorta, kukho into efana nesango elilawula ukuhamba kwegazi. Yiloo nto siyibiza ngokuba yivalvu ye-aorta. Ukuba le valve ayivuli okanye ayivali kakuhle, kuvela iingxaki ezinkulu ekuhambeni kwegazi emzimbeni wonke. I-TAVR ibandakanya ukutshintsha ivalvu eyonakeleyo nengasebenzi kakuhle ngevalvu entsha.

Ngubani ofuna inkqubo ye-TAVR?

Olu nyango lufuneka kakhulu kubantu abanemeko ebizwa ngokuba yi -aortic stenosis . Oko kukuthi, ivalvu ye-aortic esithethe ngayo ngaphambili inciphile. Njengesango elinomhlwa, le valve ayivuli ngokupheleleyo.

Kukho izizathu ezininzi eziphambili zokuba ivalvu inciphe ngale ndlela:

• Ukwaluphala: Ngokuqhelekileyo kubantu abaneminyaka engaphezu kwama-70 ubudala, iidipozithi zecalcium ziyaqokelelana kwivalvu, nto leyo ebangela ukuba iqine kwaye iqine.
• Ezinye iimeko zonyango: Le valve ingonakala ngokukhawuleza ngenxa yeemeko ezifana nesifo sentliziyo esibangelwa yirheumatic okanye ezinye iziphene zentliziyo ezizalwa nazo (umz., ivalvu ye-aortic ye-bicuspid).

Xa ivalvu incipha, intliziyo kufuneka isebenze nzima kunangaphambili ukuze ipompe inani legazi elifunekayo emzimbeni. Kufana nenjini ekufuneka ipompe amanzi amaninzi ngepayipi evalekileyo. Ekuhambeni kwexesha, olu xinzelelo longezelelweyo entliziyweni lunokwenza buthathaka izihlunu zentliziyo, ekugqibeleni zikhokelele ekusileleni kwentliziyo.

Kwenzeka ntoni ngaphambi kwe-TAVR?

Ngaphambi kokuba wenze i-TAVR, ugqirha wakho uza kwenza uvavanyo oluninzi ukuze ahlole ngokuchanekileyo imeko yakho. Olu vavanyo lunokunika umfanekiso ocacileyo wendlela igazi elihamba ngayo entliziyweni yakho kunye nokuba kukho naziphi na ezinye iingxaki.

Ezi ziimvavanyo ezihlala zenziwa:

• Uvavanyo lwegazi
• I-Echocardiogram - Oku kufana nokuskena kwentliziyo.
• I-Electrocardiogram (ECG)
• I-CT scan okanye i-MRI scan
• Ukufakwa kwe-catheter kwintliziyo - Oku kujonga ukuba akukho zithintelo kwimithambo yentliziyo ehambisa igazi entliziyweni.

Emva kokuba zonke ezi mvavanyo zenziwe, ugqirha uza kuthetha nawe aze akuchazele yonke into malunga nonyango, into omawuyilindele emva koko, kunye nendlela oza kunikwa ngayo i-anesthesia. Ungabuza nayiphi na imibuzo onokuba nayo ngeli xesha.

Uza kucelwa ukuba uyeke ukutya nokusela iiyure ezi-4-6 ngaphambi konyango. Kwakhona, kufuneka ubuze ugqirha wakho ukuba kufuneka uyeke ukuthatha amayeza kwaye nini.

Indlela unyango lwe-TAVR olwenziwa ngayo

Le yindlela elula kakhulu. Uza kunikwa i-anesthesia ukuze ungabi nantlungu. Uza kunikwa namayeza okuthintela ukuqhekeka kwegazi.

Emva koko, ingcali yentliziyo engenelelayo ilandela la manyathelo:

1. Ukwenza umsikelo omncinci: Kwenziwa umsikelo omncinci kakhulu, ngokuqhelekileyo kufutshane nomthambo omkhulu wegazi (umthambo we-femoral) kwinxalenye ephezulu yethanga lakho, kufutshane ne-groin.

2. Ukufakwa kwe-catheter: Ngomsikelo, ityhubhu encinci kakhulu, eguquguqukayo ebizwa ngokuba yi-catheter idluliselwa kumthambo wegazi ukuya entliziyweni.

3. Ukufakela ivalvu entsha: Ivalvu entsha ithathwa ngale catheter, ibekwe ngaphakathi kwevalvu yakho endala, eyonakeleyo, ize yandiswe. Emva koko ivalvu entsha ibekwa kanye kuloo ndawo. Ivalvu endala ityhalelwa ecaleni yintsha ize ihlale apho.

4. Uvavanyo: Ivalvu entsha iyajongwa ukuze kubonwe ukuba isebenza kakuhle na kwaye kukho na ukuvuza.

5. Ukususwa kunye nokuthungwa: Ukuba yonke into ilungile, i-catheter isuswa ngononophelo, inxeba elincinci elenziwe ekuqaleni liyathungwa, kwaye kufakwa iplasta.

Ngokwesiqhelo, yonke le nkqubo ithatha malunga neyure enye okanye ezimbini.

Zithini iingenelo zoku?

I-TAVR ineengenelo ezininzi ngaphezu kotyando lwentliziyo oluvulekileyo lwendabuko.

Nangona ezi zibonelelo zintle, utyando lwentliziyo oluvulekileyo lunokufaneleka ngakumbi kwezinye izigulana. Kuya kufuneka uxoxe nogqirha wakho malunga nokuba i-TAVR okanye utyando oluvulekileyo lolona khetho lufanelekileyo kuwe.

Ngaba akukho miphumo emibi? Masithethe nangeengozi

I-TAVR lunyango oluphumelele kakhulu. Ngenxa yokuqhubela phambili kwezobuchwepheshe, iingxaki ngoku azixhaphakanga. Nangona kunjalo, njengakweyiphi na inkqubo yezonyango, kukho iingozi ezincinci.

• Inkqubo yombane yentliziyo iyachaphazeleka, nto leyo ebangela ukuba kufakelwe i-pacemaker .
• Ukopha kwegazi kujikeleza ivalvu entsha.
• Istroke.
• Ukopha.
• Usulelo.
• Ukonakala kwezintso, intliziyo, okanye imithambo yegazi.

Ugqirha wakho uza kukuchazela kakuhle ezi ngozi. Ekubeni oku kwenziwa liqela lezonyango elinamava kakhulu, iingozi ziphantsi kakhulu.

Ingaba inkqubo ye-TAVR ayifanelekanga kuye wonke umntu?

Nangona olu nyango luluncedo kakhulu, alufanelekanga kuye wonke umntu. Ugqirha wakho usenokungacebisi i-TAVR kumntu onezi meko zilandelayo:

• Ukuba ukhe wahlaselwa yintliziyo kwisithuba senyanga.
• Ukuba uneziphene zentliziyo ezintsonkothileyo.
• Ukuba kukho iingxaki ngezinye iivalvu zentliziyo (umz. i-Mitral regurgitation).
• Ukuba usandul’ ukuba nestroke okanye i-TIA (uhlaselo lwe-ischemic oludlulayo).
• Ukuba unesifo sezintso esinzulu.

Ugqirha wakho uza kumisela unyango olufanelekileyo kuwe ngokusekelwe kwimeko yakho yempilo iyonke.

Kuthatha ixesha elingakanani ukuphiliswa?

Uninzi lwabantu lunokubuyela ekhaya besuka esibhedlele kungekapheli usuku okanye ezimbini emva konyango lwe-TAVR. Ixesha elithathwayo ukuze umntu aphile ngokupheleleyo liyahluka kumntu nomntu.

• Ngokwesiqhelo ungaqhubeka nemisebenzi yakho yemihla ngemihla kwiintsuku ezimbalwa.
• Kuya kufuneka ulinde malunga neveki ngaphambi kokuba wenze izinto ezifana nokuphakamisa iintsimbi.
• Ungaya emsebenzini emva kweeveki ezimbini uze uqhube emva kwenyanga.
• Kungathatha iiveki ezi-6 ukuya kwezili-10 ukuze umntu aphile ngokupheleleyo.

Ugqirha wakho uza kukunika iingcebiso malunga nobungakanani bokuphumla okudingayo, into omawuyenze, kunye nento ongamawuyenze. Ukulandela loo ngcebiso kubaluleke kakhulu ukuze uphile ngokukhawuleza.

Ukongeza, ungathunyelwa kwinkqubo yokuvuselela intliziyo , oluluhlu lwemithambo ekhethekileyo yokuqinisa intliziyo yakho. Oku kuya kukhawulezisa inkqubo yakho yokuchacha.

Udinga nini ukubona ugqirha?

Emva konyango lwe-TAVR, uya kucelwa ukuba uye kuhlolwa, malunga kanye ngenyanga uze emva koko kube kanye ngonyaka. Olu tyelelo lokulandelela lubaluleke kakhulu ukuqinisekisa ukuba ivalvu entsha isebenza kakuhle. Nangona kunjalo, ukuba ufumana naziphi na iimpawu ezingezantsi, kufuneka ufowunele ugqirha wakho ngoko nangoko.

Kwimeko yongxamiseko efana nentlungu eqatha esifubeni okanye ubunzima obukhulu bokuphefumla , yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko.