Masifunde ngonyango lwe-mitral valve (TMVR) olungenalo utyando.

Ngaba wena okanye umntu omaziyo okanye umhlobo osenyongweni wakhe waxelelwa ngugqirha ukuba unengxaki nge-'Mitral Valve' yentliziyo yakho kwaye udinga utyando? Xa sisiva igama elithi "utyando lwentliziyo," uninzi lwethu luyoyika kancinci, akunjalo? Yinto eqhelekileyo leyo. Kuba sivile ngotyando olubandakanya ukuvula isifuba nokwenza utyando olukhulu. Kodwa ubusazi, isayensi yezonyango ihambele phambili kakhulu ngoku. Ke ngoko, kukho indlela entsha enokutshintsha le valve ngaphandle kokuvula isifuba nangokusikwa okuncinci kakhulu. Namhlanje, siza kuthetha ngendlela yonyango eye yaba luncedo olukhulu kubantu abaninzi, ebizwa ngokuba yi-'Transcatheter Mitral Valve Replacement' okanye i-TMVR ngamafutshane.

Kalula nje, yintoni iTMVR?

Kulungile, masiyibeke ngokulula. I-TMVR yinkqubo ethatha indawo yevalvu ye-mitral entliziyweni yakho. Kodwa into ekhethekileyo ngayo kukuba ayenziwa ngokuvula isifuba sakho ngokupheleleyo njengotyando lwentliziyo evulekileyo. Endaweni yoko, kufakwa ityhubhu encinci (i-catheter) ngenxeba elincinci kakhulu, kwaye ivalvu entsha ifakwe entliziyweni yakho.

Khawucinge nje endaweni yokususa ivalvu enkulu uze uyifake entsha, uthatha iindawo zevalvu entsha ngomngxuma omncinci uze uzifake ngaphakathi. Le yinkqubo engenabungozi kangako kunotyando olukhulu. Ivalvu entsha efakwe ngolu hlobo inokuba yeyokwenziwa. Okanye ingaba yivalvu yendalo eyenziwe ngenkomo, ihagu, okanye izicubu zentliziyo yomntu. Emva kokuba ivalvu entsha ifakwe, iqala ukwenza into efanayo naleyo yenziwa yivalvu yakho endala, enesifo.

Ngubani ofuna olu nyango lweTMVR?

Ukuze sikuqonde oku, masiqale sijonge ukuba yintoni le 'valvu ye-mitral' kwaye kwenzeka ntoni kuyo.

Intliziyo yethu ineegumbi ezine eziphambili. Ezimbini phezulu nezimbini ezantsi. Ivalvu ye-mitral iphakathi kwe-atrium yasekhohlo kunye ne-ventricle yasekhohlo. Ifana nomnyango ophakathi kwamagumbi amabini. Lo mnyango uneziqwenga ezimbini (amaphecana). Ngalo lonke ixesha intliziyo ibetha, ezi ziqwenga ziyavuleka kwaye zivale. Oku kuvumela igazi ukuba lihambe kwicala elinye kuphela, ukusuka kwigumbi eliphezulu ukuya kwigumbi elisezantsi. Umsebenzi ophambili wale valve kukuthintela igazi ukuba libuye umva.

Kodwa ngamanye amaxesha, nokuba kususela ekuzalweni okanye kamva, iingxaki ezahlukeneyo zinokwenzeka ngale valve. Kukho iintlobo ezimbini zeengxaki.

Xa ezi meko ziba mandundu, zinokubangela iimpawu ezinje ngokuphefumla kancinci, ukudinwa, kunye nentlungu yesifuba. Zingakhokelela nakwiimeko ezinzulu ngakumbi ezifana ne-atrial fibrillation (ukubetha kwentliziyo okungaqhelekanga), uxinzelelo lwegazi oluphezulu emaphaphu (uxinzelelo lwegazi oluphezulu emiphungeni), okanye ukungasebenzi kakuhle kwentliziyo.

Ngaba iTMVR kunye neMitraClip ziyafana?

Hayi. Nangona zombini zingezonyango ezingangenisi kakhulu kwiingxaki zevalvu ye-mitral, kukho umahluko phakathi kwezi zimbini.

• I-TMVR yindawo yokutshintsha ivalvu iyonke .
• I-MitraClip™ yindlela yokulungisa iivalvu. Kufana nokubeka ikliphu encinci phakathi kweeflephu ezimbini zevalvu evuzayo, ukunqanda ukuvuza.

Ingcali yakho yentliziyo iya kugqiba ukuba loluphi unyango olulungele wena.

Kwenzeka ntoni ngaphambi konyango lwe-TMVR?

Ngaphambi kolu nyango, iqela lakho lezonyango liza kukuhlola ngononophelo. Oku kuza kuquka ikakhulu ezi mvavanyo zilandelayo:

• I-Echocardiogram: Olu luvavanyo lwe-ultrasound lwentliziyo. Lunokubona ngokucacileyo indlela amagumbi entliziyo kunye neevalvu ezisebenza ngayo.
• I-CT Scan: Oku kuthatha imifanekiso yentliziyo nemithambo yegazi enamacala amathathu (3D) kwaye kunceda ekucwangciseni unyango.

Besebenzisa ulwazi oluvela kwezi mvavanyo, iqela lezonyango liceba ubungakanani bevalvu engcono kunye nendlela yokunyanga efanelekileyo kuwe.

Ukongeza, ingcali yokubulala iintlungu iza kuthetha nawe ize igqibe ukuba yeyiphi na indlela efanelekileyo yokubulala iintlungu ukuze ungaziva iintlungu ngexesha lenkqubo. Usenokulaliswa ngokupheleleyo (i-anesthesia eqhelekileyo), okanye ungalaliswa ungaziva iintlungu (i-conscious sedation).

Kwiintsuku ezimbalwa ngaphambi konyango lwakho, ugqirha wakho uya kukunika imiyalelo ecacileyo yendlela yokulungiselela. Ezi zingabandakanya:

• Amanye amayeza, anjengezinto zokunciphisa igazi, asenokufuna ukuyeka ukusebenzisa amayeza kangangeentsuku ezimbalwa.
• Ngomhla wonyango, uza kucelwa ukuba uzile ukutya (ungatyi okanye usele) iiyure ezimbalwa.
• Emva konyango, bacela ukuba bakulungiselele imoto yokukusa ekhaya usuka esibhedlele.

Kwenzeka ntoni ngexesha lonyango lwe-TMVR?

Lonke olu tyando ludla ngokuthatha malunga neeyure ezimbini ukuya kwezintathu kwaye lwenziwa liqela elikhulu loogqirha, kuquka oogqirha bentliziyo, oogqirha bentliziyo abangenelelayo, iingcali zemifanekiso, kunye neengcali ze-anesthesiologists.

Nantsi inkcazo elula yenyathelo ngenyathelo yoko kwenzekayo ngexesha lonyango:

1. Okokuqala, indawo apho kuza kwenziwa khona ukusika (ngokuqhelekileyo i-groin okanye indawo encinci esifubeni) iyacocwa kwaye iinwele ziyasuswa ukuba kuyimfuneko.

2. Emva koko, i-cannula (umgca we-IV) iya kufakwa emthanjeni ongalweni yakho, apho uya kunikwa amayeza kunye nolwelo olufunekayo.

3. Okulandelayo, ivalvu entsha incamathiselwa esiphelweni setyhubhu encinci neguquguqukayo ebizwa ngokuba yi-catheter .

4. Ngoku, kwenziwa umsike omncinci kakhulu kwindawo emiselweyo emqolo okanye esifubeni, kwaye ngaloo ndlela, le catheter ifakwa kwimithambo yegazi.

5. Besebenzisa ubuchwepheshe obukhethekileyo bokuthatha imifanekiso, njenge-X-rays, oogqirha bakhokela ngononophelo le catheter ngemithambo yegazi ukuya kwi-mitral valve esentliziyweni.

6. Xa sele ifikile, ivalvu entsha ifakwa ngaphakathi kwevalvu endala, enesifo.

7. Nje ukuba ivalvu entsha ibekwe kakuhle, i-catheter isuswa ngononophelo kwaye inxeba elincinci livalwe.

Kulo lonke eli xesha, iqela lezonyango liza kuqhubeka nokujonga yonke into ukususela kuxinzelelo lwegazi kunye namanqanaba eoksijini yegazi ukuya kwindlela intliziyo yakho esebenza ngayo kusetyenziswa i-echocardiogram.

Kwenzeka ntoni emva konyango?

Emva kokuba unyango luphelile, uza kusiwa kwigumbi lokuchacha. Iqela lezonyango liza kukunyamekela kakuhle ude uphile emva kokusebenzisa i-anesthesia. Abanye abantu banokufuna ukuhlala kwigumbi labagula kakhulu (ICU) okwethutyana. Ngokwesiqhelo, kuya kufuneka uhlale esibhedlele iintsuku ezimbalwa.

Ngaphambi kokuba ugoduke, oogqirha baza kukuchazela ngokucacileyo into ekufuneka uyenze ngokulandelayo.

• Ukuvuselelwa kwentliziyo: Iingcebiso malunga nokuzilolonga kunye nokutshintsha indlela yokuphila ukunceda ukuqinisa intliziyo kwakhona.
• Amadinga okulandela: Iintsuku ekufuneka uphinde udibane nogqirha.
• Amayeza: Ingcebiso ngamayeza amatsha okuqalisa okanye amayeza amadala okuqalisa kwakhona.
• Umsebenzi oqhelekileyo: Ungabuyela nini emsebenzini uze uqalise imisebenzi yakho eqhelekileyo?

Zithini iingenelo zonyango lwe-TMVR?

Xa kuthelekiswa notyando lwentliziyo oluvulekileyo, le ndlela ye-catheter ineenzuzo ezininzi.

• Isifo se-Mitral valve sinokulungiswa.
• Ukuncipha kweempawu ezibangelwa sisifo, ezinje ngokuphefumla nzima nokudinwa.
• Umngcipheko oncitshisiweyo weengxaki zempilo ezinzulu.
• Uyakwazi ukuchacha ngokukhawuleza kunotyando oluvulekileyo.
• Impembelelo enciphileyo emzimbeni nakwiintlungu.

Ngaba kukho naziphi na iingozi okanye iingxaki ngolu nyango?

Ewe. Nangona iingozi ziphantsi kunotyando lwentliziyo oluvulekileyo, njengakweyiphi na inkqubo yezonyango, i-TMVR inokuba neengozi kunye neengxaki ezithile. Nangona kunjalo, ezi azixhaphakanga kakhulu.

Nazi ezinye zeengxaki eziphambili ezinokwenzeka:

• Amahlwili egazi: Ukuba la mahlwili egazi aya engqondweni, istroke inokwenzeka.
• Ukonakala kwezicubu: Udonga lwentliziyo (ukugqobhoka kwe-ventricular yasekhohlo) okanye umthambo wegazi ohambisa igazi entliziyweni (umthambo we-coronary) lunokwenzakala.
• Ukuvaleka kwendlela yokuphuma kwegazi kwi-ventricular yasekhohlo: Ivalvu entsha ithintela indlela yokuphuma kwegazi kwigumbi elisezantsi lasekhohlo.
• Ukuhamba kwevalvu: Ukuhamba kwevalvu ukusuka kwindawo yayo esisigxina.

Ezinye iingxaki zisenokufuna unyango olongezelelekileyo okanye utyando.

Kuthatha ixesha elingakanani ukuchacha?

Uninzi lwabantu lunokubuyela kwimisebenzi yalo yesiqhelo baze basebenze kwiiveki ezimbalwa. Nangona kunjalo, kungathatha iinyanga ezimbini ukuya kwezintathu ukuba baphile ngokupheleleyo . Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho ngononophelo. Musa ukungxama emsebenzini onzima okanye kwimisebenzi enzima.

Kuxa kutheni apho kufuneka ufumane ingcebiso kagqirha emva konyango?

Le yinxalenye ebaluleke kakhulu. Xa ubuyela ekhaya emva konyango, kufuneka uqaphele utshintsho emzimbeni wakho. Kukho iimpawu ezithile, ukuba ziyavela, kufuneka ufune ingcebiso kagqirha ngokukhawuleza .

I-TMVR lukhetho oluxabisekileyo kakhulu lonyango kubantu abanesifo se-mitral valve abangakwaziyo ukwenza utyando lwentliziyo oluvulekileyo. Ukuba unemibuzo engaphezulu malunga noku, nceda uzive ukhululekile ukuthetha nogqirha wakho. Uya kukwazi ukukuchazela ukhetho lonyango olungcono kuwe.