Intliziyo yethu sisitho esimangalisayo esisebenza ngokungayekiyo. Ngaphakathi kule ntliziyo, kukho iivalvu ezine ezisebenza njengeengcango ezine ukulawula ngokuchanekileyo ukuhamba kwegazi. Ezi zivumela igazi ukuba lihambe kwicala elinye kuphela. Elinye lala mavalvu libizwa ngokuba yi-'Mitral valve'. Eli likwicala lasekhohlo lentliziyo phakathi kwegumbi eliphezulu (atrium yasekhohlo) kunye negumbi elisezantsi (i-ventricle yasekhohlo). Kodwa ngamanye amaxesha le valve ye-mitral inokuba nesifo. Oko kuthetha ukuba igazi linokuvuza ngasemva ngaphandle kokuvala ngokufanelekileyo, okanye linokuvaleka ngaphandle kokuvula ngokufanelekileyo. Ngoko ke kule meko, loo valve kufuneka itshintshwe.
Ngoko ke yintoni iTMVR?
Ngamafutshane, i-TMVR (Transcatheter Mitral Valve Replacement) yindlela yonyango yanamhlanje ethatha indawo yevalvu ye-mitral eyonakeleyo ngevalvu entsha ngaphandle kotyando olukhulu lwentliziyo.
Khawucinge nje, endaweni yotyando olukhulu olubandakanya ukuvula isifuba nokumisa intliziyo, ityhubhu encinci (i-catheter) idluliselwa ngomngxuma omncinci kakhulu emqolo okanye esifubeni, ecaleni komthambo wegazi, ukuya entliziyweni, kwaye ivalvu entsha ifakwa ngetyhubhu kwaye iqiniswe endaweni yevalvu endala, enesifo. Le valve intsha inokuba yivalvu eyenziwe ngumntu, okanye ingenziwa ngezicubu zezilwanyana (inkomo, ihagu). Kule nkqubo, ivalvu endala ayisuswa, kodwa endaweni yoko entsha ifakwa ngaphakathi kuyo kwaye iqiniswe.
Ngubani ngokwenene odinga olu nyango?
Kukho iintlobo ezimbini eziphambili zesifo se-mitral valve:
1. Ukubuyela kwevalvu ye-Mitral: Oku kwenzeka xa iiflephu ezimbini zevalvu zingavali kakuhle, nto leyo ebangela ukuba inxalenye yegazi elimpontshwa yintliziyo ivuza umva. Kufana namanzi avuza kwimpompo ephukileyo.
2. I-Mitral valve stenosis: Oku kwenzeka xa ivalvu iba mxinwa kwaye ingavuli kakuhle. Oku kunciphisa inani legazi elinokugeleza phambili. Njengaxa umbhobho uvaliwe, ukuhamba kwamanzi kuyehla.
Xa zombini ezi meko ziba nzima, iimpawu ezinzima ezifana nokuphefumla kancinci, i-atrial fibrillation, uxinzelelo lwegazi oluphezulu emaphaphu, kunye nokusilela kwentliziyo kunokwenzeka.
Ngokwesiqhelo, utyando lwentliziyo oluvulekileyo lwenziwa kwiimeko ezinje. Nangona kunjalo, i-TMVR lukhetho oluhle kakhulu kwabo bakhulileyo, abanezinye iingxaki zempilo, kwaye abanakukwazi ukumelana neengozi zotyando olukhulu olunjalo.
Ngaba iTMVR kunye neMitraClip ziyafana?
Hayi. Nangona zombini ezi ndlela zonyango zenziwa ngaphandle kokuvula intliziyo, zimbini iindlela.
- I-MitraClip™: Oku kuquka ukulungisa ivalvu evuzayo. Oku kuquka ukubeka isixhobo esincinci esifana nekliphu phakathi kwamaphetshana amabini evalvu ukuthintela igazi ekuvutheni.
- I-TMVR:Oku akuyonto yokulungisa, kodwa kufakelwe ivalvu entsha ngokupheleleyo.
Kwenzeka ntoni ngaphambi konyango lwe-TMVR?
Emva kokugqiba ekubeni bakunike olu nyango, iqela lezonyango liza kukuxilonga ngononophelo.
- Uvavanyo: Kwenziwa uvavanyo oluninzi, olufana ne-"Echocardiogram" ukujonga ukusebenza kwentliziyo kunye ne-"CT scan" ukujonga ulwakhiwo lwentliziyo. Ezi zisetyenziselwa ukucwangcisa unyango.
- Ukuthetha nge-anesthesia: Ingcali iza kuthetha nawe ngohlobo lwe-anesthesia oza kuyinikwa ukuze uphephe iintlungu ngexesha lonyango. Isigqibo siza kwenziwa ngokusekelwe kwimeko yakho, nokuba uza kunikwa i-anesthesia eqhelekileyo okanye i-conscious sedation.
- Imiyalelo: Ugqirha uza kukunika imiyalelo ekhethekileyo.
- Amanye amayeza (ingakumbi amayeza okunciphisa igazi) asenokufuna ukuba ayeke kangangeentsuku ezimbalwa.
- Uza kucelwa ukuba uzile ukutya iiyure ezimbalwa ngosuku lonyango.
- Uza kwaziswa ukuba uze nomntu ekhaya emva konyango.
Kwenzeka ntoni ngexesha lonyango?
Olu nyango ludla ngokuthatha malunga neeyure ezimbini ukuya kwezintathu. Iqela leengcali, kuquka oogqirha bentliziyo, iingcali zentliziyo, kunye neengcali ze-anesthesiologists, libandakanyeka koku.
Ngamafutshane, ezi zizinto ezenzekayo.
1. Indawo yokusikwa (i-groin okanye isifuba) iyacocwa kwaye ilungiswe.
2. I-cannula (umgca we-IV) ifakwa emthanjeni engalweni, apho kunikwa khona amayeza afunekayo kunye nolwelo.
3. Ivalvu entsha iqhotyoshelwe esiphelweni setyhubhu encinci (i-catheter).
4. Le tube ifakwa kwimithambo yegazi ngenxeba elincinci elenziwe emqolo okanye esifubeni.
5. Ngokusebenzisa iteknoloji ekhethekileyo yokufota, le tube ikhokelwa kwivalvu ye-mitral yentliziyo.
6. Ivalvu entsha ifakwa kwivalvu endala, enesifo, ibekwe ngokuchanekileyo, kwaye ifakwe.
7. Emva koko ityhubhu iyasuswa kwaye i-incision iyavalwa.
Iqela lezonyango lijonga yonke into, kuquka uxinzelelo lwegazi kunye namanqanaba eoksijini, kulo lonke eli xesha.
Kwenzeka ntoni emva kweTMVR?
Emva konyango, uza kusiwa kwigumbi lokuchacha. Uza kuhlolwa ngokusondeleyo de uphile emva kokusebenzisa i-anesthesia. Abanye abantu banokufuna ukuhlala kwigumbi labagula kakhulu (ICU) usuku olunye okanye ezimbini. Ngokwesiqhelo, kuya kufuneka uhlale esibhedlele iintsuku ezimbalwa.
Xa ubuyela ekhaya, ugqirha wakho uza kukunika iingcebiso ngezi zinto zilandelayo:
- Indlela yokuzibandakanya kwiinkqubo zokuvuselela intliziyo.
- Iindibano zokulandelela.
- Malunga namayeza okuqalisa kwakhona kunye namayeza amatsha okusebenzisa.
- Ndingabuyela nini kwimisebenzi eqhelekileyo nasemsebenzini?
Iingenelo kunye neengozi zonyango lwe-TMVR
Njengakwezinye iindlela zonyango, kukho iingenelo kunye neengozi. Makhe sizijonge.
| Iingenelo | Iingozi kunye neengxaki |
|---|---|
| Isifo se-Mitral valve siyalungiswa. | Kukho umngcipheko wokuba amahlwili egazi avele aze aye engqondweni, nto leyo ebangela isifo sohlangothi. |
| Ukwehla okubonakalayo kweempawu (ezifana nokuphefumla kancinci). | Ukonakala kwezicubu zentliziyo. Umzekelo: Ukugqobhoka kwe-ventricular yasekhohlo. |
| Ukuchacha ngokukhawuleza kunotyando lwentliziyo oluvulekileyo. | Ukuvaleka kwendlela yokuphuma kwe-ventricular yasekhohlo. |
| Akukho silonda sikhulu kwaye iintlungu zincinci. | Ivalvu efakelweyo inokuhamba okanye itshintshe ukusuka kwindawo yayo. |
Into ebalulekileyo kukuba ezi ngozi azixhaphakanga, kwaye ukuba kukho naziphi na iingxaki, iqela lezonyango likulungele ukuguqukela kwangoko kutyando oluvulekileyo okanye ukuthatha amanye amanyathelo afanelekileyo.
Ufanele ufune nini ingcebiso yezonyango ezingxamisekileyo?
Xa ubuyela ekhaya emva konyango, kufuneka ulumke kakhulu ngeempawu ezithile. Ukuba ufumana ezi mpawu zilandelayo , yiya kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngoko nangoko.
| Yiya kwi-ETU ngokukhawuleza! | |
|---|---|
| Iimpawu zestroke |
|
| Iimpawu zokuhlaselwa yintliziyo | |
| Ukuba unale mpawu, yazisa ugqirha wakho. | |
| Iingxaki ezinxulumene nokusika | Izithungo ziyakhululeka, ziphuma igazi enxebeni. |
| Iimpawu zosulelo | Intlungu, ukubomvu, ubomvu okanye ulwelo oluphumayo, umkhuhlane kwindawo yenxeba. |
| Iimpawu zehlwili legazi | Intlungu, ukudumba, kunye nokutshintsha kombala kwiindawo ezifana nethanga, idolo, okanye iqatha. |
| Ezinye iimpawu zokuhlaselwa yintliziyo | Ukutyeba ngequbuliso, ukudumba kwemilenze namaqatha. |
Umyalezo Wokuya Ekhaya
- I-TMVR yindlela yonyango yanamhlanje ethatha indawo yevalvu ye-mitral ngaphandle kokuvula intliziyo, inengozi encinci kunye nokuchacha ngokukhawuleza.
- Olu khetho luhle kakhulu, ingakumbi kwabo balupheleyo okanye abanezinye iingxaki zempilo ezenza kube nzima kubo ukwenza utyando olukhulu.
- Ukuba wena okanye umntu osondeleyo kuwe unesifo se-mitral valve, thetha nogqirha wakho wentliziyo malunga nolu khetho lonyango. Nguye oza kugqiba ukuba loluphi unyango olulungele wena.
- Emva konyango, ukulandela imiyalelo kagqirha wakho ngokufanelekileyo kubalulekile ukuze uphile ngokukhawuleza. Hlala uqaphela iimpawu ezilumkisayo.
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