Ngaba unokucinga ngokutshintsha ivalvu yentliziyo ngaphandle kokuvula isifuba ngokupheleleyo? Ewe, ngoku yinyani. Namhlanje sithetha ngale teknoloji izise ithemba elitsha kubantu abaninzi abaneengxaki zevalvu yemiphunga ngenxa yesifo sentliziyo sokuzalwa. Masiqale oku ngencoko elula kakhulu neyobuhlobo.
Kalula nje, yintoni iTPVR?
I-TPVR, emele iTranscatheter Pulmonary Valve Replacement , lutyando oluthatha indawo yevalvu yepulmonary engasebenzi kakuhle entliziyweni yakho ngevalvu entsha ngokusebenzisa umsikelo omncinci kakhulu. Ngokwesiqhelo, xa sicinga ngotyando lwentliziyo, sicinga ngotyando olubandakanya ukwenza umsikelo omkhulu phakathi kwesifuba nokuvula isifuba. Nangona kunjalo, kule nkqubo, umsikelo omkhulu onjalo awukwenziwa.
Kunoko, oogqirha benza umngxuma omncinci eluswini lwe-groin yakho baze benze umsebenzi ngayo. Le valve ye-pulmonary, esebenza njengesango elithumela igazi elisuka entliziyweni yakho liye emiphungeni yakho, ibaluleke kakhulu. Abantu abazalwa benesifo sentliziyo sokuzalwa banokuba neengxaki ngale valve njengoko bekhula emva kotyando besebancinci. Ngoko ke, ukutshintsha loo valve ngale ndlela kunokuphucula kakhulu ubomi bakho kunye nomgangatho wobomi, kwaye kuphephe ukuphinda kwenziwe utyando olukhulu.
Kwenzeka ntoni ngokwenene kwinkqubo yeTPVR?
Kwindlela eqhelekileyo yotyando lwentliziyo evulekileyo, ithambo lesifuba liyasikwa, isigulana siqhagamshelwe kumatshini we-heart-lung bypass, ivalvu endala iyasuswa, kuze kufakwe entsha. Oku kuthatha ixesha elide, kuthatha ixesha elide ukuphiliswa, kwaye kwabanye abantu, olu tyando luyingozi.
Kodwa akunjalo nge-TPVR. Ingcali yentliziyo engenelelayo ifaka ityhubhu encinci (i-catheter) ngomthambo osesinqeni sakho ize ikhokele ivalvu entsha ngetyhubhu iye entliziyweni yakho. Konke oku kwenziwa phantsi kwesikhokelo sobuchwepheshe obufana nee-X-ray. Nje ukuba ikwindawo efanelekileyo, ivalvu entsha iyavuthelwa ngebhaluni ize ibekwe endaweni yayo.
Oku kufana nokufaka isakhelo esitsha socango kwisakhelo socango esidala ngaphandle kokusisusa.
Emva kokuba oku kwenziwe, ukuhamba kwegazi ukusuka entliziyweni ukuya emiphungeni kubuyiselwa ngokufanelekileyo. Umsebenzi entliziyweni uyancitshiswa, kwaye umzimba ufumana ioksijini engcono. Kwiimeko ezininzi, umntu oye wenza olu tyando unokubuyela ekhaya ngaloo mini inye .
Kuza kwenzeka ntoni ukuba ivalvu yam yemiphunga ayisebenzi kakuhle?
Kukho iingxaki ezimbini eziphambili ezibonakala kwivalvu yemiphunga. Makhe sizijonge ngokufutshane ezi.
| Imeko yezonyango | Kalula nje... |
|---|---|
| I-Pulmonary Stenosis | Ivalvu iba mxinwa kwaye ayivuli kakuhle, nto leyo ethintela ukuhamba kwegazi ukusuka entliziyweni ukuya emiphungeni. Oku kubeka uxinzelelo olukhulu kwicala lasekunene lentliziyo. Ekuhambeni kwexesha, i-atrium yasekunene yentliziyo inokungasebenzi. |
| Ukubuyela kwegazi kwi-pulmonary regurgitation (ukuvuza kwegazi kwi-pulmonary valve) | Ngenxa yokuba ivalvu ayivali kakuhle, inxalenye yegazi elimpontshelwa emiphungeni iphinda ivuzele entliziyweni. Oku kunciphisa nomthamo wegazi eliya entliziyweni, nto leyo enyusa uxinzelelo kwicala lasekunene lentliziyo kwaye inokukhokelela ekusileleni kwentliziyo. |
Kuzo zombini ezi meko, unokufumana iimpawu ezifana nezi:
- Ubunzima bokuphefumla (ukuphelelwa ngamandla)
- Ukudumba kwesisu nemilenze (i-edema)
- Iintlungu zesifuba
- Ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza (ukubetha kwentliziyo)
Ezi mpawu zibangelwa kukungasebenzi kakuhle kwentliziyo okanye ukubetha kwentliziyo okungacwangciswanga (arrhythmias). Ezi mpawu zihlala ziphucuka emva kotyando lwe-TPVR.
Ngubani olona tyando lweTPVR lufanelekileyo kuye?
Ukuba uzelwe unemeko echaphazela ivalvu yemiphunga yentliziyo yakho, ungazuza kolu tyando. Ngokukodwa,
- Abantu abaye benza utyando lwevalvu yemiphunga besebancinci.
- Abantu abadala kunye nabantu abancinci ababenayo loo valve bayavaleka okanye bavuza ngokuhamba kwexesha.
- Amaxesha amaninzi, oogqirha bacinga ngenkqubo ye-TPVR kubantu abafumene i-homograft (ukufakelwa kwevalvu) komnye umntu besebancinci, xa loo valve iba buthathaka ngokuhamba kwexesha.
Ezinye zeemeko eziphambili ezinyangwa ngolu tyando zezi:
- I-Pulmonary Atresia: Imeko apho ivalvu yemiphunga ingakheki xa izalwa.
- I-Regurgitant Pulmonary Valve: Imeko apho igazi livuza ngasemva nge-valve.
- I-Tetralogy of Fallot: Imeko apho igazi elilungileyo nelibi lixubana khona ngenxa yokudibanisa iziphene ezine zentliziyo.
- I-Truncus Arteriosus: Imeko apho imithambo yegazi emibini ephambili ephuma entliziyweni idibana khona.
- Ukutshintshwa kweMithambo Emikhulu: Imeko apho imithambo yegazi emibini ephambili yentliziyo itshintsha kwaye idibene.
Utyando lwe-TPVR luvelise iziphumo eziphumeleleyo kakhulu njengonyango lwezi meko.
Kwenzeka ntoni ngaphambi, ngexesha nasemva kotyando?
Ukulungiselela ngaphambi kotyando
Ukuze agqibe kwelokuba olu tyando lukulungele na, ugqirha wakho uza kuqala akuhlole ngononophelo. Unokwenza uvavanyo oluninzi, olufana nolu:
- I-Angiogram
- Iskeni ye-CT yentliziyo
- I-MRI yentliziyo
- I-Echocardiogram
- I-Electrocardiogram (ECG)
Ngokusekelwe kwiziphumo zezi mvavanyo, ugqirha wakho uya kucebisa utyando lwe-TPVR okanye agqibe ekubeni ajonge imeko yakho okwethutyana. Uya kukunika iingcebiso malunga nokutya omawukutye kunye namayeza omawuyeke ukuwasebenzisa (ingakumbi amayeza okunciphisa igazi) ngaphambi kotyando. Ungalibali ukuxelela ugqirha wakho malunga nazo naziphi na izinto ezibangela ukuba ube ne-allergies.
Ngexesha lotyando
Ngaphambi kokuba utyando luqale, uza kunikwa i-anesthesia ukuze ungeva ntlungu. Kulapho ke kuphela apho ingcali iza kuqala khona ukusebenza.
1. Okokuqala, kwenziwa umngxuma omncinci kwi-groin yakho (i-femoral vein) okanye mhlawumbi entanyeni yakho (i-jugular vein) kwaye kufakwa ityhubhu (i-catheter) ngayo.
2. Emva koko, kusetyenziswa ubuchwepheshe obufana ne-X-reyi, ivalvu entsha ikhokelwa ngetyhubhu ize ihambe ngocingo iye kwindawo efanelekileyo entliziyweni. Le valve igotywa phezu kwebhaluni.
3. Xa ifika kwindawo eyiyo, ibhaluni iyavuthelwa. Ivalvu entsha iyakhula ize ingene kakuhle ngaphakathi kwivalvu endala. Ukususela ngaloo mzuzu, ivalvu entsha iqala ukusebenza.
4. Okokugqibela, jonga ukuba ivalvu isebenza kakuhle kwaye ususe zonke iityhubhu ezifakiweyo.
Le nkqubo yonke idla ngokuthatha malunga neeyure ezimbini okanye ezintathu .
Emva kotyando
Emva kotyando, uza kugcinwa esibhedlele ubusuku bonke ukuze ujongwe. Ukuba yonke into ihamba kakuhle, uza kukwazi ukuya ekhaya kusasa . Ugqirha wakho uza kukunika imiyalelo ekufuneka uyilandele xa ubuyela ekhaya. Kwiimeko ezininzi , uza kukwazi ukuqhubeka nemisebenzi yakho yesiqhelo kwiintsuku ezisixhenxe .
Ziziphi iingenelo kunye neengozi zendlela ye-TPVR?
Njengakwezinye iinkqubo zonyango, kukho iingenelo kunye neengozi ezincinci. Masiqaphele zombini ezi zinto.
| Iingenelo | Iingozi/Iingxaki |
|---|---|
| Ixesha lokuchacha lifutshane. | Intlungu, ukudumba, okanye ukudumba apho ityhubhu ifakwe khona. |
| Umngcipheko wokosuleleka uphantsi. | Ihlwili legazi. |
| Ixesha lokuhlala esibhedlele lifutshane. | Ukonakala kwemithambo yegazi. |
| Akukho zinxeba zikhulu, kukho amanxeba amancinci kuphela. | Iintsholongwane (ingakumbi izifo zengaphakathi lentliziyo - i-Endocarditis). |
| Kukho umngcipheko omncinci kunotyando lwentliziyo oluvulekileyo. | Ukuphazamiseka kwentliziyo (i-Arrhythmia). |
Amaxesha amaninzi, iingxaki ezinzima ezifana nokuhlaselwa yintliziyo, isifo sohlangothi, okanye ukufa zinokwenzeka. Kodwa ezi azixhaphakanga. Ugqirha wakho uza kuthetha nawe ngazo zonke ezi zinto ngokweenkcukacha.
Eminye imibuzo onokuba nayo
Iza kuhlala ixesha elingakanani le valve intsha?
Kuxhomekeke kwizinto ezininzi, njengempilo yakho iyonke kunye nokusebenza kwentliziyo yakho. Abanye abantu banokufuna utyando olunjalo kwakhona emva kwexesha elithile.
Ngaba kukho into ethile ekufuneka ndenze ngaphambi kokuba ndinyangwe ngamazinyo?
Ewe, oku kubaluleke kakhulu. Ngexesha lonyango lwamazinyo, iintsholongwane ezisuka emlonyeni wakho zingangena egazini zize zibangele usulelo lwevalvu entsha yentliziyo (endocarditis). Ke ngoko, xa usiya kugqirha wamazinyo, kufuneka umxelele kwangaphambili ukuba ukhe wafakelwa ivalvu yentliziyo endaweni yayo. Kusenokufuneka uthathe amayeza okubulala iintsholongwane ngaphambi kokuba kukhutshwe izinyo.
Ndingangena na ekuhlolweni kokhuseleko kwisikhululo seenqwelo-moya?
Ewe, akukho ngxaki. Ii-X-reyi kunye neeskena zokhuseleko lwesikhululo seenqwelo-moya aziyi kuyonakalisa ivalvu yakho. Nangona kunjalo, ngokuqinisekileyo kufuneka uthethe nogqirha wakho ngaphambi kokuba wenze i-MRI scan.
Umyalezo Wokuya Ekhaya
- I-TPVR yindlela yotyando yanamhlanje ethatha indawo yevalvu yemiphunga yentliziyo ngomngxuma omncinci entlango, ngaphandle kokuvula isifuba.
- Oku kulungele ngakumbi abantu abaneengxaki zevalvu yamaphaphu ngenxa yesifo sentliziyo sokuzalwa.
- Inexesha elifutshane lokuchacha, iingozi ezimbalwa, kunye nokuhlala esibhedlele ixesha elifutshane kunotyando lwentliziyo oluvulekileyo.
- Ungabuyela kubomi obuqhelekileyo kwiintsuku ezimbalwa emva kolu tyando.
- Ukuba unesifo esifanayo, thetha nogqirha wakho wentliziyo ngale ndlela yonyango ukuze ubone ukuba ikulungele na.
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