Ingabe udokotela wakho ushilo ukuthi umthambo wegazi oyinhloko othwala igazi elinomoya-mpilo lisuka enhliziyweni yakho emzimbeni wakho uye waba buthakathaka futhi waba neqhubu elifana nebhaluni esisekelweni salo? Noma mhlawumbe basikisele ukuthi ungase udinge ukuhlinzwa ngenxa yalokhu? Kungokwemvelo ukuzizwa ukhathazekile uma uzwa lokhu, kodwa sicela wazi ukuthi lena inqubo ebalulekile eyenzelwe ukusindisa impilo yakho. Namuhla, sizoxoxa ngqo ngokuthi kuyini ukushintshwa kwe-Aortic Root, kwenziwa kanjani, nakho konke okudingeka ukwazi ngale nqubo eNirogi Lanka.
Kalula nje, kuyini ukushintshwa kwe-Aortic Root?
I-aorta iyisitho segazi esikhulu nesibaluleke kakhulu emzimbeni wakho, esixhunywe ngqo enhliziyweni yakho. Ingxenye yokuqala lapho i-aorta inamathela khona enhliziyweni yakho yaziwa ngokuthi "i-Aortic Root." Ngezinye izikhathi, udonga lwalesi sigaba luyabuthaka futhi luqale ukukhukhumala njengebhaluni. Yilokhu esikubiza ngokuthi "i-Aneurysm."
Ingozi eyinhloko yokuba ne-aneurysm ukuthi ingadabula (ihlukanise) noma iqhume (iqhume) nganoma yisiphi isikhathi. Uma lokhu kwenzeka, kungaholela ekuphumeni kwegazi okukhulu kwangaphakathi, okuyisimo esiphuthumayo esisongela ukuphila.
Ngesikhathi sokufakwa kwe-Aortic Root Replacement, udokotela wakho ohlinzayo ususa ingxenye ye-aorta ebuthaka, evuvukele bese eyishintsha nge-graft yokwenziwa. Le nqubo ivimbela ngempumelelo lezi zinkinga eziyingozi futhi isiza ekuvikeleni impilo yakho.
Yiziphi izinhlobo eziyinhloko zalokhu kuhlinzwa?
Kunezindlela ezimbili eziyinhloko zokwenza lokhu kuhlinzwa. Ngokusekelwe esimweni sakho sezokwelapha, udokotela wakho ohlinzayo uzonquma indlela efanele kakhulu yokululama kwakho.
| Uhlobo Lokuhlinzwa | Incazelo |
|---|---|
| Inqubo Yokufaka Izimpande Ze-Aortic (ARR) / Bentall | Kule nqubo, impande eyonakele ye-aorta yakho ishintshwa kanye ne-aortic valve kusetshenziswa i-synthetic graft kanye ne-valve entsha. Lena indinganiso yegolide uma i-aortic valve yakho ivuza noma i-calcified kakhulu. Uma kusetshenziswa i-mechanical valve, kuzodingeka uthathe umuthi wokubulala ama-coagulant impilo yakho yonke ukuvimbela ama-blood clots. |
| Ukufakwa Kwempande Engashiyi Amavalvu (VSRR) | Njengoba igama lisho, le nqubo ithatha indawo yengxenye ebuthaka yomthambo ngenkathi igcina i-aortic valve yakho enempilo. Lokhu kulungele iziguli ezisencane noma labo abanezinkinga zezicubu ezixhumene (njenge-Marfan syndrome) abanama-valve anempilo. Inzuzo enkulu ukuthi ngokuvamile awudingi ama-blood thinners okuhlala impilo yonke. Kunezindlela ezimbili eziyinhloko: inqubo kaYacoub kanye nenqubo kaDavid. |
Izinhlobo ezincane ze-VSRR
I-VSRR yenziwa kusetshenziswa enye yezindlela ezimbili eziyinhloko: izinqubo zikaYacoub noDavid.
- Inqubo kaYacoub: Lokhu kuhilela ukulungisa impande ye-aorta ukuze ivumelane nevalvu yokuqala. Ngokuvamile ifaneleka kahle iziguli ezindala noma labo abane-aneurysm engabangelwa yizimo zofuzo.
- Inqubo kaDavid: Lokhu kuhilela ukufaka kabusha ivalvu ngaphakathi kwe-graft yokwenziwa. Nakuba iyinkimbinkimbi kakhulu ngokobuchwepheshe, isetshenziswa kabanzi futhi inconywa kakhulu ezigulini ezincane ezinezimo zofuzo ezifana ne-Marfan syndrome.
Ubani Odinga Lokhu Kuhlinzwa Futhi Nini?
Uma impande ye-aorta yakho ikhulisiwe, ubhekene nengozi engaba khona yokuqhekeka noma ukuqhekeka, okwenza ukuhlinzwa kube yinto ebalulekile. Nakuba lokhu kungenzeka ngenxa yokuguga, izimo zofuzo ezifana ne-Marfan syndrome noma i-Loeys-Dietz syndrome zingabangela ukuthi la ma-aneurysms ayingozi akhule kusenesikhathi empilweni.
Izinqumo mayelana nokuhlinzwa zisekelwe kubukhulu be-aneurysm kanye nephrofayili yakho yengozi ethile:
- Uma ungenazo izingozi zofuzo eziyisisekelo, ngokuvamile kunconywa ukuhlinzwa lapho ububanzi bufinyelela ku -5.5 cm .
- Uma une-Marfan syndrome, umkhawulo uvame ukuba ngu-5.0 cm .
- Uma une-Marfan syndrome ehlangene nomlando womndeni wokusikwa kwe-aorta, izinhlelo zokukhulelwa, noma ukukhula okusheshayo (ngaphezu kuka-3mm ngonyaka), ukuhlinzwa kunganconywa ku -4.5 cm .
- Uma une-valve ye-aortic ye-bicuspid kanye nezinye izici eziyingozi njengomfutho wegazi ophakeme ongalawuleki, ukungenelela kuvame ukucatshangelwa ku -5.0 cm .
Okubaluleke kakhulu, lezi zinqumo zenziwe ngokwezifiso kakhulu. Udokotela wakho ohlinzayo waseNirogi Lanka uzonquma isikhathi esifanele senqubo yakho ngokusekelwe eminyakeni yakho, impilo yakho iyonke, kanye nomlando wezokwelapha.
Indlela Yokulungiselela Ukuhlinzwa Kwakho
Ngenxa yokuthi le inqubo enkulu, ukulungiselela okuphelele kubalulekile. Ithimba lakho lezokwelapha lizokwenza ukuhlolwa okuphelele:
- Ukuhlolwa kwegazi: Ukuhlola ukusebenza kwezinso zakho kanye nokusebenza kwesistimu yonke.
- I-CT noma i-Cardiac MRI: Ukuze uthole imephu eningiliziwe yayo yonke i-aorta yakho.
- I-Coronary angiography: Ukuqinisekisa ukuthi imithambo yegazi enikeza inhliziyo yakho iphilile.
- I-Duplex ultrasound: Ukuhlola impilo yemithambo yakho ye-carotid entanyeni.
Kumelwe ube nengxoxo eqotho nodokotela wakho mayelana nalokhu:
- Yonke imithi: Lokhu kufaka phakathi amavithamini, izithasiselo zemithi, kanye nemithi ethengwa ngaphandle kwemithi kadokotela, eminye yayo okungadingeka iyekwe ngaphambi kokuhlinzwa.
- Izimo zempilo ezikhona: Izimo ezifana nomfutho wegazi ophakeme kumele zilawulwe ngokucophelela ngaphambi kokuhlinzwa.
- Ukubhema: Kumelwe uyeke ukubhema okungenani inyanga eyodwa ngaphambi kokuhlinzwa. Sicela ubuze ithimba lakho laseNirogi Lanka uma udinga ukwesekwa ekuyekeni.
Ngesikhathi Nangemva Kwenqubo
Ngesikhathi sokuhlinzwa, uzobekwa ngaphansi kwe-anesthesia ejwayelekile. Uzoxhunywa emshinini we-cardiopulmonary bypass , othatha okwesikhashana umsebenzi wenhliziyo namaphaphu akho, okuvumela udokotela ohlinzayo ukuthi asebenze enhliziyweni eqinile nenganyakazi.
Udokotela ohlinzayo uzokwenza i-incision esifubeni sakho, asuse ingxenye ye-aorta ebuthaka, bese eyifaka esikhundleni sayo nge-graft yokwenziwa. Imithambo ye-coronary ibe isixhunywa kabusha ku-graft ngaphambi kokuba i-incision ivalwe. Inqubo ivame ukuthatha amahora amane kuya kwayisithupha .
Ngemva kokuhlinzwa, uzochitha isikhathi e-Intensive Care Unit (ICU) ngaphambi kokuthuthela ewadini yokululama evamile. Isikhathi esiphelele sokuhlala esibhedlela ngokuvamile siba yisonto elilodwa, lapho uzoqashwa ngokucophelela futhi unikezwe ukuphathwa kobuhlungu kanye nemithi edingekayo.
Siyini Isikhathi Sokululama?
Ukululama okuphelele ngemva kwale nqubo enkulu kuvame ukuthatha amasonto ayi-6 kuya kwayi-12 , futhi kwezinye izimo, izinyanga eziningana. Umzimba wakho udinga isikhathi esiningi kanye nesineke ukuze ululame kahle ngemva kokuhlinzwa okuyinkimbinkimbi kangaka.
- Emasontweni ayisithupha okuqala: Gwema ukushayela, ukuphakamisa izinto ezisindayo, noma ukwenza imisebenzi enzima.
- Ngemisebenzi yasehhovisi: Ungase ukwazi ukubuyela emsebenzini cishe emavikini ayi-6-8.
- Ngemisebenzi enzima ngokomzimba: Kuzodingeka ulinde isikhathi eside, njengoba ithimba lakho lezokunakekelwa kwempilo likweluleka.
Ukulandela imiyalelo kadokotela wakho ngokunembile nokuhlanganyela ezinhlelweni zokuvuselela inhliziyo kuzokusiza kakhulu ukuthi ululame ngokushesha nangokushelelayo.
Isikhathi Sokufuna Ukunakekelwa Kwezokwelapha Ngokushesha
Ngemva kokubuyela ekhaya, uma ubona noma yiziphi izimpawu ezilandelayo, xhumana nodokotela wakho ngokushesha.
| Izimpawu Okufanele Uziqaphele | |
|---|---|
| Ukukhathazeka Ngokusikwa Ngokuhlinzwa: | |
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| Ezinye Izinto Ezikhathazayo: | |
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Indlela Yokuqaphela Isimo Esiphuthumayo
Uma une-aneurysm engalashwanga, izimpawu ezilandelayo zingase zibonise ukuthi iyaqhuma noma iyadabuka. Esimweni esinjalo, funa usizo oluphuthumayo ngokushesha ngokuya emnyangweni wezimo eziphuthumayo oseduze noma ushayele u-911 (noma izinsizakalo zezimo eziphuthumayo zasendaweni).
- Ubuhlungu obungazelelwe, obungabekezeleleki esifubeni noma emhlane ongaphezulu (ngokuvamile obuchazwa njengokudabuka noma ukuklebhuka).
- Ukujuluka okukhulu kanye nesikhumba esibandayo nesinomswakama.
- Ubunzima bokuphefumula.
- Ukuzizwa unesizungu noma ukuphelelwa yithemba.
- Ukushaya kwenhliziyo okusheshayo noma okungajwayelekile.
Izinto Ezibalulekile Okufanele Uzithathe (eNirogi Lanka)
- Ukufakwa Kwezimpande Ze-Aortic inqubo yokuhlinzwa esindisa impilo eyenziwa engxenyeni yokuqala ye-aorta ebuthaka.
- Kunezinhlobo ezimbili eziyinhloko zalolu hlinzeko: olulodwa oluthatha indawo ye-aortic valve (ARR) kanye nolunye oluyigcinayo (VSRR). Udokotela wakho ohlinzayo uzonquma indlela engcono kakhulu kuwe.
- Nakuba ukululama okuphelele kuthatha izinyanga eziningana, amazinga empumelelo kanye nokusinda kwale nqubo aphezulu kakhulu (cishe ama-98%-99%).
- Ukunamathela ngokuqinile eziqondisweni zezokwelapha zangaphambi kokuhlinzwa kanye nezangemva kokuhlinzwa kubalulekile ukuze ululame kahle.
- Unganqikazi ukuxoxa nganoma yimiphi imibuzo noma ukwesaba nodokotela wakho. Nakuba le nqubo iyinto evamile kochwepheshe bezokwelapha, kuyinto ebalulekile kuwe, futhi kuyinto evamile ukuba nokukhathazeka.
Ukufakwa Kwempande Ye-Aortic, I-Aorta, Ukuhlinzwa Kwenhliziyo, I-Aneurysm, Inqubo ye-Bentall, i-Marfan syndrome, i-Aortic valve, Isifo Senhliziyo, Ukuhlinzwa Kwenhliziyo
