Ingabe ngezinye izikhathi uzizwa usinda esifubeni sakho noma uphefumula kanzima uma ukhathele kancane? Noma ingabe udokotela wakho ukutshelile ukuthi unenkinga nge-valve enhliziyweni yakho nokuthi udinga ukuyishintsha ngokuhlinzwa? Kuvamile ukuzizwa wesaba futhi ukhathazekile kancane uma uzwa into efana nale. Kodwa ungakhathazeki. Namuhla sikhuluma ngalokhu kuhlinzwa, okubizwa ngokuthi 'i-Surgical Aortic Valve Replacement' (SAVR). Ake sixoxe ngalokhu kalula nangendlela ongayiqonda.
Kusho ukuthini ngempela ukushintshwa kwe-aortic valve?
Cabanga ngenhliziyo yethu njengephampu yamanzi. Umthambo wegazi oyinhloko opompa igazi lisuka kule nhliziyo liye emzimbeni wonke ubizwa ngokuthi 'i-Aorta'. Ngakho-ke, 'isango' eliphakathi kwenhliziyo nalo mthambo wegazi oyinhloko libizwa ngokuthi i-Aortic valve . Njalo lapho inhliziyo ishaya, leli sango liyavuleka bese igazi liphuma, bese livaleka futhi.
Ngezinye izikhathi, ngenxa yokuguga noma ngenxa yezinye izimo zezokwelapha, lo mnyango uyeka ukusebenza kahle.
- Umnyango awuvuli kahle: Lokhu kubizwa ngokuthi i-Aortic Stenosis . Kufana nomnyango ongavuli yonke indlela, ngakho-ke awekho indawo eyanele yokuthi igazi liphume enhliziyweni.
- Umnyango awuvaleki kahle: Lokhu kubizwa ngokuthi i-Aortic Regurgitation . Njengomnyango omdala, uma ungavaleki kahle, elinye igazi eliphumile livuza liphindela emuva.
Kuzo zombili izimo, inhliziyo kufanele isebenze kanzima kunokujwayelekile. Kufana nokuzama ukuvula umnyango obhajwe. Ngokuhamba kwesikhathi, lokhu kusebenza ngokweqile kungalimaza inhliziyo. Kungabangela nezimpawu ezifana nobuhlungu besifuba nobunzima bokuphefumula. Uma kungelashwa, lesi simo singasongela impilo.
Ngakho-ke, lokhu sikubiza ngokuthi ukuhlinzwa, i-SAVR, lapho sisusa khona leli valve elonakele bese silifaka elisha. Lokhu kunciphisa izimpawu zakho, kuvikela inhliziyo yakho, futhi kukunikeza ithuba lokuphila impilo enempilo isikhathi eside.
Kwenzekani ngaphambi kokuhlinzwa?
Ngenxa yokuthi lokhu kuwukuhlinzwa okukhulu, uzohlolwa ngokucophelela ngaphambi kokuba kuqale. Lokhu kuhlolwa kuzosisiza sikhethe ukwelashwa okufanele impilo yakho.
Ukuhlolwa okuvamile ngaphambi kokuhlinzwa
Ngokuvamile kuzodingeka wenze izivivinyo eziningana ezinjengalezi.
| Igama Lokuhlolwa | Mane nje wenze lokhu... |
|---|---|
| I-Echocardiogram (i-Echo) | Ukuskena ukuhlola ukusebenza kwenhliziyo nama-valve ayo. |
| I-Electrocardiogram (ECG/EKG) | Ukuhlola ukusebenza kukagesi kwenhliziyo. |
| I-X-ray yesifuba | I-X-ray yesifuba ukuhlola isimo senhliziyo namaphaphu. |
| Ukufakwa kwe-Catheterization Yenhliziyo | Ithubhu elincane lidlula emthanjeni wegazi liye enhliziyweni ukuhlola ingcindezi engaphakathi kwenhliziyo kanye nemithambo yegazi. |
| Ukuhlolwa kwegazi nomchamo | Ukuhlola impilo yomzimba iyonke, njengokusebenza kwezinso. |
Ngaphezu kwalokho, ithimba lezokwelapha lizokweluleka ngokuthi ungalungiselela kanjani ukuhlinzwa.
- Kudingeka uzile ukudla isikhathi esingakanani (ngaphandle kokudla noma ukuphuza) ngaphambi kokuhlinzwa?
- Kungakhathaliseki ukuthi udinga ukuyeka okwesikhashana ukuthatha noma yimiphi imithi oyithathayo njengamanje.
- Sekuyisikhathi sokufika esibhedlela.
- Izinto okufanele zilethwe esibhedlela nezinto okungafanele zilethwe.
Okubaluleke kakhulu: Ungesabi ukubuza udokotela wakho nganoma yini ongayiqondi noma yimiphi imibuzo onayo. Uma ubhema, ukuyeka ukubhema ngokushesha ngangokunokwenzeka ngaphambi kokuhlinzwa kunganciphisa kakhulu ingozi yezinkinga.
Ake sikhethe isitayela sezinwele esisha esikufanele.
Isinqumo esibaluleke kakhulu ozosenza ngaphambi kokuhlinzwa ukuthi hlobo luni lwevalvu entsha ozoyithola. Kunezinhlobo ezimbili eziyinhloko.
| Uhlobo lwe-Valve | Incazelo kanye nezinzuzo/ububi |
|---|---|
| I-valve Yebhayoloji / Ye-Bioprosthetic | Lezi zenziwe ngezicubu zengulube, zenkomo, noma (ezingavamile) zabantu. Inzuzo: Akudingeki ukuthi uphuze imithi yokunciphisa ukugabha kwegazi impilo yakho yonke. Ububi: Lezi azihlali njalo. Ngokuvamile zidinga ukushintshwa ngemva kweminyaka eyi-10-20. |
| Ivalvu Yomshini | Lezi zenziwe ngezinto eziqinile njengekhabhoni nensimbi. Inzuzo: Lezi zihlala impilo yonke. Awudingi ukuzishintsha futhi. Ububi: Kuzodingeka uthathe umuthi wokunciphisa igazi njenge-Warfarin impilo yakho yonke ukuze uvimbele ingozi yokuqhekeka kwegazi. |
Udokotela wakho ohlinzayo uzoxoxa nawe ngokuthi iyiphi i-valve engcono kakhulu kuwe ngokusekelwe eminyakeni yakho, impilo yakho, nendlela ophila ngayo. Ngokuvamile, ama-valve omshini anconywa abantu abangaphansi kweminyaka engu-50, kanti ama-valve ebhayoloji anconywa abantu abangaphezu kweminyaka engu-65.
Indlela ukuhlinzwa okwenziwa ngayo isinyathelo ngesinyathelo
Lokhu kuhlinzwa kuvame ukuthatha amahora amabili kuya kwamane, lapho ulele khona ubuthongo obujulile futhi ungezwa lutho.
1. Okokuqala, uzobe ungazi lutho nhlobo (`I-Anesthesia`) .
2. Okulandelayo, uzoxhunywa emshinini wenhliziyo namaphaphu . Lo mshini uzothatha umsebenzi wenhliziyo namaphaphu okwesikhashana ngesikhathi sokuhlinzwa. Uzophinde usetshenziswe ukumisa inhliziyo yakho okwesikhashana (i-cardioplegia). Lokhu kuzovumela udokotela ohlinzayo ukuthi enze ukuhlinzwa ngokuphephile ngaphandle kokushaya kwenhliziyo yakho.
3. Udokotela ohlinzayo wenza i-incision engaba amasentimitha angu-1.5 ubude phakathi kwesifuba sakho ukuze avule ithambo lesifuba (`Sternum`) futhi afinyelele enhliziyweni. Lokhu kubizwa ngokuthi 'Sternotomy'.
4. Ivalvu endala ye-aortic eyonakele iyasuswa bese ithathelwa indawo yivalvu entsha ethungelwa endaweni yayo.
5. Ngemuva kwalokho, i-sternum evuliwe ixhunywa kabusha kusetshenziswa izintambo. Lezi zintambo zivame ukushiywa emzimbeni impilo yonke.
6. Ekugcineni, ukunqunywa kwesikhumba kuthungwa kuvaliwe.
Isikhathi sokululama ngemva kokuhlinzwa
Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela cishe izinsuku ezi-5. Phakathi nalesi sikhathi, ithimba lezokwelapha lizohlala liqapha isimo sakho. Bazokusiza ukuthi uhambe kancane kancane futhi wenze imisebenzi evamile.
Ngokuvamile kuthatha amasonto amane kuya kwayisishiyagalombili ukululama ngokuphelele.Kuthatha isikhathi esingafika onyakeni. Kuvamile ukuzizwa ukhathele phakathi nalesi sikhathi. Lokhu kungenxa yokuthi umzimba wakho uyalulama. Ngemva kokubuyela ekhaya, udokotela wakho angase akuncome ukuthi uye ohlelweni lokwelapha inhliziyo. Lokhu kuzokusiza ufunde izinto eziningi, njengokujwayela ukuzivocavoca nokudla ukudla okunempilo kwenhliziyo.
Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?
Inzuzo enkulu yalokhu kuhlinzwa ukuthi kungasindisa izimpilo . Isifo se-aortic valve singabulala uma singelashwa. Izinga lempumelelo liphezulu kakhulu. Kwabaningi, ingozi yokufa noma izinkinga ezinkulu ezifana nesifo sohlangothi iphansi kakhulu, cishe i-1% - 2%.
Kodwa njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile.
- Ukuphazamiseka kwenhliziyo (`Arrhythmia`)
- Isidingo se-pacemaker ehlala njalo
- Ukopha
- Izifo
- Isifo sohlangothi
- Ukufa
Le ngozi ayifani kuwo wonke umuntu. Iyahlukahluka kuye ngezinto ezifana neminyaka yakho kanye nezinye izimo zezokwelapha. Udokotela wakho ohlinzayo uzochaza izinga lakho lobungozi kuwe.
| Uma lezi zimpawu zivela ngesikhathi sokululama kwakho, shayela udokotela wakho ngokushesha! |
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Ingabe ikhona enye indlela yokuhlinzwa esikhundleni se-SAVR?
Yebo, kwabanye iziguli, ikakhulukazi labo asebekhulile noma abasengozini enkulu yokuhlinzwa okukhulu ngenxa yezinye izimo, inqubo ebizwa ngokuthi i-Transcatheter Aortic Valve Replacement (TAVR) ingase ifaneleke kakhulu. Lokhu kuhilela ukufaka ivalvu entsha kuvalvu endala ngomsikelo omncane esifubeni, ngaphandle kokuyivula. Lena inqubo elula futhi idinga isikhathi esincane sokululama. Ithimba lakho lezokwelapha lizonquma ukuthi i-SAVR noma i-TAVR ikulungele yini.
Umlayezo Wokuya Nawe Ekhaya
- Ukufakelwa Kwevalvu Ye-Aortic Yokuhlinzwa (i-SAVR) kuyindlela yokuhlinzwa ephumelela kakhulu futhi evame ukwenziwa yevalvu ye-aortic eyonakele.
- Udokotela wakho uzokusiza ukuthi ukhethe i-valve yezinto eziphilayo noma yemishini ngokusekelwe eminyakeni yakho kanye nesimo sakho sempilo.
- Kuthatha cishe amasonto angu-4-8 ukululama ngokuphelele, futhi kubaluleke kakhulu ukulandela iseluleko sezokwelapha phakathi nalesi sikhathi.
- Uma ubona noma yiziphi izimpawu eziyisixwayiso ngesikhathi sokululama kwakho, njengomkhuhlane, ubuhlungu besifuba, noma izinguquko enxebeni lakho lokuhlinzwa, yazisa udokotela wakho ngokushesha.
- Khuluma nodokotela wakho ngokukhululekile nganoma yimiphi imibuzo noma ukwesaba onakho ngalokhu.
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