Kuvamile ukuzizwa wesaba kancane lapho udokotela wakho ekutshela ukuthi unenkinga nge-valve yenhliziyo. Ikakhulukazi uma ethi udinga ukuhlinzwa ngenxa yayo. Kodwa inqubo kaRoss esizokhuluma ngayo namuhla inqubo yokuhlinzwa ephumelela kakhulu enganikeza impilo entsha kubantu abanezifo ze-valve yenhliziyo, ikakhulukazi intsha. Ngakho-ke ake sixoxe ngalokhu ngqo, kalula.
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Kalula nje, iyini inqubo kaRoss?
Lokhu ukuhlinzwa kwenhliziyo okuyinkimbinkimbi, kodwa okunekhono kakhulu. Kuhilela ukusebenzisa izingxenye zomzimba wakho ukulungisa ivalvu yenhliziyo enesifo. Ukuze kube sobala, kuhilela izinyathelo ezimbili:
1. Ivalvu ye-aorta enesifo senhliziyo yakho iyasuswa bese ithathelwa indawo yivalvu yakho yamaphaphu enempilo.
2. Ngemuva kwalokho, ivalvu yamaphaphu evela kumnikeli ophilile iyatshalwa endaweni lapho kwakukhona khona ivalvu yamaphaphu esusiwe.
Cabanga ngakho njengokusebenzisa ingxenye yomzimba wakho ukulungisa iphutha elikhulu. Lokhu kunezinzuzo eziningi kunokufaka ivalvu yokwenziwa.
Kungani sidinga lokhu kuhlinzwa?
I-aortic valve ifana nesango elibaluleke kakhulu enhliziyweni yethu. Leli sango liyavuleka futhi livumela igazi elihlanzekile, elicebile ngo-oxygen ukuthi ligeleze lisuka enhliziyweni liye emzimbeni wonke. Liphinde livimbele igazi ukuthi libuyele enhliziyweni phakathi kokushaya kwenhliziyo, njengoba leli valve livala.
Kodwa ngezinye izikhathi leli valve lingaba nesifo. Kunezindlela ezimbili eziyinhloko:
- I-Stenosis: Lokhu kwenzeka lapho ivalvu ingavuli kahle bese incipha. Lokhu kuvimbela umzimba ekutholeni igazi elanele.
- Ukubuyela kwesisu: Lokhu kwenzeka lapho ivalvu ingavali kahle futhi ivuza, okuvumela igazi ukuthi libuyele enhliziyweni.
Zombili lezi zinkinga zingabangela izimpawu ezifana nokukhathala kanye nokuphelelwa umoya. Uma zingelashwa, zingandisa ingozi yakho yokwehluleka kwenhliziyo kanye nokutheleleka okukhulu. Inqubo kaRoss isusa ivalvu enesifo futhi ibuyisele ukusebenza kwenhliziyo okuvamile.
Kungani ukhethe i-Pulmonary Valve esikhundleni se-Aortic Valve?
Ungase uzibuze ukuthi kungani kwenziwa ushintsho olunjalo, kungani ungatholi enye ivalvu yokwenziwa? Kunezizathu eziningana eziqondile zalokhu.
- Ukumelana Nokucindezeleka: Ivalvu ye-aorta ingaphansi kwengcindezi enkulu, ngakho-ke ivalvu entsha efakwe kuyo idinga ukuqina kakhulu futhi iqine. Ivalvu yakho yamaphaphu ilungele lokhu.
- Izingozi zama-valve okwenziwa: Kukhona ingozi yokuqhekeka kwegazi uma kufakwa ama-valve okwenziwa. Ngakho-ke, kufanele uthathe imithi yokunciphisa igazi impilo yakho yonke. Kodwa uma usebenzisa izicubu zakho, leyo ngozi cishe ayikho.
- Ukufakwa: Ivalvu yamaphaphu ifana kakhulu ngobukhulu kanye nesimo sevalvu ye-aorta.
- Indawo enengcindezi ephansi: I-valve yomnikelo ibekwa lapho i-valve yamaphaphu yayikhona. Leyo ndawo ingaphansi kwengcindezi ephansi. Ngakho-ke noma ngabe leyo valve ibuthakathaka kancane, ngeke ibe nomthelela omkhulu.
Ubani ofanele futhi ongafaneleki kulolu hlinzwa?
Inqubo kaRoss ayiyona eyokuhlinzwa kwawo wonke umuntu. Odokotela bakhetha iziguli zayo ngokusekelwe ezicini eziningana.
| Labo ngokuvamile abafanelekela ukuhlinzwa | Abantu ngokuvamile abangafaneleki ukuhlinzwa |
|---|---|
| Abantu abangaphansi kweminyaka engama-60 ubudala. | Abantu abanezifo ezihlasela amasosha omzimba njenge-lupus kanye ne-rheumatoid arthritis. |
| Abantu abazalwa bene-aortic stenosis. | Abantu abanezinkinga zezicubu ezixhumeneyo njenge -Marfan syndrome . |
| Abantu abanezinye izifo ze-aortic valve. | Abantu abanesifo semithambo yegazi yenhliziyo, okuwukuvimbeka kwemithambo yegazi engaphezu kwemithathu enhliziyweni. |
| Abantu abanesifo se-aortic valve (i-aortic valve endocarditis). | Abantu abanesifo se-pulmonary valve. |
Into ebaluleke kakhulu ukuthi udokotela wakho wenhliziyo athathe isinqumo sokugcina sokuthi lokhu kuhlinzwa kulungile yini kuwe noma cha.
Indlela ukuhlinzwa okwenziwa ngayo isinyathelo ngesinyathelo
Lokhu ukuhlinzwa okuhleliwe kahle okuthatha amahora amaningana.
1. Ukubulala izinzwa:Okokuqala, uzofakwa ngaphansi kwe-anesthesia ejwayelekile. Ngakho ngeke uzizwe lutho futhi ngeke ube nenkumbulo yokuhlinzwa.
2. Umshini wenhliziyo namaphaphu: Okulandelayo, uzoxhunywa emshinini we-cardiopulmonary bypass . Lo mshini uthatha okwesikhashana umsebenzi wenhliziyo namaphaphu akho ngesikhathi sokuhlinzwa. Lokhu kuvumela odokotela abahlinzayo ukuthi benze ukuhlinzwa ngokuphephile ngaphandle kokuvimba inhliziyo yakho.
3. Ukuvula isifuba: Odokotela abahlinzayo benza ukusika phakathi kwesifuba, besika ithambo lesifuba kuzo zombili izinhlangothi (i-sternotomy) ukuze bafinyelele inhliziyo.
4. Ukuhlolwa kwevalvu: Ivalvu yamaphaphu ihlolwa ngokucophelela ukuze kubonakale ukuthi iphilile ngokwanele yini ukufaka esikhundleni sevalvu ye-aorta.
5. Ukufakwa esikhundleni sevalvu: Okulandelayo, ivalvu ye-aorta eyonakele iyasuswa bese ivalvu yakho yamaphaphu itshalwa ngokucophelela endaweni yayo.
6. Ukufakelwa kwevalvu yomnikeli: Okulandelayo, ivalvu ethathwe kumnikeli ophilile ifakwa endaweni engenalutho lapho kwakukhona khona ivalvu yamaphaphu.
7. Ukuvuselelwa kwenhliziyo: Ngemva kokuba womabili ama-valve efakwe ezindaweni ezifanele, inhliziyo yakho iyaqalwa kabusha bese ukhishwa kancane kancane emshinini wenhliziyo namaphaphu. Womabili ama-valve amasha ayahlolwa ukuqinisekisa ukuthi asebenza kahle.
8. Ukuqedwa kokuhlinzwa: Ekugcineni, i-sternum ihlanganiswa kabusha futhi iboshwe ngezintambo, i-incision iyathungwa, futhi imbozwe ngebhandeji elihlanzekile.
Izinzuzo kanye nezingozi ezingaba khona zalokhu kuhlinzwa
Njenganoma yikuphi ukuhlinzwa, i-Ross Procedure inezinzuzo kanye nezingozi. Izingozi zingancishiswa ngokuthola ukwelashwa ngaphansi kokuqondiswa udokotela ohlinzayo onolwazi owenza lezi zinqubo njalo.
| Izinzuzo Eziyinhloko | Izingozi ezingaba khona |
|---|---|
| Ungaphila impilo ematasa, okuhlanganisa ukuzivocavoca nokushayela. | Ukwandiswa komthambo wegazi eduze kwevalvu entsha (ukwanda kwe-Aortic autograft). |
| Uma abesifazane befuna ukukhulelwa, bangakwenza lokho ngokuphephile. | Ukuphazamiseka kwenhliziyo (i-Arrhythmia) . |
| Ukujikeleza kwegazi okuhle kakhulu (i-hemodynamics) kufinyelelwa kuwo wonke umzimba. | Isifo senhliziyo . |
| Akudingeki ukuthi uthathe imithi yokunciphisa igazi impilo yakho yonke. | Ukopha kakhulu (Ukopha igazi) . |
| Izimpawu ziphela ngokushesha. Isiguli sizizwa singcono ngemva nje kokuhlinzwa. | Ukutheleleka . |
| Ivalvu evuzayo noma ebambekile. |
Isikhathi sokululama ngemva kokuhlinzwa kanye nesikhathi sokubonana nodokotela
Ngemva kokuhlinzwa, uzophinde uqaphe e-Cardiac ICU . Ekuqaleni, ungase uxhunywe kumshini wokuphefumula ukuze ukusize uphefumule. Uzohlala e-ICU cishe izinsuku ezinhlanu.
Kungathatha izinyanga eziningana ukululama ngokuphelele ngemva kokubuyela ekhaya. Phakathi nalesi sikhathi, ukuqunjelwa, ukulahlekelwa yisifiso sokudla, ukuqwasha, ukuba ndikindiki nokuvuvukala okuzungeze inxeba kuyinto evamile.
Okubalulekile: Ivalvu yamaphaphu etholwe kumnikeli ayihlali isikhathi eside. Ngokuvamile idinga ukushintshwa ngemva kweminyaka eyi-15-20. Ngakho-ke, ukuhlolwa kwezokwelapha kanye nokuqapha impilo yonke kubaluleke kakhulu.
Uma uhlangabezana nanoma yiziphi izimpawu zezinkinga ngemuva kokuhlinzwa, kufanele wazise udokotela wakho ngokushesha . Qaphela kakhulu lezi zimpawu ezilandelayo:
- Ubuhlungu besifuba
- Umkhuhlane noma ukubanda
- Isiyezi noma ukuquleka
- Ukukhwehlela igazi
- Ukuphuka noma ukuphuma kwegazi okungavamile
- Ukuba ndikindiki ezithweni zomzimba
- Ukuhlanza
- Igazi esitulweni (elibomvu ngokugqamile)
Umlayezo Wokuya Nawe Ekhaya
- Inqubo kaRoss iyindlela engcono kakhulu yokwelapha abantu abanesifo esibi se-aortic valve, ikakhulukazi intsha.
- Lokhu kuhilela ukuthatha ivalvu yakho yamaphaphu enempilo bese uyitshala ukuze ithathe indawo yevalvu ye-aortic enesifo.
- Ngenxa yokuthi usebenzisa izicubu zakho, ngeke kudingeke ukuthi uphuze imithi yokunciphisa igazi impilo yakho yonke. Ungaphila impilo esebenzayo.
- Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile, kodwa lezi zingozi zingancishiswa ngokuthola ukwelashwa ngaphansi kokuqondisa kukadokotela ohlinzayo onolwazi.
- Uma uhlangabezana nanoma yiziphi izimpawu ezingavamile ngemva kokuhlinzwa, xhumana nodokotela wakho ngokushesha.
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