Ingabe ubuye uzwe ukuphelelwa umoya uma ukhathele kancane, umuzwa wokuphelelwa amandla lapho ukhuphuka izitebhisi, noma umuzwa wokusinda esifubeni sakho? Ngezinye izikhathi imbangela yalezi zimpawu ingaba inkinga ngesikhala esincane enhliziyweni yethu, ivalvu. Ngakho-ke namuhla sizokhuluma ngevalvu ye-mitral enhliziyweni kanye nokuhlinzwa kokulungisa okungadingeka ngenxa yezinkinga ngayo.
Kuyini ukulungiswa kwe-valve ye-mitral?
Kalula nje, ukulungiswa kwe-mitral valve kuyindlela yokuhlinzwa kwenhliziyo evulekile elungisa izinkinga ze-mitral valve enhliziyweni yakho.
Cabanga ngenhliziyo yethu njengendlu enamakamelo amane. I-valve ye-mitral iyisango eliphakathi kwegumbi eliphezulu ngakwesobunxele (i-atrium yangakwesobunxele) kanye negumbi elingezansi ngakwesobunxele (i-ventricle yangakwesobunxele). Igazi elihlanzekile nelicebile emoyeni elivela emaphashini ethu liqala lingene ku-atrium yangakwesobunxele. Bese, lelo gazi lingena ngesango elibizwa ngokuthi i-mitral valve bese liya ku-ventricle yangakwesobunxele. Ukusuka lapho, igazi liphampunwa liye emzimbeni wonke.
Ngakho-ke uma le valve, i-valve ye-mitral, ingasebenzi kahle, uma iba nesifo, kwenza kube nzima ngenhliziyo ukusebenza kahle. Ngokuhamba kwesikhathi, lokhu kungabangela umonakalo enhliziyweni nasemaphashini. Lokhu kuhlinzwa kwenzelwe ukuvimbela noma ukulibazisa lowo monakalo.
Uma unesifo esibi kakhulu se-mitral valve, udokotela wakho cishe uzoncoma ukuhlinzwa ukuze kulungiswe noma kushintshwe i-valve. Kodwa ezimweni eziningi, ikakhulukazi uma i-valve ivuza igazi, odokotela bazozama ukulungisa i-valve esikhundleni sokuyishintsha. Lokho kungenxa yokuthi kunezinzuzo eziningi kanye nezingozi ezimbalwa zokulondoloza ingxenye yomzimba wakho.
Yiziphi izimo ezelaphayo lokhu kuhlinzwa?
Lokhu kuhlinzwa kusetshenziselwa kakhulu ukwelapha izimo ezilandelayo:
| Isimo sezokwelapha | Kuchazwe kalula |
|---|---|
| Ukuvuselelwa kwe-valve ye-mitral | Ama-flap amabili e-valve awavali kahle, okuvumela igazi elithile ukuthi livuze ngendlela engafanele, okungukuthi, emuva. Uma lokhu kuvuza kukhulu noma kubangela izimpawu, kungase kudingeke ukuhlinzwa. |
| I-stenosis ye-valve ye-mitral | Ukuvulwa kwevalvu kuyancishiswa, okuvimbela igazi elanele ukuthi lingaphumi kuyo. Uma izimpawu zinkulu noma ivalvu incishisiwe kakhulu, kungase kudingeke ukuhlinzwa. |
| Ukwehla kwe-valve ye-mitral | Amapheshana amabili e-valve aba buthaka futhi akhululeke. Kwenziwa ukuhlinzwa kwe-mitral valve okuyisithupha kwangu-10 ukuze kuvinjelwe ukuvuza kwegazi ngenxa yalesi simo. |
Lokhu kuhlinzwa kungadingeka uma uhlangothi lwesobunxele lwenhliziyo yakho lungapompi igazi elanele emzimbeni (ukwehluleka kwenhliziyo ohlangothini lwesobunxele) noma uma inhliziyo yakho ikhulisiwe. Kodwa-ke, uma isifo singesibi kakhulu, udokotela wakho angakunikeza imithi yokulawula izimpawu zakho. Kodwa-ke, kufanele uqhubeke nokuhlolwa kwenhliziyo njalo ukuze uqaphe isimo se-valve yakho. Uma isifo siqhubeka noma inhliziyo yakho yonakala, ukuhlinzwa kungadingeka kamuva.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Udokotela wakho kanye nethimba lezokwelapha bazokusiza ukulungiselela ukuhlinzwa. Kubaluleke kakhulu ukuthi ulandele imiyalelo yabo ngqo.
- Ungase ucelwe ukuthi uyeke ukuthatha imithi ethile: Ungase ucelwe ukuthi uyeke ukuthatha imithi yokunciphisa igazi (ama-anticoagulant) njenge-aspirin ne-warfarin amasonto ambalwa ngaphambi kokuhlinzwa.
- Kukusiza ukuthi uyeke ukubhema: Uma ubhema, udokotela wakho angakusiza ukuthi uyeke.
- Sebenzisa insipho yokubulala amagciwane: Uzotshelwa ukuthi ugeze umzimba wakho ngensipho yokubulala amagciwane ngobusuku bangaphambi kokuhlinzwa.
- Imithi okufanele uyithathe ngosuku lokuhlinzwa: Udokotela uzokutshela ukuthi yimiphi imithi okufanele uyithathe ekuseni ngalolo suku.
- Ukuzila Ukudla: Ngosuku lokuhlinzwa, welulekwa ukuthi ungadli noma uphuze lutho ngemva kwesikhathi esithile.
Kwenzekani ngesikhathi sokuhlinzwa?
Phakathi nalokhu kuhlinzwa, udokotela ohlinzayo uzolungisa inkinga eyodwa noma ngaphezulu nge-valve yakho. Lezi yizinyathelo ezivame ukwenzeka ngesikhathi sokuhlinzwa.
1. I-Anesthesia: Uzonikezwa imithi yokubulala izinzwa ukuze ulale ubuthongo obujulile, ungazi lutho.
2. Ukuxhumana nomshini wenhliziyo namaphaphu:Ngesikhathi sokuhlinzwa, uzoxhunywa emshinini okhethekile (umshini wokudlula inhliziyo) ozothatha umsebenzi wenhliziyo namaphaphu akho.
3. Ukwenza i-incision: Kwenziwa i-incision esifubeni. Ubukhulu balo msibo buyahlukahluka kuye ngenqubo yokuhlinzwa.
4. Indandatho ye-Annuloplasty: Indandatho efana newasher eyenziwe ngendwangu ibekwa nxazonke kwevalvu. Lokhu kunikeza ukwesekwa kwevalvu futhi kuyisize ibuyele esimweni sayo esijwayelekile.
5. Ukulungiswa kwevalvu: Ivalvu ye-mitral ilungiswa kusetshenziswa indlela eyodwa noma ngaphezulu ehlukile yokuhlinzwa.
6. Ukuhlolwa: Hlola ukuthi ivalvu ilungisiwe kahle bese wenza ezinye izinguquko uma kudingeka.
7. Ukuyekisa: Ngemva kokuhlinzwa, uzokhishwa emshinini. Khona-ke inhliziyo yakho namaphaphu kuzoqala ukusebenza futhi.
8. Ukuhlolwa kokugcina: Kwenziwa ukuhlolwa okukhethekile kwe-echo (i-transesophageal echocardiogram) ukuqinisekisa ukuthi i-valve ilungiswe ngempumelelo yini.
Yiziphi izindlela zokuhlinzwa ezisetshenziswayo kulokhu kuhlinzwa?
Odokotela abahlinzayo basebenzisa amasu ahlukene kulokhu kuhlinzwa. Khuluma nodokotela wakho mayelana nendlela esetshenziswayo ekuhlinzeni kwakho.
Izindlela zokufaka izicucu
- Ukuhlinzwa kwe-sternotomy ephelele: Ukusikwa okuphelele kwenziwa ngqo phakathi kwethambo lesifuba.
- Ukususwa kwesisu okuyingxenye: Ukusika ingxenye yethambo lesifuba eliphakathi kuphela.
- Ukuhlinzwa kwesifuba kwesokudla: Kwenziwa ukusika okuncane phakathi kwezimbambo ezimbili ohlangothini lwesokudla.
- Indlela yokusiza ngerobhothi: Ukuhlinzwa kwenziwa kusetshenziswa irobhothi kusetshenziswa ukusikwa okuncane kakhulu ezimbanjeni.
Ezinye izinqubo zokuhlinzwa
- I-Annuloplasty: Njengoba sixoxile ngaphambili, lokhu kuhilela ukubeka indandatho nxazonke zevalvu. Lokhu kuvame ukwenziwa ngesikhathi sokulungiswa kwevalvu ye-mitral.
- Ukususwa kwe-triangular noma i-quadrangular: Ingxenye encane yevalvu eyonakele iyasikwa bese isuswa, bese kuthi izingxenye ezinhle ezisele zithungwe ndawonye.
- Ukulungiswa kwe-Chordal: Uma imicu emincane efana nentambo (i-chordae) ebamba i-valve endaweni yayo yonakele, izingxenye ezonakele ziyasuswa bese kuthathelwa indawo ezokwenziwa (ezenziwe ngezinto ezifana ne-Gore-Tex®) noma ngemicu ethathwe kwenye ingxenye yenhliziyo enempilo.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, ungalindela okulandelayo:
- Kuzodingeka uhlale egunjini lokunakekelwa okujulile (ICU) usuku olulodwa noma ezimbili, lapho ithimba lezokwelapha lizoqapha khona ukushaya kwenhliziyo nokuphefumula kwakho.
- Ngemva kwalokho, kuzodingeka uhlale ewadini evamile izinsuku ezimbalwa ezengeziwe.
- Ngizokutshela ngokuvuselelwa kwenhliziyo .
- Ngemva kokubuyela ekhaya, uzofundiswa ukuthi ungalinakekela kanjani inxeba lokuhlinzwa.
Iningi labantu kufanele lihlale esibhedlela cishe isonto lonke ngemva kwalokhu kuhlinzwa.
Yiziphi izinzuzo zokwenza lokhu kuhlinzwa?
Kunezinzuzo eziningana zokulungisa ivalvu ekhona esikhundleni sokuyishintsha ngentsha.
- Amathuba okuphila isikhathi eside: Amathuba okuphila impilo ende nenempilo ngemva kokuhlinzwa ayanda.
- Ukuvikelwa okuhle kakhulu kokusebenza kwenhliziyo: Ukulimala kokusebenza kwenhliziyo kuncane kakhulu.
- Ukunciphisa ingozi yezinkinga: Kuncishisiwe ingozi yezinkinga ezifana nesifo sohlangothi kanye ne-endocarditis (ukutheleleka kwama-valve enhliziyo).
- Asikho isidingo semithi yokunciphisa igazi yesikhathi eside: Ezimweni eziningi, imithi yokunciphisa igazi (ama-anticoagulant) akudingeki ithathwe isikhathi eside.
Noma nini lapho kungenzeka, odokotela bazama ukulungisa ivalvu esikhundleni sokuyishintsha, ngoba leyo yindlela engcono kakhulu yeziguli eziningi.
Kuphumelele kangakanani ukuhlinzwa? Yiziphi izinkinga ezingaba khona?
Lokhu kuhlinzwa kuphumelele kakhulu. Ngokusho kwemibiko, ngisho neminyaka eyi-10 ngemva kokuhlinzwa, cishe ama-94% eziguli awaphumi kakhulu.
Kodwa-ke, njenganoma yikuphi ukuhlinzwa, kunezingozi nezinkinga ezingase zenzeke.
- Ukuphazamiseka kwenhliziyo (i-Arrhythmias)
- Ukopha
- I-Heart block
- Ukwehluleka kwenhliziyo
- Ukutheleleka
- Isifo sohlangothi
Khuluma nodokotela wakho ngalezi zingozi nokuthi ungazinciphisa kanjani.
Kuthatha isikhathi esingakanani ukululama?
Ngokuvamile kuthatha amasonto amane kuya kwayisishiyagalombili ukululama ngokuphelele kulokhu kuhlinzwa, yize abanye abantu bangathatha isikhathi eside.
Into ebaluleke kakhulu ukuthi, ungaqhathanisi inqubo yakho yokululama neyomunye umuntu. Ukuthi nje umakhelwane wakho ululame ngenyanga akusho ukuthi kufanele wenze kanjalo. Umzimba wawo wonke umuntu uhlukile. Uma kukuthatha isikhathi eside, lokho kuyinto evamile. Ungazicindezeli ukuthi ululame ngokushesha.
Isikhathi esithathayo ukuze ululame sincike ezintweni eziningana:
- Ubunzima besifo senhliziyo yakho ngaphambi kokuhlinzwa: Uma ukusebenza kwenhliziyo yakho sekuvele kuphazamisekile ngaphambi kokuhlinzwa, kuzothatha isikhathi ukuthola amandla kabusha.
- Impilo yakho ejwayelekile ngaphambi kokuhlinzwa: Lokhu kuzoncika ekutheni ubusebenza noma unezinye izimo zezokwelapha ezenza kube nzima.
- Indlela yokuhlinzwa esetshenzisiwe:Uma kwenziwa ukusikwa okukhulu phakathi kwesifuba (i-median sternotomy), kuzothatha cishe amasonto ayi-6-8 ukuthi ithambo liphole. Uma ukuhlinzwa kwenziwa ngokusikwa okuncane, amanxeba azophola ngokushesha.
Kufanele ubonane nini nodokotela?
Kujwayelekile ukuzwa ukungakhululeki ngemva kokuhlinzwa. Udokotela wakho uzokunikeza imithi yokwelapha izinhlungu ngenxa yalokhu. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, ungacabangi ukuthi zivamile futhi uxhumane nodokotela wakho ngokushesha.
| Izimpawu zesixwayiso okufanele uziqaphele | |
|---|---|
| Umkhuhlane, ukubanda | Ukukhwehlela igazi noma ulwelwesi oluphuzi/oluhlaza okotshani |
| Ubuhlungu besifuba | Ubunzima bokuphefumula |
| Ubomvu, ukuvuvukala, ubomvu, noma ubuhlungu obuzungeze inxeba lokuhlinzwa | Isicanucanu nokuhlanza |
| Ikhanda elibuhlungu kakhulu, isiyezi, ukulahlekelwa ukwazi | Ubunzima bokukhuluma, ukungingiza (izimpawu zesifo sohlangothi) |
| Ukushaya kwenhliziyo okungajwayelekile (okusheshayo kakhulu noma okuhamba kancane kakhulu) | Ubuhlungu, ukubomvu, noma ukuvuvukala emlenzeni ongezansi |
Ngezinye izikhathi ungase ungazi ukuthi lokhu kuyingxenye evamile yokululama noma kuyinto engathi sína. Uma ungabaza, kungcono ukushayela ucingo ubuze udokotela wakho.
Umlayezo Wokuya Nawe Ekhaya
- Ukulungiswa kwe-Mitral valve kuyindlela ephumelela kakhulu yokuhlinzwa kwesifo senhliziyo. Asikho isidingo sokwesaba lokhu.
- Ezimweni eziningi, kuzuzisa kakhulu ukulungisa ivalvu kunokuyifaka entsha.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa, ngakho lalela umzimba wakho futhi ubekezele.
- Landela imiyalelo kadokotela wakho ngqo. Uma unemibuzo noma uhlangabezana nanoma yiziphi izimpawu ezingavamile, yazisa udokotela wakho ngokushesha.
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