Ingabe udokotela wakho ukutshelile ukuthi i-valve yakho ye-mitral ibuthakathaka nokuthi udinga ukuhlinzwa? Kuvamile ukuzizwa wesaba futhi ukhathazekile kancane uma uzwa into efana nale. Kodwa ungakhathazeki. Lokhu ukuhlinzwa okuthuthukile kakhulu futhi okuphumelelayo manje. Namuhla, sizokhuluma ngokufakwa esikhundleni kwe-Mitral Valve, ukuthi kusho ukuthini, ukuthi kwenziwa kanjani, nokuthi kwenziwa kanjani, ngendlela elula kakhulu ongayiqonda.
Okokuqala, ake sibone, iyini le valve ye-mitral?
Cabanga ngenhliziyo yakho njengendlu enamakamelo amane. Kuneminyango phakathi kwala makamelo evumela igazi ukuthi ligeleze liye phambili naphambili. Le minyango ivuleka ohlangothini olulodwa kuphela. Ngakho-ke, leli valve le-mitral liwumnyango obaluleke kakhulu phakathi kwegumbi eliphezulu (i-atrium yangakwesobunxele) kanye negumbi elingezansi (i-ventricle yangakwesobunxele) ohlangothini lwesobunxele lwenhliziyo.
Igazi elihlanzekile neligcwele umoya-mpilo elivela emaphashini liqala lingene kuleli gumbi eliphezulu ngakwesobunxele. Bese kuthi, ivalvu ye-mitral ivuleke bese lelo gazi lingena ekamelweni elingezansi. Kusuka ekamelweni elingezansi lapho igazi liphampunwa khona emzimbeni wonke. Ngakho-ke lo mnyango, okungukuthi, ivalvu, kufanele uvuleke futhi uvalwe ngesikhathi esifanele.
Kodwa ngenxa yezifo ezithile, le valve ayisebenzi kahle. Khona-ke inhliziyo izwa ingcindezi enkulu. Ngokuhamba kwesikhathi, lokhu kungalimaza inhliziyo namaphaphu.
Kukuziphi izimo lapho i-valve ye-mitral idinga ukushintshwa?
Lokhu kuhlinzwa kuyadingeka ikakhulukazi ngenxa yezimo ezimbili zezokwelapha.
1. Ukubuyela kwe-Mitral: Lokhu kwenzeka lapho i-valve ingavali kahle. Bese kuthi elinye igazi elingene ekamelweni elingezansi livuze libuyele ekamelweni eliphezulu. Kufana nokukhiya komnyango okuphukile.
2. I-Mitral Stenosis: Okwenzekayo lapha ukuthi i-valve ayivuli kahle. Iba mncane futhi ivalwe. Bese indlela yokugeleza kwegazi isuka ekamelweni eliphezulu iye ekamelweni elingezansi ivalwe. Kufana nomnyango obhajwe.
Odokotela bahlala bezama ukulungisa ivalvu yakho. Kungcono ukugcina izicubu zakho. Kodwa-ke, uma ivalvu yonakele kakhulu ukuba ingalungiswa, ivalvu entsha iyona engcono kakhulu futhi ephephile.
Ivalvu kungenzeka ingalungiseki ngenxa yezizathu ezilandelayo:
- Uma ivalvu yonakele kakhulu ngenxa yokutheleleka enhliziyweni (i-endocarditis).
- Uma ivalvu isibe nezibazi futhi ijiyile ngenxa yesifo senhliziyo esibangelwa yi-rheumatic (Rheumatic Heart Disease) esenzeka ebuntwaneni.
- Uma ama-calcium deposits akheke ku-valve futhi eba njengetshe.
- Uma uhlelo lwentambo oluthambile (imisipha ye-papillary noma i-chordae) olusekela i-valve lonakele.
Yiziphi izinhlobo ezintsha zama-valve?
Uma uthola i-valve entsha, kunezinhlobo ezimbili eziyinhloko ongakhetha kuzo. Zombili zinezinzuzo nezinkinga zazo. Wena nodokotela wakho kuzodingeka ninqume ndawonye ukuthi yikuphi okungcono kakhulu kuwe, ngokusekelwe eminyakeni yakho, indlela ophila ngayo, kanye nempilo yakho.
| Uhlobo lwevalvu | Incazelo kanye nezinzuzo | Izinto ezimbi nezinto eziphawulekayo |
|---|---|---|
| Ivalvu Yomshini | Lawa amavalvu aqinile kakhulu enziwe ngezinsimbi ezifana nekhabhoni ne-titanium. Ngokuvamile ahlala impilo yonke. Awadingi ukuhlinzwa okwengeziwe. | Kuzodingeka uthathe umuthi wokunciphisa igazi impilo yakho yonke (i-Warfarin). Kunengozi enkulu yokopha uma uthatha lo muthi. Kuzodingeka ukuthi igazi lakho lihlolwe njalo. Lokhu kuyingozi kwabesifazane abakhulelwe nalabo abawa njalo. |
| I-valve Yebhayoloji/Ye-Bioprosthetic | Lezi zenziwe ngezicubu zezilwane (ezithathwe ezingulubeni noma ezinkomeni). Inzuzo enkulu ukuthi akudingeki uphuze imithi yokunciphisa igazi impilo yakho yonke (ngaphandle mhlawumbe kwezinyanga ezimbalwa zokuqala). | Lezi azihlali isikhathi eside njengama-valve omshini. Ngokuvamile ziyaguga eminyakeni eyi-10-20. Ngemuva kwalokho kufanele wenze olunye ukuhlinzwa bese ufaka i-valve entsha. |
Odokotela bavame ukusebenzisa isiqondiso esinjengalesi:
- Uma ungaphansi kweminyaka engama-50 ubudala: i-valve yomshini (ngaphandle uma ukhulelwe noma uhlela ukukhulelwa).
- Uma uneminyaka ephakathi kuka-50 no-65 ubudala: noma yiluphi uhlobo lwalezi ezimbili.
- Uma uneminyaka engaphezu kwengu-65 ubudala: i-valve yezinto eziphilayo.
Lesi yisinqumo esikhulu, ngakho ungangabazi ukuxoxa nganoma yimiphi imibuzo noma ukwesaba onakho nodokotela wakho.
Kwenzekani ngaphambi nangesikhathi sokuhlinzwa?
Ukulungiselela ngaphambi kokuhlinzwa
Udokotela wakho uzokunikeza imiyalelo yokuthi ungalungiselela kanjani ukuhlinzwa. Ngokuvamile kuzodingeka wenze okulandelayo:
- Yeka ukuthatha imithi ethile (ikakhulukazi imithi yokunciphisa igazi) amasonto ambalwa ngaphambi kokuhlinzwa.
- Uma ubhema, yeka ngokuphelele.
- Geza umzimba wakho ngensipho yokubulala amagciwane ngobusuku bangaphambi kokuhlinzwa.
- Yeka ukudla nokuphuza kusukela phakathi kwamabili ngobusuku bangaphambi kokuhlinzwa.
- Hlela ukuthi othile akusize uma ufika ekhaya. Ungase ukuthole kunzima ukuphakamisa izinto ezisindayo noma ukupheka isikhashana. Ngakho-ke, kubaluleke kakhulu ukuthola usizo elungwini lomndeni noma kumngane.
Ngesikhathi sokuhlinzwa
Lokhu kuvame ukuba ukuhlinzwa kwenhliziyo evulekile. Lokhu kusho ukuthi ukuhlinzwa kwenziwa ngembobo esifubeni. Kodwa-ke, abanye abantu bangenza ukuhlinzwa nge-catheter (i-transcatheter). Udokotela wakho uzonquma ukuthi lokhu kulungile yini kuwe.
Ngesikhathi sokuhlinzwa:
1. Uzophelelwa yimizwa ngokuphelele. Ngakho ngeke uzizwe noma ukhumbule lutho.
2. Ngesikhathi sokuhlinzwa, uzoxhunywa emshinini okhethekile (Cardiopulmonary Bypass Machine) ukuze wenze umsebenzi wenhliziyo namaphaphu akho.
3. Udokotela ohlinzayo wenza i-incision esifubeni bese efika enhliziyweni.
4. Ngemuva kwalokho, ivalvu ye-mitral eyonakele isuswa ngokucophelela, bese ivalvu entsha ithungwa endaweni yayo. Odokotela bazama ukonga izicubu zakho ezinempilo ngangokunokwenzeka.
5. I-valve entsha iyahlolwa ukuqinisekisa ukuthi isebenza kahle, isifuba siyavalwa, bese ukhishwa emshinini wenhliziyo namaphaphu.
Lokhu kuhlinzwa kuvame ukuthatha cishe amahora amabili kuya kwamane.
Ngemva kokuhlinzwa nokululama
Kuzodingeka uhlale esibhedlela cishe isonto lonke ngemva kokuhlinzwa.
- Uzochitha usuku lokuqala noma ezimbili egunjini lokunakekelwa okujulile (i-ICU), lapho konke kusukela ekushayeni kwenhliziyo yakho kuya ekuphefumuleni kwakho kuzoqashwa ngokucophelela.
- Bese bedluliselwa ewadini evamile.
- Kuvamile ukuba nokushaya kwenhliziyo okungajwayelekile (`Arrhythmias`) ngemva kokuhlinzwa. Kunikezwa imithi yalokhu.
- Imithi yokuvimbela ukujiya kwegazi (ukwelashwa kokuvimbela ukujiya kwegazi) iyaqalwa.
- Uzothunyelwa ohlelweni lokuvuselelwa kwenhliziyo ukuze usheshise ukululama kwakho.
Ngokuvamile kuthatha amasonto ama-4 kuya kwayi-8 ukululama. Kodwa lokhu kuyahlukahluka kuye ngomuntu nomuntu. Lesi sikhathi singahluka kuye ngezinto ezifana neminyaka yakho kanye nempilo yakho yangaphambi kokuhlinzwa. Ngakho ungasheshi. Lalela umzimba wakho futhi uthole ukuphumula okwanele.
Yiziphi izimpawu zengozi okufanele uzibike kudokotela wakho ngokushesha?
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngemva kokubuyela ekhaya, ungazinaki. Shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo wesibhedlela esiseduze (i-ETU).
| Izimpawu eziyingozi | |
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| Uma uthatha imithi yokunciphisa igazi, qaphela nalokhu: | |
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Umlayezo Wokuya Nawe Ekhaya
- Ukufakelwa kwe-valve ye-Mitral akumelwe ukwesabe. Kungukuhlinzwa okuphumelele kakhulu okungasindisa impilo yakho futhi kuthuthukise ikhwalithi yempilo yakho.
- Ukukhetha i-valve efanele wena, phakathi komshini nowebhayoloji, kuyisinqumo esibalulekile okufanele wena nodokotela wakho nisenze ndawonye.
- Kuthatha isikhathi ukululama ngemva kokuhlinzwa. Phakathi naleso sikhathi, ukuphumula nokusekelwa komndeni kubalulekile. Ungalokothi uphuthume izinto.
- Qaphela izinto ezingaba yingozi ngemva kokubuyela ekhaya. Uma ungabaza, funa iseluleko sezokwelapha ngokushesha.
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