Okudingeka ukwazi ngenqubo ye-TAVR (Transcatheter Aortic Valve Replacement), ethatha indawo yevalvu ngaphandle kokuvula inhliziyo

Uma uzwa igama elithi "ukuhlinzwa kwenhliziyo," yini efika engqondweni? Esikhathini esiningi, sicabanga ngokuhlinzwa okukhulu okuhilela ukuvula isifuba, akunjalo? Kodwa ngokuthuthuka kwesayensi yezokwelapha, manje sekukhona ukwelashwa okulula kakhulu, okungenangozi kakhulu kwezinye izinkinga zenhliziyo. Namuhla, sizokhuluma ngenye yokwelashwa okusha nokuphumelelayo.

Iyini i-TAVR? Masiyiqonde kalula.

Incazelo ephelele ye-TAVR i- Transcatheter Aortic Valve Replacement . Ngezinye izikhathi ibizwa nangokuthi i-TAVI (Transcatheter Aortic Valve Implantation). Womabili la magama abhekisela endleleni efanayo yokwelapha.

Kalula nje, i-TAVR iyindlela yokushintsha ivalvu ye-aorta yenhliziyo ngokusebenzisa ukusikwa okuncane kakhulu, ngaphandle kokuvula isifuba.

Cabanga ngenhliziyo yethu njengephampu yamanzi endlini. Le phampu ithumela igazi emzimbeni wonke ngephayiphi eyinhloko. Le phayiphi eyinhloko ibizwa ngokuthi i-aorta. Uma igazi lisuka enhliziyweni liya kule aorta, kuba nento efana nesango elilawula ukugeleza kwegazi. Yilokho esikubiza ngokuthi i-aortic valve. Uma le valve ingavuli noma ingavali kahle, kuvela izinkinga ezinkulu ekugelezeni kwegazi emzimbeni wonke. I-TAVR ihilela ukufaka esikhundleni se-valve eyonakele nengasebenzi kahle nge-valve entsha.

Ubani odinga inqubo ye-TAVR?

Lokhu kwelashwa kuyadingeka kakhulu kubantu abanesimo esibizwa ngokuthi i-aortic stenosis . Okusho ukuthi, ivalvu ye-aortic esikhulume ngayo ekuqaleni inciphile. Njengesango eligqwalile, le valve ayivuli ngokuphelele.

Kunezizathu eziningana eziyinhloko zokuthi kungani i-valve incipha ngale ndlela:

• Ukuguga: Ngokuvamile kubantu abaneminyaka engaphezu kwengu-70 ubudala, ama-calcium deposits anqwabelana ku-valve, okwenza ukuthi iqine futhi iqine.
• Ezinye izimo zezokwelapha: Le valve ingalimala ngokushesha ngenxa yezimo ezifana nesifo senhliziyo esibangelwa amalunga noma ezinye izinkinga zenhliziyo ezizalwa nazo (isb., i-bicuspid aortic valve).

Uma ivalvu incipha, inhliziyo kufanele isebenze kanzima kunangaphambili ukuze ipompe inani legazi elidingwa ngumzimba. Kufana nomshini odinga ukupompa amanzi engeziwe ngepayipi elivalekile. Ngokuhamba kwesikhathi, lokhu kucindezeleka okwengeziwe enhliziyweni kungenza buthaka imisipha yenhliziyo, ekugcineni kuholele ekuhlulekeni kwenhliziyo.

Kwenzekani ngaphambi kwe-TAVR?

Ngaphambi kokuba wenze i-TAVR, udokotela wakho uzokwenza izivivinyo eziningana ukuze ahlole ngokunembile isimo sakho. Lezi zivivinyo zingakunikeza isithombe esicacile sendlela igazi eligeleza ngayo enhliziyweni yakho nokuthi ngabe zikhona yini ezinye izinkinga.

Lezi yizivivinyo ezivame ukwenziwa:

• Ukuhlolwa kwegazi
• I-Echocardiogram - Lokhu kufana nokuskena kwenhliziyo.
• I-Electrocardiogram (ECG)
• I-CT scan noma i-MRI scan
• Ukufakwa kwe-catheter kwenhliziyo - Lokhu kuhlola ukuvaleka kwemithambo yenhliziyo ehambisa igazi enhliziyweni.

Ngemva kokuba zonke lezi zivivinyo seziqediwe, udokotela uzokhuluma nawe futhi akuchazele konke mayelana nokwelashwa, ukuthi yini ongayilindela ngemva kwalokho, nokuthi uzonikezwa kanjani i-anesthesia. Ungabuza noma yimiphi imibuzo ongase ube nayo ngalesi sikhathi.

Uzocelwa ukuthi uyeke ukudla nokuphuza amahora angu-4-6 ngaphambi kokwelashwa. Futhi, kufanele ubuze udokotela wakho uma kudingeka uyeke ukuthatha noma yimiphi imithi nokuthi nini.

Indlela yokwelashwa kwe-TAVR eyenziwa ngayo

Lena inqubo elula kakhulu. Uzonikezwa i-anesthesia ukuze ungezwa ubuhlungu. Uzonikezwa nemithi yokuvimbela ukuqhekeka kwegazi.

Ngemuva kwalokho, udokotela wezifo zenhliziyo ongenelelayo ulandela lezi zinyathelo:

1. Ukwenza ukusika okuncane: Kwenziwa ukusika okuncane kakhulu, ngokuvamile eduze komthambo wegazi omkhulu (umthambo we-femoral) engxenyeni engenhla yethanga lakho, eduze kwe-groin.

2. Ukufakwa kwe-catheter: Ngokusika, ithubhu elincane kakhulu neliguquguqukayo elibizwa ngokuthi i-catheter lidluliselwa emthanjeni wegazi kuze kufike enhliziyweni.

3. Ukufaka ivalvu entsha: Ivalvu entsha ithathwa ngale catheter, ibekwe ngaphakathi kwevalvu yakho endala, eyonakele, bese inwetshwa. Ivalvu entsha ibe isibekwa khona kanye kuleyo ndawo. Ivalvu endala isunduzelwa eceleni yintsha bese ihlala lapho.

4. Ukuhlolwa: Ivalvu entsha iyahlolwa ukuze kubonakale ukuthi isebenza kahle yini nokuthi kukhona yini ukuvuza.

5. Ukususwa kanye nokuthungwa: Uma konke kulungile, i-catheter isuswa ngokucophelela, imbobo encane eyenziwe ekuqaleni iyathungwa, bese kufakwa i-plaster.

Ngokuvamile, yonke le nqubo ithatha cishe ihora elilodwa noma amabili.

Yiziphi izinzuzo zalokhu?

I-TAVR inezinzuzo eziningi kunokuhlinzwa kwenhliziyo okujwayelekile.

Naphezu kwalezi zinzuzo, ukuhlinzwa kwenhliziyo okuvulekile kungase kufaneleke kakhulu kwezinye iziguli. Kufanele uxoxe nodokotela wakho ukuthi i-TAVR noma ukuhlinzwa okuvulekile kuyindlela engcono kakhulu yokwelapha.

Azikho yini imiphumela emibi? Ake sixoxe nangezingozi

I-TAVR iyindlela yokwelapha ephumelela kakhulu. Ngokuthuthuka kobuchwepheshe, izinkinga seziyivelakancane manje. Kodwa-ke, njenganoma iyiphi inqubo yezokwelapha, kunezingozi ezincane.

• Uhlelo lukagesi lwenhliziyo luyathinteka, okudinga ukufakwa kwe-pacemaker .
• Ukopha okuzungeze ivalvu entsha.
• Isifo sohlangothi.
• Ukopha.
• Ukutheleleka.
• Ukulimala kwezinso, inhliziyo, noma imithambo yegazi.

Udokotela wakho uzokuchazela kahle lezi zingozi. Njengoba lokhu kwenziwa yithimba lezokwelapha elinolwazi olukhulu, izingozi ziphansi kakhulu.

Ingabe inqubo ye-TAVR ayifanele wonke umuntu?

Nakuba lokhu kwelashwa kuzuzisa kakhulu, akufanele wonke umuntu. Udokotela wakho angase angancomi i-TAVR kumuntu onezimo ezilandelayo:

• Uma uke waba nokuhlaselwa yinhliziyo phakathi nenyanga.
• Uma unesifo senhliziyo esiyinkimbinkimbi ozalwa naso.
• Uma kunezinkinga ngezinye izivalo zenhliziyo (isib. i-Mitral regurgitation).
• Uma usanda kuba nesifo sohlangothi noma i-TIA (Transient ischemic attack).
• Uma unesifo sezinso esibi kakhulu.

Udokotela wakho uzonquma ukwelashwa okufanele kakhulu kuwe ngokusekelwe esimweni sakho sempilo iyonke.

Kuthatha isikhathi esingakanani ukuphulukiswa?

Iningi labantu lingabuya esibhedlela lingakapheli usuku noma ezimbili ngemva kokwelashwa nge-TAVR. Isikhathi esithathwayo ukuze umuntu alulame ngokugcwele siyahlukahluka kuye ngomuntu.

• Ngokuvamile ungaqhubeka nemisebenzi yakho eminingi yansuku zonke zingakapheli izinsuku ezimbalwa.
• Kufanele ulinde cishe isonto ngaphambi kokwenza izinto ezifana nokuphakamisa izinsimbi.
• Ungaya emsebenzini cishe emavikini amabili bese ushayela cishe ngenyanga.
• Kungathatha amasonto ayisithupha kuya kwayi-10 ukululama ngokuphelele.

Udokotela wakho uzokweluleka ngesilinganiso sokuphumula okudingayo, okufanele ukwenze, nokuthi yini okungafanele ukwenze. Ukulandela leso seluleko kubaluleke kakhulu ukuze ululame ngokushesha.

Ngaphezu kwalokho, ungathunyelwa ohlelweni lokuvuselela inhliziyo , oluwuchungechunge lwezivivinyo ezikhethekile zokuqinisa inhliziyo yakho. Lokhu kuzosheshisa inqubo yakho yokululama.

Kunini lapho udinga ukubonana nodokotela?

Ngemva kokwelashwa kwe-TAVR, uzocelwa ukuthi uye kohlolwa, cishe kanye ngenyanga bese kuba kanye ngonyaka. Lokhu kuhlolwa okulandelayo kubaluleke kakhulu ukuqinisekisa ukuthi i-valve entsha isebenza kahle. Kodwa-ke, uma uhlangabezana nanoma yiziphi izimpawu ezingezansi, kufanele ushayele udokotela wakho ucingo ngokushesha.

Uma kwenzeka isimo esiphuthumayo njengobuhlungu obukhulu besifuba noma ubunzima obukhulu bokuphefumula , iya eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha.