Inhliziyo yethu iyisitho esimangalisayo esisebenza ngokungayeki. Ngaphakathi kwale nhliziyo, kunezivimbi ezine ezisebenza njengamasango amane okulawula ngokunembile ukugeleza kwegazi. Lawa avumela igazi ukuthi ligeleze ohlangothini olulodwa kuphela. Elinye lala mazivimbi libizwa ngokuthi 'i-valve ye-Mitral'. Lokhu kutholakala ohlangothini lwesobunxele lwenhliziyo phakathi kwegumbi eliphezulu (i-atrium yesobunxele) kanye negumbi elingezansi (i-ventricle yesobunxele). Kodwa ngezinye izikhathi le-valve ye-mitral ingaba nesifo. Lokho kusho ukuthi igazi lingavuza emuva ngaphandle kokuvala kahle, noma lingavinjelwa ngaphandle kokuvula kahle. Ngakho-ke kulokhu, lelo valve kufanele lishintshwe.
Ngakho-ke iyini i-TMVR?
Kalula nje, i-TMVR (Transcatheter Mitral Valve Replacement) iyindlela yokwelapha yesimanje ethatha indawo yevalvu ye-mitral eyonakele ngevalvu entsha ngaphandle kokuhlinzwa okukhulu kwenhliziyo.
Cabanga nje, esikhundleni sokuhlinzwa okukhulu okuhilela ukuvula isifuba nokuvimba inhliziyo, ipayipi elincane (i-catheter) lidlula ngokusikwa okuncane kakhulu esinqeni noma esifubeni, eduze komthambo wegazi, liye enhliziyweni, bese kufakwa ivalvu entsha ngepayipi bese ifakwa esikhundleni sevalvu endala, enesifo. Le valve entsha ingaba ivalvu eyenziwe ngumuntu, noma ingenziwa ngezicubu zezilwane (inkomo, ingulube). Kule nqubo, ivalvu endala ayisuswa, kodwa kunalokho entsha ifakwa ngaphakathi kwayo bese ilungiswa.
Ubani ngempela odinga lokhu kwelashwa?
Kunezinhlobo ezimbili eziyinhloko zesifo se-mitral valve:
1. Ukubuyiselwa kwevalvu ye-mitral: Lokhu kwenzeka lapho ama-flaps amabili evalvu engavali kahle, okwenza elinye igazi elimpontshelwa yinhliziyo livuze emuva. Kufana namanzi avuza empompini ophukile.
2. I-Mitral valve stenosis: Lokhu kwenzeka lapho ivalvu iba mncane futhi ingavuli kahle. Lokhu kunciphisa inani legazi elingageleza liye phambili. Njengoba nje lapho ipayipi livaliwe, ukugeleza kwamanzi kuyehla.
Uma zombili lezi zimo ziba zimbi kakhulu, kungase kube nezimpawu ezinzima ezifana nokuphelelwa umoya, i-atrial fibrillation, umfutho wegazi ophezulu wamaphaphu, kanye nokwehluleka kwenhliziyo.
Ngokuvamile, ukuhlinzwa kwenhliziyo evulekile kwenziwa ezimweni ezinjengalezi. Kodwa-ke, i-TMVR iyindlela enhle kulabo asebekhulile, abanezinye izimo zezokwelapha, futhi abangakwazi ukukhokhela izingozi zokuhlinzwa okukhulu okunjalo.
Ingabe i-TMVR ne-MitraClip ziyinto efanayo?
Cha. Ngisho noma kokubili lokhu kuyindlela yokwelapha eyenziwa ngaphandle kokuvula inhliziyo, kuyizindlela ezimbili ezahlukene.
- I-MitraClip™: Lokhu kuhilela ukulungisa ivalvu evuzayo. Lokhu kuhilela ukubeka idivayisi encane efana ne-clip phakathi kwamapheshana amabili evalvu ukuze kuvinjwe igazi ekuvuzayo.
- I-TMVR:Lokhu akuyona indlela yokulungisa, kodwa kufakwa ivalvu entsha ngokuphelele.
Kwenzekani ngaphambi kokwelashwa nge-TMVR?
Ngemva kokunquma ukukunikeza lokhu kwelashwa, ithimba lezokwelapha lizokuhlola ngokucophelela.
- Ukuhlolwa: Kwenziwa izivivinyo eziningana, njenge-"Echocardiogram" ukuhlola ukusebenza kwenhliziyo kanye ne-"CT scan" ukuhlola isakhiwo senhliziyo. Lokhu kusetshenziselwa ukuhlela ukwelashwa.
- Ukukhuluma nge-anesthesia: Uchwepheshe uzokhuluma nawe ngohlobo lwe-anesthesia ozolunikwa ukuze ugweme ubuhlungu ngesikhathi sokwelashwa. Isinqumo sizokwenziwa ngokusekelwe esimweni sakho, ukuthi uzonikezwa i-anesthesia ejwayelekile noma i-sedation eqondayo.
- Imiyalelo: Udokotela uzokunikeza imiyalelo ekhethekile.
- Eminye imithi (ikakhulukazi imithi yokunciphisa igazi) ingadinga ukuyekiswa izinsuku ezimbalwa.
- Uzocelwa ukuba uzile ukudla amahora ambalwa ngosuku lokwelashwa.
- Uzokwaziswa ukuthi ulethe umuntu ekhaya ngemva kokwelashwa.
Kwenzekani ngesikhathi sokwelashwa?
Lokhu kwelashwa kuvame ukuthatha cishe amahora amabili kuya kwamathathu. Ithimba lochwepheshe, okuhlanganisa odokotela abahlinza inhliziyo, odokotela benhliziyo, kanye nodokotela ababulala izinzwa, lihilelekile kulokhu.
Ngamafuphi, lezi yizinto ezenzekayo.
1. Indawo yokusikwa (i-groin noma isifuba) iyahlanzwa futhi ilungiswe.
2. I-cannula (umugqa we-IV) ifakwa emthanjeni engalweni, lapho kunikezwa khona imithi edingekayo kanye noketshezi.
3. Ivalvu entsha inamathele ekugcineni kwepayipi elincane (i-catheter).
4. Leli payipi lifakwa emthanjeni wegazi ngokusebenzisa ukusikwa okuncane okwenziwa embotsheni noma esifubeni.
5. Kusetshenziswa ubuchwepheshe obukhethekile bokuthwebula izithombe, leli payipi liqondiswa ku-valve ye-mitral enhliziyweni.
6. Ivalvu entsha ifakwa kuvalvu endala, enesifo, ibekwe kahle, bese ifakwa.
7. Ipayipi liyasuswa bese imbobo ivalwa.
Ithimba lezokwelapha liqapha konke, okuhlanganisa umfutho wegazi lakho kanye namazinga omoya-mpilo, phakathi nalesi sikhathi sonke.
Kwenzekani ngemva kwe-TMVR?
Ngemva kokwelashwa, uzoyiswa ekamelweni lokululama. Uzoqashwa ngokucophelela uze ululame ngemva kokuhlinzwa. Abanye abantu kungadingeka bahlale egunjini lokunakekelwa okujulile (ICU) usuku olulodwa noma ezimbili. Ngokuvamile, kuzodingeka uhlale esibhedlela izinsuku ezimbalwa.
Uma usuya ekhaya, udokotela wakho uzokweluleka ngalokhu okulandelayo:
- Indlela yokubamba iqhaza ezinhlelweni zokuvuselela inhliziyo.
- Ama-aphoyintimenti okulandelela.
- Mayelana nemithi okufanele uyiqale kabusha kanye nemithi emisha okufanele uyithathe.
- Ngingabuyela nini emisebenzini evamile nasemsebenzini?
Izinzuzo nezingozi zokwelashwa nge-TMVR
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezinzuzo kanye nezingozi. Ake sizibheke.
| Izinzuzo | Izingozi Nezinkinga |
|---|---|
| Isifo se-valve ye-mitral siyalungiswa. | Kukhona ingozi yokuthi amahlule egazi akheke futhi aye ebuchosheni, okubangela isifo sohlangothi. |
| Ukwehla okuphawulekayo kwezimpawu (njengokuphelelwa umoya). | Ukulimala kwezicubu zenhliziyo. Isibonelo: Ukubhoboka kwe-ventricle yesobunxele. |
| Ukululama ngokushesha kunokuhlinzwa kwenhliziyo okuvulekile. | Ukuvaleka kwendlela yokuphuma kwe-ventricle yesobunxele. |
| Akukho silonda esikhulu futhi ubuhlungu buncane. | Ivalvu efakiwe ingahamba noma isuke endaweni yayo. |
Into ebalulekile ukuthi lezi zingozi azivamile, futhi uma kuvela izinkinga, ithimba lezokwelapha likulungele ukuguqukela ngokushesha ekuhlinzeni okuvulekile noma ukuthatha ezinye izinyathelo ezifanele.
Kufanele usifune nini iseluleko sezokwelapha esiphuthumayo?
Uma ubuyela ekhaya ngemva kokwelashwa, kufanele uqaphele kakhulu ngezimpawu ezithile. Uma uhlangabezana nalezi zimpawu ezilandelayo , hamba uye e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha.
| Yiya ku-ETU ngokushesha! | |
|---|---|
| Izimpawu zesifo sohlangothi |
|
| Izimpawu zokuhlaselwa yinhliziyo | |
| Uma unalezi zimpawu, yazisa udokotela wakho. | |
| Izinkinga ezihlobene nokusika | Izithungo ziyakhululeka, ziphuma igazi enxebeni. |
| Izimpawu zokutheleleka | Ubuhlungu, ukubomvu, ubomvu noma ukuphuma koketshezi, umkhuhlane endaweni yenxeba. |
| Izimpawu ze-clot yegazi | Ubuhlungu, ukuvuvukala, kanye nokushintsha kombala ezindaweni ezifana nethanga, idolo, noma iqakala. |
| Ezinye izimpawu zokuhlaselwa yinhliziyo | Ukukhuluphala okungazelelwe, ukuvuvukala kwemilenze namaqakala. |
Umlayezo Wokuya Nawe Ekhaya
- I-TMVR iyindlela yokwelapha yesimanje ethatha indawo ye-mitral valve ngaphandle kokuvula inhliziyo, ngengozi encane kanye nokululama okusheshayo.
- Lena inketho enhle kakhulu, ikakhulukazi kulabo asebekhulile noma abanezinye izimo zezokwelapha ezenza kube nzima ngabo ukuhlinzwa okukhulu.
- Uma wena noma othile oseduze nawe enesifo se-mitral valve, khuluma nodokotela wakho wenhliziyo ngale ndlela yokwelashwa. Uzonquma ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe.
- Ngemva kokwelashwa, ukulandela imiyalelo kadokotela wakho ngqo kubalulekile ukuze ululame ngokushesha. Hlala uqaphele izimpawu eziyisixwayiso.
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