Ungacabanga ukushintsha ivalvu yenhliziyo ngaphandle kokuvula isifuba ngokuphelele? Yebo, sekuyinto engokoqobo manje. Namuhla sikhuluma ngalobu buchwepheshe obulethe ithemba elisha kubantu abaningi abanezinkinga zevalvu yamaphaphu ngenxa yesifo senhliziyo sokuzalwa. Ake siqale lokhu ngengxoxo elula kakhulu nenobungane.
Kalula nje, iyini i-TPVR?
I-TPVR, emele i-Transcatheter Pulmonary Valve Replacement , iwukuhlinzwa okuthatha indawo ye-valve yamaphaphu engasebenzi kahle enhliziyweni yakho nge-valve entsha ngokusebenzisa ukusika okuncane kakhulu. Ngokuvamile, uma sicabanga ngokuhlinzwa kwenhliziyo, sicabanga ngokuhlinzwa okuhilela ukwenza ukusika okukhulu phakathi kwesifuba nokuvula isifuba. Kodwa-ke, kule nqubo, ukusika okukhulu okunjalo akwenziwa.
Kunalokho, odokotela benza imbobo encane esikhumbeni sendawo yakho yangaphakathi bese benza umsebenzi ngayo. Le valve yamaphaphu, esebenza njengesango elithumela igazi lisuka enhliziyweni yakho liye emaphashini akho, ibaluleke kakhulu. Abantu abazalwa benesifo senhliziyo sokuzalwa bangase babe nezinkinga ngale valve njengoba bekhula ngemva kokuhlinzwa beseyizingane. Ngakho-ke, ukufaka leyo valve esikhundleni sale ndlela kungathuthukisa kakhulu impilo yakho kanye nekhwalithi yokuphila, futhi kugweme ukudinga ukuhlinzwa okukhulu kaninginingi.
Kwenzekani ngempela ohlelweni lwe-TPVR?
Ekuhlinzweni kwenhliziyo okuvamile, ithambo lesifuba liyasikwa, isiguli sixhunywe emshinini wokudlulisa inhliziyo namaphaphu, ivalvu endala iyasuswa, bese kufakwa entsha. Lokhu kuthatha isikhathi eside, kuthatha isikhathi eside ukuphulukiswa, futhi kwabanye abantu, lokhu kuhlinzwa kuyingozi.
Kodwa akunjalo nge-TPVR. Udokotela wenhliziyo ohlinzayo ufaka ipayipi elincane (i-catheter) ngomthambo osesinqeni sakho bese eqondisa ivalvu entsha ngepayipi iye enhliziyweni yakho. Konke lokhu kwenziwa ngaphansi kwesiqondiso sobuchwepheshe obufana ne-X-ray. Uma isisendaweni efanele, ivalvu entsha iyafuthwa ngebhaluni bese iqiniswa endaweni yayo.
Lokhu kufana nokufaka uhlaka olusha lomnyango ohlakeni lomnyango oludala ngaphandle kokulisusa.
Ngemva kokuthi lokhu sekwenziwe, ukugeleza kwegazi kusuka enhliziyweni kuya emaphashini kubuyiselwa ngendlela efanele. Umsebenzi enhliziyweni uyancishiswa, futhi umzimba uthola umoya-mpilo ongcono. Ezimweni eziningi, umuntu oye wahlinzwa angaya ekhaya ngalolo suku .
Kwenzekani uma ivalvu yami yamaphaphu ingasebenzi kahle?
Kunezinkinga ezimbili eziyinhloko ezibonakala ku-valve yamaphaphu. Ake sibheke kafushane lezi.
| Isimo sezokwelapha | Kalula nje... |
|---|---|
| I-Pulmonary Stenosis | Ivalvu iba mncane futhi ayivuli kahle, okuvimbela ukugeleza kwegazi kusuka enhliziyweni kuya emaphashini. Lokhu kubeka ukucindezeleka okukhulu ohlangothini lwesokudla lwenhliziyo. Ngokuhamba kwesikhathi, i-atrium yesokudla yenhliziyo ingaze yehluleke. |
| Ukubuyela kwesisu emaphashini (ukuvuza kwegazi kusuka ku-valve yamaphaphu) | Ngenxa yokuthi ivalvu ayivali kahle, elinye igazi elimpontshelwa emaphashini liphinde livuzele enhliziyweni. Lokhu kunciphisa nenani legazi eliya enhliziyweni, okwandisa ukucindezeleka ohlangothini lwesokudla lwenhliziyo futhi kungaholela ekuhlulekeni kwenhliziyo. |
Kuzo zombili lezi zimo, ungase ube nezimpawu ezifana nalezi:
- Ubunzima bokuphefumula (ukuphelelwa umoya)
- Ukuvuvukala kwesisu nemilenze (i-edema)
- Ubuhlungu besifuba
- Ukuzizwa sengathi inhliziyo yakho ishaya ngokushesha (ukushaya kwenhliziyo)
Lezi zimpawu zibangelwa ukwehluleka kwenhliziyo noma ukushaya kwenhliziyo okungajwayelekile (i-arrhythmias). Lezi zimpawu zivame ukuba ngcono ngemva kokuhlinzwa kwe-TPVR.
Ngubani lo kuhlinzwa kwe-TPVR okufanelekela kakhulu?
Uma uzalwa unesifo esithinta ivalvu yamaphaphu yenhliziyo yakho, ungase uzuze kulokhu kuhlinzwa. Ikakhulukazi,
- Abantu abake bahlinzwa i-pulmonary valve beseyingane.
- Abantu abadala kanye nentsha ababenayo leyo valve bayavaleka noma bavuza ngokuhamba kwesikhathi.
- Ngokuvamile, odokotela bacabanga ngenqubo ye-TPVR kubantu abathole i-homograft (ukufakelwa i-valve) kumnikeli besebancane, lapho leyo valve iba buthaka ngokuhamba kwesikhathi.
Ezinye zezimo eziyinhloko eziphathwa ngalokhu kuhlinzwa yilezi:
- I-Pulmonary Atresia: Isimo lapho i-valve yamaphaphu ingakheki khona lapho kuzalwa.
- I-Regurgitant Pulmonary Valve: Isimo lapho igazi livuza khona libuyela emuva nge-valve.
- I-Tetralogy of Fallot: Isimo lapho igazi elihle nelibi lihlangana khona ngenxa yokuhlanganiswa kweziphambeko ezine zenhliziyo.
- I-Truncus Arteriosus: Isimo lapho imithambo yegazi emibili eyinhloko ephuma enhliziyweni ihlangana khona.
- Ukuguqulwa Kwemithambo Emikhulu: Isimo lapho imithambo yegazi emibili eyinhloko yenhliziyo ishintshaniswa futhi ixhunywe khona.
Ukuhlinzwa kwe-TPVR kuveze imiphumela ephumelela kakhulu njengokwelashwa kwezimo ezinjalo.
Kwenzekani ngaphambi, ngesikhathi nangemva kokuhlinzwa?
Ukulungiselela ngaphambi kokuhlinzwa
Ukuze anqume ukuthi lokhu kuhlinzwa kulungile yini kuwe, udokotela wakho uzoqala akuhlole ngokucophelela. Angenza izivivinyo eziningana, njengokuthi:
- I-Angiogram
- I-CT scan yenhliziyo
- I-MRI yenhliziyo
- I-Echocardiogram
- I-Electrocardiogram (ECG)
Ngokusekelwe emiphumeleni yalezi zivivinyo, udokotela wakho uzoncoma ukuhlinzwa kwe-TPVR noma anqume ukuqapha isimo sakho isikhashana. Uzokweluleka nangokuthi yikuphi ukudla okufanele ukudle kanye nemithi okufanele uyeke ukuyisebenzisa (ikakhulukazi imithi yokunciphisa igazi) ngaphambi kokuhlinzwa. Ungakhohlwa ukutshela udokotela wakho nganoma yikuphi ukungezwani komzimba ongase ube nakho.
Ngesikhathi sokuhlinzwa
Ngaphambi kokuba ukuhlinzwa kuqale, uzonikezwa i-anesthesia ukuze ungezwa ubuhlungu. Kulapho-ke kuphela lapho uchwepheshe eqala khona ukusebenza.
1. Okokuqala, kwenziwa ukusikwa okuncane embotsheni yakho (umthambo we-femoral) noma mhlawumbe entanyeni yakho (umthambo we-jugular) bese kufakwa ipayipi (i-catheter) ngalo.
2. Bese, kusetshenziswa ubuchwepheshe obufana ne-X-ray, ivalvu entsha iqondiswa ngepayipi bese ihambisana nocingo iye endaweni efanele enhliziyweni. Le valve igoqwa phezu kwebhaluni.
3. Uma ifika endaweni efanele, ibhaluni liyafuthwa. Ivalvu entsha iyakhula futhi ingena kahle ngaphakathi kwevalvu endala. Kusukela ngaleso sikhathi kuqhubeke, ivalvu entsha iqala ukusebenza.
4. Okokugcina, hlola ukuthi ivalvu isebenza kahle bese ususa wonke amapayipi afakiwe.
Lonke lolu hlelo luvame ukuthatha cishe amahora amabili noma amathathu .
Ngemva kokuhlinzwa
Ngemva kokuhlinzwa, uzogcinwa esibhedlela ubusuku bonke ukuze uhlolwe. Uma konke kuhamba kahle, uzokwazi ukuya ekhaya ngakusasa ekuseni . Udokotela wakho uzokunikeza imiyalelo okufanele uyilandele uma uya ekhaya. Ezimweni eziningi , uzokwazi ukuqhubeka nemisebenzi yakho evamile zingakapheli izinsuku eziyisikhombisa .
Yiziphi izinzuzo nezingozi zendlela ye-TPVR?
Njenganoma iyiphi inqubo yezokwelapha, kunezinzuzo nezingozi ezincane. Masiqaphele kokubili.
| Izinzuzo | Izingozi/Izinkinga |
|---|---|
| Isikhathi sokululama sifushane. | Ubuhlungu, ukudumba, noma ukuvuvukala lapho ipayipi lifakwe khona. |
| Ingozi yokutheleleka iphansi. | Ihluli. |
| Isikhathi sokuhlala esibhedlela sifushane. | Ukulimala kwemithambo yegazi. |
| Azikho izibazi ezinkulu, kukhona ukusikeka okuncane nje. | Ukutheleleka (ikakhulukazi ukutheleleka kolwelwesi lwangaphakathi lwenhliziyo - i-Endocarditis). |
| Kukhona ingozi encane kunokuhlinzwa kwenhliziyo okuvulekile. | Ukuphazamiseka kwenhliziyo (i-Arrhythmia). |
Akuvamile kakhulu ukuthi kube nezinkinga ezinkulu njengokuhlaselwa yinhliziyo, isifo sohlangothi, noma ukufa. Kodwa lezi azivamile. Udokotela wakho uzokhuluma nawe ngazo zonke lezi zinto ngokuningiliziwe.
Eminye imibuzo ongase ube nayo
Le valve entsha izohlala isikhathi esingakanani?
Kuncike ezintweni eziningi, njengempilo yakho iyonke kanye nokusebenza kwenhliziyo. Abanye abantu kungadingeka baphinde bahlinzwe ngale ndlela ngemva kwesikhashana.
Ingabe kukhona okudingeka ngikwenze ngaphambi kokwelashwa kwamazinyo?
Yebo, lokhu kubaluleke kakhulu. Ngesikhathi sokwelashwa kwamazinyo, amabhaktheriya avela emlonyeni wakho angangena egazini futhi abangele ukutheleleka kwevalvu entsha yenhliziyo (i-endocarditis). Ngakho-ke, uma uya kudokotela wamazinyo, kufanele umtshele kusenesikhathi ukuthi uke wafakelwa ivalvu yenhliziyo. Kungase kudingeke futhi ukuthi uthathe ama-antibiotic ngaphambi kokuba kukhishwe izinyo.
Ngingakwazi yini ukuhlola ezokuphepha esikhumulweni sezindiza?
Yebo, akukho nkinga. Ama-X-ray kanye nezikena zokuphepha esikhumulweni sezindiza ngeke zilimaze i-valve yakho. Kodwa-ke, kufanele ukhulume nodokotela wakho ngaphambi kokuba uhlolwe nge-MRI.
Umlayezo Wokuya Nawe Ekhaya
- I-TPVR inqubo yokuhlinzwa yesimanje ethatha indawo yevalvu yamaphaphu yenhliziyo ngomsikelo omncane embotsheni, ngaphandle kokuvula isifuba.
- Lokhu kufaneleka kakhulu kubantu abanezinkinga zama-valve ephaphu ngenxa yesifo senhliziyo sokuzalwa.
- Inesikhathi esifushane sokululama, izingozi ezimbalwa, kanye nokuhlala esibhedlela isikhathi esifushane kunokuhlinzwa kwenhliziyo okuvulekile.
- Ungabuyela empilweni evamile zingakapheli izinsuku ezimbalwa ngemva kwalokhu kuhlinzwa.
- Uma unesifo esifanayo, khuluma nodokotela wakho wenhliziyo ngale ndlela yokwelapha ukuze ubone ukuthi ikulungele yini.
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