Ngezinye izikhathi kungenzeka ukuthi wake wezwa ngomntwana owazalwa enenkinga ethile yenhliziyo ngesikhathi esemncane. Mhlawumbe lowo mntwana wahlinzwa ngaleso sikhathi futhi isimo salungiswa. Kodwa lapho umntwana onjalo ekhula kancane, lapho efika eminyakeni esemncane, inkinga yenhliziyo eyayikhona kulolo buntwana ingaphinde ivele ngendlela ehlukile. Esimweni esinjalo, namuhla sizokhuluma ngendlela yokwelapha ebaluleke kakhulu enganikeza amandla amakhulu empilweni.
Ngakho-ke, iyini i-TPVR?
Kalula nje, i-TPVR , noma i-Transcatheter Pulmonary Valve Replacement , inqubo ekhethekile ethatha indawo yevalvu yamaphaphu engasebenzi kahle enhliziyweni yakho, kodwa ngaphandle kokuvula isifuba sakho. Lokhu kuzwakala kumangalisa, akunjalo? Ngokuvamile, uma sicabanga ngokuthatha indawo yevalvu yenhliziyo, sicabanga ngokuhlinzwa kwenhliziyo evulekile, okuhilela ukwenza ukusika okukhulu phakathi kwesifuba. Kodwa-ke, kule nqubo ye-TPVR, udokotela ohlinzayo wenza ukusika okuncane kakhulu esikhumbeni se-groin yakho futhi enze yonke inqubo ngayo.
I-valve yamaphaphu iyisango elilawula ukudlula kwegazi lisuka enhliziyweni yethu liye emaphashini ethu. Uma lingasebenzi kahle, ukugeleza kwegazi emzimbeni wonke kuzophazamiseka. Ngakho-ke ngale ndlela, uma ushintsha i-valve engasebenzi kahle ngentsha, isikhathi sakho sokuphila kanye nekhwalithi yokuphila kuzokhula kakhulu. Futhi, kuzosiza ukulibazisa noma ukugwema ngokuphelele isidingo sokuhlinzwa okukhulu okuphindaphindiwe.
Kwenzekani ngempela ngale ndlela yokwelapha i-TPVR?
Cabanga ukuthi ekuhlinzeni kwenhliziyo okuvulekile kwendabuko, odokotela basika ithambo lesifuba bese bedlulisela okwesikhashana umsebenzi wenhliziyo emshinini (umshini we-heart-lung bypass), bese besusa i-valve endala bese befaka entsha. Lokhu kuthatha isikhathi eside, kuthatha isikhathi eside ukuphulukiswa, futhi kungaba yingozi kakhulu kwabanye iziguli ukuthi zenze ukuhlinzwa okukhulu kangaka.
Kodwa indlela ye-TPVR ihluke kakhulu. Iyindlela engangenisi kakhulu . Nakhu okwenzekayo:
1. Udokotela wenhliziyo ohlinzayo wenza i-incision encane emthanjeni wegazi omkhulu embotsheni yakho (umthambo we-femoral) bese efaka ipayipi elincane neliguquguqukayo, elibizwa ngokuthi i-catheter, ngalo.
2. Ngaphakathi kwale catheter kukhona ivalvu entsha, ibhaluni elincane eligoqiwe.
3. Esebenzisa amasu akhethekile njenge-X-ray, udokotela uqondisa ngokucophelela le catheter ngemithambo yegazi kuze kufike lapho i-valve yamaphaphu ikhona khona enhliziyweni.
4. Uma selifikile endaweni yalo, ibhaluni liyafuthwa. Ivalvu entsha, ebigoqiwe, iyakhula futhi ishayeke endaweni lapho kwakukhona khona ivalvu endala.
5. Kusukela ngaleso sikhathi kuqhubeke, ivalvu entsha iqala ukusebenza. Ukugeleza kwegazi kusuka enhliziyweni kuya emaphashini kubuyiselwa esimweni esijwayelekile.
Enye yezinzuzo ezinkulu zalokhu ukuthi abantu abaningi abake bathola lokhu kwelashwa bangaya ekhaya ngokushesha. Isikhathi sokululama sifushane kakhulu.
Ngakho-ke, kwenzekani uma le valve yamaphaphu ingasebenzi kahle?
Kunezinkinga ezimbili eziyinhloko ezingase zenzeke nge-valve yamaphaphu.
| Isimo sezokwelapha | Kalula nje... |
|---|---|
| I-Pulmonary Stenosis | Ngenxa yokuthi ivalvu ayivuli kahle, inciphisa inani legazi elingageleza ngalo liye emaphashini. Lokhu kubeka umthwalo omkhulu ohlangothini lwesokudla lwenhliziyo, okungabangela ukuthi leyo ngxenye yehluleke ukusebenza. |
| Ukubuyela kwesisu emaphashini | Ngenxa yokuthi ivalvu ayivali kahle, igazi elimpontshelwa emaphashini liphinde lingene enhliziyweni. Lokhu kungabangela ukucindezeleka okukhulu enhliziyweni futhi kubangele ukuthi uhlangothi lwesokudla lungasebenzi kahle. |
Ngenxa yalezi zimo ezimbili, ungase ube nezimpawu ezifana nokuphelelwa umoya (ukuphelelwa umoya) , ukuvuvukala kwemilenze nesisu (ukuvuvukala) , ubuhlungu besifuba , kanye nokushaya kwenhliziyo okungajwayelekile . Lezi zimpawu zizoncipha kakhulu ngemva kokwelashwa nge-TPVR.
Ubani lokwelashwa okufanelekela kakhulu?
Uma wazalwa unesifo senhliziyo futhi wahlinzwa useyingane, kunethuba elihle lokuthi lokhu kwelashwa kuzokufanela. Ngoba i-valve eyafakwa ebuntwaneni (ngokuvamile i-homograft) ingase yonakale ngokuhamba kwesikhathi. Khona-ke izimo ezishiwo ngenhla, njenge-stenosis noma i-regurgitation, zingabonakala ebudaleni obusha. Yingakho odokotela bencoma indlela ye-TPVR kubantu abanjalo.
Le nqubo isetshenziselwa ukwelapha izifo zenhliziyo ezilandelayo zokuzalwa:
- I-Tetralogy of Fallot: Inhlanganisela yeziphambeko ezine, okuhlanganisa nezimbobo enhliziyweni, okubangela ukuxubana kwegazi elihle nelibi.
- I-Pulmonary Atresia: Isimo lapho i-valve yamaphaphu ingakheki khona lapho kuzalwa.
- I-Truncus Arteriosus: Imithambo yegazi emibili eyinhloko evela enhliziyweni (i-aorta kanye nomthambo wamaphaphu) ixhunywe ndawonye ukuze yakhe owodwa.
- Ukuguqulwa Kwemithambo Emikhulu: Imithambo yegazi emibili emikhulu ishintshiwe futhi ixhunywe ezinhlangothini ezingalungile.
Into ebaluleke kakhulu ukuthi udokotela wakho uzonquma ukuthi lokhu kwelashwa kukufanele yini, ngokusekelwe emlandweni wakho wezokwelapha, isimo sakho sempilo samanje, kanye nokuhlolwa okukhethekile okuningana.
Kwenzekani ngaphambi nangemva kokwelashwa?
Ukulungiselela ngaphambi kokwelashwa
Ukuze abone ukuthi ungakwazi yini ukwenza i-TPVR, udokotela wakho uzokuxilonga ngokucophelela futhi angenza isivivinyo sokucindezeleka kokuzivocavoca. Ngaphezu kwalokho, kungenziwa izivivinyo ezilandelayo:
- I-Angiogram
- I-CT scan yenhliziyo
- I-MRI yenhliziyo
- I-Echocardiogram
- Ukuhlolwa kwe-ECG
Ngemva kokucabangela konke lokhu, udokotela uzonquma ukuthi yisiphi ikhambi elingcono kakhulu kuwe.
Ngesikhathi sokwelashwa
Uzonikezwa i-anesthesia ngaphambi kokuba kuqale ukwelashwa, ngakho ngeke uzwe ubuhlungu. Yonke inqubo ithatha cishe amahora amabili kuya kwamathathu. Odokotela bazofaka i-catheter, babeke i-valve, bahlole ukusebenza kwayo, bese besusa i-catheter.
Ngemva kokwelashwa
Uzogcinwa esibhedlela ukuze uhlolwe ubusuku bonke futhi uzothunyelwa ekhaya ngosuku olulandelayo. Uzokwazi ukuqhubeka nemisebenzi yakho evamile cishe ngesonto.
Yiziphi izinzuzo nezingozi?
Njenganoma yiluphi uhlobo lokwelashwa, lolu lunezinzuzo kanye nezingozi ezithile.
| Izinzuzo | Izingozi |
|---|---|
| Isikhathi sokululama sifushane. | Ihluli. |
| Ingozi yokutheleleka iphansi. | Ukulimala kwemithambo yegazi. |
| Isikhathi sokuhlala esibhedlela sifushane. | Ukushaya kwenhliziyo okungajwayelekile (i-Arrhythmia). |
| Ngeke kube khona izibazi ezinkulu. | Ukutheleleka kwenhliziyo (i-Endocarditis). |
| Ubuhlungu buncane. | Ukopha okungalindelekile. |
Akuvamile kakhulu ukuthi kube nezinkinga ezinkulu njengokuhlaselwa yinhliziyo, isifo sohlangothi, noma ukufa. Ngakho-ke, kubalulekile ukuxoxa ngezinzuzo kanye nokubi kwalokhu kwelashwa nodokotela wakho ngaphambi kokwenza isinqumo.
Ezinye izinto ezibalulekile okufanele uzazi
Ivalvu entsha ihlala isikhathi esingakanani?
Lokhu kuncike empilweni yakho iyonke kanye nesimo senhliziyo yakho. Abanye abantu kungadingeka baphinde bahlinzwe ngemva kwesikhashana. Kodwa izindaba ezinhle ukuthi uma kudingeka, ungashintshwa enye ivalvu ngenqubo ye-TPVR.
Ingabe udinga ukuqaphela ngesikhathi sokwelashwa kwamazinyo?
Yebo, lokhu kubaluleke kakhulu. Ngesikhathi sezinto ezifana nokukhishwa kwamazinyo nokuhlanzwa kwamazinyo, amabhaktheriya emlonyeni angangena egazini futhi adlule kulo abangele isimo esibi esibizwa ngokuthi i-endocarditis , ukutheleleka kwevalvu yenhliziyo esanda kufakelwa. Ngakho-ke, ngaphambi kokuba uthole ukwelashwa kwamazinyo, kufanele nakanjani wazise udokotela wakho wamazinyo ukuthi uke waba ne-TPVR. Ungase ucelwe ukuthi uthathe ama-antibiotic ngaphambi kokwelashwa.
Ingabe zikhona izinkinga ngokuphepha kwezindiza?
Cha. Ama-X-ray asesikhumulweni sezindiza kanye nokuhlolwa kokuphepha ngeke kukulimaze. Kodwa-ke, uma ucabangela ukuskena kwe-MRI, khuluma nodokotela wakho kuqala.
Umlayezo Wokuya Nawe Ekhaya
- I-TPVR iyindlela yokwelapha yesimanje, engangenisi kakhulu ethatha indawo yevalvu yamaphaphu yenhliziyo ngomsikelo omncane, ngaphandle kokuvula isifuba.
- Lesi yisisombululo esihle sezinkinga zama-valve ezenzeka esemncane, ikakhulukazi kulabo abahlinzwa beseyizingane ngenxa yesifo senhliziyo abazalwa naso.
- Kunesikhathi esincane sokululama, ukuhlala esibhedlela okuncane, kanye nobuhlungu obuncane kunokuhlinzwa kwenhliziyo okuvamile.
- Njengakuzo zonke izindlela zokwelapha, kunezingozi, ngakho-ke kufanele uxoxe ngalokhu nodokotela wakho ngaphambi kokunquma ukuthi kulungile yini kuwe.
- Kubaluleke kakhulu enhlalakahleni yakho ukulandela imiyalelo kadokotela wakho ngemva nje kokwelashwa nokubona udokotela wakho ngezinsuku ezihleliwe.
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