Ingabe udokotela wakho ukutshelile ukuthi impande yakho ye-aortic ikhulisiwe kancane nokuthi udinga ukuhlinzwa? Kuvamile ukuzizwa wesaba futhi ukhathazekile kancane uma uzwa lokho. Ubani ongathandi igama elithi "ukuhlinzwa kwenhliziyo"? Kodwa ungakhathazeki. Ubuchwepheshe buthuthuke kakhulu namuhla. Namuhla, sizokhuluma ngokuhlinzwa okuphumelelayo kakhulu, okukhethekile okuxazulula le nkinga ngaphandle kokususa ingxenye ebaluleke kakhulu yenhliziyo yakho, okuyi-'valve' yakho yemvelo.
Kuyini Ukufakwa Esikhundleni Kwezimpande Ze-Aortic Valve-Sparing?
Ukuze siqonde lokhu, ake siqale sibheke indlela inhliziyo esebenza ngayo. Cabanga ngenhliziyo yakho njengephampu yamanzi ekhaya lakho. Le phampu iphampa igazi emzimbeni wakho wonke.
- I-Aorta: Lena yipayipi elikhulu kunawo wonke eliphuma enhliziyweni. Lithwala igazi liye emzimbeni wonke.
- Impande ye-Aortic: Lena yingxenye yokuqala yomthambo oyinhloko oxhumanisa nenhliziyo. Kufana nalapho unamathisela khona ipayipi ku-motor.
- I-Aortic Valve: Lena yingxenye ebaluleke kakhulu yendaba. Lapho ixhumana khona nenhliziyo, kukhona ingxenye esebenza njengomnyango. Lapho inhliziyo ipompa igazi, lo mnyango uyavuleka, ukhiphe igazi. Bese lo mnyango uvala ukuze igazi lingabuyeli enhliziyweni. Yilokhu esikubiza ngokuthi `(i-Aortic Valve)`.
Manje, kwabanye abantu, impande yalomthambo omkhulu oxhumanisa nenhliziyo, i-`(Aortic Root)` iba buthakathaka kancane bese iqala ukukhukhumala futhi ibe nkulu njengebhaluni. Lokhu sikubiza ngokuthi `(Aortic Root Aneurysm)`. Uma ikhula kanje, lowo mnyango, lelo valvu, awuvaleki kahle. Bese igazi liqala ukuvuza emuva, `(Aortic Regurgitation)`.
Esikhathini esidlule, lapho kuvela lolu hlobo lwenkinga, odokotela abahlinzayo babesusa impande ye-aortic kanye ne-aortic valve, bese befaka impande ye-aortic kanye ne-valve yokwenziwa. Lokhu kuhlinzwa kubizwa ngokuthi inqubo ye-Bentall .
Kodwa manje, uma ivalvu yakho isesimweni esihle, okusho ukuthi ayonakele kakhulu, esikhundleni sokususa leyo valve yemvelo eyigugu, kususwa kuphela i-`(Aortic Root)` eyonakele, kufakwa ipayipi elisha lokwenziwa (`graft`), bese ivalvu yakho ixhunywe kuyo kabusha. Kalula nje, lokhu kubizwa ngokuthi i-Valve-Sparing Aortic Root Replacement .
Yiziphi izimo eziphathwayo ngalokhu kuhlinzwa?
Lokhu kuhlinzwa kwenziwa ikakhulukazi ngesimo esibizwa ngokuthi `(Aortic Root Aneurysm)`. Lokhu kusho ukuthi impande ye-aorta ivuvukele njengebhaluni. Lokhu kungaba yingozi, ngoba uma iba nkulu kunomkhawulo othile, ingaqhuma (iqhume) noma idabuke (i-aortic dissection).
Abanye abantu banezinkinga zezicubu ezixhumene nezakhi zofuzo, njenge-Marfan syndrome. Abantu abanalezi zimo basengozini enkulu yokuthola i-aortic root aneurysm.
Ubani ofanelekela lokhu kuhlinzwa?
Udokotela wakho uzokwenza izivivinyo ezahlukahlukene ukuze anqume ukuthi ungumuntu ofanele yini kulokhu kuhlinzwa. Ngokuvamile, ungase ube umuntu ofanele yini kule nqubo,
- Uma i-Aortic Valve yakho ine-calcification encane kakhulu noma ingenayo nhlobo.
- Ngaphandle kokuthi ivalvu yonakele kakhulu.
- Uma ivalvu isebenza kahle, noma ingalungiswa ngokulungiswa okuncane.
- Lokhu kuhlinzwa kunconywa kakhulu kubantu abangaphansi kweminyaka engu-75 kanye nalabo abanezifo zofuzo.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Njengoba lokhu kuwukuhlinzwa okukhulu, kubaluleke kakhulu ukukulungiselela kahle. Udokotela wakho ohlinzayo uzokunikeza imiyalelo ecacile ngalokhu.
- Imithi: Kufanele utshele udokotela wakho nganoma yimiphi imithi oyithathayo njengamanje. Angase akucele ukuthi uyeke noma ushintshe eminye imithi (ikakhulukazi imithi yokunciphisa igazi) ngaphambi kokuhlinzwa.
- Ukuzila Ukudla: Uzocelwa ukuthi ungadli noma uphuze lutho ngemva kwamabili ebusuku ngaphambi kokuhlinzwa. Ungaphuzi ngisho namanzi.
- Ukuhlolwa: Udokotela uzoyala ukuhlolwa okuningana ukuze ahlele ukuhlinzwa.
- I-Echocardiogram (ukuskena kwenhliziyo)
- Ukuhlolwa kwegazi
- Iskeni se-CT esivalwe nge-EKG
- I-MRI yenhliziyo
- I-Angiogram ye-Coronary
- Ukubhema: Uma ubhema, kubalulekile ukuthi uyeke ukubhema ngokuphelele okungenani inyanga eyodwa ngaphambi kokuhlinzwa.
- Buza imibuzo: Khuluma nodokotela wakho ngokukhululekile nganoma yikuphi ukukhathazeka noma ukwesaba onakho. Kuzoba impumuzo enkulu ukwazi konke ngokucacile.
Kwenziwa kanjani ukuhlinzwa?
Lokhu kuhlinzwa kuvame ukuthatha amahora angama-4 kuya kwayi-6. Uma kwenziwa ngesandla ngudokotela ohlinzayo onolwazi, inhliziyo iyamiswa isikhashana, cishe ihora. Izinyathelo ezihilelekile kule nqubo zimi kanje.
1. I-Anesthesia: Okokuqala, uzonikezwa i-anesthesia ukuze ulale ubuthongo obukhulu. Ngakho ngeke uzwe ubuhlungu.
2. Ukuvula isifuba: Udokotela wenza i-incision phakathi kwesifuba (median sternotomy) ukuze afinyelele inhliziyo.
3. Umshini wenhliziyo namaphaphu: Okulandelayo, uzoxhunywa emshinini wenhliziyo namaphaphu (umshini we-cardiopulmonary bypass). Lo mshini uzokwenza umsebenzi wenhliziyo namaphaphu akho ngesikhathi sokuhlinzwa. Uzokunikeza nomuthi wokumisa inhliziyo yakho okwesikhashana.
4. Ukuhlukaniswa kwamavalvu: Udokotela ohlinzayo uzohlukanisa ngokucophelela ivalvu yakho ye-aorta nezicubu ezizungezile.
5. Ukulungiswa:Uma kukhona umonakalo omncane kuma-valve flaps, uyalungiswa ngokushesha.
6. Ukususa ingxenye eyonakele: Ingxenye evuvukile neyonakele ye-`(Aortic Root)` iyanqunywa bese isuswa.
7. Ukufakelwa kwepayipi lokwenziwa: Esikhundleni salokho, kuthathwa ipayipi lokwenziwa elithi "graft" elenziwe ngendwangu ekhethekile, lenziwe ngosayizi ofanele wena, bese lifakwa kuleyo ndawo.
8. Ukuhlanganisa kabusha ivalvu: Ngemuva kwalokho , ivalvu yakho yemvelo , esuswe ngokucophelela, ifakwa ngaphakathi kwepayipi elisanda kufakelwa bese ithungwa ndawonye (ukuyifaka kabusha).
9. Ukuhlola: Hlola ukuthi konke kulungile yini, hlola ukuthi ivalvu iyavula futhi ivala kahle yini, nokuthi kukhona yini ukuvuza.
10. Ukuvala: Imithambo yenhliziyo ehambisa igazi enhliziyweni ibe isixhunywa ku-graft entsha. Ususwa emshinini wenhliziyo namaphaphu futhi uma inhliziyo yakho iqala ukusebenza futhi, ukusikwa esifubeni sakho kuyavalwa.
11. Ukuhlolwa kokugcina: Ngaphambi kokukhishwa egumbini lokuhlinza, kwenziwa i-"transesophageal echocardiogram" ukuqinisekisa impumelelo yokuhlinzwa.
Intuthuko yesimanje ekuhlinzeni
Ngokuhamba kwesikhathi, odokotela bangeze amasu amasha ukuze lokhu kuhlinzwa kuphumelele kakhudlwana.
- Ukunciphisa i-Annulus: Kalula nje, isisekelo esibamba i-valve (i-aortic annulus) sicindezelwe ukuze silingane nomzimba wakho. Lokhu kuzovimbela igazi ekuphumeni kwe-valve esikhathini esizayo.
- Ukudala Ama-Aortic Sinuses Amasha (Neosinuses): Impande ye-aorta yemvelo inokudlidliza okuncane. Njengoba i-graft entsha iyipayipi eliqondile, idala nokudlidliza okuncane. Lokhu kwenza ukugeleza kwegazi kube ngokwemvelo futhi kunciphisa ukulimala kwamapheshana e-valve.
Ziyini izinzuzo zalokhu kuhlinzwa?
Lokhu kuhlinzwa kunezinzuzo eziningana ezinkulu kunokuhlinzwa kwendabuko kweBentall (okuhlanganisa ukufaka ivalvu kanye nevalvu).
| Inzuzo | Ukuhlinzwa Kokunciphisa Amavalvu | Ukuhlinzwa kwe-Bentall (nge-valve yomshini) |
|---|---|---|
| Izinto zokunciphisa igazi impilo yonke | Akudingeki ukuthi uyithathe. | Imithi efana neCoumadin (Warfarin) kumele ithathwe impilo yonke. |
| Amahlule egazi, ingozi yokushaywa yisifo sohlangothi | Kuphansi kakhulu. | Okubaluleke kakhulu . |
| Ingozi yokutheleleka kwe-valve (i-endocarditis) | Kuphansi kakhulu. | Kakhulu . |
| Isidingo sokuhlinzwa kokushintsha i-valve | Kuphansi kakhulu. Abantu abangu-95% ngeke bayidinge iminyaka eyi-10. | Kungase kudingeke ngokuhamba kwesikhathi. |
Kuthatha isikhathi esingakanani ukululama ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzogcinwa egunjini lokunakekelwa okujulile (ICU) usuku olulodwa noma ezimbili, bese udluliselwa egunjini elivamile. Ngokuvamile ungaya ekhaya usuka esibhedlela ezinsukwini ezi-4 kuya kweziyi-7.
Kuthatha cishe amasonto ayisithupha ukululama ngokugcwele nokubuyela emisebenzini evamile.
Phakathi nalesi sikhathi,
- Ukubamba iqhaza ohlelweni lokuvuselela inhliziyo kungumqondo omuhle. Kuzokusiza ukuthi ululame ngokushesha futhi ube namandla.
- Udokotela uthi ungenzi lutho olufana nokuphakamisa izinsimbi noma ukushayela cishe amasonto ayisithupha.
- Ama-aphoyintimenti okulandelela: Ungase ungacabangi ukuthi udinga ukubona udokotela wakho futhi ngemva kokuba usululame. Kodwa kubalulekile ukwenza kanjalo . Kubalulekile ukugcina isimo senhliziyo yakho sihlolwe njalo.
Isikhathi sokufonela udokotela ngokushesha
Ngemva kokubuyela ekhaya, uma uba nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
| Isibonakaliso | Okufanele ukunake |
|---|---|
| Izinguquko endleleni yokusika | Ubomvu, ukuvuvukala, ubuhlungu obukhulu, ukufudumala, kanye nobomvu obuphuzi noma obuluhlaza nxazonke kwesilonda. |
| Ubuhlungu besifuba | Ubuhlungu besifuba obungazelelwe noma obukhulu. |
| Ubunzima bokuphefumula | Ukuphelelwa umoya ngokuzumayo. |
| Ukuvuvukala kwemilenze | Ukuvuvukala kwemilenze noma ukungakwazi ukuhambisa imilenze. |
| Isiyezi noma ukuquleka | Ukuzizwa unesizungu kakhulu, ukuquleka, noma ukukhathala okukhulu. |
| Umkhuhlane noma umkhuhlane | Umkhuhlane ohambisana nokubanda, ukuphuma koketshezi oluphuzi noma oluluhlaza. |
Kuvamile ukuzizwa ukhathazekile ngaphambi kwanoma yikuphi ukuhlinzwa okukhulu. Kodwa khumbula, lokhu kuhlinzwa kwenzelwa ukusindisa impilo yakho nokukusiza uhlale uphilile isikhathi eside. Khuluma nomndeni wakho nabangani ngalokhu. Ukusekelwa kwabo kuzoba amandla amakhulu kuwe ngalesi sikhathi.
Umlayezo Wokuya Nawe Ekhaya
- Ukufakwa Kwezimpande Ze-Aortic Ezisindisa Amavalvu kuyindlela yokuhlinzwa ethuthukisiwe esindisa ivalvu yakho yemvelo ye-aortic futhi yelapha ukunwebeka kwezimpande ze-aortic.
- Inzuzo enkulu yalokhu ukuthi akudingeki uphuze imithi yokunciphisa igazi impilo yakho yonke, njengoba ubungenza nge-valve yomshini.
- Lokhu kuhlinzwa kungenziwa ngaphansi kokuqondisa kukadokotela ohlinzayo onolwazi esibhedlela esinezikhungo ezinhle futhi kunezinga eliphezulu lempumelelo (ngaphezu kuka-99%).
- Kuthatha cishe amasonto ayisithupha ukululama ngokuphelele ngemva kokuhlinzwa. Phakathi naleso sikhathi, kubaluleke kakhulu ukulandela imiyalelo kadokotela.
- Ungesabi ukukhuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Kuyimfanelo enkulu ukuthi ube nolwazi oluphelele ngaphambi kokuba ungene ekuhlinzweni.
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