Utyando lwevalvu yentliziyo

Utyando lwevalvu yentliziyo lusetyenziselwa ukulungisa okanye ukufaka endaweni yezivalo zentliziyo ezinesifo.

Igazi elihamba phakathi kwamagumbi ahlukeneyo entliziyo kufuneka ligele kwivelufa yentliziyo. Igazi eliphuma entliziyweni yakho liye kwiirriyithi ezinkulu kufuneka liphume nakwivalve yentliziyo.

Ezi zivalo zivula ngokwaneleyo ukuze igazi liphume. Emva koko bayavala, bagcina igazi lingabuyi umva.

Kukho iivelufa ezi-4 entliziyweni yakho:

• Ivalufa yeAortic
• Mitral ivelufa
• Ivaluva yetricuspid
• Ivelufa Pulmonic

Ivalvu ye-aortic yeyona valve ixhaphakileyo ekufuneka itshintshwe. Ivalve ye-mitral yeyona valve ixhaphakileyo ekufuneka ilungisiwe. Kunqabile kuphela ukuba ivelufa ye-tricuspid okanye ivelufa ye-pulmonic ilungiswe okanye itshintshwe.

Ngaphambi kotyando lwakho, uya kufumana i-anesthesia ngokubanzi. Uya kulala kwaye ungakwazi kuva iintlungu.

Kutyando lwentliziyo oluvulekileyo, ugqirha wotyando usika utyando olukhulu kwisifuba sakho ukufikelela entliziyweni nakwi-aorta. Unxibelelana nomatshini wokudlula kwentliziyo kunye nemiphunga.Intliziyo yakho imisiwe ngelixa uqhagamshele kulo matshini. Lo matshini wenza umsebenzi wentliziyo yakho, ukubonelela ngeoksijini kunye nokususa ikhabhon diokside.

Utyando lwevalvu olungena kancinci lwenziwa ngokusika okuncinci kunokwenza utyando, okanye nge-catheter efakwe kulusu. Kusetyenziswa iindlela ngeendlela ezahlukeneyo:

• Utyando olwenziwe ngomzimba (ngesikhumba)
• Utyando oluncediswa ziirobhothi

Ukuba ugqirha wakho wotyando unokuyilungisa i-mitral valve yakho, unokuba:

• Iringi yentsimbi. Ugqirha ulungisa indawo enjenge-ring ejikeleze ivalve ngokuthunga isangqa seplastiki, ilaphu, okanye izicwili ezijikeleze ivalve.
• Ukulungiswa kwevalve. Ugqirha usika, enze imilo, okanye akhe elinye lamaphetshana evalve. Amaphetshana ziimpapasho ezivulekileyo kwaye zivale ivalve. Ukulungiswa kwevalve kungcono kwi-valral mitral kunye ne-tricuspid valves. Ivalvu ye-aortic ihlala ingalungiswa.

Ukuba ivelufa yakho yonakele kakhulu, kuyakufuneka ivelufa entsha. Oku kubizwa ngokuba luvavanyo ngokutsha lwevalvevu. Ugqirha wakho uyakususa ivelufa yakho kwaye ubeke entsha endaweni yayo. Ezona ntlobo ziphambili zevalvu zintsha zezi:

• Oomatshini abenziwe ngezinto ezenziwe ngabantu, ezinje ngesinyithi (intsimbi engenasici okanye ititanium) okanye iiceramic. Ezi zivalo zihlala ixesha elide, kodwa kuya kufuneka uthathe amayeza okusika igazi, njenge-warfarin (Coumadin) okanye i-aspirin, ubomi bakho bonke.
• I-Biological-eyenziwe yinyama yabantu okanye yezilwanyana. Ezi zivalo zihlala iminyaka eyi-12 ukuya kwe-15, kodwa akunakufuneka uthathe abacoci gazi ubomi babo bonke.

Kwezinye iimeko, oogqirha banokusebenzisa i-valve yakho ye-pulmonic ukubuyisela i-valve ye-aortic eyonakalisiweyo. Ivelufa yemiphunga emva koko yatshintshwa yivelufu eyenziweyo (le ibizwa ngokuba yiRoss Procedure). Le nkqubo inokuba luncedo kubantu abangafuniyo ukuthatha abacoci begazi ubomi babo bonke. Nangona kunjalo, ivelufa entsha ye-aortic ayihlali xesha lide kwaye inokufuna ukubuyiselwa kwakhona ngomatshini okanye ivelufa yebhayoloji.

Izihloko ezihambelanayo zibandakanya:

• Utyando lwevalvu yeAortic -ungena kancinci
• Utyando lwe-aortic valve-luvulekile
• Utyando lweMitral valve -yincinci
• Utyando lweMitral valve-luvulekile

Ungadinga utyando ukuba ivelufa yakho ayisebenzi kakuhle.

• Ivalve engavaliyo yonke indlela iya kuvumela igazi ukuba livuze ngasemva. Oku kubizwa ngokuba kukuphindaphinda.
• Ivalve engavuli ngokupheleleyo iya kunciphisa ukuhamba kwegazi phambili. Oku kubizwa ngokuba yi-stenosis.

Unokufuna utyando lwevalvu yentliziyo ngezi zizathu:

• Iziphene kwivelufa yentliziyo yakho zibangela iimpawu zentliziyo, ezinje ngesifuba (angina), ukuphefumla kancinci, ukuphelelwa ngamandla (i-syncope), okanye ukusilela kwentliziyo.
• Uvavanyo lubonisa ukuba utshintsho olwenziwe kwivelufa yentliziyo yakho luqala ukubuchaphazela ngokunzulu ukusebenza kwentliziyo yakho.
• Ugqirha wakho ufuna ukubuyisela okanye ukulungisa ivalve yentliziyo yakho ngaxeshanye njengokuba usenziwa utyando lwentliziyo oluvulekileyo ngesinye isizathu, njenge-coronary artery bypass graft surgeon.
• Ivalve yentliziyo yakho yonakaliswe lusulelo (i-endocarditis).
• Ufumene ivalve yentliziyo entsha kwixa elidlulileyo kwaye ayisebenzi kakuhle, okanye unezinye iingxaki ezinje ngegazi, usulelo, okanye ukopha.

Ezinye zeengxaki zentliziyo yevalve eziphathwe ngotyando zezi:

• Ukungabikho kwe-aortic
• I-aortic stenosis
• Isifo sentliziyo esibelekileyo
• Ukuphinda kubuyiswe iMitral-acute
• Ukubuyiselwa kweMitral-okungapheliyo
• IMitral stenosis
• I-Mitral valve prolapse
• I-valve stenosis yepulmonary
• Ukuhlaziywa kweTricuspid
• I-valve yeTricuspid stenosis

Umngcipheko wokuhlinzwa kwentliziyo uquka:

• Ukufa
• Ukuhlaselwa yintliziyo
• Ukumelwa yintliziyo
• Ukopha kufuna ukuphinda usebenze
• Ukuqhekeka kwentliziyo
• Ukubetha kwentliziyo ngokungaqhelekanga (arrhythmia)
• Ukungaphumeleli kwezintso
• I-post-pericardiotomy syndrome - umkhuhlane ophantsi kunye nentlungu esifubeni enokuhlala ukuya kuthi ga kwiinyanga ezi-6
• Stroke okanye enye ingozi yokwexeshana okanye esisigxina engqondweni
• Usulelo
• Iingxaki ngokunyanga kwamathambo ebeleni
• Ukudideka okwethutyana emva kotyando ngenxa yomatshini wentliziyo-wemiphunga

Kubaluleke kakhulu ukuthatha amanyathelo okuthintela usulelo lwevalvu. Kuya kufuneka uthathe ii-antibiotics ngaphambi komsebenzi wamazinyo kunye nezinye iinkqubo zokuhlasela.

Ukulungiselela kwakho inkqubo kuya kuxhomekeka kuhlobo lotyando lwevalve onalo:

• Utyando lwevalvu yeAortic -ungena kancinci
• Utyando lwe-aortic valve-luvulekile
• Utyando lweMitral valve -yincinci
• Utyando lweMitral valve-luvulekile

Ukubuyiselwa kwakho emva kwenkqubo kuya kuxhomekeka kuhlobo lotyando lwevalve onalo:

• Utyando lwevalvu yeAortic -ungena kancinci
• Utyando lwe-aortic valve-luvulekile
• Utyando lweMitral valve -yincinci
• Utyando lweMitral valve-luvulekile

Ukuhlala esibhedlele okuphakathi ziintsuku ezi-5 ukuya kwezi-7. Umongikazi uya kukuxelela indlela yokuzikhathalela ekhaya. Ukufumana kwakhona ngokupheleleyo kuya kuthatha iiveki ezimbalwa ukuya kwiinyanga ezininzi, kuxhomekeke kwimpilo yakho ngaphambi kotyando.

Inqanaba lokuphumelela kotyando lwevalvu yentliziyo liphezulu. Umsebenzi unokuzikhupha iimpawu zakho kwaye wandise ubomi bakho.

Ii-valves zentliziyo yoomatshini azisoloko zisilela. Nangona kunjalo, amahlwili egazi anokukhula kwezi zivalo. Ukuba iifom yegazi iyenzeka, unokuba noxinzelelo. Ukopha kunokwenzeka, kodwa oku kunqabile. Izivalo zeethishu zihlala umndilili we-12 ukuya kwi-15 leminyaka, kuxhomekeke kuhlobo lwevalve. Ukusetyenziswa kwexesha elide kweyeza lokucoca igazi kuhlala kungafuneki ngezivalo zethishu.

Kuhlala kukho umngcipheko wosulelo. Thetha nogqirha wakho ngaphambi kokuba naluphi na uhlobo lonyango.

Ukucofa kwee-valves zentliziyo yomatshini kunokuvakala esifubeni. Oku kuqhelekile.

Ukutshintshwa kwevalve; Ukulungiswa kwevalve; Isilumko sentliziyo sokufakelwa; Izivalo zoomatshini; Ivaluva zokufakelwa

• Utyando lwevalvu yentliziyo - ukukhutshwa

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• Ivaluva zentliziyo - umbono ongaphandle
• Iipavali zentliziyo-umbono ogqwesileyo
• Utyando lwevalvu yentliziyo-uthotho

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UHermann HC, uMack MJ. Unyango lweTranscatheter yesifo sentliziyo se-valvular. Ku: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 72.

Nishimura. RA, Otto CM, Bonow RO, okqhubekayo. Ukuhlaziywa okujolise kwisikhokelo se-AHA / ACC sika-2014 kulawulo lwezigulana ezinesifo sentliziyo: ingxelo yeAmerican College of Cardiology / American Heart Association Task Force kwiZikhokelo zokuSebenza. J NdinguColl Cardiol. Ngo-2017; 70 (2): 252-289. IINKCUKACHA: 28315732 pubmed.ncbi.nlm.nih.gov/28315732/.

I-Otto CM, iBonow RO. Isifo sentliziyo seValvular. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 67.

I-Rosengart TK, i-Anand J. Isifo sentliziyo esifunyenweyo: i-valvular. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 60.