Utyando lwevalvu yeAortic -ungena kancinci

Igazi liphuma entliziyweni yakho liye kwisitya esikhulu segazi esibizwa ngokuba yi-aorta. Ivalve ye-aortic yahlula intliziyo kunye ne-aorta. Ivalvu ye-aortic ivula ukuze igazi liphume. Iyavala ke ukugcina igazi lingabuyeli entliziyweni.

Unokufuna utyando lwevalvu ye-aortic ukuze ubeke endaweni yayo i-aortic valve entliziyweni yakho ukuba:

• Ivalve yakho ye-aortic ayivali yonke indlela, ngenxa yoko igazi liyavuza libuyele entliziyweni. Oku kubizwa ngokuba kukuphinda kusebenze kwakhona.
• Ivalvu yakho ye-aortic ayivuli ngokupheleleyo, ngoko ukuphuma kwegazi entliziyweni kuyacuthwa. Oku kubizwa ngokuba yi-aortic stenosis.

Ivalve aortic inokutshintshwa kusetyenziswa:

• Utyando oluncinci olungenelelayo lwe-aortic valve, olwenziwe kusetyenziswa ukusika okukodwa okanye nangaphezulu
• Vula utyando lwevalvu ye-aortic, olwenziwe ngokusika okukhulu esifubeni sakho

Ngaphambi kotyando lwakho, uya kufumana i-anesthesia ngokubanzi.

Uya kuba ulele kwaye ungenazintlungu.

Zininzi iindlela zokwenza utyando lwevalvu encinci ye-aortic. Iitekhnoloji zibandakanya i-min-thoracotomy, min-sternotomy, utyando oluncediswa zirobhothi, kunye notyando olwenziwa ngazinye. Ukwenza iinkqubo ezahlukeneyo:

• Ugqirha wakho angenza i-2-intshi ukuya kwi-intshi ezintathu (5 ukuya kwi-7.6 iisentimitha) zinqunqwe kwindawo elungileyo yesifuba sakho kufutshane ne-sternum (ithambo lesifuba). Izihlunu kwindawo leyo ziya kwahlulwa. Oku kuvumela ugqirha ukuba afike entliziyweni nakwivalve ye-aortic.
• Ugqirha wakho ugqirha unokwahlulahlula kuphela isahlulo esingaphezulu kwethambo lakho lesifuba, evumela ukubonakaliswa kwevalve ye-aortic.
• Ngokwenza utyando olwenziwe ngerobhothi, ugqirha wotyando wenza amanxeba amancinci ama-2 ukuya kwezi-4 esifubeni sakho. Ugqirha usebenzisa ikhompyuter ekhethekileyo ukulawula iingalo zerobhothi ngexesha lotyando. Umbono we-3D wentliziyo kunye nevalve ye-aortic ibonisiwe kwikhompyuter kwigumbi lokusebenza.

Kuya kufuneka ukuba ubekho kumatshini wemiphunga yentliziyo yazo zonke ezi tyando.

Xa ivelufa ye-aortic yonakele kakhulu ukuba ingalungiswa, kufakwa ivalve entsha. Ugqirha wakho uyakususa i-valve yakho ye-aortic kwaye uthunge entsha endaweni yayo. Zimbini iintlobo eziphambili zezivalo:

• Oomatshini, abenziwe ngezinto ezenziwe ngabantu, njenge titanium okanye ikhabhoni. Ezi zivalo zihlala ixesha elide. Uya kudinga ukuthatha iyeza lokucoca igazi, njenge-warfarin (Coumadin), ubomi bakho bonke ukuba unolu hlobo lwevalvu.
• Ibhayoloji, eyenziwe yinyama yabantu okanye yezilwanyana. Ezi zivalo zihlala iminyaka eli-10 ukuya kwengama-20, kodwa akunakufuneka uthathe abacoci gazi ubomi bakho bonke.

Enye indlela ye-transcatheter aortic valve replacement (TAVR). Utyando lwe-TAVR aortic valve lunokwenziwa ngesicatshulwa esincinci esenziwe kwi-groin okanye esifubeni sasekhohlo. Ivalve yokutshintsha idluliselwe kwisitya segazi okanye entliziyweni kwaye inyuswe yaya kwi-aortic valve. I-catheter inebhaluni ekugqibeleni. Ibhaluni inyuselwe ukolula ukuvulwa kwevalve. Le nkqubo ibizwa ngokuba yi-valvuloplasty engagungqiyo kwaye ivumela ivalve entsha ukuba ibekwe kule ndawo. Ugqirha emva koko uthumela i-catheter ene-valve eqhotyoshelweyo kwaye uyikhuphe ivalve ukuthatha indawo ye-aortic valve eyonakalisiweyo. Ivalve yebhayoloji isetyenziselwa i-TAVR. Awudingi ukuba ubekho kumatshini wemiphunga yentliziyo yale nkqubo.

Ngamanye amaxesha, uya kuba notyando lwe-coronary artery (okanye i-CABG), okanye uqhaqho ukubuyisela inxenye ye-aorta kwangaxeshanye.

Nje ukuba ivalve entsha isebenze, ugqirha wakho uya:

• Vala ukusikwa okuncinci entliziyweni yakho okanye kwi-aorta
• Beka iicatheters (iityhubhu eziguqukayo) ezijikeleze intliziyo yakho ukukhupha ulwelo olwakhayo
• Vala ukusika kotyando kwimisipha yakho kunye nolusu

Olu tyando lunokuthatha iiyure ezi-3 ukuya kwezi-6, nangona kunjalo, inkqubo ye-TAVR ihlala imfutshane.

Utyando lwe-aortic valve lwenziwa xa ivelufa ingasebenzi kakuhle. Utyando lunokwenziwa ngezi zizathu:

• Utshintsho kwivelufa yakho ye-aortic ibangela iimpawu zentliziyo, ezinje ngesifuba, ukuphefumla kancinci, ukuphelelwa ngamandla, okanye ukusilela kwentliziyo.
• Uvavanyo lubonisa ukuba utshintsho kwivalve yakho ye-aortic lonakalisa umsebenzi wentliziyo yakho.
• Ukonakala kwentliziyo yesivalo kwintsholongwane (endocarditis).

Inkqubo encinci yokungena inokuba nezibonelelo ezininzi. Kukho iintlungu ezimbalwa, ukulahleka kwegazi, kunye nomngcipheko wosulelo. Uya kuphila ngokukhawuleza kunokuba ubuya kutyando lwentliziyo oluvulekileyo.

I-valvuloplasty ye-Percutaneous kunye ne-catheter-based based valve efana ne-TAVR yenziwa kuphela kubantu abagula kakhulu okanye abasengozini enkulu yokuhlinzwa okukhulu kwentliziyo. Iziphumo ze-valvuloplasty engagungqiyo azihlali ixesha elide.

Iingozi zalo naluphi na utyando zezi:

• Ukopha
• Amahlwili egazi emilenzeni anokuhamba aye emiphungeni
• Iingxaki zokuphefumla
• Usulelo, kubandakanya imiphunga, izintso, isinyi, isifuba, okanye iivevvu zentliziyo
• Impendulo kumayeza

Eminye imingcipheko iyahluka ngokobudala bomntu. Eminye yemingcipheko yile:

• Ukonakala kwamanye amalungu, imithambo-luvo, okanye amathambo
• Ukuhlaselwa yintliziyo, ukubetha, okanye ukufa
• Usulelo lwevalve entsha
• Ukungaphumeleli kwezintso
• Ukubetha kwentliziyo ngendlela engaqhelekanga ekufuneka kunyangwe ngamayeza okanye ngesincedisi-ntliziyo
• Ukuphilisa kakubi ukusikwa
• Ukufa

Soloko uxelela umboneleli wakho wezempilo:

• Ukuba ukhulelwe okanye unokukhulelwa
• Ngawaphi amayeza owasebenzisayo, nditsho neziyobisi, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo

Unokwazi ukugcina igazi kwibhanki yegazi ukuze utofelwe ngexesha nasemva kotyando. Buza umboneleli wakho malunga nendlela wena kunye namalungu osapho lwakho onokunikela ngayo ngegazi.

Kwiveki engaphambi kotyando, unokucelwa ukuba uyeke ukuthatha amayeza enza ukuba kube nzima kwigazi lakho ukuba lijiye. Oku kunokubangela ukwanda kwegazi ngexesha lotyando.

• Ezinye zazo ziyi-aspirin, ibuprofen (Advil, Motrin), kunye ne-naproxen (Aleve, Naprosyn).
• Ukuba uthatha i-warfarin (Coumadin) okanye i-clopidogrel (Plavix), thetha nogqirha wakho phambi kokuba uyeke okanye utshintshe indlela owathatha ngayo la machiza.

Ngexesha leentsuku ngaphambi kokuhlinzwa kwakho:

• Buza ukuba ngawaphi amayeza ekufuneka uwathathe ngosuku lotyando lwakho.
• Ukuba uyatshaya, kufuneka uyeke. Cela uncedo kumboneleli wakho.
• Soloko umboneleli wakho ekwazi ukuba unokubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye nakuphi na ukugula ngexesha elikhokelela kuqhaqho lwakho.

Lungisa indlu yakho xa ufika ekhaya uvela esibhedlele.

Hlamba kwaye uhlambe iinwele zakho kusuku olungaphambi kotyando. Kuya kufuneka uhlambe umzimba wakho ezantsi kwentamo ngesepha ekhethekileyo. Khuhla isifuba sakho amaxesha ama-2 okanye ama-3 ngale sepha. Kananjalo unokucelwa ukuba uthathe isibulala-zintsholongwane ukuthintela usulelo.

Ngomhla wotyando lwakho:

• Unokucelwa ukuba ungaseli okanye utye nantoni na emva kobusuku bobusuku ngaphambi kokwenziwa kotyando. Oku kubandakanya ukusebenzisa itshungama kunye neminti. Hlamba umlomo wakho ngamanzi ukuba uziva womile. Lumka ungaginye.
• Thatha amayeza oxelelwe ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Uzakuxelelwa ukuba ufike nini esibhedlele.

Emva kotyando lwakho, uya kuchitha iintsuku ezi-3 ukuya kwezi-7 esibhedlele. Uya kuchitha ubusuku bokuqala kwigumbi labagula kakhulu (ICU). Abongikazi baya kuyibeka esweni imeko yakho ngalo lonke ixesha.

Uninzi lwexesha, uya kusiwa kwigumbi eliqhelekileyo okanye icandelo lokhathalelo lwesibhedlele ngaphakathi kweeyure ezingama-24. Uya kuqala umsebenzi kancinci. Ungaqala inkqubo yokwenza intliziyo nomzimba wakho womelele.

Unokuba neetyhubhu ezimbini okanye ezintathu esifubeni sakho ukukhupha ulwelo olujikeleze intliziyo yakho. Uninzi lwexesha, ezi zithathwa ngaphandle kweentsuku ezi-1 ukuya kwezi-3 emva kotyando.

Unokuba ne-catheter (ityhubhu eguqukayo) kwisinyi sakho ukucoca umchamo. Unokuba nemigca ye-intravenous (IV) yolwelo. Abongikazi baya kujonga ngokusondeleyo iimonitha ezibonisa iimpawu zakho ezibalulekileyo (ukubetha, ubushushu, kunye nokuphefumla). Uya kuvavanywa igazi mihla le kunye nee-ECG zokuvavanya ukusebenza kwentliziyo yakho de ube wanele ngokwaneleyo ukuba ungagoduka.

I-pacemaker yethutyana ingafakwa entliziyweni yakho ukuba isingqi senhliziyo yakho siye sicothe emva kotyando.

Xa sele usekhaya, ukuchacha kuthatha ixesha. Yithathe lula, kwaye ube nomonde nesiqu sakho.

Iimpawu zeentliziyo zentsimbi azipheli rhoqo. Nangona kunjalo, amahlwili egazi anokuvela kuwo. Ukuba iifom yegazi iyenzeka, unokuba noxinzelelo. Ukopha kunokwenzeka, kodwa oku kunqabile.

Izivalovhi zebhayoloji zinomngcipheko osezantsi wamahlwili egazi, kodwa zihlala zisilela ekuhambeni kwexesha. Unyango oluncinci olungenayo intsholongwane lwenziwe ngcono kwiminyaka yakutshanje. Obu buchule bukhuselekile kubantu abaninzi kwaye bunokunciphisa ixesha lokubuyisela kunye neentlungu. Iziphumo ezilungileyo, khetha ukuba utyando lwevalvu yakho kwiziko elenza uninzi lwezi nkqubo.

Ukubuyiselwa okanye ukulungiswa kwe-mini-thoracotomy aortic valve; Utyando lwevalvular yentliziyo; Mini-sternotomy; Ukutshintshwa kwerobot ye-aortic encediswa yirobotically; Ukutshintshwa kwesivalo seTranscatheter aortic

• Iziyobisi Antiplatelet - P2Y12 inhibitors
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• Ukuthatha warfarin (Coumadin)

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