Utyando lweMitral valve -yincinci

Utyando lweMitral valve lutyando ukuze kulungiswe okanye kutshintshwe i-mitral valve entliziyweni yakho.

Igazi liphuma kwimiphunga kwaye lingena kwigumbi lokumpompa kwentliziyo ebizwa ngokuba yi-atrium yasekhohlo. Igazi emva koko lingena kwigumbi lokugqibela lokumpompa kwentliziyo ebizwa ngokuba yi-ventricle yasekhohlo. I-mitral valve ibekwe phakathi kwala magumbi mabini. Iyaqinisekisa ukuba igazi liqhubeka nokuqhubela phambili entliziyweni.

Unokufuna utyando kwi-mitral valve yakho ukuba:

• Ivalve ye-mitral yomelele (ibaliwe). Oku kuthintela igazi ukuba lingahambeli phambili ngevalve.
• Ivalve ye-mitral ikhululekile kakhulu. Igazi lithanda ukubuyela umva xa oku kusenzeka.

Utyando oluncinci lwe-mitral valve lwenziwa ngokusikwa okuncinci. Olunye uhlobo lomsebenzi, ukuvula utyando lwevalval mitral, kufuna ukusikwa okukhulu.

Ngaphambi kotyando lwakho, uya kufumana i-anesthesia ngokubanzi.

Uya kuba ulele kwaye ungenazintlungu.

Kukho iindlela ezahlukeneyo zokwenza utyando lwe-mitral valve.

• Ugqirha wakho wentliziyo unokwenza i-intshi ezi-2 ukuya kuma-intshi ama-intshi ezi-5 ukuya kwezi-7.5 usike kwicala lasekunene lesifuba sakho kufutshane ne-sternum (ithambo lesifuba). Imisipha kuloo ndawo iya kwahlulwa. Oku kuvumela ugqirha ukuba afike entliziyweni. Ukucuthwa okuncinci kwenziwa kwicala lasekhohlo lentliziyo yakho ukuze ugqirha akwazi ukulungisa okanye ukubuyisela i-mitral valve.
• Kutyando lwe-endoscopic, ugqirha wakho wotyando wenza imingxunya emincinci emi-1 ukuya kwemine esifubeni sakho. Utyando lwenziwa ngokusikwa kusetyenziswa ikhamera kunye nezixhobo ezizodwa zotyando. Ngokwenza utyando olwenziwe ngerobhothi, ugqirha wotyando wenza amanxeba amancinci ama-2 ukuya kwezi-4 esifubeni sakho. Ukusikwa kumalunga ne-1/2 ukuya ku-3/4 intshi (1.5 ukuya ku-2 cm) nganye. Ugqirha usebenzisa ikhompyuter ekhethekileyo ukulawula iingalo zerobhothi ngexesha lotyando. Umbono we-3D wentliziyo kunye nevalval mitral ziboniswa kwikhompyuter kwigumbi lokusebenza.

Uya kudinga umatshini wemiphunga yentliziyo kwezi ntlobo zotyando. Uyakudityaniswa kwesi sixhobo ngokusika okuncinci kwi-groin okanye esifubeni.

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

• Iringi annuloplasty - Ugqirha uqinisa ivalve ngokuthunga isangqa sentsimbi, ilaphu, okanye izicwili ezijikeleze ivalve.
• Ukulungiswa kweValve - Ugqirha wotyando, uyila, okanye akhe enye okanye zombini iimpazamo ezivulekileyo kwaye zivale ivalve.

Uya kudinga ivelufa entsha ukuba kukho umonakalo omkhulu kwi-mitral valve yakho. Oku kubizwa ngokuba luqhaqho olwenziwe ngokutsha. Ugqirha wakho ususa enye okanye yonke i-mitral valve yakho kwaye uthunge entsha endaweni. Zimbini iintlobo eziphambili zezivalo:

• Oomatshini - Benziwe ngezinto ezenziwe ngabantu, njenge titanium kunye nekhabhoni. Ezi zivalo zihlala ixesha elide. Uya kudinga ukuthatha iyeza lokucoca igazi, njengewarfarin (Coumadin), ubomi bakho bonke.
• Biological -Yenziwe ngamathambo omntu okanye izilwanyana. Ezi zivalo zihlala iminyaka eli-10 ukuya kweli-15 okanye ngaphezulu, kodwa ngekhe ufune ukuthatha igazi elincinci ebomini.

Utyando lungathabatha iiyure ezi-2 ukuya kwezi-4.

Olu tyando ngamanye amaxesha lunokwenziwa ngokusebenzisa umthambo we-groin, ngaphandle kokusika esifubeni sakho. Ugqirha uthumela i-catheter (ityhubhu eguqukayo) kunye nebhaluni encanyathiselwe esiphelweni. Ibhaluni inyusa ukolula ukuvulwa kwevalve. Le nkqubo ibizwa ngokuba yi-valvuloplasty engagungqiyo kwaye yenzelwe i-mitral valve.

Inkqubo entsha ibandakanya ukubeka i-catheter ngokusebenzisa i-artery kwi-groin kunye nokucofa ivalve ukuthintela ivelufa ukuba ingavuzi.

Unokufuna utyando ukuba i-mitral valve yakho ayisebenzi ngokufanelekileyo kuba:

• Unokubuyiswa kwakhona kwe-mitral- Xa i-mitral valve ingavali yonke indlela kwaye ivumela igazi ukuba libuyele kwi-atria yasekhohlo.
• Unayo i-mitral stenosis - Xa i-mitral valve ingavuli ngokupheleleyo kwaye ithintela ukuhamba kwegazi.
• Ivalve yakho iye yavelisa usulelo (i-endocarditis echaphazelayo).
• Unobunzima be-mitral valve prolapse obungalawulwa ngamayeza.

Olunye utyando olungenelelayo lunokwenziwa ngezi zizathu:

• Utshintsho kwi-valve ye-mitral yakho lubangela iimpawu ezinkulu zentliziyo, ezifana nokuphefumula okufutshane, ukuvuvukala komlenze, okanye ukungaphumeleli kwentliziyo.
• Uvavanyo lubonisa ukuba utshintsho kwi-mitral valve yakho luqala ukonakalisa ukusebenza kwentliziyo yakho.
• Ukonakala kwentliziyo yesivalo kwintsholongwane (endocarditis).

Inkqubo encinci yokungenelela inezibonelelo ezininzi. Kukho iintlungu ezimbalwa, ukulahleka kwegazi, kunye nomngcipheko wosulelo. Uya kuphila ngokukhawuleza kunokuba ubuya kutyando lwentliziyo oluvulekileyo. Nangona kunjalo, abanye abantu abanakho ukuba nolu hlobo lwenkqubo.

I-valvuloplasty ene-Percutaneous inokwenziwa kuphela kubantu abagula kakhulu ukuba bangabinayo i-anesthesia. Iziphumo zale nkqubo azihlali ixesha elide.

Iingozi zalo naluphi na utyando zezi:

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

Ubuchule obuncinci bokungenelela obunobungozi bunobungozi obuncinci kunokuhlinzwa okuvulekileyo.Imingcipheko enokubakho kuqhaqho lwevalvu olungenayo kangako zezi:

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

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.

Ukuba uyatshaya, kufuneka uyeke. Cela uncedo kumboneleli wakho.

Ngexesha leentsuku ngaphambi kokuhlinzwa kwakho:

• Kwithuba leveki e-1 ngaphambi kotyando, unokucelwa ukuba uyeke ukuthatha amayeza enza ukuba kube nzima kwigazi lakho ukuba lijiye. Oku kunokubangela ukwanda kwegazi ngexesha lotyando. Amanye ala mayeza aquka iasprini, 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.
• Buza ukuba zeziphi iziyobisi ekufuneka uzithathile ngosuku lotyando 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:

• 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.

Lindela ukuchitha iintsuku ezi-3 ukuya kwezi-5 esibhedlele emva kotyando. Uya kuvuka kwigumbi lokunyamekela abagulayo (ICU) kwaye uphinde ubuye khona kangangeentsuku ezi-1 okanye ezi-2. Abongikazi baya kujonga ngokusondeleyo iimonitha ezibonisa iimpawu zakho ezibalulekileyo (ukubetha, ubushushu, kunye nokuphefumla).

Imibhobho emibini ukuya kwemithathu iya kuba sesifubeni sakho ukukhupha ulwelo olujikeleze intliziyo yakho. Bahlala besuswa kwiintsuku ezi-1 ukuya kwezi-3 emva kotyando. Unokuba ne-catheter (ityhubhu eguqukayo) kwisinyi sakho ukucoca umchamo. Unokuba nemigca efakwa ngaphakathi (IV) ukufumana ulwelo.

Uya kusuka e-ICU uye kwigumbi lesibhedlele eliqhelekileyo. Intliziyo yakho kunye neempawu ezibalulekileyo ziya kujongwa de ube ukulungele ukugoduka. Uya kufumana amayeza entlungu ngenxa yeentlungu esifubeni sakho.

Umongikazi wakho uya kukunceda ukuqala umsebenzi kancinci. Ungaqala inkqubo yokwenza intliziyo nomzimba wakho womelele.

I-pacemaker ingafakwa entliziyweni yakho ukuba izinga lokubetha kwentliziyo yakho liyacotha emva kotyando. Oku kunokuba okwethutyana okanye unokufuna isigxina ngokusisigxina ngaphambi kokuba uphume esibhedlele.

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 zithande ukusilela ixesha elide.

Iziphumo zokulungiswa kwevalve mitral zibalasele. Iziphumo ezilungileyo, khetha ukwenza utyando kwiziko elenza uninzi lwezi nkqubo. Utyando lwevalvu eyonakalisayo encinci luphuculwe kakhulu kule minyaka idlulileyo. Obu buchule bukhuselekile kubantu abaninzi, kwaye bunokunciphisa ixesha lokubuyisela kunye neentlungu.

Ukulungiswa kweMitral valve-ekunene mini-thoracotomy; Ukulungiswa kweMitral valve - inxenye ephezulu okanye esezantsi ye-sternotomy; Ukulungiswa kweerobhothi zokuncedisa i-endoscopic; Iimpawu zemithambo yevalvuloplasty

• Iziyobisi Antiplatelet - P2Y12 inhibitors
• I-Aspirin kunye nesifo sentliziyo
• Utyando lwevalvu yentliziyo - ukukhutshwa
• Ukuthatha warfarin (Coumadin)

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IGoldstone AB, Woo YJ. Unyango lotyando lwevalvu ye-mitral. Ku: Sellke FW, del Nido PJ, Swanson SJ, ii-eds. Ugqirha weSabiston kunye noSpencer wesifuba. Umhla we-9. IPhiladelphia, PA: Elsevier; 2016: isahluko 80.

UHerrmann 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.

UThomas JD, uBonow RO. Isifo seMitral valve. 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 69.