Ukutshintshwa kwesivalo seTranscatheter aortic

I-Transcatheter aortic valve replacement (TAVR) yinkqubo esetyenziselwa ukubuyisela ivalve ye-aortic ngaphandle kokuvula isifuba. Isetyenziselwa ukunyanga abantu abadala abangaphilanga ngokwaneleyo ukuba benze utyando lwevalvu rhoqo.

I-aorta ngumthambo omkhulu ophethe igazi elisuka entliziyweni yakho liye kuwo wonke umzimba wakho. Igazi liphuma entliziyweni yakho liye kwi-aorta ngevalve. Le ivelufa ibizwa ngokuba yivelive aortic. Iyavula ukuze igazi liphume. Iyavala ke, ukugcina igazi lingaphumi liye ngasemva.

Ivalve ye-aortic engavuli ngokupheleleyo iya kuthintela ukuhamba kwegazi. Oku kubizwa ngokuba yi-aortic stenosis. Ukuba kukho ukuvuza, kubizwa ngokuba kukuphinda kusebenze kwakhona. Uninzi lwevalvu ze-aortic zitshintshiwe kuba zithintela ukuhamba phambili nge-aorta ukuya kwingqondo nasemzimbeni.

Inkqubo iyakwenziwa esibhedlele. Kuya kuthatha iiyure ezi-2 ukuya kwezi-4.

• Ngaphambi kotyando lwakho, unokufumana i-anesthesia ngokubanzi. Oku kuyokubeka kubuthongo obungenazintlungu. Rhoqo, le nkqubo yenziwa nawe uhleli kakhulu. Awulele ngokupheleleyo kodwa awuva zintlungu. Oku kubizwa ngokuba kukudambisa okuphakathi.
• Ukuba kusetyenziswa ianesthesia ngokubanzi, uya kuba netyhubhu ubeke umqala wakho uqhagamshelwe kumatshini ukukunceda uphefumle. Oku kususwa ngokubanzi emva kwenkqubo. Ukuba kusetyenziswa i-sedation emodareyithayo, akukho bhobho yokuphefumla iyafuneka.
• Ugqirha uya kwenza ukusikwa (ukusikwa) kumthambo kwindawo yakho yokuqaqamba okanye esifubeni kufutshane nethambo lakho lebele.
• Ukuba awunayo i-pacemaker, ugqirha unokuyifaka. Uya kuyinxiba iiyure ezingama-48 emva kotyando. I-pacemaker inceda intliziyo yakho ukubetha kwisingqi esiqhelekileyo.
• Ugqirha uya kufaka intambo encinci ebizwa ngokuba yi-catheter ngokusebenzisa umthambo wentliziyo yakho kunye ne-valve ye-aortic.
• Ibhaluni encinci esiphelweni se-catheter iya kwandiswa kwi-aortic valve yakho. Oku kubizwa ngokuba yi-valvuloplasty.
• Ugqirha uya kuthi emva koko akhokele ivalve entsha ye-aortic ngaphezulu kwe-catheter kunye nebhaluni kwaye ayibeke kwi-aortic valve yakho. Ivalve yebhayoloji isetyenziselwa i-TAVR.
• Ivelufa entsha iya kuvulwa ngaphakathi ivelufa endala. Iya kwenza umsebenzi wevalvu endala.
• Ugqirha uzakususa i-catheter kwaye avale ukusikwa ngemithungo kunye nokunxiba.
• Awudingi ukuba ubekho kumatshini wemiphunga yentliziyo yale nkqubo.

I-TAVR isetyenziselwa abantu abane-aortic stenosis ebukhali abangaphilanga ngokwaneleyo ukuba benze utyando lwesifuba oluvulekileyo ukubuyisela ivalve.

Kubantu abadala, i-aortic stenosis ixhaphake kakhulu ngenxa yedipozithi yecalcium enciphisa ivalve. Oku kuchaphazela ngokubanzi abantu abadala.

I-TAVR inokwenziwa ngezi zizathu:

• Unempawu ezinkulu zentliziyo, ezinjengeentlungu zesifuba (angina), ukuphefumla okufutshane, ukuphelelwa ngamandla (i-syncope), okanye ukusilela kwentliziyo.
• Uvavanyo lubonisa ukuba utshintsho kwivelufa yakho ye-aortic iqala ukonakalisa kakhulu indlela esebenza ngayo intliziyo yakho.
• Awunakho ukwenza utyando lwevalvu rhoqo kuba ingabeka impilo yakho emngciphekweni. (Qaphela: Izifundo zenziwa ukubona ukuba ngaba abaguli abaninzi banokuncedwa ngotyando.)

Le nkqubo inezibonelelo ezininzi. Kukho iintlungu ezimbalwa, ukulahleka kwegazi, kunye nomngcipheko wosulelo. Uya kuphila ngokukhawuleza kunokuba ubuya kwenza utyando esifubeni.

Umngcipheko wayo nayiphi na ianesthesia yile:

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

Eminye imingcipheko yile:

• Ukonakala kwimithambo yegazi
• Unokufuna utyando lwentliziyo oluvulekileyo ukulungisa iingxaki ezivelayo ngexesha lenkqubo
• Ukuhlaselwa yintliziyo okanye ukubetha
• Usulelo lwevalve entsha
• Ukungaphumeleli kwezintso
• Ukubetha kwentliziyo okungaqhelekanga
• Ukopha
• Ukuphilisa kakubi ukusikwa
• Ukufa

Soloko uxelela ugqirha wakho okanye umongikazi ukuba ngawaphi amayeza owasebenzisayo, kubandakanya amayeza eekhawuntareni, amayeza awongezelelayo, okanye amayeza.

Kuya kufuneka ubone ugqirha wakho wamazinyo ukuze uqiniseke ukuba akukho nosulelo emlonyeni wakho. Ukuba alunyangwanga, ezi zifo zinokusasazeka entliziyweni yakho okanye kwivelufa yentliziyo entsha.

Ngexesha leeveki ezi-2 ngaphambi kotyando, unokucelwa ukuba uyeke ukuthatha amayeza enza ukuba kube nzima kwigazi lakho ukubambeka. 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 kwenkqubo yakho:

• Buza ugqirha wakho ukuba ngawaphi amayeza ekufuneka uwathathe ngemini yenkqubo yakho.
• Ukuba uyatshaya, kufuneka uyeke. Buza ugqirha wakho akuncede.
• Soloko ugqirha wakho azi ukuba unokubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye nakuphi na ukugula ngexesha elikhokelela kwinkqubo yakho.
• Ngomhla ngaphambi kwenkqubo yakho, ishawa kunye ne-shampoo kakuhle. Unokucelwa ukuba uhlambe umzimba wakho wonke ngaphantsi kwentamo yakho ngesepha ekhethekileyo. Khuhla isifuba sakho amaxesha ama-2 okanye ama-3 ngale sepha. Kananjalo unokucelwa ukuba uthathe isibulala-zintsholongwane ukuthintela usulelo.

Ngomhla wotyando lwakho:

• Ngokwesiqhelo uya kucelwa ukuba ungaseli okanye utye nantoni na emva kobusuku phakathi kobusuku ngaphambi kwenkqubo yakho. Oku kubandakanya itshungama kunye nokusebenzisa umoya wokuphefumla. Hlamba umlomo wakho ngamanzi ukuba uziva womile, kodwa lumka ungaginyeki.
• Thatha amayeza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Ugqirha okanye umongikazi wakho uza kukuxelela ukuba ufike nini esibhedlele.

Unokulindela ukuchitha iintsuku ezi-1 ukuya kwezi-4 esibhedlele.

Uya kuchitha ubusuku bokuqala kwigumbi labagula kakhulu (ICU). Abongikazi baya kukubeka esweni ngokusondeleyo. Ngokwesiqhelo ngaphakathi kweeyure ezingama-24, uya kusiwa kwigumbi eliqhelekileyo okanye iyunithi yokhathalelo lotshintsho esibhedlele.

Ngosuku emva kotyando, uya kuncedwa uphume ebhedini ukuze uphakame kwaye ujikeleze. Ungaqala inkqubo yokwenza intliziyo nomzimba wakho womelele.

Ababoneleli bakho bezempilo baya kukubonisa indlela yokuzikhathalela ekhaya. Uya kufunda ukuba uhlambe njani kwaye unakekele inxeba lotyando. Uya kunikwa nemiyalelo malunga nokutya kunye nokuzilolonga. Qiniseka ukuba uthatha nawaphi na amayeza njengoko kumiselwe. Kuya kufuneka ukuba uthathe abacoci gazi ubomi bakho bonke.

Ugqirha wakho uya kuthi ungene ukuze ulandele ixesha lokujonga ukuba ivelufa entsha isebenza kakuhle na.

Qiniseka ukuba uxelela nabaphi na ababoneleli bakho ukuba utshintshiwe. Qiniseka ukuba uyakwenza oku ngaphambi kokuba ube neenkqubo zonyango okanye zamazinyo.

Ukuba nale nkqubo kunokuwuphucula umgangatho wobomi bakho kwaye kukuncede uphile ixesha elide kunokuba ubungenakho ukwenzeka. Unokuphefumla ngokulula kwaye ube namandla ngakumbi. Unokwazi ukwenza izinto obungenakuzenza ngaphambili kuba intliziyo yakho iyakwazi ukumpompa igazi eline-oksijini kuwo wonke umzimba wakho.

Akucaci ukuba i-valve entsha iya kuhlala isebenza ixesha elingakanani, ke qiniseka ukuba ubonane nogqirha wakho rhoqo.

Valvuloplasty - aortic; TAVR; Ukufakwa kwevalveic aortic (TAVI)

UArsalan M, uKim WK, uWalther T.Transcatheter. Ku: Sellke FW, Ruel M, ii-eds. IAtlas yeTekhnoloji yoPhando lwentliziyo. Ngomhla wesi-2. IPhiladelphia, PA: Elsevier; I-2019: isahluko 16.

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.

ILindman BR, iBonow RO, i-Otto CM. Isifo sevalve seAortic. 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 68.

I-Patel A, Kodali S. Transcatheter aortic valve replacement: izikhombisi, inkqubo kunye neziphumo. Ku: I-Otto CM, iBonow RO, ii-eds. Isifo sentliziyo iValvular: Umhlobo kwiZifo zentliziyo zeBraunwald. Umhla we-5. IPhiladelphia, PA: Elsevier; 2021: isahluko 12.

Thourani VH, Iturra S, uSarin EL. Ukutshintshwa kwesivalo seTranscatheter aortic. Ku: Sellke FW, del Nido PJ, Swanson SJ, ii-eds. Ugqirha weSabiston kunye noSpencer wesifuba. Umhla we-9. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 79.