Ukuhlinzwa kokudlula kwenhliziyo

Ukuhlinzwa kokudlula kwenhliziyo kwakha umzila omusha, obizwa ngokuthi ukudlula, ukuze igazi nomoya-mpilo uhambe uzungeze ukuvinjelwa ukufinyelela inhliziyo yakho.

Ngaphambi kokuhlinzwa kwakho, uzothola i-anesthesia ejwayelekile. Uzobe ulele (uqulekile) futhi awunazinhlungu ngesikhathi sokuhlinzwa.

Uma unganakile, udokotela ohlinzayo wenhliziyo uzokwenza ukusika okuhlinzekwe ngamasentimitha angama-20 kuya kwangu-25.5 phakathi kwesifuba sakho. Isifuba sakho sesifuba sizohlukaniswa ukuze kuvulwe isikhala. Lokhu kuvumela udokotela wakho ohlinzayo ukuthi abone inhliziyo yakho kanye ne-aorta, umthambo wegazi oyinhloko oholela enhliziyweni uye kuwo wonke umzimba wakho.

Iningi labantu elinokuhlinzwa kokudlula kwenhliziyo lixhunywe kumshini wokudlula wenhliziyo-lung, noma iphampu yokudlula.

• Inhliziyo yakho imisiwe ngenkathi uxhumeke kulo mshini.
• Lo mshini wenza umsebenzi wenhliziyo yakho namaphaphu ngenkathi inhliziyo yakho imisiwe ukuhlinzwa. Lo mshini ungeza umoya-mpilo egazini lakho, uhambise igazi emzimbeni wakho, futhi ususe isikhutha.

Olunye uhlobo lokuhlinzwa okwedlula eceleni alusebenzisi umshini wokudlula wenhliziyo nephaphu. Inqubo yenziwa ngenkathi inhliziyo yakho isashaya. Lokhu kubizwa ngokuthi yi-off-pump pump coronary bypass, noma i-OPCAB.

Ukwakha ubumbano lokudlula:

• Udokotela uzothatha umthambo noma umthambo kusuka kwenye ingxenye yomzimba wakho awusebenzise ukwenza ukuchezuka (noma ukuxhumanisa) ezungeze indawo evinjiwe emthanjeni wakho. Udokotela wakho angasebenzisa umthambo, obizwa nge-saphenous vein, ovela emlenzeni wakho.
• Ukuze ufinyelele kulo mthambo, kuzosikwa ngaphakathi ngaphakathi komlenze wakho, phakathi kweqakala lakho nokububula. Omunye umkhawulo wokuxhunyelelwa uzothungathwa emthanjeni wakho we-coronary. Omunye umkhawulo uzothungwa embobeni eyenziwe ku-aorta yakho.
• Isitsha segazi esifubeni sakho, esibizwa ngokuthi umthambo wangaphakathi wamammary (IMA), ungasetshenziswa futhi njengesixhunyeleliso. Umkhawulo owodwa walo mthambo usuvele uxhunywe egatsheni le-aorta yakho. Omunye umkhawulo unamathiselwe emthanjeni wakho we-coronary.
• Eminye imithambo yegazi ingasetshenziselwa ukufakwa ekuhlinzeni okudlula. Okuvame kakhulu ngumthambo osabalalayo esihlakaleni sakho.

Ngemuva kokudonswa kwesihlanganisi, ithambo lakho lesifuba lizovalwa ngezintambo. Lezi zintambo zihlala ngaphakathi kuwe. Ukusikwa kokuhlinzwa kuzovalwa ngemithungo.

Lokhu kuhlinzwa kungathatha amahora amane kuya kwayisithupha. Ngemuva kokuhlinzwa, uzoyiswa egumbini labagula kakhulu.

Ungadinga le nqubo uma uvinjelwe komunye noma ngaphezulu kwemithambo yakho yenhliziyo. Imithambo yegazi iCoronary yimithambo enikeza inhliziyo yakho umoya-mpilo nezakhi ezithwalwa egazini lakho.

Lapho umthambo owodwa noma eminingi yemithambo yegazi ivalwa ngokwengxenye noma ngokuphelele, inhliziyo yakho ayilitholi igazi elanele. Lokhu kubizwa ngokuthi yisifo senhliziyo esiyischemic, noma i-coronary artery disease (CAD). Kungadala ubuhlungu besifuba (angina).

Ukuhlinzwa ngokudlula komthambo weCoronary kungasetshenziselwa ukuthuthukisa ukugeleza kwegazi kuye enhliziyweni yakho. Kungenzeka ukuthi udokotela wakho uqale wazama ukukuphatha ngemithi. Kungenzeka ukuthi uke wazama nokushintsha kokuvivinya umzimba nokudla, noma i-angioplasty nge-stenting.

I-CAD yehlukile kumuntu nomuntu. Indlela okutholakala ngayo nokuthi yelashwa ngayo nayo iyohluka. Ukuhlinzwa kokudlula kwenhliziyo wuhlobo olulodwa lwezokwelapha.

Ezinye izinqubo ezingasetshenziswa:

• Ukubekwa kwe-Angioplasty nokuqina
• Ukuhlinzwa kokudlula kwenhliziyo - kukuhlasela kancane

Izingozi zanoma yikuphi ukuhlinzwa zifaka:

• Ukopha
• Ukutheleleka
• Ukufa

Izingozi ezingaba khona zokuhlinzwa nge-coronary bypass zifaka:

• Ukutheleleka, kufaka phakathi ukutheleleka kwesilonda esifubeni, okungenzeka kwenzeke uma ukhuluphele, unesifo sikashukela, noma usuvele uhlinzwe
• Isifo senhliziyo
• Unhlangothi
• Izinkinga zesigqi senhliziyo
• Ukuhluleka kwezinso
• Ukwehluleka kwamaphaphu
• Ukudangala nokushintshashintsha kwemizwelo
• Umkhuhlane ophansi, ukukhathala, nobuhlungu besifuba, ndawonye obubizwa nge-postpericardiotomy syndrome, obungaphela izinyanga eziyisithupha
• Ukulahleka kwememori, ukulahleka kokucaca kwengqondo, noma "ukucabanga okungaqondakali"

Hlala utshela umhlinzeki wakho wezempilo ukuthi imiphi imishanguzo oyisebenzisayo, ngisho nezidakamizwa noma amakhambi owathengile ngaphandle kadokotela.

Phakathi nezinsuku ngaphambi kokuhlinzwa kwakho:

• Esikhathini seviki elingu-1 ngaphambi kokuhlinzwa, ungacelwa ukuthi uyeke ukuthatha izidakamizwa ezenza kube nzima ngegazi lakho ukuminyana. Lokhu kungadala ukopha okwengeziwe ngesikhathi sokuhlinzwa. Kubandakanya i-aspirin, ibuprofen (njenge-Advil neMotrin), i-naproxen (efana ne-Aleve neNaprosyn), nezinye izidakamizwa ezifanayo. Uma uthatha i-clopidogrel (i-Plavix), khuluma nodokotela wakho ohlinzayo mayelana nokuthi uyeka nini ukuyithatha.
• Buza ukuthi imiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa.
• Uma ubhema, zama ukuyeka. Cela usizo kumhlinzeki wakho.
• Xhumana nomhlinzeki wakho uma unomkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma esinye isifo.
• Lungisa ikhaya lakho ukuze ukwazi ukuhamba kalula lapho ubuya esibhedlela.

Ngosuku olungaphambi kokuhlinzwa kwakho:

• Ukugeza kanye ne-shampoo kahle.
• Ungacelwa ukuthi ugeze wonke umzimba wakho ngaphansi kwensipho yakho ngensipho ekhethekile. Khuhla isifuba sakho amahlandla ama-2 noma ama-3 ngale nsipho.
• Qiniseka ukuthi uzomisa.

Ngosuku lokuhlinzwa:

• Uzocelwa ukuthi ungaphuzi noma ungadli lutho ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa kwakho. Hlanza umlomo wakho ngamanzi uma uzizwa womile, kodwa qaphela ukuthi ungagwinyi.
• Thatha noma yimiphi imithi otshelwe ukuthi uyiphuze ngophuzo oluncane lwamanzi.

Uzotshelwa ukuthi ufika nini esibhedlela.

Ngemuva kokuhlinzwa, uzohlala izinsuku ezintathu kuya kwezi-7 esibhedlela. Uzochitha ubusuku bokuqala egumbini labagula kakhulu (i-ICU). Cishe uzothuthelwa egunjini lokunakekela elejwayelekile noma lesikhashana kungakapheli amahora angama-24 kuye kwangama-48 ngemuva kwenqubo.

Amashubhu amabili kuya kwamathathu azoba sesifubeni sakho ukukhipha uketshezi olusuka enhliziyweni yakho. Zivame ukususwa ezinsukwini ezi-1 ukuya kwezi-3 ngemuva kokuhlinzwa.

Ungaba nepayipi (ishubhu eliguquguqukayo) esinyeni sakho ukukhipha umchamo. Ungase futhi ube nemigqa ye-intravenous (IV) yamanzi. Uzonamathiselwa emishini ebheka ukushaya kwenhliziyo yakho, izinga lokushisa nokuphefumula kwakho. Abahlengikazi bazohlala bebuka abaqaphi bakho.

Ungaba nezintambo eziningana ezixhunywe kwi-pacemaker, ezikhishwa ngaphambi kokukhishwa kwakho.

Uzokhuthazwa ukuqala kabusha eminye imisebenzi futhi ungaqala uhlelo lokuvuselela inhliziyo kungakapheli izinsuku ezimbalwa.

Kuthatha amasonto amane kuya kwayisithupha ukuqala ukuzizwa ungcono ngemuva kokuhlinzwa. Abahlinzeki bakho bazokutshela ukuthi ungazinakekela kanjani ekhaya ngemuva kokuhlinzwa.

Ukululama ekuhlinzweni kuthatha isikhathi. Ungahle ungaziboni izinzuzo ezigcwele zokuhlinzwa kwakho izinyanga ezi-3 kuya kwezi-6. Kubantu abaningi abanezinhliziyo ezidlula ukuhlinzwa, ama-graft ahlala evulekile futhi asebenza kahle iminyaka eminingi.

Lokhu kuhlinzwa akuvimbeli ukuvimba komthambo we-coronary ukubuya. Ungenza izinto eziningi ukunciphisa le nqubo phansi, kufaka phakathi:

• Ukungabhemi
• Ukudla ukudla okunempilo kwenhliziyo
• Ukuvivinya umzimba njalo
• Ukwelapha umfutho wegazi ophezulu
• Ukulawula ushukela ophakeme wegazi (uma unesifo sikashukela) ne-cholesterol ephezulu

Ukudlula komthambo we-coronary we-Off-pump; OPCAB; Ukushaya ukuhlinzwa kwenhliziyo; Ukuhlinzwa nge-Bypass - inhliziyo; CABG; Umthambo weCoronary udlula ngokuxhunyelelwa; Umthambo weCoronary udlula ukuhlinzwa; Ukuhlinzwa kokudlula kweCoronary; Isifo semithambo yegazi Coronary - CABG; I-CAD - CABG; I-Angina - CABG

• I-Angina - ukukhishwa
• U-Angina - ukuthi ubuze ini kudokotela wakho
• I-Angina - lapho unezinhlungu esifubeni
• Ukukhishwa kwe-angioplasty ne-stent - inhliziyo
• Izidakamizwa ze-antiplatelet - P2Y12 inhibitors
• I-Aspirin nesifo senhliziyo
• Ukuphepha kwamakamelo abantu abadala
• Ukusebenza ngemuva kokuhlaselwa yisifo senhliziyo
• Ukusebenza lapho unesifo senhliziyo
• Ibhotela, imajarini namafutha okupheka
• I-catheterization yenhliziyo - ukukhishwa
• Cholesterol nendlela yokuphila
• I-cholesterol - ukwelashwa kwezidakamizwa
• Ukulawula umfutho wegazi ophakeme
• Kuchazwe amafutha ezokudla
• Amathiphu okudla okusheshayo
• Isifo senhliziyo - ukukhipha
• Isifo senhliziyo - okufanele ubuze udokotela wakho
• Ukuhlinzwa kokudlula kwenhliziyo - ukukhipha
• Isifo senhliziyo - izici eziyingozi
• Inhliziyo pacemaker - ukukhipha
• Uwafunda kanjani amalebula okudla
• Ukudla okunosawoti omningi
• Ukudla kwaseMedithera
• Ukuvimbela ukuwa
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile
• Lapho unesicanucanu nokuhlanza

• Inhliziyo - ukubuka kwangaphambili
• Imithambo yenhliziyo engemuva
• Imithambo yenhliziyo yangaphakathi
• I-atherosclerosis
• Ukuhlinzwa kokudlula kwenhliziyo - uchungechunge
• Inhliziyo yedlula ukuhlinzwa imbobo

I-Al-Atassi T, i-Toeg HD, i-Chan V, i-Ruel M. Coronary artery idlula ngokuxhunyelelwa. Ku: Sellke FW, del Nido PJ, Swanson SJ, ama-eds. Ukuhlinzwa kweSabiston neSpencer kwesifuba. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2016: isahluko 88.

UHillis LD, uSmith PK, noAnderson JL, et al. Umhlahlandlela we-ACCF / AHA ka-2011 we-coronary artery bypass graft surgery: umbiko we-American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. Ukujikeleza. 2011; 124 (23): e652-e735. I-PMID: 22064599 pubmed.ncbi.nlm.nih.gov/22064599/.

UKulik A, uRuel M, uJneid H, et al. Ukuvinjelwa kwesibili ngemuva kokuhlinzwa ngokudlula komthambo we-coronary: isitatimende sesayensi esivela ku-American Heart Association. Ukujikeleza. 2015; 131 (10): 927-964. I-PMID: 25679302 pubmed.ncbi.nlm.nih.gov/25679302/.

UMorrow DA, de Lemos JA. Isifo senhliziyo esisimeme. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Izifo Zenhliziyo zeBraunwald: Incwadi Yemithi Yezinhliziyo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 61.

U-Omer S, uCornwell LD, u-Bakaeen FG. Isifo senhliziyo esitholakele: ukunganeli kwenhliziyo. Ku: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 59.