Ukuhlinzwa kwe-aortic valve - kuvulekile

Igazi liphuma liphuma enhliziyweni yakho lingene emthanjeni omkhulu wegazi obizwa nge-aorta. I-aortic valve ihlukanisa inhliziyo ne-aorta. I-aortic valve iyavula ukuze igazi liphume. Bese ivala ukugcina igazi lingabuyeli enhliziyweni.

Ungadinga ukuhlinzwa kwe-aortic valve ukufaka i-aortic valve enhliziyweni yakho uma:

• I-valve yakho ye-aortic ayivali yonke indlela, ngakho-ke igazi liyavuza lingene enhliziyweni. Lokhu kubizwa ngokuthi yi-aortic regurgitation.
• I-valve yakho ye-aortic ayivuli ngokugcwele, ngakho ukuphuma kwegazi okuphuma enhliziyweni kuyancipha. Lokhu kubizwa nge-aortic stenosis.

Ukuhlinzwa kwe-valve ye-aortic kuvala isikhala se-valve ngokusika okukhulu esifubeni sakho.

I-aortic valve nayo ingashintshwa kusetshenziswe ukuhlinzwa kwe-aortic valve okungajwayelekile. Lokhu kwenziwa kusikwa okumbalwa okuncane.

Ngaphambi kokuhlinzwa kwakho uzothola i-anesthesia ejwayelekile. Uzolala ungezwa zinhlungu.

• Udokotela wakho ohlinzayo uzosika phakathi nesifuba sakho ngamasentimitha angu-10 ubude (amasentimitha angama-25).
• Okulandelayo, udokotela wakho ohlinzayo uzohlukanisa ithambo lakho lesifuba ukuze akwazi ukubona inhliziyo yakho kanye ne-aorta.
• Ungahle udinge ukuxhumeka kumshini wokudlula wenhliziyo-lung noma iphampu yokudlula. Inhliziyo yakho imisiwe ngenkathi uxhumeke kulo mshini. Lo mshini wenza umsebenzi wenhliziyo yakho ngenkathi inhliziyo yakho imisiwe.

Uma i-valve yakho ye-aortic yonakele kakhulu, uzodinga i-valve entsha. Lokhu kubizwa ngokuthi ukuhlinzwa esikhundleni. Udokotela wakho ohlinzayo uzosusa i-valve yakho ye-aortic bese ethunga entsha. Kunezinhlobo ezimbili eziyinhloko zama-valve amasha:

• Imishini, eyenziwe ngezinto ezenziwe ngabantu, njenge-titanium noma i-carbon. La ma-valve ahlala isikhathi eside kakhulu. Ungadinga ukuthatha umuthi wokunciphisa igazi, njenge-warfarin (i-Coumadin) impilo yakho yonke uma unalolu hlobo lwe-valve.
• Okuphilayo, okwenziwe ngezicubu zomuntu noma zesilwane. Lawa ma-valve angahlala iminyaka eyi-10 kuye kwengu-20, kepha kungenzeka ungadingi ukuthatha abacoci begazi impilo yakho yonke.

Lapho nje i-valve entsha isebenza, udokotela wakho ohlinzayo uzokwenza lokhu:

• Vala inhliziyo yakho bese ususa umshini wenhliziyo-lung.
• Beka ama-catheters (amashubhu) azungeze inhliziyo yakho ukukhipha uketshezi olwakhayo.
• Vala ithambo lakho lesifuba ngezintambo zensimbi engagqwali. Kuzothatha cishe amaviki ayisithupha kuye kwayishumi nambili ukuthi ithambo liphole. Izintambo zizohlala ngaphakathi emzimbeni wakho.

Lokhu kuhlinzwa kungathatha amahora amathathu kuye kwayi-5.

Kwesinye isikhathi ezinye izinqubo zenziwa ngesikhathi sokuhlinzwa okuvulekile kwe-aortic. Lokhu kufaka phakathi:

• Ukuhlinzwa kokudlula kweCoronary
• Ukushintshwa kwezimpande ze-aortic (inqubo kaDavid)
• Inqubo yeRoss (noma switch)

Ungadinga ukuhlinzwa uma i-valve yakho ye-aortic ingasebenzi kahle. Ungadinga ukuhlinzwa kwe-valve yenhliziyo evulekile ngalezi zizathu:

• Izinguquko ku-valve yakho ye-aortic zidala izimpawu ezinkulu zenhliziyo, njengobuhlungu besifuba, ukuphefumula okuncane, ukuphelelwa amandla, noma ukwehluleka kwenhliziyo.
• Ukuhlolwa kukhombisa ukuthi izinguquko ku-aortic valve yakho seziqala ukulimaza kakhulu ukuthi inhliziyo yakho isebenza kahle kangakanani.
• I-valve yenhliziyo yakho ilinyazwe ukutheleleka kwe-valve yenhliziyo (endocarditis).
• Uthole i-valve yenhliziyo entsha esikhathini esedlule futhi ayisebenzi kahle.
• Unezinye izinkinga ezifana namahlule egazi, ukutheleleka, noma ukopha.

Izingozi zanoma yikuphi ukuhlinzwa yilezi:

• Amahlule egazi emilenzeni angahamba aye emaphashini
• Ukwehla kwegazi
• Izinkinga zokuphefumula
• Ukutheleleka, kufaka phakathi amaphaphu, izinso, isinye, isifuba, noma ama-valve wenhliziyo
• Ukusabela emithini

Izingozi ezingaba khona zokuhlinzwa okuvulekile kwenhliziyo yilezi:

• Isifo senhliziyo noma isifo sohlangothi
• Izinkinga zesigqi senhliziyo
• Ukutheleleka nge-incision, okungenzeka kakhulu ukuthi kwenzeke kubantu abakhuluphele ngokweqile, abanesifo sikashukela, noma asebevele benza lokhu kuhlinzwa
• Ukutheleleka kwe-valve entsha
• Ukuhluleka kwezinso
• Ukulahleka kwememori nokulahleka kokucaca kwengqondo, noma "ukucabanga okungaqondakali"
• Ukuphulukiswa kabi kwesiqhumane
• I-Post-pericardiotomy syndrome (umkhuhlane osezingeni eliphansi nobuhlungu besifuba) obungahlala ezinyangeni eziyisithupha
• Ukufa

Njalo utshele umhlinzeki wakho wezokunakekelwa kwempilo:

• Uma ukhulelwe noma ungakhulelwa
• Imiphi imithi oyiphuzayo, ngisho nezidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela

Ungakwazi ukugcina igazi ebhange legazi ukuze lifakwe phakathi nangemva kokuhlinzwa kwakho. Buza umhlinzeki wakho ukuthi wena namalungu omndeni wakho ninganikela kanjani ngegazi.

Uma ubhema, kufanele uyeke. Cela usizo kumhlinzeki wakho.

Esikhathini seviki elingu-1 ngaphambi kokuhlinzwa, ungacelwa ukuthi uyeke ukuthatha imishanguzo eyenza kube nzima ngegazi lakho ukuminyana. Lokhu kungadala ukopha okwengeziwe ngesikhathi sokuhlinzwa.

• Eminye yale mithi i-aspirin, ibuprofen (Advil, Motrin), ne-naproxen (Aleve, Naprosyn).
• Uma uthatha i-warfarin (i-Coumadin) noma i-clopidogrel (i-Plavix), khuluma nodokotela wakho ohlinzayo ngaphambi kokuma noma ukushintsha indlela oyisebenzisa ngayo le mithi.

Phakathi nezinsuku ngaphambi kokuhlinzwa kwakho:

• Buza ukuthi imiphi imithi okufanele uyithathe ngosuku lokuhlinzwa kwakho.
• Ngaso sonke isikhathi vumela umhlinzeki wakho azi ukuthi unomkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma esinye isifo esikhathini esiholela ekuhlinzweni kwakho.

Lungisa indlu yakho lapho ufika ekhaya uvela esibhedlela.

Geza bese ugeza izinwele zakho kusuku olungaphambi kokuhlinzwa kwakho. Ungadinga ukugeza umzimba wakho wonke ngaphansi kwentamo yakho ngensipho ekhethekile. Khuhla isifuba sakho amahlandla ama-2 noma ama-3 ngale nsipho.

Ngosuku lokuhlinzwa kwakho:

• Imvamisa uzocelwa ukuthi ungaphuzi noma ungadli lutho ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa kwakho. Lokhu kuhlanganisa ukusebenzisa ushungamu nomoya wokuphefumula. Hlanza umlomo wakho ngamanzi uma uzizwa womile. Qaphela ukuthi ungagwinyi.
• Thatha imithi otshelwe ukuthi uyiphuze ngophuzo oluncane lwamanzi.
• Uzotshelwa ukuthi ufika nini esibhedlela.

Lindela ukuchitha izinsuku ezine kuya kwezi-7 esibhedlela ngemuva kokuhlinzwa. Uzochitha ubusuku bokuqala e-ICU futhi ungahlala lapho izinsuku ezi-1 kuya kwezi-2. Kuzoba namashubhu amabili kuya kwamathathu esifubeni sakho ukukhipha uketshezi olusuka enhliziyweni yakho. Lezi 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) yokuhambisa uketshezi. Abahlengikazi bazobheka ngokucophelela abaqaphi abakhombisa izimpawu zakho ezibalulekile (ukushaya ngamandla, ukushisa, nokuphefumula kwakho).

Uzothuthelwa egumbini lesibhedlela elijwayelekile usuka e-ICU. Inhliziyo yakho nezimpawu zakho ezibalulekile zizoqhubeka nokuqashwa uze uye ekhaya. Uzothola umuthi wezinhlungu ukulawula izinhlungu ezungeze ukusika kwakho kokuhlinzwa.

Umhlengikazi wakho uzokusiza ukuthi uqale kancane kancane umsebenzi othile. Ungaqala uhlelo lokwenza inhliziyo nomzimba wakho uqine.

Ungaba ne-pacemaker efakwe enhliziyweni yakho uma izinga lokushaya kwenhliziyo yakho lihamba kancane ngemuva kokuhlinzwa. Kungaba okwesikhashana noma unomphela.

Ama-valve wenhliziyo asebenzayo awaphumeleli kaningi. Kodwa-ke, amahlule egazi angavela kuwo. Uma kwenzeka amahlule egazi, ungahle ube nesifo sohlangothi. Ukopha kungenzeka, kepha lokhu akuvamile.

Ama-valve wezinto eziphilayo anengozi encane yamahlule egazi, kepha athanda ukwehluleka isikhathi eside. Ukuze uthole imiphumela emihle, khetha ukuhlinzwa kwe-aortic valve esikhungweni esenza eziningi zalezi zinqubo.

Ukushintshwa kwe-aortic valve; I-aortic valvuloplasty; Ukulungiswa kwe-aortic valve; Ukubuyiselwa - i-aortic valve; I-AVR

• Izidakamizwa ze-antiplatelet - P2Y12 inhibitors
• I-Aspirin nesifo senhliziyo
• Ukuhlinzwa kwe-valve yenhliziyo - ukukhipha
• Ukuhlinzwa kwenhliziyo yezingane - ukukhishwa
• Ukuthatha i-warfarin (Coumadin)

ILindman BR, iBonow RO, i-Otto CM. Isifo se-aortic valve. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 68.

URosengart TK, u-Anand J. Isifo senhliziyo esitholakele: i-valvular. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 60.