Ukuhlinzwa kwe-Mitral valve - kungena kancane

Ukuhlinzwa kwe-Mitral valve ukuhlinzwa ukuze kulungiswe noma kushintshwe i-mitral valve enhliziyweni yakho.

Igazi liphuma emaphashini bese lingena egumbini lokumpompa lenhliziyo elibizwa ngokuthi i-atrium yesobunxele. Igazi bese lingena egumbini lokugcina lokumpompa lenhliziyo elibizwa nge-ventricle yesobunxele. I-valve ye-mitral itholakala phakathi kwala magumbi amabili. Kwenza isiqiniseko sokuthi igazi lilokhu liqhubekela phambili lingena enhliziyweni.

Ungadinga ukuhlinzwa kwi-mitral valve yakho uma:

• I-mitral valve iqina (ibaliwe). Lokhu kuvimbela igazi ukuba liqhubekele phambili nge-valve.
• I-valve ye-mitral ikhululekile kakhulu. Igazi livame ukuhlehlela emuva lapho lokhu kwenzeka.

Ukuhlinzwa okuncane okuhlasela i-mitral valve kwenziwa ngokusikeka okuncane okuningana. Olunye uhlobo lokusebenza, ukuhlinzwa okuvulekile kwe-mitral valve, kudinga ukusikwa okukhulu.

Ngaphambi kokuhlinzwa kwakho, uzothola i-anesthesia ejwayelekile.

Uzobe ulele futhi ungenazinhlungu.

Kunezindlela ezahlukahlukene zokwenza ukuhlinzwa kwe-mitral valve okungajwayelekile.

• Udokotela ohlinzayo wenhliziyo yakho angenza usike wamasentimitha amabili kuya kwamasentimitha ama-5 kuya kwangu-7.5 ubude engxenyeni efanele yesifuba sakho eduze kwe-sternum (isifuba sesifuba). Kuzohlukaniswa imisipha endaweni. Lokhu kuvumela udokotela ohlinzayo ukuthi afinyelele inhliziyo. Ukusikwa okuncane kwenziwa ohlangothini lwesobunxele lwenhliziyo yakho ukuze udokotela ohlinzayo akwazi ukulungisa noma ukufaka esikhundleni se-mitral valve.
• Ekuhlinzeni okungapheli, udokotela wakho ohlinzayo wenza izimbobo ezincane ezi-1 kuye kwezingu-4 esifubeni sakho. Ukuhlinzwa kwenziwa ngokusikeka kusetshenziswa ikhamera namathuluzi wokuhlinza akhethekile. Ekuhlinzweni kwe-valve okusizwa irobhothi, udokotela ohlinzayo usika izingcezu ezimbili kuya kwezi-4 esifubeni sakho. Ukusikeka kungamasentimitha angu-1/2 kuya ku-3/4 (1.5 kuya 2 amasentimitha) lilinye. Udokotela ohlinzayo usebenzisa ikhompyutha ekhethekile ukulawula izingalo zamarobhothi ngesikhathi sokuhlinzwa. Ukubukwa kwe-3D kwenhliziyo ne-mitral valve kukhonjiswa kukhompyutha egumbini lokusebenza.

Uzodinga umshini wenhliziyo namaphaphu kulezi zinhlobo zokuhlinzwa. Uzoxhunywa kule divayisi ngokusikeka okuncane emgodini noma esifubeni.

Uma udokotela wakho ohlinzayo ekwazi ukulungisa i-mitral valve yakho, ungahle ube:

• I-ring annuloplasty - Udokotela ohlinzayo uqinisa i-valve ngokuthunga indandatho yensimbi, indwangu noma izicubu ezungeze i-valve.
• Ukulungiswa kwe-valve - Udokotela ohlinzayo usika, abumbe, noma akhe kabusha eyodwa noma womabili amabhomu avula futhi avale i-valve.

Uzodinga i-valve entsha uma kukhona umonakalo omkhulu kakhulu ku-mitral valve yakho. Lokhu kubizwa ngokuthi ukuhlinzwa esikhundleni. Udokotela wakho ohlinzayo angasusa enye noma yonke i-valve yakho ye-mitral bese ethunga entsha endaweni. Kunezinhlobo ezimbili eziyinhloko zama-valve amasha:

• Umshini - Wenziwe ngezinto ezenziwe ngabantu, njenge-titanium ne-carbon. La ma-valve ahlala isikhathi eside kakhulu. Uzodinga ukuthatha umuthi wokunciphisa igazi, njenge-warfarin (Coumadin), impilo yakho yonke.
• Okuphilayo - Kwenziwe ngezicubu zomuntu noma zesilwane. Lawa ma-valve ahlala iminyaka eyi-10 kuya kwengu-15 noma ngaphezulu, kepha mhlawumbe awudingi ukuthatha abathathi begazi impilo yonke.

Ukuhlinzwa kungathatha amahora amabili kuya kwangu-4.

Lokhu kuhlinzwa kwesinye isikhathi kungenziwa ngomthambo we-groin, ngaphandle kokusikeka esifubeni sakho. Udokotela uthumela ipayipi (ithubhu eliguquguqukayo) elinebhaluni elinamathiselwe ekugcineni. Ibhaluni lifutheka ukwelula ukuvulwa kwe-valve. Le nqubo ibizwa ngokuthi yi-valvuloplasty enqamulelayo futhi yenzelwe i-mitral valve evinjiwe.

Inqubo entsha ifaka ukufaka ipayipi lokuhambisa ipayipi ngomthambo osemgodini bese usika i-valve ukuvimbela i-valve ukuthi ingavuzi.

Ungadinga ukuhlinzwa uma i-mitral valve yakho ingasebenzi kahle ngoba:

• Une-mitral regurgitation - Lapho i-mitral valve ingavali yonke indlela futhi ivumela igazi ukuthi liphinde libuyele e-atria yangakwesobunxele.
• Une-mitral stenosis - Uma i-mitral valve ingavuli ngokugcwele futhi ivimbela ukuhamba kwegazi.
• I-valve yakho ithuthukise ukutheleleka (i-endocarditis esithathelwanayo).
• Une-prolral valve prolapse enzima engalawulwa ngomuthi.

Ukuhlinzwa okuncane kungenziwa ngenxa yalezi zizathu:

• Izinguquko ku-valve yakho ye-mitral zidala izimpawu ezinkulu zenhliziyo, njengokuphefumula okuncane, ukuvuvukala kwemilenze, noma ukwehluleka kwenhliziyo.
• Izivivinyo zibonisa ukuthi ushintsho ku-mitral valve yakho seluqala ukulimaza ukusebenza kwenhliziyo yakho.
• Ukulimala kwe-valve yenhliziyo yakho ekutheleleni (endocarditis).

Inqubo encane yokuhlasela inezinzuzo eziningi. Kunobuhlungu obuncane, ukulahleka kwegazi, kanye nengozi yokutheleleka. Futhi uzolulama ngokushesha kunalokho ongakuthola ekuhlinzweni kwenhliziyo okuvulekile. Kodwa-ke, abanye abantu kungenzeka bangakwazi ukuthola lolu hlobo lwenqubo.

I-valvuloplasty enamandla ingenziwa kuphela kubantu abagula kakhulu ukuthi bangaba ne-anesthesia. Imiphumela yale nqubo ayihlali isikhathi eside.

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

Amasu wokuhlinza amancane angenabungozi anezingozi ezimbalwa kakhulu kunokuhlinzwa okuvulekile.Izingozi ezingaba khona ezivela ekuhlinzweni kwevelufa okungajwayelekile yilezi:

• Ukulimala kwezinye izitho, izinzwa, noma amathambo
• Isifo senhliziyo, isifo sohlangothi, noma ukufa
• Ukutheleleka kwe-valve entsha
• Ukushaya kwenhliziyo okungafanele okufanele kulashwe ngemithi noma nge-pacemaker
• Ukuhluleka kwezinso
• Ukuphola kabi kwamanxeba

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 mayelana nokuthi wena namalungu akho omndeni unganikela kanjani ngegazi.

Uma ubhema, kufanele uyeke. Cela usizo kumhlinzeki wakho.

Phakathi nezinsuku ngaphambi kokuhlinzwa kwakho:

• 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 ifaka phakathi 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.
• Buza ukuthi imiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.
• Lungisa indlu yakho lapho ufika ekhaya uvela esibhedlela.
• Geza bese ugeza izinwele zakho kusuku olungaphambi kokuhlinzwa. Ungadinga ukugeza umzimba wakho ngaphansi kwensipho yakho ngensipho ekhethekile. Khuhla isifuba sakho amahlandla ama-2 noma ama-3 ngale nsipho. Ungacelwa futhi ukuthi uthathe i-antibiotic ukuvikela ukutheleleka.

Ngosuku lokuhlinzwa:

• Ungacelwa ukuthi ungaphuzi noma ungadli lutho ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa kwakho. Lokhu kufaka phakathi ukusebenzisa i-chewing gum naminti. 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 ezintathu kuya kwezi-5 esibhedlela ngemuva kokuhlinzwa. Uzophaphama egumbini labagula kakhulu (i-ICU) bese ululama lapho usuku olungu-1 noma 2. Abahlengikazi bazobheka ngokucophelela abaqaphi abakhombisa izimpawu zakho ezibalulekile (ukushaya kwenhliziyo, izinga lokushisa, nokuphefumula).

Amashubhu amabili kuya kwamathathu azoba sesifubeni sakho ukukhipha uketshezi olusuka enhliziyweni yakho. Imvamisa zisuswa ezinsukwini ezi-1 ukuya kwezi-3 ngemuva kokuhlinzwa. Ungaba nepayipi (ishubhu eliguquguqukayo) esinyeni sakho ukukhipha umchamo. Ungase futhi ube nemigqa ye-intravenous (IV) ukuthola uketshezi.

Uzosuka e-ICU uye egumbini lesibhedlela elijwayelekile. Inhliziyo yakho nezimpawu zakho ezibalulekile zizobhekwa uze ulungele ukuya ekhaya. Uzothola umuthi wezinhlungu wezinhlungu esifubeni sakho.

Umhlengikazi wakho uzokusiza ukuqala umsebenzi kancane. Ungaqala uhlelo lokwenza inhliziyo nomzimba wakho uqine.

I-pacemaker ingafakwa enhliziyweni yakho uma izinga lokushaya kwenhliziyo yakho lihamba kancane ngemuva kokuhlinzwa. Lokhu kungaba kwesikhashana noma ungadinga i-pacemaker unomphela ngaphambi kokuphuma esibhedlela.

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.

Imiphumela yokulungiswa kwe-mitral valve mihle kakhulu. Ukuze uthole imiphumela emihle, khetha ukuhlinzwa esikhungweni esenza eziningi zalezi zinqubo. Ukuhlinzwa kancane kwe-valve yenhliziyo sekuthuthuke kakhulu eminyakeni yamuva. Lezi zindlela ziphephile kubantu abaningi, futhi zinganciphisa isikhathi sokululama nobuhlungu.

Ukulungiswa kweMitral valve - i-mini-thoracotomy yesokudla; Ukulungiswa kwe-Mitral valve - i-sternotomy ephezulu noma engaphansi; Ukulungiswa kwe-valve okusiza amarobhothi; I-mitral valvuloplasty yemithambo

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

I-Bajwa G, i-Mihaljevic T. Ukuhlinzwa kwe-mitral valve okuncane: indlela ye-sternotomy engaphelele. Ku: Sellke FW, Ruel M, ama-eds. I-Atlas Yezindlela Zokuhlinza Zenhliziyo. Okwesibili. IPhiladelphia, PA: Elsevier; 2019: isahluko 20.

IGoldstone AB, Woo YJ. Ukwelashwa kokuhlinzwa kwe-mitral valve. Ku: Sellke FW, del Nido PJ, Swanson SJ, ama-eds. Ukuhlinzwa kweSabiston neSpencer kwesifuba. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2016: isahluko 80.

UHerrmann HC, uMack MJ. Izindlela zokwelapha zeTranscatheter zesifo senhliziyo se-valvular. 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 72.

UThomas JD, uBonow RO. Isifo seMitral 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 69.