Isibhedlela Esihamba Phambili Sokuhlinza ICardiac Resynchronization Therapy Pacemaker (CRT-P) e-Hyderabad

I-Advanced Cardiac Resynchronization Therapy Pacemaker (CRT-P) Ukuhlinzwa

Ukuhluleka kwenhliziyo kuthinta izigidi zabantu emhlabeni jikelele. Ukwelashwa kabusha kwe-cardiac resynchronization kungashintsha izimpilo zeziguli ezinenkinga yokuncipha kwengxenye ye-ventricular ejection kanye nokubambezeleka kokuqhutshwa kwe-intraventricular.

Imishini yokwelapha i-cardiac resynchronization isebenza ngendlela ehlukile kunejwayelekile abenzi benhliziyo. Lawa madivaysi athumela ama-impulses kagesi anesikhathi kuwo womabili ama-ventricle ngokusebenzisa imikhondo eyisipesheli yokugijima. Lokhu kufinyela kwenhliziyo okuvumelanisiwe kuthuthukisa ukuphuma kwenhliziyo futhi kuthuthukisa ukusebenza kahle kwenhliziyo. Iziguli ezine-left bundle branch block (LBBB) zizuza kakhulu kulokhu kwelashwa ngoba i-LBBB ibangela ukubambezeleka kokufinyela kwe-ventricular kwesokunxele.

Lesi sihloko sichaza ama-pacemakers okwelapha inhliziyo, umsebenzi wawo, ukufaneleka kwesiguli, kanye nemiphumela elindelekile ngesikhathi nangemva kwenqubo ezibhedlela ze-CARE Group.

Kungani Izibhedlela ze-CARE ziyisinqumo sakho esiphezulu sokuhlinzwa kwe-Cardiac Resynchronisation Therapy Pacemaker (CRT-P) e-Hyderabad

Ungathembela Izibhedlela ze-CARE ngempilo yakho yenhliziyo. Amaphuzu avelele abalulekile afaka:

• Sinochwepheshe izazi zenhliziyo kanye nama-electrophysiologists anolwazi olunzulu ekuthuthukisweni zokwelapha isigqi senhliziyo njenge-CRT-P.
• Sinamalebhu e-cath esimanje aklanyelwe ukunemba nokuphepha phakathi nazo zonke izinqubo zenhliziyo.
• Indlela yethu yokunakekela okuphelele iyakusekela esinyathelweni ngasinye, kusukela emfundweni yangaphambi kokuhlinzwa ukuya ekuvuseleleni inhliziyo ngemva kokuhlinzwa.
• I-CARE yamahora onke iqinisekisa ukunaka izidingo zakho ngokushesha.

I-Cardiac Resynchronization Therapy Pacemaker (CRT-P) Odokotela Abahlinzayo Abangcono Kakhulu eNdiya

Khetha indawo Hyderabad Visakhapatnam Bhubaneshwar Nagpur Raipur esilengayo I-Aurangabad Imitholampilo Nezikhungo Zezokwelapha

Khetha Isibhedlela CARE Hospitals, Banjara Hills, Hyderabad CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad CARE Hospitals, HITEC City, Hyderabad CARE Hospitals, Nampally, Hyderabad I-Gurunanak CARE Hospitals, Musheerabad, Hyderabad CARE Hospitals, Bhubaneswar I-Ganga CARE Hospital Limited, eNagpur I-Ramkrishna CARE Hospitals, eRaipur CARE Izibhedlela, Ramnagar, Visakhapatnam CARE Hospitals Outpatient Centre, HITEC City, Hyderabad CARE Hospitals, Malakpet, Hyderabad Izibhedlela ze-CARE CHL, e-Indore Izibhedlela Ezihlangene ze-CIIGMA (Iyunithi Yezibhedlela ze-CARE), Chh. Sambhajinagar CARE Izibhedlela, Health City, Arilova CARE Medical Center, Tolichowki, Hyderabad

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  UDkt. Bipin Bihari Mohanty

  Umqondisi Womtholampilo & I-HOD

  Ukuhlinzwa Kwenhliziyo Nokuhlinzwa Kwemithambo

  Bhala iNqunto
• 

  UDkt. G Rama Subramanyam

  Umqondisi Womtholampilo kanye Nomeluleki Sr. - Ukuhlinzwa Kwenhliziyo

  Ukuhlinzwa kwe-Cardiothoracic

  Bhala iNqunto
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  UDkt. G. Usha Rani

  umxhumanisi

  Ukuhlinzwa kwe-Cardiothoracic

  Bhala iNqunto
• 

  UDkt. M Sanjeeva Rao

  Udokotela Wokuhlinza I-Cardiothoracic

  Ukuhlinzwa kwe-Cardiothoracic

  Bhala iNqunto
• 

  UDkt. Manoranjan Misra

  Umqondisi wezokwelapha

  CTVS

  Bhala iNqunto
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  UDkt. Suvakanta Biswal

  Asso. Umqondisi Womtholampilo

  CTVS

  Bhala iNqunto
• 

  UDkt. Vinod Ahuja

  Udokotela Wokuhlinza I-Cardiothoracic

  Ukuhlinzwa kwe-Cardiothoracic

  Bhala iNqunto
• 

  UDkt Manish Porwal

  Umqondisi Wezempilo kanye neNhloko Yomnyango

  I-Cardio Vascular and Thoracic Surgeon

  Bhala iNqunto
• 

  UDkt. Anand Deodhar

  Sr. Udokotela Wokuhlinza Inhliziyo Nemithambo yegazi

  Ukuhlinzwa Kwenhliziyo

  Bhala iNqunto
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  UDkt. Revanth Maramreddy

  Sr. Consultant

  I-Cardiothoracic kanye ne-Vascular Surgery

  Bhala iNqunto
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  UDkt. Nagireddi Nageswara Rao

  Umqondisi Womtholampilo kanye Nomeluleki Ongu-Sr. - CTVS, MICS & Nodokotela Ohlinzayo Wokufakelwa Kwenhliziyo

  Ukuhlinzwa KweCardio-Thoracic

  Bhala iNqunto
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  UDkt. Ravi Raju Chigullapally

  Sr. Consultant Cardio Thoracic Vascular, Invasive Kancane & Endoscopic Cardiac Surgeon

  Cardiology

  Bhala iNqunto

Izindlela Ezithuthukile Zokuhlinza Esibhedlela Sokunakekelwa

Ezibhedlela ze-CARE, ongoti bethu benhliziyo abangochwepheshe basebenzisa amathuluzi okuxilonga nawokuthwebula athuthukile njengokuthwebula kwesithombe esisezingeni eliphezulu kanye nobuchwepheshe bemephu be-3D ukuze kubekwe idivayisi okunembile kanye nokwelashwa komuntu siqu. Odokotela benza izinqubo ze-CRT-P besebenzisa amasu anembe, ahlasela kancane anciphisa ubuhlungu & asheshise ukululama.

Sinezinhlelo zokuqapha zesikhathi sangempela ezilandelela ukusebenza kwenhliziyo kuyo yonke inqubo, okwenza izinguquko ngesikhathi sangempela. Ochwepheshe bethu bezifo zenhliziyo benza ngokwezifiso futhi balungise kahle amadivayisi e-CRT-P esiguli ngasinye.

Izinkomba Zokuhlinza ICardiac Resynchronization Therapy Pacemaker (CRT-P)

Odokotela batusa ukuhlinzwa kwe-CRT-P ezigulini ezine:

• Ukwehluleka kwenhliziyo ngengxenye ye-left ventricular ejection ≤35%
• Ubude besikhathi se-QRS ≥120 ms (iphakamisa ukubambezeleka kukagesi enhliziyweni)
• Izimpawu eziqhubekayo naphezu kwemithi (i-NYHA class III kanye ne-ambulatory IV)
• Ibhulokhi yegatsha lenqwaba (LBBB)

I-CRT-P nayo ingazuzisa iziguli i-fibrillation ye-atrial abahlangabezana nalezi zidingo. Ucwaningo lwembula ukuthi amanye ama-ventricles eziguli ezihluleka kwenhliziyo awahlangani ndawonye.

Izinhlobo zezinqubo zeCardiac Resynchronisation Therapy Pacemaker (CRT-P).

Iziguli zingathola izinhlobo ezimbili eziyinhloko zamadivaysi okwelapha e-cardiac resynchronisation:

• I-CRT-P (I-Pacemaker kuphela): Lolu cingo luthumela amasignali kagesi avumelanisa amabhithi e-ventricular. Iziguli ezinokwehluleka kwenhliziyo kanye nezinkinga zokuqhuba ziyazuza kulolu khetho.
• I-CRT-D (I-Pacemaker ene-Defibrillator): Le divayisi ethuthukisiwe inakho kokubili ukunyakazisa kanye namandla okukhipha i-fibrillation. Iziguli ezihluleka inhliziyo ezisengozini yokufa ngokuzumayo kwenhliziyo ngokuvamile zidinga le nketho.

Ukulungiselela Ukuhlinzwa Kwangaphambi Kwe-CRT-P

Ukulungela ukwelashwa kokuvumelanisa kabusha kwenhliziyo kudinga izinyathelo ezimbalwa eziqinisekisa imiphumela engcono kakhulu.

Iziguli zidinga ukuhlolwa okuphelele njengama-MRIs enhliziyo noma ama-transthoracic echocardiograms ngaphambi kokuhlinzwa. Odokotela bahlola amashejuli emithi, ikakhulukazi uma unemithi enciphisa igazi engase idinge ukulungiswa. Ukugeza okukhethekile kwe-antimicrobial kusiza ukunciphisa ingozi yokutheleleka. Iziguli kufanele zikhumbule:

• Zila ukudla okungenani amahora angu-6 ngaphambi kwenqubo
• Thatha imithi ebekiwe njengoba uyaliwe
• Ukulandela imiyalelo yangaphambi kokuhlinzwa njengokusho kukadokotela ohlinzayo kanye nezeluleko zethimba labahlinzayo. 

Inqubo Yokuhlinzwa ye-CRT-P

Ukuhlinzwa ngokuvamile kuthatha amahora angu-2-4. 

• Udokotela ohlinzayo uqala ngokufaka ndikindiki indawo yesifuba nge- i-anesthetic yendawo. 
• Ukusika okuncane kuya ngaphansi kwe-collarbone. 
• Izintambo ezintathu zidlula emithanjeni futhi zifinyelele ezindaweni ezithile zenhliziyo ngokuqondiswa kwe-X-ray. 
• Umshini wokushaya inhliziyo uxhumeka kule mikhondo bese uhlala ngaphansi kwesikhumba.

Ukubuyiselwa Kokuhlinzwa Kwangemva kwe-CRT-P

Iziguli zihlala esibhedlela amahora angama-24-48 ngemuva kokuhlinzwa ukuze ziqashwe. Ingalo yangakwesobunxele kufanele ithule cishe amahora ayi-12 ukuze igcine imikhondo isendaweni. Ukuhlolwa kokusebenza kwedivayisi kwenzeka phakathi nama-aphoyintimenti okulandelela avamile. Ukubuyisela kuhlanganisa:

• Ukunyakaza kwengalo okulinganiselwe amaviki angu-4-6
• Ukugcina indawo yokusika ihlanzekile futhi yomile
• Ukuthatha imithi ebekiwe njengoba kuyalelwe

Izingozi Nezinkinga

Inqubo ngokuvamile iphephile kodwa iza nezingozi ezingaba khona. Lokhu kubandakanya: 

• Ukutheleleka 
• Ukopha noma imihuzuko endaweni yokufakelwa
• Ukukhishwa komthofu 
• I-Pneumothorax (iphaphu eliwile) ezimweni ezingavamile
• I-phrenic nerve stimulation ebangela ukudikiza kwe-diaphragmatic 
• I-Pocket hematoma (iqoqo legazi endaweni yokufakelwa)
• I-coronary sinus perforation ngesikhathi sokubekwa komthofu.

Izinzuzo Zokuhlinzwa Kwe-CRT-P

Lokhu kwelashwa kuthuthukisa kakhulu ukusebenza kwenhliziyo ngokusiza ama-ventricles ukuthi ashaye ndawonye kahle. Iziguli zibe sezithola ukugeleza kwegazi okungcono, kunciphe ukuphelelwa umoya, ukuvakashelwa okuncane ezibhedlela, kanye nezinga lempilo elithuthukisiwe.

Usizo Lomshwalense Wokuhlinza Kwenhliziyo Kabusha Kwenhliziyo

Abahlinzeki abaningi bomshwalense wezempilo bakhava izinqubo ze-CRT kubantu abafanelekayo. Izibhedlela ze-CARE zinikeza umhlahlandlela ophelele womshwalense futhi zisebenzisana Nabaphathi Benkampani Yangaphandle ukwenza izimangalo zibe lula.

Umbono Wesibili Wokuhlinza Kwenhliziyo Yokuvuselela Inhliziyo

Ukuba yinkimbinkimbi kwenqubo kwenza ukuthola umbono wesibili komunye uchwepheshe kubaluleke kakhulu. Izazi ze-electrophysiologists ezehlukene zenhliziyo zingase zisikisele izindlela ezahlukahlukene ngokusekelwe ebuchwephesheni babo kanye nesimo sakho esithile.

Isiphetho

I-CRT-P imaka impumelelo ezigulini ezihluleka yinhliziyo ezibhekene nezinkinga ezithile zokuqhutshwa kukagesi. Lokhu kwelashwa okushintsha impilo kusiza iziguli ezinengxenyana encishisiwe ye-ventricular ejection kanye nebhulokhi yegatsha lenqwaba. Ukwelashwa kusebenza ngokubuyisela ukufinyela kwenhliziyo okuvumelanisiwe ngokusebenzisa ama-impulses kagesi afakwe isikhathi ngokucophelela kuwo womabili ama-ventricles.

Ukwelashwa kwe-CRT-P, ngaphandle kokungabaza, kuye kwashintsha izinketho zokwelapha zeziguli ezihluleka yinhliziyo. Abantu abangakwazi ukuqeda ukukhathala nokuphelelwa umoya naphezu kwemithi manje babona ukuthuthuka okukhulu ekusebenzeni kwenhliziyo yabo kanye nempilo yonke. Ukufinyela kwenhliziyo okuvunyelaniswe kangcono kumpompa igazi ngempumelelo kakhudlwana futhi kubhekane nembangela esikhundleni sokulawula izimpawu.