Ukuhlinzwa Kwe-Stent Les Heart Valve

Ukuhlinzwa Kwe-Stent Les Heart Valve

I-Stentless Heart Valve Surgery

Inhliziyo yakhiwe izicubu zemisipha ezinikeza igazi kuwo wonke umzimba. Kuyisitho sokumpompa esinamagumbi amane. Amakamelo amabili aphezulu aziwa ngokuthi i-atria, kanti amagumbi aphansi aziwa ngokuthi ama-ventricles. Kunama-valve akhona emakamelweni agcina igazi ligeleza liye phambili ngenhliziyo. Lezi zinhlobo ezine zama-valve yi-valve ye-tricuspid, i-mitral valve, i-pulmonary valve kanye ne-aortic valve. I-valve ngayinye inama-flap. Ama-flap of tricuspid kanye nama-mitral valves aziwa ngokuthi amapheshana futhi, ama-flap of pulmonary and aortic valves aziwa ngokuthi ama-cusps.

Uma i-valve eyodwa kwezine ingasebenzi kahle noma igula noma ilimale, khona-ke inqubo yokuhlinzwa yenziwa ukubuyisela imisebenzi yenhliziyo. Le nqubo yaziwa ngokuthi ukuhlinzwa kwe-valve yenhliziyo. Kulokhu kuhlinzwa, odokotela abahlinzayo balungisa futhi babuyisele inhliziyo eyonakele noma i-valve. I-valve yenhliziyo ingalungiswa kusetshenziswa izindlela ezihlukahlukene zokuhlinza njengokuhlinzwa kwenhliziyo evulekile noma ukuhlinzwa kwenhliziyo okungavamisile.

Ngokuvamile, ekuhlinzeni ama-valve enhliziyo aqinile, ama-valve angenasici asetshenziswa ezindaweni zama-pulmonary kanye ne-aortic valve esikhundleni sokushintshwa kwezimpande ezigcwele noma endaweni engaphansi kwe-coronary. 

Izinkomba Ezibonisa Isidingo Sokuhlinzwa Kwevalve Yenhliziyo Engenasici

Lokhu kuhlinzwa kuyadingeka lapho ama-valve engasebenzi kahle. Isidingo salokhu kuhlinzwa sivela lapho isiguli esinama-valve alimele sibonisa lezi zimpawu ezilandelayo:

• isiyezi

• I-stenosis (isifo se-valve yenhliziyo)

• Inkinga yokuphefumula

• Regurgitation (isifo se-valve yenhliziyo)

• ubuhlungu besifuba

• palpitations

• Ukuvuvukala kwesisu, izinyawo, noma amaqakala

• Ukukhula kwesisindo ngenxa yokugcinwa koketshezi

Izinhlobo Zokushintshwa Kwevalvu Yenhliziyo 

Ngaphansi kunezinhlobo zokuhlinza esikhundleni se-valve yenhliziyo lapho kusetshenziswa khona ama-valve okwenziwa:

• Ukushintshwa kwe-aortic valve - Lokhu kuhlinzwa kwenziwa ku-valve ye-aortic. Ukuhlinzwa kwenziwa uma isiguli sinesifo sokuzalwa esibangela ukuphindaphinda noma i-stenosis.

• Ukushintshwa kwe-Mitral valve - Lokhu kuhlinzwa kunconywa uma i-valve ingavali ngokuphelele noma ingavaleki ngokuphelele. Kulokhu kuhlinzwa, i-valve eyonakele ithathelwa indawo i-valve yebhayoloji noma i-valve yokwenziwa.

• Ukushintshwa kwe-valve kabili - Lokhu kuhlinzwa okushintshwayo kushintshwa kokubili kwe-aortic ne-mitral valve noma lonke uhlangothi lwesobunxele lwenhliziyo.

• Ukushintshwa kwe-valve yamaphaphu - Lokhu kuhlinzwa kuyadingeka ukwelapha ukukhubazeka kokuzalwa, i-stenosis, evimbela ukugeleza kwegazi.

Izingozi Ezihambisana Nokuhlinzwa Kwevalve Yenhliziyo Engenasici

Izinkinga ezingase zivele ngesikhathi sokuhlinzwa esikhundleni se-valve yenhliziyo ezimweni ezingavamile, zibalwe ngezansi:

• Ama-clots egazi

• ukopha

• Izinkinga zamaphaphu

• Isifo senhliziyo

• Stroke

• I-pneumonia

• Ukutheleleka

• Pancreatitis

• Izinkinga zokuphuza

• Ukusebenza okungalungile kwe-valve eshintshiwe noma elungisiwe

• Ukungajwayelekile kwesigqi senhliziyo (arrhythmia)

Ukuhlolwa Kokuxilongwa Kwenziwa Ngaphambi Kokuhlinzwa Kwevalve Yenhliziyo Engenasici

Ezibhedlela ze-CARE, ithimba lodokotela abanokuhlangenwe nakho lenza izivivinyo ezihlukahlukene zokuxilonga ukuze kutholwe ukuthi isiguli siyakufanelekela yini ukuhlinzwa noma cha. Lezi zivivinyo zimi kanje:

• I-Electrocardiogram (ECG) - Lokhu kuhlola kuthola amagumbi akhulisiwe enhliziyo, isigqi esingavamile senhliziyo nesifo senhliziyo.

• I-X-ray yesifuba - Lokhu kuhlolwa kwe-imaging kusiza udokotela ekunqumeni ubukhulu benhliziyo, izifo ze-valve yenhliziyo nesimo samaphaphu.

• I-MRI yenhliziyo - Kulokhu kuhlolwa, amaza omsakazo nezizibuthe zisetshenziswa ukuze kutholwe izithombe ezinemininingwane yenhliziyo. Amakamelo enhliziyo aphansi ahlolwa ngalokhu kuhlolwa.

• I-catheterization yenhliziyo - Lokhu ukuhlolwa kokuxilonga okuhlaselayo lapho ukuthwebula kwemithambo yenhliziyo kwenziwa kusetshenziswa amashubhu amancane. Ukuhlolwa kusiza ukuhlola imisebenzi yenhliziyo kanye nesifo se-coronary artery.

Inqubo Yokuhlinzwa Kwe Valve Yenhliziyo Engenasici

Ezibhedlela ze-CARE, le nqubo elandelayo ilandelwa ngesikhathi sokuhlinzwa:

• Isiguli sicelwa ukuthi sikhiphe bonke ubucwebe nezinye izinto ezingase ziphazamise ngesikhathi sokuhlinzwa.

• Odokotela babe sebeqala umugqa ofakwa emthanjeni (IV) esandleni noma engalweni yesiguli ukuze bajove uketshezi lwe-IV neminye imithi. Bazofaka ama-catheter esihlakaleni noma entanyeni ukuze bahlole isimo senhliziyo nomfutho wegazi.

• Emva kwalokhu, ishubhu lokuphefumula lizofakwa emaphashini ngomlomo. Isiguli sibe sesixhunywa kumshini wokuphefumula.

• Udokotela ohlinzayo uzofaka i-transesophageal echocardiogram epayipini lokugwinya ukuze aqaphe imisebenzi yamavalvu.

• Umchamo ukhishwa ngosizo lweshubhu eliguquguqukayo nelithambile. Elinye ishubhu lisetshenziselwa ukukhipha uketshezi lwesisu.

• Uma udokotela ohlinzayo enza ukuhlinzwa kwenhliziyo evulekile, khona-ke uzosihlinza maphakathi nesifuba. Kodwa-ke, uma enza inqubo engathandeki kakhulu, uzokwenza izimbobo ezincane.

• Ngemuva kwalokhu, udokotela uzosika ithambo lesifuba phakathi futhi uzolihlukanisa. 

• Udokotela uzomisa inhliziyo yesiguli ukuze bakwazi ukushintsha noma ukulungisa inhliziyo. Lokhu kuzokwenziwa ngosizo lomshini we-heart-lung bypass.

• Lapho inhliziyo iyekile ukushaya, odokotela bazoshintsha ivalve egulayo noma eyonakele bafake ivalvu yokwenziwa uma kwenzeka kushintshwa ivalvu. Endabeni yokulungiswa kwe-valve, inqubo izoxhomeka ohlotsheni lwesifo se-valve. 

• Ngemva kokuphothulwa kokuhlinzwa, odokotela bazokwethusa inhliziyo ukuze iqale ukushaya futhi. 

• Ngemuva kokuqapha i-valve, isifuba sesifuba sizovalwa ngosizo lwezithungo.

• Bazosebenzisa amashubhu ukukhipha uketshezi oluzungeze inhliziyo.

• Ekugcineni, i-incision ivaliwe nge-sutures noma i-glue yokuhlinzwa futhi, khona-ke ukugqoka kwenziwa.

Izibhedlela ZOKUNAKEKELA Zingasiza Kanjani?

Ezibhedlela ze-CARE, sihlinzeka ngendawo yokuhlinzwa kwe-valve yenhliziyo engenazithi. Odokotela abahamba phambili besibhedlela sethu benza izivivinyo ezihlukahlukene zokuxilonga ngaphambi kokuhlinzwa futhi banikeze izindlela zokwelapha eziqondene nawe ezigulini. Abasebenzi abaqeqeshiwe banikeza usizo oluphelele kanye nokunakekelwa kokugcina ezigulini phakathi nangemuva kokuhlinzwa. Isibhedlela silandela imigomo yokwelashwa yamazwe ngamazwe ukuze sinikeze imiphumela engcono kakhulu ezigulini.