Opaleshoni ya aortic valve - yowonongeka pang'ono

Magazi amatuluka mumtima mwanu ndikulowa mumtsuko waukulu wamagazi wotchedwa aorta. Valavu ya aortic imasiyanitsa mtima ndi aorta. Valavu ya aortic imatseguka kuti magazi azitha kutuluka. Kenako imatseka kuti magazi asabwerere mumtima.

Mungafunike opaleshoni yamavalo aortic kuti mutenge valavu ya aortic mumtima mwanu ngati:

• Valavu yanu ya aortic siyitsekera njira yonse, chifukwa chake magazi amabwereranso mumtima. Izi zimatchedwa kuti aortic regurgitation.
• Valavu yanu ya aortic siyitseguka kwathunthu, chifukwa chake magazi amatuluka mumtima amachepetsedwa. Izi zimatchedwa aortic stenosis.

Valavu ya aortic ikhoza kusinthidwa pogwiritsa ntchito:

• Opaleshoni yovuta kwambiri ya aortic valve, yochitidwa kamodzi kapena zingapo zocheperako
• Tsegulani opareshoni ya aortic valve, yomwe idachitika pocheka kwambiri pachifuwa chanu

Musanachite opareshoni yanu, mudzalandira opaleshoni.

Mudzakhala mukugona komanso opanda ululu.

Pali njira zingapo zochitira opaleshoni ya valavu ya aortic yocheperako. Njira zimaphatikizira min-thoracotomy, min-sternotomy, opaleshoni yothandizidwa ndi ma robot, ndi maopaleshoni amtundu uliwonse. Kuchita njira zosiyanasiyana:

• Dokotala wanu amatha kudula 2-inchi mpaka 3-inchi (5 mpaka 7.6 masentimita) kudula mbali yakumanja ya chifuwa chanu pafupi ndi sternum (breastbone). Minofu m'derali igawika. Izi zimalola dokotalayo kufika pamtima ndi valavu ya aortic.
• Dokotala wanu amatha kugawaniza gawo lapamwamba la fupa lanu la m'mawere, kulola kutulutsa valavu ya aortic.
• Pochita opaleshoni yamavuto othandizira, dokotalayo amapanga mabala awiri kapena anayi mchifuwa mwanu. Dokotalayo amagwiritsa ntchito kompyuta yapadera kuti azitha kuyendetsa manja a roboti pa nthawi yochita opaleshoniyo. Mawonekedwe a 3D a mtima ndi valavu ya aortic amawonetsedwa pakompyuta mchipinda chogwiritsira ntchito.

Mungafunike kukhala pamakina am'mapapu amtima pama opaleshoni onsewa.

Valavu ya aortic ikawonongeka kwambiri kuti isakonzeke, valavu yatsopano imayikidwa. Dokotala wanu adzachotsa valavu yanu ya aortic ndikusoka yatsopano m'malo mwake. Pali mitundu iwiri ikuluikulu yamagetsi yatsopano:

• Mawotchi, opangidwa ndi zinthu zopangidwa ndi anthu, monga titaniyamu kapena kaboni. Ma valve awa amakhala motalika kwambiri. Muyenera kumwa mankhwala ochepetsa magazi, monga warfarin (Coumadin), kwa moyo wanu wonse ngati muli ndi valavu yamtunduwu.
• Thupi, lopangidwa ndi mnofu wa munthu kapena nyama. Ma valve awa amakhala zaka 10 mpaka 20, koma mwina simusowa kuti muchepetse magazi kwa moyo wonse.

Njira ina ndi transcatheter aortic valve m'malo (TAVR). TAVR aortic valve opareshoni imatha kuchitika kudzera paching'onoting'ono tomwe timapangidwa m'mimba kapena pachifuwa chakumanzere. Valavu yosinthira imadutsa mumtsuko wamagazi kapena mumtima ndikusunthira ku valavu ya aortic. Catheter ili ndi buluni kumapeto. Baluniyo ili ndi mpweya wotambasula kutsegula kwa valavu. Njirayi imatchedwa valvuloplasty yokhayokha ndipo imalola kuti valavu yatsopano iyike pamalopo. Kenako dokotalayo amatumiza catheter yokhala ndi valavu yolumikizidwa ndikuchotsa valavu kuti itenge malo a valavu yowonongeka. Valavu yachilengedwe imagwiritsidwa ntchito pa TAVR. Simuyenera kukhala pamakina am'mapapu amtima kuti muchite izi.

Nthawi zina, mumakhala ndi opareshoni ya mitsempha yodutsa magazi (CABG), kapena opareshoni kuti mutenge gawo limodzi la aorta nthawi yomweyo.

Valavu yatsopano ikayamba kugwira ntchito, dokotalayo:

• Tsekani zocheperako pamtima kapena aorta
• Ikani ma catheters (machubu osinthasintha) mozungulira mtima wanu kuti muthe madzi omwe amamanga
• Tsekani kudula kwa minofu yanu ndi khungu lanu

Kuchita opaleshoni kumatha kutenga maola 3 mpaka 6, komabe, njira ya TAVR nthawi zambiri imakhala yayifupi.

Opaleshoni ya aortic valve imachitika ngati valavu sigwira ntchito bwino. Opaleshoni itha kuchitidwa pazifukwa izi:

• Kusintha kwa valavu yanu ya aortic kumayambitsa zizindikilo zazikulu za mtima, monga kupweteka pachifuwa, kupuma pang'ono, kufooka, kapena kulephera kwa mtima.
• Mayeso akuwonetsa kuti kusintha kwa valavu yanu ya aortic kumawononga ntchito yamtima wanu.
• Kuwonongeka kwa valavu yamtima wanu ku matenda (endocarditis).

Njira yocheperako imatha kukhala ndi maubwino ambiri. Pali kupweteka pang'ono, kutaya magazi, komanso chiopsezo chotenga kachilombo. Mudzachira mwachangu kuposa momwe mungachitire ndi opaleshoni yotseguka yamtima.

Mavitamini a valvuloplasty ndi a catheter-based based valve monga TAVR amachitika mwa anthu omwe akudwala kwambiri kapena omwe ali pachiopsezo chachikulu cha opaleshoni ya mtima. Zotsatira za valvuloplasty yokhayokha sizikhala zazitali.

Kuopsa kwa opaleshoni iliyonse ndi:

• Magazi
• Magazi amatundikira m'miyendo yomwe imatha kupita kumapapu
• Mavuto opumira
• Matenda, kuphatikiza m'mapapu, impso, chikhodzodzo, chifuwa, kapena mavavu amtima
• Zomwe zimachitika ndi mankhwala

Zowopsa zina zimasiyana malinga ndi msinkhu wa munthu. Zina mwaziwopsezozi ndi izi:

• Kuwonongeka kwa ziwalo zina, misempha, kapena mafupa
• Matenda a mtima, sitiroko, kapena imfa
• Kutenga valavu yatsopano
• Impso kulephera
• Kugunda kwamtima kosafunikira komwe kumayenera kuthandizidwa ndi mankhwala kapena pacemaker
• Kuchira koyipa kwa cheka
• Imfa

Nthawi zonse uzani wothandizira zaumoyo wanu:

• Ngati muli ndi pakati kapena mutha kukhala ndi pakati
• Ndi mankhwala ati omwe mukumwa, ngakhale mankhwala, zowonjezera, kapena zitsamba zomwe mwagula popanda mankhwala

Mutha kusungira magazi kubanki yosungira magazi kuti muthe kumuika magazi mkati komanso mukamachita opaleshoni. Funsani omwe akukuthandizani za momwe inu ndi abale anu mungaperekere magazi.

Kwa sabata lisanafike opaleshoni, mwina mungafunsidwe kuti musiye kumwa mankhwala omwe amalepheretsa magazi anu kuphimba. Izi zingayambitse magazi ochulukirapo panthawi yochita opareshoni.

• Ena mwa iwo ndi aspirin, ibuprofen (Advil, Motrin), ndi naproxen (Aleve, Naprosyn).
• Ngati mukumwa warfarin (Coumadin) kapena clopidogrel (Plavix), lankhulani ndi dotolo wanu musanayime kapena kusintha momwe mumamwa mankhwalawa.

M'masiku asanachitike opaleshoni yanu:

• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.
• Mukasuta, muyenera kusiya. Funsani omwe akukuthandizani kuti akuthandizeni.
• Nthawi zonse muziwuza omwe akukuthandizani ngati muli ndi chimfine, chimfine, malungo, matenda a herpes, kapena matenda ena aliwonse nthawi yomwe mungachitike opaleshoni yanu.

Konzekerani nyumba yanu mukafika kunyumba kuchokera kuchipatala.

Sambani ndi kutsuka tsitsi lanu tsiku lisanachitike opaleshoni. Mungafunike kusamba thupi lanu pansi pa khosi lanu ndi sopo wapadera. Tsukani chifuwa chanu kawiri kapena katatu ndi sopo. Mwinanso mungafunsidwe kuti mutenge maantibayotiki kuti muteteze matenda.

Patsiku la opareshoni yanu:

• Mutha kupemphedwa kuti musamamwe kapena kudya chilichonse pakati pausiku usiku musanachite opareshoni. Izi zimaphatikizapo kugwiritsa ntchito chingamu ndi timbewu tonunkhira. Muzimutsuka m'kamwa ndi madzi ngati mukuuma. Samalani kuti musameze.
• Tengani mankhwala omwe mwauzidwa kuti mumwe ndikumwa madzi pang'ono.
• Mudzauzidwa nthawi yobwera kuchipatala.

Pambuyo pa opareshoni yanu, mutha kukhala masiku atatu mpaka 7 muchipatala. Mugona usiku woyamba m'chipinda cha odwala mwakayakaya (ICU). Anamwino adzayang'anira matenda anu nthawi zonse.

Nthawi zambiri, mudzasamutsidwa kupita kuchipinda chokhazikika kapena chipinda chosamalira odwala mchipatala mkati mwa maola 24. Muyamba ntchito pang'onopang'ono. Mutha kuyambitsa pulogalamu yolimbitsa mtima ndi thupi lanu.

Mutha kukhala ndi machubu awiri kapena atatu m'chifuwa mwanu kuti muthe madzi mumtima mwanu. Nthawi zambiri, awa amatengedwa masiku 1 mpaka 3 atachitidwa opaleshoni.

Mutha kukhala ndi catheter (chubu chosinthika) mu chikhodzodzo chanu kukhetsa mkodzo. Muthanso kukhala ndi mizere yolowa (IV) yamadzi. Anamwino amayang'anitsitsa zowunikira zomwe zimawonetsa zofunikira zanu (kugunda, kutentha, ndi kupuma). Mudzakhala ndi kuyezetsa magazi tsiku ndi tsiku ndi ma ECG kuti muyese mtima wanu mpaka mutakwanira kubwerera kunyumba.

Wopanga pacemaker kwakanthawi akhoza kuyikidwa mumtima mwanu ngati mtima wanu ungachedwe pambuyo pochitidwa opaleshoni.

Mukakhala kunyumba, kuchira kumatenga nthawi. Osazengereza, ndipo khalani oleza mtima nanu.

Mawotchi amagetsi amtima samalephera nthawi zambiri. Komabe, magazi amatha kuundana. Ngati magazi amaundana, mutha kukhala ndi stroke. Kutuluka magazi kumatha kuchitika, koma izi ndizochepa.

Mavavu azachilengedwe amakhala ndi chiopsezo chocheperako magazi, koma amalephera kupitilira nthawi. Kuchita maopareshoni ochepa a mtima kwasintha m'zaka zaposachedwa. Njira izi ndizotetezeka kwa anthu ambiri ndipo zimatha kuchepetsa nthawi ndi ululu. Kuti mupeze zotsatira zabwino, sankhani kuchitidwa opaleshoni yanu ya aortic valve pamalo omwe amathandizira kwambiri.

Mini-thoracotomy aortic valve m'malo kapena kukonza; Mtima opaleshoni valvular; Mini-sternotomy; Robotically-assisted aortic valve m'malo; Transcatheter aortic valve m'malo

• Mankhwala osokoneza bongo - P2Y12 inhibitors
• Aspirin ndi matenda amtima
• Opaleshoni ya valve yamtima - kutulutsa
• Kuchita opaleshoni yamtima wa ana - kutulutsa
• Kutenga warfarin (Coumadin)

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Lamelas J. Wowonongeka pang'ono, mini-thoracotomy aortic valve m'malo mwake. Mu: Sellke FW, Ruel M, olemba., Eds. Atlas of Cardiac Njira Zopangira. Wachiwiri ed. Philadelphia, PA: Elsevier; 2019: mutu 10.

Reiss GR, Williams MR. Udindo wa opaleshoni ya mtima. Mu: Topol EJ, Teirstein PS, olemba. Buku Lophunzitsira la Cardiology. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 32.

Rosengart TK, Anand J. Anapeza matenda amtima: valvular. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: chap 60.