Kuchita opaleshoni yamagetsi a Mitral - kovuta kwambiri

Kuchita opaleshoni ya Mitral valve ndi opaleshoni kuti mukonze kapena musinthe valavu yamitral mumtima mwanu.

Magazi amatuluka m'mapapu ndikulowa mchipinda chopopera chamtima chotchedwa atrium yakumanzere. Magaziwo kenako amapita kuchipinda chomaliza chopopera chamtima chotchedwa ventricle wakumanzere. Valavu ya mitral ili pakati pazipinda ziwirizi. Zimatsimikizira kuti magazi amapitabe patsogolo kudutsa mumtima.

Mungafunike kuchitidwa opaleshoni pa mitral valve yanu ngati:

• Valavu ya mitral ndi yolimba (yowerengedwa). Izi zimalepheretsa magazi kuti apite patsogolo kudzera pa valavu.
• Valavu ya mitral ndiyotayirira kwambiri. Magazi amakonda kubwerera m'mbuyo izi zikachitika.

Opaleshoni ya mitral yamavuto ochepa imachitika kudzera pocheka pang'ono. Ntchito ina, yotseguka yotsegula mitral valve, imafuna kudula kwakukulu.

Musanachite opareshoni yanu, mudzalandira opaleshoni.

Mudzakhala mukugona komanso opanda ululu.

Pali njira zingapo zochitira opaleshoni yamagetsi yama mitral yocheperako.

• Dokotala wanu wochita opaleshoni ya mtima amatha kudula masentimita 5 mpaka 7.5 m'lifupi mwa chifuwa chanu pafupi ndi sternum (breastbone). Minofu m'derali igawika. Izi zimathandiza dokotalayo kuti afike pamtima. Kudulidwa pang'ono kumapangidwa kumanzere kwa mtima wanu kuti dokotalayo athe kukonza kapena kusintha valavu ya mitral.
• Pochita opaleshoni yotsiriza, dokotalayo amapanga mabowo ang'onoang'ono 1 mpaka 4 m'chifuwa chanu. Opaleshoni imachitika kudzera pakucheka pogwiritsa ntchito kamera ndi zida zapadera za opaleshoni. Pochita opaleshoni yamavuto othandizira, dokotalayo amapanga mabala awiri kapena anayi mchifuwa mwanu. Mabalawa amakhala pafupifupi mainchesi 1/2 mpaka 3/4 (1.5 mpaka 2 sentimita) iliyonse. Dokotalayo amagwiritsa ntchito kompyuta yapadera kuti azitha kuyendetsa manja a roboti pa nthawi yochita opaleshoniyo. Mawonekedwe a 3D pamtima ndi valavu yamitral amawonetsedwa pakompyuta m'chipinda chogwiritsira ntchito.

Mufunika makina am'mapapu amtima amtundu wa opareshoni. Mudzalumikizidwa ndi chipangizochi kudzera pocheka pang'ono pakhosi kapena pachifuwa.

Ngati dotolo wanu atha kukonza valavu yanu ya mitral, mutha kukhala ndi:

• Ring annuloplasty - Dokotalayo amalimbitsa valavu pomanga mphete yachitsulo, nsalu, kapena minofu mozungulira valavuyo.
• Kukonza mavavu - Dokotalayo amachepetsa, kupanga, kapena kumanganso imodzi mwaziphuphu zomwe zimatsegula ndikutseka valavu.

Mudzafunika valavu yatsopano ngati pali kuwonongeka kochuluka kwa mitral valve yanu. Izi zimatchedwa kuti opaleshoni m'malo mwake. Dokotala wanu akhoza kuchotsa ena kapena mitral valve yanu yonse ndikusoka yatsopano m'malo mwake. Pali mitundu iwiri ikuluikulu yamagetsi yatsopano:

• Mawotchi - Opangidwa ndi zinthu zopangidwa ndi anthu, monga titaniyamu ndi kaboni. Ma valve awa amakhala motalika kwambiri. Muyenera kumwa mankhwala ochepetsa magazi, monga warfarin (Coumadin), kwa moyo wanu wonse.
• Thupi - Lopangidwa ndi mnofu wa munthu kapena nyama. Ma valve awa amakhala zaka 10 mpaka 15 kapena kupitilira apo, koma mwina simuyenera kutenga opaka magazi kwa moyo wanu wonse.

Kuchita opaleshoni kumatha kutenga maola awiri kapena anayi.

Kuchita opaleshoniyi nthawi zina kumatha kuchitika kudzera m'mitsempha ya kubuula, osadulidwa pachifuwa. Dokotala amatumiza catheter (chubu chosinthika) chokhala ndi buluni yomangika kumapeto. Buluni imadzaza kuti itambasule kutsegula kwa valavu. Njirayi imatchedwa valvuloplasty yokhayokha ndipo imapangidwa ndi mitral valve yotsekedwa.

Njira yatsopano imaphatikizapo kuyika catheter kudzera mumtsempha m'mimba ndikudula valavu kuti valavu isatuluke.

Mungafunike kuchitidwa opaleshoni ngati mitral valve yanu sigwira bwino chifukwa:

• Muli ndi mitral regurgitation - Pamene mitral valve siyitseka njira yonse ndikulola magazi kuti abwerere kumanzere kumanzere.
• Muli ndi mitral stenosis - Pamene mitral valve siyitseguka kwathunthu ndikuletsa magazi.
• Valavu yanu yatenga matenda (opatsirana endocarditis).
• Muli ndi ma prolapse a mitral valve omwe samayang'aniridwa ndi mankhwala.

Kuchita opaleshoni yaying'ono kumatha kuchitika pazifukwa izi:

• Zosintha mu mitral valve yanu zikuyambitsa zizindikilo zazikulu zamtima, monga kupuma pang'ono, kutupa kwa mwendo, kapena mtima kulephera.
• Mayesero akuwonetsa kuti kusintha kwa mitral valve yanu ikuyamba kuvulaza mtima wanu.
• Kuwonongeka kwa valavu yamtima wanu ku matenda (endocarditis).

Njira yocheperako imakhala ndi maubwino ambiri. Pali kupweteka pang'ono, kutaya magazi, komanso chiopsezo chotenga matenda. Mudzachira mwachangu kuposa momwe mungachitire ndi opaleshoni yotseguka yamtima. Komabe, anthu ena sangakhale ndi njira zamtunduwu.

Valvuloplasty yokhazikika imatha kuchitika mwa anthu omwe akudwala kwambiri kuti asakhale ndi anesthesia. Zotsatira za njirayi sizikhala zazitali.

Zowopsa za opaleshoni iliyonse ndi izi:

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

Njira zochepa zopangira opaleshoni zimakhala ndi zoopsa zochepa kuposa opaleshoni yotseguka.Zowopsa zomwe zitha kuchitidwa ndi ma valve ochepa opangira ma valve ndi awa:

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

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.

Mukasuta, muyenera kusiya. Funsani omwe akukuthandizani kuti akuthandizeni.

M'masiku asanachitike opaleshoni yanu:

• Kwa sabata limodzi musanachite opareshoni, mwina mungafunsidwe kuti musiye kumwa mankhwala omwe amalepheretsa magazi anu kuphimba. Izi zingayambitse magazi ochulukirapo panthawi yochita opareshoni. Ena mwa mankhwalawa ndi monga 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.
• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni 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 opaleshoniyi:

• 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.

Yembekezerani kuti muzikhala masiku atatu kapena asanu muchipatala mukatha opaleshoni. Mudzadzuka m'chipinda cha anthu odwala mwakayakaya (ICU) ndikupeza komweko kwa masiku 1 kapena awiri. Anamwino amayang'anitsitsa zowunikira zomwe zimawonetsa zofunikira zanu (kugunda, kutentha, ndi kupuma).

Machubu awiri kapena atatu azikhala m'chifuwa mwanu kuti muthe madzi mumtima mwanu. Nthawi zambiri amachotsedwa 1 mpaka 3 masiku atachitidwa opaleshoni. Mutha kukhala ndi catheter (chubu chosinthika) mu chikhodzodzo chanu kukhetsa mkodzo. Muthanso kukhala ndi mizere yolowa (IV) kuti mutenge madzi.

Mudzachoka ku ICU kupita kuchipinda chanthawi zonse. Mtima wanu ndi zizindikiro zanu zidzayang'aniridwa mpaka mutakonzeka kupita kwanu. Mukalandira mankhwala opweteka pachifuwa.

Namwino wanu adzakuthandizani kuyamba ntchito pang'onopang'ono. Mutha kuyambitsa pulogalamu yolimbitsa mtima ndi thupi lanu.

Wopanga pacemaker atha kuyikidwa mumtima mwanu ngati kugunda kwa mtima kwanu kumachedwetsa kwambiri atachitidwa opaleshoni. Izi zitha kukhala zakanthawi kapena mungafune wopanga pacem yokhazikika musanachoke kuchipatala.

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 mwayi wocheperako wamagazi, koma amalephera kupitilira nthawi yayitali.

Zotsatira zakukonzekera kwa mitral valve ndizabwino kwambiri. Kuti mupeze zotsatira zabwino, sankhani kuchitidwa opaleshoni pamalo omwe amathandizira kwambiri. Opaleshoni yaying'ono yovutitsa mtima yawonjezeka kwambiri m'zaka zaposachedwa. Njira izi ndizabwino kwa anthu ambiri, ndipo zimatha kuchepetsa nthawi ndi ululu.

Kukonza ma valve a Mitral - mini-thoracotomy; Kukonza ma Mitral valve - pang'ono sternotomy chapamwamba kapena chapansi; Kukonza ma valve a endoscopic; Mitundu ya mitral valvuloplasty

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

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Goldstone AB, Woo YJ. Chithandizo cha opaleshoni cha mitral valve. Mu: Sellke FW, del Nido PJ, Swanson SJ, olemba. Opaleshoni ya Sabiston ndi Spencer pachifuwa. 9th ed. Philadelphia, PA: Elsevier; 2016: chap 80.

Herrmann HC, Mack MJ. Mankhwala opatsirana pogonana a valvular matenda amtima. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 72.

Thomas JD, Bonow RO. Matenda a Mitral valve. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 69.