Transcatheter aortic valve m'malo

Transcatheter aortic valve m'malo (TAVR) ndi njira yogwiritsira ntchito valavu ya aortic osatsegula chifuwa. Amagwiritsidwa ntchito pochizira achikulire omwe alibe thanzi lokwanira kuchitidwa ma valve nthawi zonse.

Aorta ndi mtsempha wamagazi waukulu womwe umanyamula magazi kuchokera mumtima mwanu kupita ku thupi lanu lonse. Magazi amatuluka mumtima mwanu ndikulowera ku aorta kudzera pa valavu. Valavuyu amatchedwa valavu ya aortic. Amatseguka kuti magazi athe kutuluka. Kenako imatseka, kuletsa magazi kuti asatuluke chammbuyo.

Valavu ya aortic yomwe siyitsegula kwathunthu imalepheretsa kuyenda kwa magazi. Izi zimatchedwa aortic stenosis. Ngati palinso kutayikira, kumatchedwa kuti aortic regurgitation. Ma valavu ambiri aortic amasinthidwa chifukwa amaletsa kuyenda mtsogolo kudzera mu aorta kupita kuubongo ndi thupi.

Njirayi idzachitika mchipatala. Zitenga pafupifupi 2 mpaka 4 maola.

• Musanachite opaleshoni yanu, mutha kulandira anesthesia wamba. Izi zidzakupangitsani kugona mopanda ululu. Nthawi zambiri, njirayi imachitika nanu mutakhazikika. Simukugona tulo koma simukumva kuwawa. Izi zimatchedwa sedation yaying'ono.
• Ngati anesthesia amagwiritsidwa ntchito, mudzakhala ndi chubu choyika pakhosi panu cholumikizidwa ndi makina kuti akuthandizeni kupuma. Izi zimachotsedwa pambuyo potsatira ndondomekoyi. Ngati kugwiritsidwa ntchito moyenera, sipafunika kupuma.
• Dotolo adzadula (incision) mumtsempha wam'mimba mwanu kapena m'chifuwa mwanu pafupi ndi fupa la m'mawere.
• Ngati mulibe pacemaker kale, adokotala amatha kuyikamo. Mudzavala kwa maola 48 pambuyo pa opareshoni. Wopanga pacemaker amathandiza mtima wanu kugunda mokhazikika.
• Dotolo amalumikiza chubu chochepa kwambiri chotchedwa catheter kudzera pamitsempha kumtima kwanu ndi valavu ya aortic.
• Buluni yaying'ono kumapeto kwa catheter idzawonjezeredwa mu valavu yanu ya aortic. Izi zimatchedwa valvuloplasty.
• Dokotala atsogolera valavu yatsopano ya aortic pamwamba pa catheter ndi baluni ndikuyiyika mu valavu yanu ya aortic. Valavu yachilengedwe imagwiritsidwa ntchito pa TAVR.
• Valavu yatsopano itsegulidwa mkati mwa valavu yakale. Idzachita ntchito ya valavu yakale.
• Dotolo amachotsa catheter ndikutseka chodulira ndi ma ulusi komanso mavalidwe.
• Simuyenera kukhala pamakina am'mapapu amtima kuti muchite izi.

TAVR imagwiritsidwa ntchito kwa anthu omwe ali ndi aortic stenosis omwe alibe thanzi lokwanira kuti achite opaleshoni pachifuwa kuti atenge valavu.

Kwa achikulire, aortic stenosis nthawi zambiri imakhala chifukwa cha calcium yomwe imachepetsa valavu. Izi zimakhudza anthu okalamba.

TAVR itha kuchitidwa pazifukwa izi:

• Mukukhala ndi zizindikilo zazikulu zamtima, monga kupweteka pachifuwa (angina), kupuma movutikira, kufooka (syncope), kapena mtima kulephera.
• Mayeso akuwonetsa kuti kusintha kwa valavu yanu ya aortic ikuyamba kuwononga kwambiri momwe mtima wanu umagwirira ntchito.
• Simungathe kuchitidwa maopaipi pafupipafupi chifukwa zitha kuyika thanzi lanu pachiwopsezo. (Chidziwitso: Kafukufuku akuchitidwa kuti awone ngati odwala ambiri angathandizidwe ndi opaleshoniyi.)

Njirayi ili ndi maubwino ambiri. Pali kupweteka pang'ono, kutaya magazi, komanso chiopsezo chotenga matenda. Mudzachira mwachangu kuposa momwe mungachitire ndi opareshoni pachifuwa.

Zowopsa za anesthesia iliyonse ndi izi:

• 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 ndi izi:

• Kuwonongeka kwa mitsempha yamagazi
• Mungafunike opaleshoni yotseguka yamtima kuti mukonze zovuta zomwe zimachitika panthawiyi
• Matenda a mtima kapena sitiroko
• Kutenga valavu yatsopano
• Impso kulephera
• Kugunda kwamtima kosazolowereka
• Magazi
• Kuchira koyipa kwa cheka
• Imfa

Nthawi zonse uzani dokotala kapena namwino mankhwala omwe mukumwa, kuphatikizapo mankhwala owonjezera, owonjezera, kapena zitsamba.

Muyenera kukawona dokotala wanu wa mano kuti muwone ngati mulibe matenda mkamwa mwanu. Matendawa akapanda kuchiritsidwa, amatha kufalikira pamtima panu kapena valavu yatsopano yamtima.

Kwa milungu iwiri musanachite opareshoni, mutha kupemphedwa 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 omwe musanachite izi:

• Funsani dokotala wanu za mankhwala omwe muyenera kumwa patsiku lanu.
• Mukasuta, muyenera kusiya. Funsani dokotala wanu kuti akuthandizeni.
• Nthawi zonse dziwitsani dokotala ngati muli ndi chimfine, chimfine, malungo, herpes breakout, kapena matenda ena aliwonse munthawi yomwe mungayambe.
• Patsiku lisanachitike, kusamba ndi shampu bwino. Mutha kupemphedwa kuti musambe thupi lonse 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:

• Nthawi zambiri mudzafunsidwa kuti musamwe kapena kudya kalikonse pakati pausiku usiku womwe musanachite. Izi zimaphatikizapo kutafuna chingamu komanso kugwiritsa ntchito timbewu ta mpweya. Muzimutsuka m'kamwa ndi madzi ngati mukuuma, koma samalani kuti musameze.
• Tengani mankhwala omwe dokotala wanu adakuwuzani kuti mumwe pang'ono pokha madzi.
• Dokotala wanu kapena namwino adzakuuzani nthawi yoti mufike kuchipatala.

Mutha kuyembekeza kuthera masiku 1 mpaka 4 muchipatala.

Mugona usiku woyamba m'chipinda cha odwala mwakayakaya (ICU). Anamwino adzakuyang'anirani mosamala. Nthawi zambiri mkati mwa maola 24, mumasunthidwa kupita kuchipinda chokhazikika kapena kuchipatala.

Tsiku lotsatira opaleshoni, mudzathandizidwa pakama kuti muthe kudzuka ndikuyenda mozungulira. Mutha kuyambitsa pulogalamu yolimbitsa mtima ndi thupi lanu.

Opereka chithandizo chamankhwala akuwonetsani momwe mungadzisamalirire nokha kunyumba. Muphunzira kusamba komanso kusamalira bala la opareshoni. Mudzapatsidwanso malangizo azakudya komanso zolimbitsa thupi. Onetsetsani kuti mukumwa mankhwala aliwonse omwe akuperekedwa. Mungafunike kumwa magazi ochepetsa magazi pamoyo wanu wonse.

Dokotala wanu adzakubweretsani nthawi yotsatira kuti muwone ngati valavu yatsopano ikugwira ntchito bwino.

Onetsetsani kuti mumauza aliyense wa omwe amakupatsirani kuti mwasintha valavu. Onetsetsani kuti muchite izi musanalandire chithandizo chilichonse chamankhwala kapena mano.

Kukhala ndi njirayi kumatha kusintha moyo wanu ndikukuthandizani kuti mukhale ndi moyo wautali kuposa momwe mungachitire popanda kuchita izi. Mutha kupuma mosavuta komanso kukhala ndi mphamvu zambiri. Mutha kuchita zinthu zomwe simukanatha kuchita kalekale chifukwa mtima wanu umatha kupopera magazi okhala ndi mpweya wokwanira m'thupi lanu lonse.

Sizikudziwika bwinobwino kuti valavu yatsopanoyo izigwirabe ntchito mpaka liti, onetsetsani kuti mwaonana ndi dokotala wanu kuti akupatseni nthawi zonse.

Valvuloplasty - kung'ambika; TAVR; Kuyika ma transcatheter aortic valve (TAVI)

Arsalan M, Kim WK, Walther T. Transcatheter m'malo mwa valavu. Mu: Sellke FW, Ruel M, olemba., Eds. Atlas of Cardiac Njira Zopangira. Wachiwiri ed. Philadelphia, PA: Elsevier; 2019: mutu 16.

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.

Lindman BR, Bonow RO, Otto CM. Matenda a valve aortic. 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 68.

Patel A, Kodali S. Transcatheter aortic valve m'malo: ziwonetsero, njira, ndi zotsatira. Mu: Otto CM, Bonow RO, eds. Matenda a Mtima wa Valvular: Wothandizana ndi Matenda a Mtima a Braunwald. 5th ed. Philadelphia, PA: Elsevier; 2021: chaputala 12.

Thourani VH, Iturra S, Sarin EL. Transcatheter aortic valve m'malo. Mu: Sellke FW, del Nido PJ, Swanson SJ, olemba. Opaleshoni ya Sabiston ndi Spencer pachifuwa. 9th ed. Philadelphia, PA: Elsevier; 2016: chap 79.