Ukwelashwa okwethutyana kwe-Aortic Stenosis
I-aortic stenosis yintliziyo yesimo esivame ukukhula kwaye ikhulise ngeminyaka. I-valve ye-aortic yenye yeentsimbi ezine zentliziyo kwintliziyo yomntu, kwaye inokulimaza kakhulu ngokubalwa. Le yimeko ebalulekileyo enokuchaphazela iindawo ezihambayo ze-valve kwaye yenza kube lula ukusebenza.
Kwixesha elidlulileyo, unyango oluphambili lwe-aortic stenosis lwaluvulekileyo ukuhlinzwa kwintliziyo apho i-valve yayilungiswa okanye i-valve eyenziwe ngamathambo okanye izinto zokufakelwa ziza kusetyenziswa ukutshintshela i-valve ye-aortic eyonakalisiweyo.
Namhlanje, kukho ukhetho olutsha noluncinci oluthiwa yiTranscatheter Aortic Valve Replacement (TAVR) enokuba lunokukhethwa kwezigulane ezingenako ukunyamezela indlela yokuvulwa kwenhliziyo evulekileyo yokulungisa okanye ukutshintsha i-valve ye-aortic.
Yintoni i-Aortic Valve?
Ukuze uqonde ukutshintsha i-aortic valve, kubalulekile ukuqonda into eyenziwa yi-aortic valve. I-valve ye-aortic iphakathi kwe-ventricle engasekhohlo kunye ne-aorta, kwaye inceda ukulawula ukuhamba kwegazi entliziyweni, ukuya kwi-aorta kunye nomzimba wonke. I-valor ye-aortic ephilileyo inqanda igazi ukuba lisuke entliziyweni kungekudala, livula kuphela xa lixesha lokuba igazi liphume kwiprojekiti engasekhohlo kunye ne-aorta. Xa i-valor i-aortic ibonakalisiwe kwaye iyancipha, le meko ibizwa ngokuba yi-aortic stenosis kwaye ingaba yingozi kakhulu, njengoko ukugeleza kwegazi akusekho kakuhle okanye kusebenza kakuhle.
Iimpawu ze-Aortic Stenosis
Xa i-valve ye-aortic ibalwa, ayisasebenzi kakuhle, kwaye intliziyo kufuneka isebenze nzima ukupompa igazi emzimbeni.
Ezinye izigulane ezine-syncope yamava aortic stenosis, okanye iziqwenga zokuphelelwa amandla. Basenokuba nobuhlungu besifuba, kunye neemeko ezinzima, ingxaki ye-valve ingakhokelela ekuphuhlisweni kwesinye isimo esibi, esibizwa ngokuba yi-congestive heart failure.
Ukukhathala nokunyanzeliswa kokuzivocavoca ngenye yeempawu zokuqala ze-aortic stenosis, kodwa kwiimeko ezinzima izigulane zinokuba zibuthathaka kangangokuba zikwazi ukuhamba ngaphezu kweenyawo ezimbalwa.
Le meko ingaba nzima kangangokuba ukunciphisa ubomi okanye ukusongela ubomi xa kushiywe kungakhange kulandelelwe, okukhokelela ekufuneni ukulungiswa okanye ukutshintshwa kwe-valve.
Ngubani Okhethiweyo kwi-TAVR Surgery
Izigulane ezigulane kakhulu ze-aortic stenosis - ngubani ohlala esisigulane esinesidingo esikhulu senqwelo yentliziyo esebenza kakuhle - inkqubo evulekileyo yenhliziyo ingabonwa ingozi kakhulu. Ugqirha lunzima kakhulu kumzimba, kwaye ezinye izigulane azikwazi ukunyamezela loo nqanaba loxinzelelo lwangokwenyama, okwenza ingozi yokuvuleka kwentliziyo evule ngaphezu kwembuyekezo. Kwizigulane ezibonakala zigula kakhulu ukunyamezela ukuhlinzwa, okanye abo banikezela umgangatho ophezulu wokungcipheka komngcipheko, inkqubo ye-TAVR ingaba yindlela efanelekileyo.
I-TAVR Inkqubo
Izigulane eziphezulu zengozi ye-aortic stenosis, ukuhlinzwa kwe-TAVR inokuba yinto ekhethiweyo yokubonelela i-aortic valve ngaphandle kokucinezeleka kwengqondo yokuvulwa kwenhliziyo, i- cardiopulmonary bypass kunye ne- anesthesia jikelele . Inqubo eyenziwa ngenye indlela, oko kuthetha ukuba "utyando" luyenziwa ngokufaka izixhobo kwisitya somfazi nge-incision encinci kwaye ngokunyamekela phambili kwimithambo yegazi kuze kufike i-valve ye-aortic. Izigulane ezinesifo senhliziyo ziza kufumana inkqubo yokutshintshwa kwintsimbi ye-valve ifanelwe.
Ngeenkqubo ze-TAVR, i-valve yokufakelwa ihlanganiswe kwiphakheji encinci elincinci ngokwaneleyo ukuba ifakwe kwisitya segazi kunye nezixhobo. Xa endaweni, i-valve esikhundleni sayo isetyenzisiwe, ukuvula ubungakanani bayo obupheleleyo. Emva kokuba i-TAVR isendaweni, ithatha indawo ye-aortic valve eyonakalisiweyo kwaye ilawula ukukhululwa kwegazi entliziyweni.
Izingozi ze-TAVR
Ingozi ye-TAVR ukuhlinzwa iyimfuneko kwaye kufuneka ixoxwe kunye nodokotela wakho ngaphambi kwenkqubo. Ingozi ye-TAVR ifana nemingcipheko yokuvuleka kwentliziyo evulekile ukulungisa okanye ukubuyisela i-valor ye-aortic, kwaye ifake umngcipheko wokubethelwa, ukuphuma kwegazi, ukukhupha, ukulimaza entliziyweni ngaphezu kweengozi ze-anesthesia.
Xa kuthelekiswa nezigulane ezinokuvuleka kwentliziyo evulekile ye-aortic stenosis kunye nezigulane ezineenkqubo ze-TAVR, izigulane ze-TAVR zinomngcipheko omkhulu wokufuna i-pacemaker kunyaka olandela inkqubo, kodwa banomngcipheko omncinci wokufa kunye nokufa kunyaka olandela ukuhlinzwa.
Inkqubo ye-TAV yinto entsha, kwaye ngoko, uphando olude lwexesha elide alufumanekanga ngeli xesha eMelika. Yiyiphi uphando olukhoyo, nangona kunjalo, lubonisa ukuba izigulane eziphezulu zengozi zihamba kakuhle nakwiindlela ezincinci ezingenakudlula ukulungiswa kwintliziyo evulekileyo.
Emva kwe-TAVR
Kubalulekile ukuba ukhumbule ukuba inkqubo ye-TAV iphucula ubomi, kodwa ayiqinisekisi ukuphulukana ngokupheleleyo kwisifo senhliziyo. Uninzi lwezigulane lunokuphucuka okuphawulekayo kumgangatho wobomi kunye nokulungiswa kwevaji ye-aortic, kodwa kunokuthi kube nomonakalo ohlala njalo kwimisipha yentliziyo ngenxa yesiphakamiso esifanelekileyo okanye ezinye iimeko zentliziyo.
Imithombo:
I-Transcatheter i-Aortic-Valve Replacement nge-Self-Expanding Prosthesis. I-New England Journal of Medicine. Ufikelele kuMatshi 2014.