Kuvhiya kwevhavha yemoyo

Kuvhiya kwevhavha yemoyo kunoshandiswa kugadzirisa kana kutsiva mavharuvhu emwoyo anorwara.

Ropa rinoyerera pakati pemakamuri akasiyana emoyo wako rinofanira kuyerera kuburikidza nevhavha yemoyo. Ropa rinoyerera richibuda mukati memwoyo wako kupinda mutsinga huru rinofanira kuyererawo kuburikidza nevheji yemoyo.

Mavharuvhu aya anovhura zvakakwana kuti ropa riyerere nepakati. Ivo vanobva vavhara, vachichengetedza ropa kubva kuyerera richidzokera kumashure.

Kune mavhavha mana mumoyo mako:

• Aortic vharafu
• Mitral vharafu
• Tricuspid vharafu
• Pulmonic vharafu

Iyo aortic vheji ndiyo yakajairika vharuvhu inotsiviwa. Iyo mitral vharuvhu ndiyo yakajairika vharuvhu inogadziriswa. Kashoma chete iyo iyo tricuspid vharafu kana iyo pulmonic vharuvhu inogadziriswa kana kutsiviwa.

Usati wavhiyiwa, iwe uchagamuchira anesthesia yakajairika. Iwe unenge wakarara uye usingakwanise kunzwa kurwadziwa.

Mukuvhiya kwemoyo wakashama, chiremba anovhiya anoita kucheka kukuru kwekuvhiya mubhokisi rako rechipfuva kuti usvike pamwoyo uye aorta. Iwe wakabatanidzwa kune moyo-mapapu wekupfuura muchina.Moyo wako unomiswa iwe uchinge wakabatana kune uyu muchina. Muchina uyu unoita basa remwoyo wako, uchipa okisijeni uye kubvisa kabhoni dhayokisaidhi.

Kuvhiya kushoma kwevhavhavha kunoitwa kuburikidza nekucheka kudiki pane kuvhiya kwakavhurika, kana kuburikidza nekateti inoiswa kuburikidza neganda. Maitiro akati wandei akasiyana anoshandiswa:

• Kuvhiya kwepercutaneous (kuburikidza neganda)
• Kuvhiyiwa-robhoti

Kana chiremba wako achivhiya achigadzirisa yako mitral vharafu, iwe unogona kunge uine:

• Mhete annuloplasty. Chiremba anovhiya anogadzirisa chikamu-senge chikamu chakatenderedza vharuvhu nekusona ringi repurasitiki, jira, kana nyama yakatenderedza vharuvhu.
• Kugadziriswa kwevhavha. Chiremba anovhiya, anoumba, kana anovaka zvekare rimwe kana akawanda emapepa evhavha. Mapepa acho akavhurika anovhura nekuvhara vharuvhu. Kugadziriswa kwemagetsi kwakanakira iyo mitral uye tricuspid mavharuvhu. Iyo aortic vharafu kazhinji haina kugadziriswa.

Kana vharafu yako yakanyanya kukuvara, iwe uchazoda vharuvhu nyowani. Izvi zvinodaidzwa kunzi kuvhiya kwevhavha. Chiremba wako anobvisa vharafu yako woisa imwe nyowani munzvimbo. Mhando huru dzevhavha nyowani ndidzo:

• Mechanical - yakagadzirwa nezvinhu zvakagadzirwa nevanhu, simbi (simbi isina simbi kana titanium) kana zvedongo. Aya mavhavha anogara kwenguva refu, asi iwe uchafanirwa kutora mushonga wekuonda-ropa, senge warfarin (Coumadin) kana aspirin, kweupenyu hwako hwese.
• Biological - yakagadzirwa nevanhu kana mhuka mhuka. Aya mavhavha anotora makore gumi kusvika gumi nemashanu, asi iwe ungangodaro usingade kutora vatete veropa kweupenyu hwese.

Mune zvimwe zviitiko, vanovhiya vanogona kushandisa yako wega pulmonic vharuvhu kutsiva yakakuvara aortic vharafu. Iyo pulmonic vharuvhu inozotsiviwa neyevheji yekugadzira (iyi inonzi iyo Ross Procedure). Maitiro aya anogona kubatsira kune vanhu vasingade kutora vanoonda ropa kweupenyu hwavo hwese. Nekudaro, iyo nyowani aortic vharuvhu haigare kwenguva yakareba uye ingangoda kutsiviwa zvakare neanenge ari megiki kana biologic vharafu.

Nyaya dzakabatana dzinosanganisira:

• Kuvhiya kweaortic vharuvhu - kushomeka zvishoma
• Kuvhiya kweaortic vharuvhu - yakavhurika
• Kuvhiyiwa kweMitral vharuvhu - zvishoma zvinokanganisa
• Mitral valve kuvhiyiwa - kuvhura

Ungangoda kuvhiyiwa kana vharafu yako isingashande mushe.

• Vharuvhu isinga vharike nzira yese inobvumira ropa kudonha richidzokera kumashure. Izvi zvinonzi kudzokazve.
• Iyo vharuvhu isingavhure zvakakwana inogumira kumberi kuyerera kweropa. Izvi zvinonzi stenosis.

Iwe ungangoda moyo kuvhiyiwa vharuvhu yemoyo nekuda kwezvikonzero izvi:

• Kukanganisa kuri mumoyo wako vharuvhu kuri kukonzeresa zvikuru moyo zviratidzo, sekurwadziwa pachifuva (angina), kupfupika kwemweya wekufema, kupera simba (syncope), kana kushaya moyo.
• Miedzo inoratidza kuti shanduko mumoyo wako vharuvhu iri kutanga kukanganisa zvakanyanya moyo wako mashandiro.
• Chiremba wako anoda kutsiva kana kugadzirisa yako vharuvhu yemoyo panguva imwe chete sezvauri kuvhiyiwa moyo wakavhurika kune chimwe chikonzero, senge arononary artery bypass graft surgery.
• Yako vharuvhu yemoyo yakakuvara nehutachiona (endocarditis).
• Iwe wakagamuchira vharuvhu nyowani yemoyo munguva yakapfuura uye haisi kushanda mushe, kana iwe uine mamwe matambudziko senge kuwanda kweropa, hutachiona, kana kubuda ropa.

Mimwe yematambudziko emagetsi emagetsi anorapwa nekuvhiya ndeaya:

• Aortic kusakwana
• Aortic stenosis
• Congenital moyo vharuvhu chirwere
• Mitral kudzoka - kwakanyanya
• Mitral kudzokorora - chisingaperi
• Mitral stenosis
• Mitral vharuvhu inowedzera
• Pulmonary vharafu stenosis
• Tricuspid kudzokorora
• Tricuspid vharafu stenosis

Njodzi dzekuvhiyiwa moyo dzinosanganisira:

• Rufu
• Kumira kurova kwemoyo
• Kutadza kwemoyo
• Kubuda ropa kunoda kuitwazve
• Kubvaruka kwemoyo
• Kusajairika kurova kwemoyo (arrhythmia)
• Itsvo kutadza
• Post-pericardiotomy syndrome - yakaderera fivhiri uye kurwadziwa kwepfupa kunogona kugara kusvika kumwedzi mitanhatu
• Stroke kana imwe yenguva pfupi kana yekusingaperi kukuvara kwehuropi
• Utachiona
• Matambudziko nekupora kwemazamu
• Kukanganiswa kwenguva pfupi mushure mekuvhiyiwa nekuda kwemoyo-mapapu muchina

Zvakakosha kutora matanho ekudzivirira hutachiona hwevhavha. Ungangoda kutora mishonga inorwisa mabhakitiriya pamberi pebasa remazino uye dzimwe nzira dzinokanganisa.

Kugadzirira kwako kwemaitiro kunoenderana nerudzi rwekuvhiya kwevhavha iwe yauinayo:

• Kuvhiya kweaortic vharuvhu - kushomeka zvishoma
• Kuvhiya kweaortic vharuvhu - yakavhurika
• Kuvhiyiwa kweMitral vharuvhu - zvishoma zvinokanganisa
• Mitral valve kuvhiyiwa - kuvhura

Kudzoreredza kwako mushure mekuita kunoenderana nemhando yekuvhiyiwa kwevhavha iwe yauinayo:

• Kuvhiya kweaortic vharuvhu - kushomeka zvishoma
• Kuvhiya kweaortic vharuvhu - yakavhurika
• Kuvhiyiwa kweMitral vharuvhu - zvishoma zvinokanganisa
• Mitral valve kuvhiyiwa - kuvhura

Wepakati pekugara muchipatara mazuva mashanu kusvika manomwe. Mukoti achakuudza maitiro ekuzvichengeta wega kumba. Kupora zvakakwana kunotora mavhiki mashoma kusvika kumwedzi yakati wandei, zvichienderana nehutano hwako usati wavhiyiwa.

Kubudirira kwehuwandu hwekuvhiyiwa kwevhavha yemoyo kwakakwira. Iko kuvhiya kunogona kubvisa zviratidzo zvako uye kuwedzera hupenyu hwako.

Mechanical moyo mavharuvhu haawanzo kutadza. Nekudaro, kugwamba kweropa kunogona kukura pane aya mavhavha. Kana ropa rakagwamba rikaumbika, unogona kunge uine sitiroko. Kubuda ropa kunogona kuitika, asi izvi hazviwanzo. Matinji emagetsi anogara avhareji yemakore gumi nemaviri kusvika gumi nemashanu, zvichienderana nerudzi rwevhavha. Kushandiswa kwenguva refu kweropa-kutapudza mushonga kazhinji hakudiwe nemavhuvhu emagetsi.

Kune nguva dzose njodzi yekutapukirwa. Taura nachiremba wako usati wawana chero mhando yekurapa maitiro.

Kubaya kwema mechanical moyo mavhavha kunogona kunzwika muchipfuva. Izvi zvakajairika.

Valve kutsiva; Kugadziriswa kwevhavha; Huru vharuvhu yemoyo; Zvokuimba mavharuvhu; Prosthetic mavharuvhu

• Kuvhiya kwevhavha yemoyo - kubuda

• Mwoyo - chikamu kuburikidza nepakati
• Moyo - pamberi pekutarisa
• Mwoyo mavharuvhu - anterior maonero
• Mavharuvhu emwoyo - maonero epamusoro
• Kuvhiya kwevhavha yemoyo - akateedzana

Carabello BA. Valvular chirwere chemoyo. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsamba 66.

Hermann HC, Mack MJ. Transcatheter kurapwa kweiyo valvular chirwere chemoyo. Mune: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 72.

Nishimura. RA, Otto CM, Bonow RO, uye al. Yakagadziriswa yekuvandudza kwegore ra2014 AHA / ACC nhungamiro yevatungamiriri vevarwere vane valvular chirwere chemoyo: mushumo weAmerican College yeCardiology / American Heart Association Task Force pane Maitiro Ekudzidzira. J Ndiri Coll Cardiol. 2017; 70 (2): 252-289. PMID: 28315732 pubmed.ncbi.nlm.nih.gov/28315732/.

Otto CM, Bonow RO. Valvular chirwere chemoyo. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chits. 67.

Rosengart TK, Anand J. Yakawana chirwere chemwoyo: valvular. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya. 20th ed. Philadelphia, PA: Elsevier; 2017: chitsiko 60.