Kuvhiyiwa kweMitral vharuvhu - zvishoma zvinokanganisa

Mitral vharuvhu kuvhiyiwa kuvhiyiwa kungave kugadzirisa kana kutsiva mitral vharafu mumoyo mako.

Ropa rinoyerera kubva mumapapu uye rinopinda mukamuri yekupomba yemoyo inonzi yekuruboshwe atrium. Ropa rinozoyerera richipinda mukamuri yekupedzisira yekupomba yemoyo inonzi yekuruboshwe ventricle. Iyo mitral vharafu iri pakati pemakamuri maviri aya. Inoita chokwadi chekuti ropa rinoramba richifamba kuenda mberi kuburikidza nemoyo.

Iwe ungangoda kuvhiyiwa pane yako mitral vharafu kana:

• Iyo mitral vharuvhu yakaoma (yakaverengerwa). Izvi zvinodzivirira ropa kuti rirege kufambira mberi kuburikidza nevhavha.
• Iyo mitral vharuvhu yakanyanyisa kusununguka. Ropa rinowanzoyerera richidzokera kumashure kana izvi zvikaitika.

Zvishoma zvinokanganisa mitral vharuvhu kuvhiyiwa kunoitwa kuburikidza akati wandei mashoma akachekwa. Imwe mhando yekuvhiya, yakavhurika mitral vharuvhu kuvhiyiwa, inoda yakakura kukura.

Usati wavhiyiwa, iwe uchagamuchira anesthesia yakajairika.

Iwe unenge wakarara uye usina kurwadziwa.

Kune nzira dzakasiyana siyana dzekuita mashoma ekuvhiya mitral vharuvhu kuvhiya.

• Anovhiya moyo anogona kuita 2-inch kusvika 3-inch-kureba (5 kusvika 7.5 masentimita) akachekwa muchikamu chekurudyi chechipfuva chako pedyo ne sternum (breastbone). Tsandanyama munzvimbo iyi dzinozopatsanurwa. Izvi zvinoita kuti chiremba anovhiya asvike pamwoyo. Kucheka kudiki kunoitwa kuruboshwe kwemoyo wako kuitira kuti chiremba agadzirise kana kutsiva mitral vharuvhu.
• Mukuvhiya kwekupedzisira, chiremba wako anoita 1 kusvika ku4 maburi madiki mubhokisi rako. Kuvhiya kunoitwa kuburikidza nekucheka uchishandisa kamera uye akakosha ekuvhiya maturusi. Zve robhoti-yakabatsirwa vharuvhu kuvhiyiwa, chiremba anovhiya anoita maviri kusvika mana madiki akacheka mubhokisi rako. Kucheka kwacho kunosvika 1/2 kusvika 3/4 inches (1.5 kusvika 2 masentimita) imwe neimwe. Chiremba anovhiya anoshandisa komputa chaiyo kudzora maoko erobhoti panguva yekuvhiya. Kuona kwe 3D kwemoyo uye mitral vharafu inoratidzwa pakombuta mune yekuvhiya kamuri.

Iwe unozoda moyo-mapapu muchina kune aya marudzi ekuvhiya. Iwe unozobatanidzwa kune ichi chishandiso kuburikidza nekucheka kudiki muguyo kana pachipfuva.

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

• Ring annuloplasty - Chiremba anovhiya anosunga vharuvhu nekusona mhete yesimbi, machira, kana zvinyama zvakakomberedza vharuvhu.
• Kugadziriswa kwemagetsi - Muvhiyi anodimbura, kuumba, kana kuvaka zvakare rimwe kana maviri emakwenzi anovhura nekuvhara vharuvhu.

Iwe uchazoda vharuvhu nyowani kana paine kukuvara kwakawanda kune yako mitral vharafu. Uku ndiko kunonzi kuvhiya kutsiva. Chiremba wako anogona kubvisa imwe kana yako yose mitral vharuvhu uye kusona nyowani munzvimbo. Kune maviri akakosha mhando evhavha nyowani:

• Mechanical - Yakagadzirwa nezvinhu zvakagadzirwa nevanhu, senge titanium uye kabhoni. Aya mavhavha anogara kwenguva refu. Iwe unozofanirwa kutora mushonga unoonda-ropa, senge warfarin (Coumadin), kweupenyu hwako hwese.
• Biological - Yakagadzirwa nevanhu kana mhuka yemhuka. Aya mavhavha anotora makore gumi kusvika gumi nemashanu kana kupfuura, asi pamwe haufanire kutora vanocheka ropa kweupenyu hwese.

Kuvhiya kwacho kunogona kutora maawa maviri kusvika mana.

Uku kuvhiyiwa dzimwe nguva kunogona kuitwa kuburikidza neinogunura arteri, pasina akacheka pachifuva chako. Chiremba anotumira catheter (inoshanduka chubhu) ine bharumu rakanamatira kumagumo. Bhaluni rinokwenya kutambanudza kuvhura kwevhavha. Iyi nzira inonzi percutaneous valvuloplasty uye inoitirwa yakavharirwa mitral vharuvhu.

Maitiro matsva anosanganisira kuisa katheta kuburikidza netsinga iri muchigunha nekucheka vharuvhu kudzivirira vharuvhu kubuda.

Iwe ungangoda kuvhiyiwa kana yako mitral vharafu isingashande nemazvo nekuti:

• Iwe une mitral regurgitation - Kana iyo mitral vharuvhu isingavhare nzira yese uye ichibvumira ropa kudonhedza richidzokera kumashure kuruboshwe atria.
• Iwe une mitral stenosis - Kana iyo mitral vharuvhu isingavhure zvizere uye inodzivirira kuyerera kweropa.
• Valve yako yagadzira hutachiona (hutachiona endocarditis).
• Iwe une yakanyanya mitral vharuvhu prolapse iyo isingadzorwe nemushonga.

Kuvhiya kushoma kunoitika kunogona kuitwa nekuda kwezvikonzero izvi:

• Shanduko mune yako mitral vharafu iri kukonzeresa zvikuru moyo zviratidzo, sekufema kufema, gumbo kuzvimba, kana moyo kutadza.
• Miedzo inoratidza kuti shanduko mune yako mitral vharafu iri kutanga kukuvadza moyo wako mashandiro.
• Kukuvadza kwemoyo wako vharuvhu kubva kuhutachiona (endocarditis).

Maitiro mashoma ekupinza ane mabhenefiti mazhinji. Iko kune marwadzo mashoma, kurasikirwa kweropa, uye njodzi yehutachiona. Iwe unozopora nekukasira kupfuura iwe zvaungaita kubva kuvhura moyo kuvhiya. Nekudaro, vamwe vanhu vanogona kutadza kuve nemhando iyi maitiro.

Percutaneous valvuloplasty inogona kuitwa chete kune vanhu vanorwara zvakanyanya kuti vave neanesthesia. Mhedzisiro yemaitiro aya haagare kwenguva refu.

Ngozi dzekuvhiyiwa chero ndeidzi:

• Ropa rinovhara mumakumbo ayo anogona kuenda kumapapu
• Ropa kurasikirwa
• Matambudziko ekufema
• Utachiona, kusanganisira mumapapu, itsvo, dundira, chifuva, kana mavhavha emwoyo
• Zviitiko kumishonga

Matekiniki ekuvhiya mashoma. Ane njodzi shoma pane kuvhiya kwakavhurika.Njodzi dzinogona kuitika kubva pakuvhiya kwevharuvhu kushoma ndezvekuti:

• Kukuvadza kune dzimwe nhengo, tsinga, kana mapfupa
• Kurwara kwemoyo, sitiroko, kana kufa
• Kubatwa kwevhavha nyowani
• Kusajairika kurova kwemoyo kunofanirwa kurapwa nemishonga kana pacemaker
• Itsvo kutadza
• Kupora kwakashata kwemaronda

Nguva dzose udza mupi wako wehutano:

• Kana iwe uri kana uchigona kuve nepamuviri
• Ndeapi mishonga yauri kutora, kunyangwe zvinodhaka, zvinowedzera, kana mahebhu awakatenga pasina mushonga

Iwe unogona kukwanisa kuchengeta ropa mubhengi reropa kuitira kuwedzerwa mukati uye mushure mekuvhiyiwa kwako. Kumbira mupiki wako nezvekuti iwe nenhengo dzemhuri yako mungape sei ropa.

Ukasvuta, unofanira kurega. Kumbira mupiki wako kuti akubatsire.

Munguva yemazuva usati wavhiyiwa:

• Kwevhiki rimwe chete usati wavhiyiwa, unogona kubvunzwa kuti usiye kutora mishonga inoita kuti ropa rako rigwinike. Izvi zvinogona kukonzera kuwedzera kubuda ropa panguva yekuvhiyiwa. Mimwe yemishonga iyi inosanganisira aspirin, ibuprofen (Advil, Motrin), uye naproxen (Aleve, Naprosyn).
• Kana iwe uri kutora warfarin (Coumadin) kana clopidogrel (Plavix), taura nachiremba wako usati wamira kana kushandura maitiro aunotora izvi zvinodhaka.
• Bvunza kuti ndeapi madhiragi aunofanira kutora pazuva rekuvhiyiwa kwako.
• Gadzirira imba yako kuitira paunosvika kumba kubva kuchipatara.
• Shamba uye geza bvudzi rako zuva rapfuura kuvhiyiwa. Ungangoda kusuka muviri wako pazasi pemutsipa wako nesipo yakakosha. Svina chipfuva chako kaviri kana katatu nesipo iyi. Iwe zvakare unogona kukumbirwa kutora mushonga unodzivirira kudzivirira hutachiona.

Pazuva rekuvhiyiwa:

• Unogona kubvunzwa kuti usanwa kana kudya chero chinhu pakati pehusiku husiku usati waitwa oparesheni. Izvi zvinosanganisira kushandisa chingamu nemindi. Sukurudza muromo wako nemvura kana ichinzwa kuoma. Chenjera kuti usamedze.
• Tora mishonga yawakaudzwa kunwa nekamwe kamvura.
• Unozoudzwa nguva yekuuya kuchipatara.

Tarisira kuti upedze mazuva matatu kusvika mashanu muchipatara mushure mekuvhiyiwa. Iwe uchamuka mune yevanonyanya kutarisirwa unit (ICU) uye unozopora ipapo kwe1 kana maviri mazuva. Vanamukoti vanonyatso tarisa monitors anoratidza ako akakosha zviratidzo (kupisa, tembiricha, uye kufema).

Maviri kusvika matatu machubhu anozove ari muchipfuva chako kuburitsa fluid kubva kumativi emoyo wako. Ivo vanowanzo bviswa 1 kusvika mazuva matatu mushure mekuvhiyiwa. Iwe unogona kunge uine catheter (inoshanduka chubhu) mudundira rako kudhonza weti. Iwe unogona zvakare kuve nemitsinga (IV) mitsara kuti uwane zvinwiwa.

Uchaenda kubva kuICU uchienda kuchipatara chenguva dzose. Mwoyo wako uye zvakakosha zviratidzo zvichaongororwa kusvikira wagadzirira kuenda kumba. Iwe uchagamuchira mushonga wekurwadziwa wekurwadziwa muchipfuva chako.

Mukoti wako anobatsira kutanga chiitiko zvishoma nezvishoma. Unogona kutanga chirongwa chekusimbisa moyo wako nemuviri wako.

Pacemaker inogona kuiswa mumoyo mako kana moyo wako uchinge wakanyanya kunonoka mushure mekuvhiyiwa. Izvi zvinogona kunge zviri zvenguva pfupi kana ungangoda pacemaker yechigarire usati wabva muchipatara.

Mechanical moyo mavharuvhu haakundikani kazhinji. Zvisinei, kuvhara ropa kunogona kukura pavari. Kana ropa rakagwamba rikaumbika, unogona kunge uine sitiroko. Kubuda ropa kunogona kuitika, asi izvi hazviwanzo.

Biological mavharuvhu ane mukana wakaderera wekugwamba kweropa, asi anowanzo kutadza kwenguva yakareba.

Mhedzisiro yemitral vharuvhu yekugadzirisa yakanaka. Kuti uwane mhedzisiro, sarudza kuvhiyiwa panzvimbo inoita yakawanda yemaitiro aya. Kuvhiya kushoma kwemoyo wevhavhavha yemoyo kwakavandudza zvakanyanya mumakore achangopfuura. Aya matekinoroji akachengeteka kune vanhu vazhinji, uye anogona kudzikamisa nguva yekudzosa uye kurwadziwa.

Mitral valve kugadzirisa - kurudyi mini-thoracotomy; Mitral valve kugadzirisa - chikamu chepamusoro kana chepasi sternotomy; Robotically-yakabatsirwa endoscopic vharuvhu kugadzirisa; Percutaneous mitral valvuloplasty

• Antiplatelet zvinodhaka - P2Y12 inhibitors
• Aspirin uye chirwere chemwoyo
• Kuvhiya kwevhavha yemoyo - kubuda
• Kutora warfarin (Coumadin)

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Goldstone AB, Woo YJ. Kuvhiya kurapwa kwemitral vharafu. Mune: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston uye Spencer Kuvhiya kweChipfuva. 9th ed. Philadelphia, PA: Elsevier; 2016: chits 80.

Herrmann 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.

Thomas JD, Bonow RO. Mitral valve chirwere. 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: chitsiko 69.