Mitral valve kuvhiyiwa - kuvhura

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

Ropa rinoyerera pakati pemakamuri akasiyana mumoyo kuburikidza nemavharuvhu anobatanidza makamuri. Imwe yeiyi ndiyo mitral vharafu. Iyo mitral vharafu inovhura saka ropa rinogona kuyerera kubva kuruboshwe atrium kuenda kuruboshwe ventricle. Valve yacho inovhara, ichichengetedza ropa kubva kuyerera richidzokera kumashure.

Mune rudzi urwu rwekuvhiya, chiremba anovhiya anoita kucheka kukuru mubhokisi rako rechipfuva kuti usvike pamwoyo. Dzimwe mhando dzekuvhiya dzinoshandisa akati wandei akacheka.

Usati wavhiyiwa, iwe uchagamuchira anesthesia yakajairika.Iwe unenge wakarara uye usina kurwadziwa panguva yekuita.

• Chiremba wako achaita akacheka gumi-masendimita (25.4 masentimita) pakati pechifuva chako.
• Tevere, chiremba wako anovhiya achaparadzanisa chipfuva chako kuitira kuti uone moyo wako.
• Vazhinji vanhu vakabatana nemoyo-wemapapu yekupfuura muchina kana yepasita pombi. Moyo wako unomira paunenge wakabatana nemuchina uyu. Muchina uyu unoita basa remoyo wako moyo uchinge wamiswa.
• Kucheka kudiki kunoitwa kuruboshwe rwe moyo wako kuti chiremba wako agadzirise kana kutsiva mitral vharuvhu.

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

• Mhete annuloplasty - Iye anovhiya anogadzirisa chikamu-senge chikamu chakatenderedza vharuvhu nekusona ringi yesimbi, jira, kana nyama yakatenderedza vharuvhu.
• Kugadziriswa kwemagetsi - Muvhiyi anodimbura, kuumba, kana kuvaka zvakare imwe kana dzakawanda dzemapapiro matatu (mapepa) evhavha.

Kana yako mitral vharuvhu yakanyanya kukuvara kuti igadziriswe, iwe uchazoda vharuvhu nyowani. Uku ndiko kunonzi kuvhiya kutsiva. Chiremba wako anovhiya achabvisa yako mitral vharafu uye osona nyowani munzvimbo. Kune mhando mbiri dzemitral valves:

• Mechanical, yakagadzirwa nevanhu-yakagadzirwa (synthetic) zvishandiso, senge titanium. Aya mavhavha anogara kwenguva refu. Iwe unozofanirwa kutora mushonga unoonda-ropa, senge warfarin (Coumadin) kana aspirin, kweupenyu hwako hwese.
• Biological, yakagadzirwa nevanhu kana mhuka mhuka. Aya mavhavha anotora makore gumi kusvika gumi nemaviri. Iwe ungangodaro usingade kutora vatete veropa kweupenyu hwese.

Kamwe iyo vharuvhu nyowani kana yakagadziriswa iri kushanda, chiremba wako anovhiya acha:

• Vhara moyo wako ubvise pamwoyo-mapapu muchina.
• Isa makateti (machubhu) akatenderedza moyo wako kudurura zvinwiwa zvinovaka.
• Vhara bhonzo rako rechipfuva newaya dzesimbi dzisina tsvina. Zvinotora vhiki nhanhatu kuti pfupa ripore. Waya dzichagara mukati memuviri wako.

Iwe unogona kunge uine pacemaker yenguva pfupi yakabatana nemoyo wako kudzamara yako yenyama rhythm yadzoka.

Kuvhiya uku kunogona kutora maawa matatu kusvika matanhatu.

Iwe ungangoda kuvhiyiwa kana yako mitral vharafu isingashande mushe.

• Iyo mitral vharuvhu isingavhare nzira yese inobvumidza ropa kudonhedza richidzokera kuruboshwe atrium. Izvi zvinonzi mitral kudzokazve.
• Iyo mitral vharafu iyo isingavhure zvizere inodzivirira kuyerera kweropa. Izvi zvinonzi mitral stenosis.

Iwe ungangoda yakavhurika-moyo vharuvhu kuvhiyiwa nekuda kwezvikonzero izvi:

• Shanduko mune yako mitral vharafu iri kukonzeresa zvikuru moyo zviratidzo, senge angina (kurwadziwa pachipfuva), kupfupika kwekufema, kupera simba (syncope), kana moyo kutadza.
• Miedzo inoratidza kuti shanduko mune yako mitral vharafu iri kudzora moyo wako basa.
• Iwe uri kuvhiyiwa-kwemoyo wakasununguka kune chimwe chikonzero, uye chiremba wako angangoda kutsiva kana kugadzirisa yako mitral vharuvhu panguva imwe chete.
• Yako vharuvhu yemoyo yakakuvadzwa ne endocarditis (hutachiona hwevheji yemoyo).
• Iwe wakagamuchira vharuvhu nyowani yemoyo munguva yakapfuura, uye haisi kushanda nemazvo.
• Iwe une matambudziko akadai sekugwamba kweropa, hutachiona, kana kubuda ropa mushure mekutora moyo nyowani vharuvhu.

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

Njodzi dzinogona kuitika kubva pakuvhiyiwa-kwemoyo wakasununguka ndedzinotevera

• Chirwere chemwoyo kana sitiroko.
• Matambudziko emoyo mutinhimira.
• Utachiona mukacheka (zvinowanzoitika kune vanhu vakafutisa, vane chirwere cheshuga, kana vakatove nekuvhiyiwa uku).
• Kuyeuka ndangariro uye kurasikirwa kwekujekesa kwepfungwa, kana "kufunga kwakashata."
• Post-pericardiotomy syndrome, iyo inosanganisira yakaderera fivhiri uye kurwadziwa kwepfupa. Izvi zvinogona kutora kusvika kumwedzi mitanhatu.
• Rufu.

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 mupi wako kana iwe uye nhengo dzemhuri yako muchikwanisa kupa ropa.

Iwe ungangoda kumira kutora mishonga inoita kuti zviomere ropa rako kugwamba kwemavhiki maviri pamberi pekuvhiyiwa. Izvi zvinogona kukonzera kuwedzera kubuda ropa panguva yekuvhiyiwa.

• Mimwe yemishonga iyi maaspirin, ibuprofen (Advil, Motrin), uye naproxen (Aleve, Naprosyn).
• Kana iwe uri kutora warfarin (Coumadin) kana clopidogrel (Plavix), taura nemupi wako usati wamisa mishonga yako kana kuchinja maitiro aunotora.

Gadzirira imba yako usati waenda kuchipatara kuti zvinhu zvizoita nyore paunodzoka.

Zuva rapamberi pekuvhiyiwa kwako, geza uye geza bvudzi rako. Ungangoda kusuka muviri wako wese pazasi pemutsipa wako nesipo yakakosha. Svina chipfuva chako kaviri kana katatu nesipo iyi. Iwe zvakare ungangoda kutora mushonga unorwisa kudzivirira hutachiona.

Munguva yemazuva usati wavhiyiwa:

• Bvunza kuti ndeapi mishonga yaunofanira kutora pazuva rekuvhiyiwa kwako.
• Ukasvuta, unofanirwa kumira. Kumbira mupiki wako kuti akubatsire.
• Nguva dzose rega mupi wako azive kana iwe uine kutonhora, furuwenza, fivhiri, herpes breakout, kana chero chimwe chirwere usati wavhiyiwa.

Pazuva rekuvhiyiwa:

• Tevera mirairo yemupi wako nezve nguva yekurega kudya nekumwa.
• Tora mishonga yawakanzi utore nekamwe kamvura.
• Unozoudzwa nguva yekuuya kuchipatara.

Vanhu vazhinji vanopedza mazuva mana kusvika manomwe muchipatara mushure mekuvhiyiwa.

Iwe uchamuka mune yevanorwara zvakanyanya (ICU). Iwe uchapora ipapo kwemazuva 1 kusvika maviri. Iwe unenge uine maviri kusvika matatu machubhu muchipfuva chako kuburitsa fluid kubva kwakatenderedza moyo wako. Machubhu anowanzo bviswa 1 kusvika mazuva matatu mushure mekuvhiyiwa.

Unogona kunge uine chubhu inochinja-chinja (catheter) mubhodhoro rako kudhonza weti. Iwe unogona zvakare kuve nemitsinga (IV) mitsara kuti uwane zvinwiwa. Monitors anoratidza akakosha zviratidzo (kupomba, tembiricha, uye kufema) anozotariswa zvakanyatsonaka.

Uchaendeswa kuchipatara chenguva dzose kubva kuICU. Moyo wako uye zvakakosha zviratidzo zvichaongororwa kusvikira iwe waenda kumba. Iwe unozogamuchira marwadzo ekudzora marwadzo akakomberedza ako ekuvhiya akachekwa.

Mukoti wako achakubatsira iwe kutanga chiitiko zvishoma nezvishoma. Unogona kuenda kuchirongwa chemuviri chekurapa kuti moyo wako nemuviri zvive nesimba.

Mechanical moyo mavharuvhu anogara kwehupenyu hwese. Zvisinei, kuvhara ropa kunogona kukura pavari. Izvi zvinogona kuvakonzera kutapukirwa kana kuvhara. Kana ropa rakagwamba rikaumbika, unogona kunge uine sitiroko.

Mavharuvhu akagadzirwa kubva kumunhu kana mhuka mhuka anokundikana nekufamba kwenguva. Ivo vane avhareji yehupenyu hwemakore gumi kusvika makumi maviri vasati voda kuchinjwa. Vane mukana wakaderera wekugwamba kweropa.

Mitral vharafu kutsiva - yakavhurika; Mitral valve kugadzirisa - kuvhura; Mitral valvuloplasty

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

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.

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.

Thomas JD, Bonow RO. Mitral valve chirwere. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Mu: Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 69.