Isinqumo sokuba nokuhlinzwa kwe-mitral stenosis kuyinkimbinkimbi, futhi kufanele ihlukaniswe ngokucophelela.
Uma wena nodokotela wakho benqume ukuthi sekuyisikhathi senqubo , uzobe ulinganisa izinketho eziyisisekelo eziyisithupha zokwelapha ukwelashwa kwe-mitral stenosis yakho: Kusukela kuningi kuya kokungenani kunconywa, lezi ziyizi:
- I-perralaneous balral ball valvotomy (PMBV)
- ukukhishwa kwezimpahla
- i-mitral valve esikhundleni
Akuzona zonke lezi zindlela ezifanele wonke umuntu onemitral stenosis.
I-Percutaneous Mitral Balloon Valvotomy
E-mitral stenosis, amapheshana e - mitral valve (amaphuphu aguquguqukayo avulwa futhi avaliwe njengezinkontileka zenhliziyo) ahlanganiswa ndawonye, evimbela i-valve ukuthi ingavuli ngokuphelele. I-PMBV izama ukuhlukanisa amapheshana omunye komunye ukuze kunqunywe ukuvimbela.
Ku-PMBV, ithini elide, elincane, eliguquguqukayo (i-catheter) elinamabhaloni ahlanjululwe kuwo lidluliselwa ngaphesheya kwe-valve mitral. Ibhaluni liyakwandiswa. Inhloso ukuphula ukunamathela okuye kwafiphaza ama-leaftlet ama-mitral valve komunye nomunye.
Ngenxa yokuthi i-PMBV iyinkambiso yokucwaninga futhi ingavulwa ukuhlinzwa kwenhliziyo , kungaphansi kokuhlupheka kweziguli kunezinye izinhlobo zokuhlinzwa kwe-valve. Izinkinga zivame ukungabi ncane kakhulu, futhi ukuphumula kule nqubo kuvame ukulula.
I-PMBV iphinde isebenze kakhulu uma isenziwa kubantu abakhethiwe ngokufanele.
Ngokuvamile, i-PMBV iyindlela yokwelapha udokotela wakho oyotusa ukuba akwazi ukubhekana ne-mitral stenosis yakho, ngaphandle uma une:
- i- thrombus ye-atrial ye-atrial kwesokunxele (i-clot yegazi)
- I-calcium enamandla igxile noma eduze ne-valve yakho ye-mitral
- ukulinganisela ekuhambeni okukhulu kwe-mitral- lapho i-valve ye-mitral ingasondeli kahle, ivumela igazi ukuba livule ngokusebenzisa i-valve
Ngaphezu kwalokho, i-PMBV ngokuvamile ayiyona inketho uma i-mitral stenosis yakho ihambisana nezinye izimo zenhliziyo eziyinkimbinkimbi.
Ngemuva kwenqubo ye-PMBV, kungenzeka ukuba i-mitral stenosis iqale kancane kancane. Ngenxa yalesi sizathu, ngisho nangemva kokuthola le nqubo, kubalulekile ukuba nokuhlolwa kwenhliziyo ngezikhathi ezithile nge- echocardiography . Kufika ezingamaphesenti angu-21 eziguli ezine-PMBV ekugcineni zizodinga ukwelashwa kwesibili.
I-Mitral Commissurotomy
Umgomo we-mitral commissurotomy ufana ne-PMBV-ukuhlukanisa amapheshana ahlanganisiwe komunye nomunye. Yini ehlukile nge-mitral commissurotomy, noma kunjalo, ukuthi yinkqubo evulekile yenhliziyo efinyelela kulo mgomo ngokusetshenziswa kwekhasi lokuhlinza elibukhali.
Ukuzikhandla komzimba ngokuvamile kuveza imiphumela emihle kakhulu. Noma kunjalo, ubhekene nezingozi zokuhlinzwa okukhulu kanye nesikhathi eside sokutakula ngaphandle kwe-PMBV, yilokho okwenza odokotela bangakuphakamisi njengokhetho lokuqala.
Ukuvame ukuvame ukuvota kuyindlela enhle kubantu abazobe bezokhethwa ku-PMBV ngaphandle kokuba khona kwe-thrombus ye-atriyamu engakwesobunxele, ukubalwa kwe-valve, noma ukubuyiswa kwe-mitral.
Njengenqubo ye-PMBV, i-mitral stenosis ingahle ibuye ibuyele ngemva kokuhamba komzimba. Abantu abanenqubo yalokhu badinga ukuhlolwa okuqhubekayo kwenhliziyo.
Ukushintshwa kwe-Mitral Valve
Ukushintshwa kwe-Mitral valve yisinqumo sokugcina, ngoba sinomngcipheko ophezulu wezinkinga kunokuba yi-PMBV noma i-commissurotomy. Ukuguqula i-valve kuyadingeka lapho i-mitral stenosis ibangele i-valve mitral ukuba ibonakale yingozi kakhulu noma ibalwa, okwenza ezinye izinqubo zingenakwenzeka.
Esikhathini sokuguqula i-valve valve, i-valve ithathelwe indawo nge-valve yokufakelwa (i-prosthetic) . I-valve ye-prosthetic ingahle ihlanganise izinto ezenziwe ngumuntu (ama-valve kagesi), noma zingenziwa kusukela ku-valve yenhliziyo yesilwane, ngokuvamile ingulube (i-valve ye-bioprosthetic).
Ukunquma ukuthi yiluphi uhlobo lwe-valve yokufakelwa okufanele lusetshenziswe kuxhomeke kuneminyaka yakho nokuthi ngabe ungathatha igazi elincane laseCoumadin .
Zonke izivinji zenhliziyo ezinamandla zinezikhukhula ezengeziwe zokwenza ama-clots egazi. Noma kunjalo, ukugaya igazi akuncane kunenkinga nge-bioprosthetic kunama-valve kagesi, ngakho-ke abantu abanokuqala bangase bangadingeki ukwelashwa okungapheliyo kwe-Coumadin; labo abaneziphazamisi zemishini benza.
Kodwa-ke, ama-valve kagesi ngokuvamile abonakala ehlala isikhathi eside kunama-valve e-bioprosthetic. Uma udinga i-mitral valve esikhundleni, uneminyaka engaphansi kweminyaka engu-65, futhi ungathatha uCoumadin, udokotela wakho mhlawumbe uncoma i-valve mechanical. Uma uneminyaka engaphezu kuka-65, noma usemncane kodwa awukwazi ukuthatha i-Coumadin, i-valve ye-bioprosthetic ivame ukuphakanyiswa.
Ukuguqulwa Kwakho Kwe-Mitral Stenosis Isinqumo
Uma une-mitral stenosis, kuzodingeka usebenze eduze ne-cardiologist yakho ukuze unqume ukuthi noma nini ukuhlinzeka ngokudingekayo, bese ukhetha indlela yokuhlinzwa ehambisana nezidingo zakho ngabanye. Lapho bexilongwa ngokushesha futhi benakekelwa inhliziyo ngokweqile, abantu abaningi abane-stralosis ye-mitral namuhla bangalindela ukuphila ukuphila okuvamile.
Imithombo:
Bonow, RO, Carabello, BA, Chatterjee, K, et al. Ukubuyekezwa okugxilwe ngo-2008 okufakwe emithethweni ye-ACC / AHA 2006 yokuphathwa kweziguli ezine-valvular isifo senhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force on Iziqondiso Zokuzikhandla (IKomidi Yokubhala Ukubuyekeza Izeluleko Zika-1998 Zokuphathwa Iziguli ezine-Valvular Heart Disease): zamukelwa yiNhlangano Yezinhliziyo Zezinhliziyo Ze-Anesthesiologists, i-Society for Cardiovascular Angiography and Interventions, kanye neNhlangano Yezifo Ezihlinzeka Ngama-Thoracic. Ukujikeleza ngo-2008; 118: e523.
UBen Farhat M, Ayari M, Maatouk F, et al. I-balloon enama-percutaneous ngokuhlinzwa okuvaliwe nokuvuleka kwe-mitral commissurotomy: imiphumela eyisikhombisa yokulandelela yokuhlolwa okungahleliwe. Ukujikeleza kuka-1998; 97: 245.