Ukwelapha Okuncane Okumangalisa Ukwelashwa Kwe-Aortic Stenosis
I-aortic stenosis yinto evamile yesimo senhliziyo evame ukukhula futhi ikhulise ngeminyaka. I-valve ye-aorti ingenye yezinsimbi ezine zenhliziyo enhliziyweni yomuntu, futhi ingalimaza kakhulu ngokubalwa. Lesi yisimo esingathi sína esingathinta izingxenye ezihambayo ze-valve futhi senze kahle.
Esikhathini esedlule, ukwelashwa okuyinhloko kwe-aortic stenosis evulekile kwakuvulekile ukuhlinzeka inhliziyo lapho i-valve ilungiswa noma i-valve eyenziwe ngezicubu noma izinto zokufakelwa ingasetshenziselwa ukufaka esikhundleni sevaji e-aortic ewonakele.
Namuhla, kunenketho entsha neyinkimbinkimbi ebizwa ngokuthi i-Transcatheter Aortic Valve Replacement (TAVR) okungenzeka ibe yindlela yokuthola iziguli ezingenakubekezelela indlela yenhliziyo evulekile yokuvuselela noma ukufaka esikhundleni se-valve ye-aortic.
Yini I-Valor Aortic?
Ukuze uqondisise kahle i-aortic valve esikhundleni, kubalulekile ukuqonda ukuthi yini i-valve ye-aortic eyenzayo. I-valve ye-aortic itholakala phakathi kwe-ventricle kwesokunxele ne-aorta, futhi isiza ukulawula ukugeleza kwegazi kusuka enhliziyweni, ukuya e-aorta nakumzimba wonke. I-valve enempilo ye-aortic ivimbela igazi ukuba lisuke enhliziyweni ngokushesha kakhulu, livule kuphela uma sekuyisikhathi sokuba igazi liphume kwe-ventricle langakwesokunxele bese lifika e-aorta. Lapho i-valve ye-aortic ibonakalisiwe futhi iyancipha, lesi simo sibizwa ngokuthi i-aortic stenosis futhi singaba sína kakhulu, njengoba ukugeleza kwegazi akusekho kahle noma kusebenza kahle.
Izimpawu ze-Aortic Stenosis
Lapho i-valve ye-aortic ibalwa, ayisasebenzi kahle, futhi inhliziyo kufanele isebenze kanzima ukupompa igazi emzimbeni.
Ezinye iziguli ezine-aortic stenosis zithola isipiliyoni se-syncope, noma iziqephu zokuphelelwa amandla. Bangase babhekane nobuhlungu besifuba, futhi ezimweni ezinzima, inkinga ye-valve ingaholela ekuthuthukiseni kwesinye isimo esinzima, esibizwa ngokuthi ukuhluleka kwenhliziyo.
Ukukhathala nokubekezelelana kokuzivocavoca ezinye zezibonakaliso zokuqala ze-aortic stenosis, kodwa ezimweni ezinzima iziguli zingaba buthakathaka kangangokuthi zikwazi ukungakwazi ukuhamba ngaphezu kwezinyawo ezimbalwa.
Isimo singaba sikhulu kangangokuthi ukukhawulela impilo noma ukusongela impilo uma kushiywa kungalashwa, okuholela ekudingeni ukulungiswa noma ukuguqula i-valve.
Ubani Ongumbuzo Wokuhlinzwa Kwe-TAVR?
Iziguli ezigula kakhulu ze-aortic stenosis - obani ngokuvamile iziguli ezinesidingo esikhulu se-valve senhliziyo esebenza kahle - inqubo yenhliziyo evulekile ingabhekwa njengengozi kakhulu. Ukuhlinzwa kunzima kakhulu emzimbeni, kanti ezinye iziguli azikwazi ukubekezelela leyo nkinga yokucindezeleka ngokomzimba, okwenza izingozi zokuhlinzeka ngenhliziyo evulekile zingaphezu kwemiphumela engaba khona. Kulezi ziguli ezibonakala zigula kakhulu ukuba zibeke ukuhlinzwa, noma labo abanikeza izinga eliphakeme lokufaka ingozi, inqubo ye-TAV ingaba yindlela ehlukile.
Inqubo ye-TAVR
Iziguli eziphezulu ezibangelwa ingozi ye-aortic stenosis, ukuhlinzwa kwe-TAVR kungaba yindlela yokwenza ukuhlinzekwa kwe-valor e-aortic ngaphandle kokucindezeleka ngokomzimba wokuhlinzwa kwenhliziyo evulekile, ukuguqulwa kwe-cardiopulmonary and anesthesia jikelele . Inqubo yenziwa ngokuzenzakalelayo, okusho ukuthi "ukuhlinzeka" kwenziwa ngokufaka izinsimbi ku-artery wesifazane ngokunciphisa okuncane futhi uthuthuke kancane kancane emifuleni yegazi kuze kube yilapho kutholakala i-valve aortic. Iziguli eziye zinezinhlanzi zenhliziyo zizothola inqubo yokufaka esikhundleni se-valve engavamile.
Ngenkambiso ye-TAVR, i-valve yokufakelwa ihlanganiswa ibe iphakheji encane elincane elanele ukuba lihanjiswe esitokisini segazi kanye nezinsimbi. Uma isendaweni, ukuthuthwa kwe-valve kuthunyelwe, kuvulwa usayizi ogcwele. Uma i-TAVR isendaweni, ithatha indawo ye-aortic valve eyonakalisiwe futhi ilawula ukukhululwa kwegazi kusuka enhliziyweni.
Izingozi ze-TAVR
Izingozi zokuhlinzeka nge-TAVR zinzulu futhi kufanele zixoxwe nodokotela wakho ngaphambi kwenqubo. Izingozi ze-TAVR zifana nezingozi zokuhlinzwa kwenhliziyo evulekile ukuze kulungiswe noma kushintshwe i-valve ye-aortic, futhi kufaka ingozi yokushaya isisu, i-blood clots, ukuphuma kwegazi, ukulimala enhliziyweni ngaphezu kwezingozi ze-anesthesia.
Uma kuqhathaniswa neziguli ezikwazi ukulungisa inhliziyo ye-aortic stenosis ngeziguli ezinezinqubo ze-TAVR, iziguli ze-TAVR zinengozi enkulu yokudinga i-pacemaker ngonyaka olandela inqubo, kodwa futhi ingengozi encane yokuphuma nokufa ngonyaka olandelayo ukuhlinzwa.
Inqubo ye-TAVR entsha, futhi kanjalo, ucwaningo olude lwesikhathi eside alutholakali ngalesi sikhathi e-United States. Yikuphi ukucwaninga okutholakala, kodwa kubonisa ukuthi iziguli eziphakeme kakhulu zengozi zihamba ngendlela encane kangcono nenqubo encane engavamile kunokuba kulungiswe ukuvulwa kwenhliziyo kwe-valve.
Ngemuva kwe-TAVR
Kubalulekile ukukhumbula ukuthi inqubo ye-TAV iyathuthukisa impilo, kodwa ayiqinisekisi ukutakula okuphelele kwesifo senhliziyo. Iziguli eziningi zithola ukuthuthukiswa okuphawulekayo emkhakheni wokuphila nokulungisa i-aortic valve, kodwa kungase kube nomonakalo ohlala njalo emzimbeni wenhliziyo ngenxa yesiphakamiso esiphutha noma ezinye izimo zenhliziyo ezikhona.
Imithombo:
Ukushintshwa kwe-Transcatheter Aortic-Valve nge-Self-Expanding Prosthesis. I-New England Journal of Medicine. Kufinyeleleke ngoMashi 2014.