Chithandizo Chochepa Chodziwika kwa Aortic Stenosis
Aortic stenosis ndi chizoloŵezi cha mtima chomwe chimakula ndikuwonjezeka ndi zaka. Valve ya aortic ndi imodzi mwa magetsi anayi mkati mwa mtima wa munthu, ndipo ikhoza kuonongeka kwambiri ndi kuwerengedwa. Izi ndizoopsa kwambiri zomwe zimakhudza magawo osuntha a valve ndipo zimapangitsa kuti zikhale zochepa.
M'mbuyomu, chithandizo choyamba cha aortic stenosis chinali opaleshoni ya mtima yotseguka kumene valavuyo inakonzedwa kapena valavu yopangidwa kuchokera ku minofu kapena zida zogwiritsira ntchito zingagwiritsidwe ntchito m'malo mwa valve yowonongeka.
Masiku ano, pali njira yatsopano yosasinthika yotchedwa Transcatheter Aortic Valve Replacement (TAVR) yomwe ingakhale yosankha kwa odwala omwe sangathe kulekerera njira yowonekera yotsegulira opaleshoni kapena kukonzanso valavu ya aortic.
Kodi Valve ya Aortic Imatani?
Kuti mumvetse bwino malo a valve m'malo mwake, nkofunika kumvetsa zomwe valve ya aortic imachita. Valve ya aortic ili pakati pa ventricle yakumanzere ndi aorta, ndipo imathandiza kuchepetsa kutuluka kwa magazi kuchokera mumtima, kulowa mu aorta ndi thupi lonse. Mpweya wabwino wa aortic umateteza magazi kuti asachoke pamtima mofulumira, kutsegulira kokha ngati nthawi yoti magazi achoke kuchokera kumbuyo kwa ventricle mpaka ku aorta. Pamene valve ya aortic yowonongeka ndipo imakhala yochepetsedwa, vutoli limatchedwa aortic stenosis ndipo ikhoza kukhala yovuta kwambiri, chifukwa kuthamanga kwa magazi sikunayendetsedwe bwino kapena koyenera.
Zizindikiro za Aortic Stenosis
Pamene valve ya aortic imatha kuwerengedwa, siigwiranso ntchito bwino, ndipo mtima uyenera kugwira ntchito molimbika kupopera magazi ku thupi.
Odwala ena omwe ali ndi aortic stenosis amakhala ndi syncope, kapena zigawo zofooka. Angakhalenso ndi ululu wa chifuwa, ndipo pakakhala zovuta kwambiri, vuto la valve lingayambitse chitukuko cha vuto linalake, lotchedwa congestive heart failure.
Kutopa ndi kusagwirizana kwa masewero olimbitsa thupi ndi zina mwa zizindikiro zoyambirira za aortic stenosis, koma pozunzika kwambiri odwala akhoza kukhala ofooka kwambiri moti amalephera kuyenda maulendo angapo.
Matendawa amatha kukhala oopsa kwambiri moti moyo umalepheretsa moyo kapena kuopseza moyo ngati sungathe kuchitidwa chithandizo, zomwe zimachititsa kukonza kapena kukonzanso valavu.
Amene Ali Wosankha Kwa Opaleshoni ya TAVR
Odwala odwala aortic stenosis odwala - omwe nthawi zambiri ali odwala omwe amafunikira kwambiri valve ya mtima yomwe imagwira ntchito bwino - njira yotsegulira mtima ikhoza kuonongeka kwambiri. Kuchita opaleshoni kumakhala kovuta kwambiri kwa thupi, ndipo odwala ena sangathe kulekerera kupsinjika maganizo koteroko, kuchititsa opaleshoni ya mtima yotseguka kupitirira mphoto zomwe zingakhalepo. Kwa odwala amene amawoneka odwala kwambiri kuti asalolere opaleshoni, kapena omwe amaonetsa chiopsezo chokwanira, opaleshoni ya TAVR ikhoza kukhala njira yoyenera.
Ndondomeko ya TAVR
Odwala opaleshoni yapamwamba ya aortic stenosis, opaleshoni ya TAVR ikhoza kukhala njira yomwe imapanga kukonzanso ma valve popanda kupsinjika maganizo kwa opaleshoni ya mtima yotseguka, kupyolera m'magazi komanso anesthesia . Ndondomekoyi imachitidwa mwachisawawa, kutanthauza kuti "opaleshoni" imagwiritsidwa ntchito poika zida mu mitsempha ya chikazi pogwiritsa ntchito kachipangizo kakang'ono ndi kupyolera mitsempha mwazidzidzi mpaka mphutsi ya aortic ifike. Odwala omwe ali ndi catheterization ya mtima adzapeza njira yowonjezeredwa yowonjezera valavu kuti ikhale yofanana.
Pogwiritsa ntchito njira ya TAVR, valavuyi imapangidwira mu phukusi laling'ono lomwe limakhala lochepa kuti lisunthidwe kudzera mu chotengera cha magazi pamodzi ndi zida. Pamene ali pamalo, malo ogwiritsira ntchito valve amatumizidwa, kutsegulira kukula kwakenthu. Pamene TAVR ilipo, imalowetsa chivundikiro cha aortic chowonongeka ndikuyendetsa kumasulidwa kwa magazi kuchokera mu mtima.
Ngozi za TAVR
Kuopsa kwa opaleshoni ya TAVR ndi yaikulu ndipo muyenera kukambirana ndi dokotala wanu musanayambe. Kuopsa kwa TAVR ndi ofanana ndi kuopsa kwa opaleshoni ya mtima yotsegula kukonzanso kapena kutsegula valve ya aortic, ndikuphatikizapo chiopsezo cha kupwetekedwa, magazi, kutuluka kwa magazi, kuvulaza mtima kuphatikizapo ngozi za anesthesia.
Poyerekeza odwala omwe anali ndi mtima wokonza mtima wa aortic stenosis ndi odwala omwe anali ndi njira ya TAVR, odwala a TAVR ali ndi chiopsezo chachikulu chosowa pacemaker m'chaka chotsatira ndondomekoyi, koma amakhala ndi chiwopsezo chochepa cha magazi ndi imfa mu chaka chotsatira chitatha opaleshoni.
Ndondomeko ya TAVR ndi yatsopano, ndipo motere, kufufuza kwa nthawi yaitali sikukupezeka panthawi ino ku United States. Kodi ndifukufuku wotani umene ulipo, komabe, akusonyeza kuti odwala omwe ali pachiopsezo chachikulu amakhala bwino kwambiri ndi njira yowonongeka yochepa kusiyana ndi kukonzanso mtima kwa valve.
Pambuyo pa TAVR
Ndikofunika kukumbukira kuti njira ya TAVR ndikulingalira moyo, koma sikutsimikiziranso kuti munthu amatha kuchira matenda a mtima. Odwala ambiri amatha kusintha bwino kwa moyo wawo ndi kukonza kwa valve ya aortic, koma pangakhale kuwonongeka kwa minofu ya mtima chifukwa cha valavu yolakwika kapena zina zomwe zimakhalapo mtima.
Zotsatira:
Kukonzekera kwa Transcatheter Aortic-Valve ndi Kutsitsa Kwambiri Kwambiri. New England Journal of Medicine. Idafika mu March 2014.