Chisarudzo chekuita chirurgical stenosis chirwere chinonyangadza, uye chinofanira kunyatsotariswa.
Kana iwe nachiremba wako masarudza kuti inguva yekuita chirongwa , iwe uchange uchitarisa zvitatu zvinoshandiswa pakushandiswa kurapwa kwemaster stenosis yako: Kubva kune vakawanda kusvika kazhinji inokurudzirwa, izvi ndezvi:
- percutaneous mitral balloon valvotomy (PMBV)
- mitral commissurotomy
- mitral valve replacement
Hasi dzose idzi nzira dzakakodzera kune wese ane mitral stenosis.
Percutaneous Mitral Balloon Valvotomy
Mu mitral stenosis, mabhuku e mitral valve (mafikisi anokonzera akazaruka uye akavhara sezvinoita mwoyo inobvumirana) anosanganiswa pamwe, achidzivirira kuti valve isati yazarura zvachose. PMBV iri kuedza kuparadzanisa mapepa kubva kune umwe kune imwechete kuti isunungure kupfigirwa.
MuPBBV, yakareba, yakaonda, inogadziriswa tube (catheter) ine bhaluni yakasvibiswa yakaiswa pairi inodarika mutsara we mitral. Bhaluni inobva yawedzerwa. Chinangwa chacho ndechokuputsa matanho ayo akanganisa mitral valve leaftlets kune mumwe nemumwe.
Nemhaka yokuti PMBV chirongwa chekushaya catheterization uye kwete kuvhima mwoyo yakasununguka , inongova yakawandisa yezvakaitika kune varwere pane mamwe maitiro ekuvhiya mitral valve. Zvinetso zvinowanzova zvishoma, uye kugadzirisa kubva pane zvinowanzoita nyore nyore.
PMBV inoshandawo zvikuru kana ichiitwa nevanhu vakasarudzwa.
Muzhinji, PMBV ndiyo nzira yekuvhiya chiremba wako achakurudzira kutarisa mitral stenosis yako, kunze kwekuti une:
- imwe kuruboshwe inrial thrombus (ropa clot)
- rakakura calcium inosvika pedyo kana pedyo nemitral valve yako
- kuenzanisa kusvika kune simba mitral regurgitation- apo mitral valve haisati yavhara zvakanaka, zvichiita kuti ropa ridonhe kuburikidza nevhavha
Mukuwedzera, PMBV kazhinji haisi yekusarudza kana mitral stenosis yako inofambidzana nemamwe mamiriro ezvinhu akaoma mwoyo.
Mushure memwana weBPBV, zvinogoneka kuti mitral stenosis inotanga kuwedzera zvishoma nezvishoma zvakare. Nokuda kwechikonzero ichi, kunyange mushure mekuita izvi, zvakakosha kuva nenguva yekuongorora kwepfungwa ne echocardiography . Kusvikira 21 kubva muzana yevarwere vane PMBV vachapedzisira vachida kurapwa kwechipiri.
Mitral Commissurotomy
Chinangwa chemitral commissurotomy chakafanana neW PMBV-kuparadzanisa mapepa akafanirwa kubva kune mumwe. Ndezvipi zvakasiyana nematral commissurotomy, zvisinei, ndeyekuti iyo ndiyo nzira yakasununguka yemwoyo inobudirira ichi chinangwa nekushandiswa kwesimbi yakapinza yekuvhiya.
Kazhinji kereke inowanzopa zvibereko zvakanaka kwazvo. Kunyange zvakadaro, iwe unotarisana nezvengozi dzekuvhiyiwa kukuru uye kwenguva yakareba yekudzikinura nguva kupfuura PMBV, ndicho chinodzivirira vanachiremba kubva pakuzvirumbidza sechisarudzo chokutanga.
Izvo zvinowanzoita sarudzo yakanaka kune vanhu vanozobvumirwa kubhadhara PMBV kunze kwekuvapo kwerutivi rwemanheru rwetrial thrombus, calcification calcification, kana mitral kudzokera zvakare.
Sezvo ne PMBV nzira, mitral stenosis inogona kudzoka zvishoma nezvishoma inotevera commissurotomy. Vanhu vane nzira iyi vanodawo kupfuurira nguva nenguva kuongororwa kwemwoyo.
Mitral Valve Replacement
Mitral valve kushandura ndicho chisarudzo chokupedzisira, nokuti chinotakura njodzi yakakura yezvinetso kupfuura PMBV kana commissurotomy. Kugadziriswa kwemagetsi kunofanirwa apo mitral stenosis inokonzera mitral valve kuve yakakuvadzwa zvakanyanya kana kuverengwa, zvichiita kuti dzimwe nzira mbiri dzigoneke.
Mu mitral valve replacement, iyo valve inotsiviwa nemagetsi (prosthetic) valve . Zviputi zvinokonzerwa nemagetsi zvinogona kunge zvinoshandiswa zvakakwana zvezvinhu zvakagadzirwa nevanhu (magetsi emagetsi), kana kuti zvinogona kuitwa kubva pamwoyo valve yemhuka, kazhinji yenguruve (bioprosthetic valve).
Kusarudza kuti rudzi rwepivha yekushandisa rinoshandiswa runoenderana nezera rako uye kana iwe unogona kutora ropa rakaonda Coumadin .
Zvose zvipfeko zvemwoyo zvinoshandiswa zvinowedzera kuwedzera ropa. Zvisinei, kuvhara ropa hakusi kwechinetso ne bioprosthetic kupfuura magetsi emagetsi, saka vanhu vane chekare vangasafanira kutora nguva refu Coumadin therapy; avo vane magetsi emagetsi vanoita.
Zvisinei, magetsi emagetsi anoita sokuti anogara kwenguva yakareba kudarika bioprosthetic valves. Kana iwe uchida mitral valve kushandiswa, vari pasi pemakore makumi matanhatu nemashanu, uye iwe unogona kutora Coumadin, chiremba wako angangodaro akarayira magetsi yemagetsi. Kana iwe uri mukuru kudarika 65, kana iwe uri muduku asi haugoni kutora Coumadin, bhavheji ye bioprosthetic inowanzokurudzirwa.
Your Mitral Stenosis Surgery Chisarudzo
Kana uine mitral stenosis, iwe unoda kushanda pamwe chete nemudzidzisi wako wepadzimai kuti usarudze kana uye kana chirwere chinenge chichidikanwa, uye sarudza nzira yekuvhiya inonyatsokodzera zvinodiwa nemumwe wako. Nokukurumidza kuongororwa uye kuchengetedzeka kwepfungwa kwehana, vanhu vakawanda vane mitral stenosis nhasi vanogona kutarisira kurarama hupenyu hwemazuva ose.
Sources:
Bonow, RO, Carabello, BA, Chatterjee, K, et al. 2008 Chirevo chekushandiswa chinowanikwa muC ACC / AHA 2006 mirayiridzo yehutungamiri hwevarwere vane chirwere chepfungwa chevurvular: mushumo weAmerican College of Cardiology / American Heart Association Task Force pamusoro pekudzidzisa mazano (Komiti yekunyora kuongorora nhungamiro yekutungamira Varwere Vane Valvular Heart Disease): vanobvumirwa neSosaiti yeCrodiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, uye Society of Thoracic Surgeons. Circulation 2008; 118: e523.
Ben Farhat M, Ayari M, Maatouk F, et al. Bhaluni yePercutaneous nekuvhiya yakavharwa uye yakasununguka mitral commissurotomy: makore manomwe ekuteverwa kwekutsvaga kwemuedzo we randomized. Circulation 1998; 97: 245.