Chii chinonzi Aortic Root Surgery? Chinangwa, Maitiro & Kupora

Aortic root surgery inzira yemoyo inogadzirisa kana kutsiva hwaro hweaorta yako, tsinga huru inotakura ropa kubva mumoyo wako kuenda kune dzimwe nhengo dzemuviri wako. Iyo aortic root yakaita sehwaro hwegedhi guru remoyo wako, uye kana yakakuvara kana kukura, kuvhiyiwa kunogona kudzorera kuyerera kweropa kwakakodzera uye kuchengetedza basa remoyo wako.

Maitiro aya anogona kurira achityisa, asi zviuru zvevanhu vanovhiyiwa aortic root surgery gore rega rega. Kunzwisisa zvakabatanidzwa kunogona kukubatsira kuti unzwe wakagadzirira uye uine chivimbo pamusoro pezviitiko.

Chii chinonzi aortic root surgery?

Aortic root surgery inosanganisira kugadzirisa kana kutsiva aortic root, iyo iri chikamu uko aorta yako inobatanidzwa nemoyo wako. Nzvimbo iyi inosanganisira aortic valve uye chikamu chekutanga cheaorta pachayo.

Funga nezve aortic root seyakakosha nzvimbo uko ropa rinobuda mukamuri huru yekupomba yemoyo wako. Kana nzvimbo iyi ikarwara, kukura, kana kukuvadzwa, inogona kukanganisa kuti moyo wako unopomba ropa zvakanaka sei mumuviri wako wese.

Kune mhando dzakawanda dze aortic root surgery. Chiremba wako anogona kugadzirisa nyama yako iripo, kutsiva vhavha chete, kana kutsiva chikamu chose chemudzi zvichienderana nemamiriro ako chaiwo.

Nei aortic root surgery ichiitwa?

Chiremba wako anokurudzira aortic root surgery kana aortic root ikakura zvakanyanya, yakakuvara, kana kurwara kuti ishande nemazvo. Izvi zvinogona kuitika nekuda kwemamiriro akati wandei anokanganisa kugona kwemoyo wako kupomba ropa nemazvo.

Chikonzero chakajairika i aortic root aneurysm, uko madziro e aorta anova asina simba uye anobuda kunze semabhaluni. Pasina kurapwa, izvi zvinobuda zvinogona kuva njodzi uye zvinogona kuisa upenyu panjodzi.

Heano mamiriro makuru anogona kuda aortic root surgery:

• Aortic root aneurysm (kuwedzera kweaortic root)
• Aortic valve chirwere chinokanganisa root yakatenderedza
• Aortic dissection (kubvaruka mumadziro e aortic)
• Marfan syndrome kana mamwe matambudziko etishu anobatanidza
• Bicuspid aortic valve ine root enlargement
• Kutapukirwa kweaortic root (endocarditis)
• Congenital heart defects inokanganisa aortic root

Mamwe mamiriro asingawanzoitika seLoeys-Dietz syndrome kana Ehlers-Danlos syndrome anogonawo kuita kuti aortic root isasimba nekufamba kwenguva. Chiremba wako achanyatsoongorora mamiriro ako chaiwo kuti aone kana kuvhiyiwa kuri sarudzo yakanakisa kwauri.

Ndeipi nzira yekuvhiya aortic root?

Aortic root surgery inoitwa pasi pe general anesthesia muimba yekuvhiya muchipatara nachiremba wecardiac surgeon. Iyi nzira inowanzo tora maawa matatu kusvika ku6, zvichienderana nekuoma kwenyaya yako.

Chiremba wako achaita incision muchipfuva chako uye achashandisa muchina wemoyo-mapapu kuti atore basa rekupomba remoyo wako kwenguva pfupi panguva yekuvhiya. Izvi zvinobvumira chiremba wako kushanda pamoyo wako uchiri kumira.

Matanho chaiwo anoenderana nerudzi rwekuvhiya rwaunoda:

1. Aortic root replacement: Chiremba wako anobvisa root yakakuvadzwa uye anoitsiva negraft, kazhinji yakagadzirwa kubva kune synthetic material kana tishu kubva kumhuka
2. Valve-sparing root replacement: Iyo aortic valve ine hutano inochengetwa apo ichitsiva chete chikamu chakawedzerwa che root
3. Composite graft replacement: Ose ari maviri aortic valve uye root anotsiviwa neyuniti imwechete ine zvese zvikamu
4. Ross procedure: Iyo yako pulmonary valve inotamiswa kuti itsive aortic valve uye root

Panguva yekuvhiya, chiremba wako anogonawo kuda kubatanidza zvakare coronary arteries kuti ave nechokwadi chekuyerera kweropa kwakakodzera kumhasuru dzemoyo wako. Iyi inzira yakaoma asi yenguva dzose yenzira yacho.

Maitirwo ekugadzirira kuvhiya kwako aortic root?

Kugadzirira kuvhiyiwa kwemidzi ye aortic kunosanganisira matanho akati wandei anokosha anobatsira kuona mhedzisiro yakanakisisa. Chikwata chako chevhiyo chichakutungamirira kuburikidza nechikamu chega chega chekugadzirira mumavhiki anotungamira kuita kwako.

Kutanga, uchaenda kuyedzwa kwakazara kuti uongorore basa remoyo wako uye hutano hwako hwese. Izvi zvinowanzo sanganisira bvunzo dzeropa, X-rays yechipfuva, echocardiograms, uye dzimwe nguva cardiac catheterization kana CT scans.

Hezvino zvaunogona kutarisira panguva yekugadzirira kwako:

• Regai kusvuta kanenge mavhiki maviri vasati vavhiyiwa kuti uvandudze kupora
• Gadzirisa kana kumisa mishonga yakati wandei sezvinorairwa nachiremba wako
• Chengetedza hutsanana hwemazino hwakanaka uye kurapa chero matambudziko emazino
• Tevedza mirairo yekudya isati yavhiyiwa, kazhinji kutsanya mushure mepakati pousiku vasati vavhiyiwa
• Ronga kuti mumwe munhu akutyairire kumba uye akubatsire panguva yekupora
• Gadzirira imba yako yekupora nekugara zvakanaka uye zvinhu zviri nyore kusvika

Chiremba wako anogona zvakare kukurudzira kugadziriswa kwemoyo usati wavhiyiwa kana uine nguva. Izvi zvinogona kubatsira kusimbisa moyo wako uye kuvandudza hutano hwako hwese kune maitiro.

Maitiro ekuverenga zviyero zvako zvemidzi ye aortic?

Zviyero zvemidzi ye aortic zvinowanzo torwa uchishandisa echocardiography kana CT scans uye zvinoyerwa mumamilimita. Chiremba wako achienzanisa zviyero zvako nemhando dzakajairika zvichibva pahukuru hwako hwemuviri uye zera.

Kune vanhu vakuru vazhinji, midzi ye aortic yakajairika inoyera pakati pe20-37 millimeters panzvimbo yayo yakakura. Zvisinei, chiremba wako achaverenga zvakajairika kune saizi yako chaiyo yemuviri achishandisa kureba kwako, uremu, uye nzvimbo yemuviri.

Hezvino maitiro anoita vanachiremba zviyero zvemidzi ye aortic:

• Zvakajairika: Mukati mehuwandu hunotarisirwa hwehukuru hwako hwemuviri
• Yakawedzerwa zvishoma: 40-45 mm (inogona kuda kuongororwa)
• Yakawedzerwa zvine mwero: 45-50 mm (kuongorora kwepedyo kunodiwa)
• Yakawedzerwa zvakanyanya: Pamusoro pe50 mm (kuvhiyiwa kunowanzo kurudzirwa)

Chiremba wako achafungawo kuti midzi yako yeaortic iri kukura nekukurumidza sei nekufamba kwenguva. Kunyangwe zviyero zvidiki zvinogona kuda kuvhiyiwa kana zvikakura nekukurumidza kana uine mamwe mamiriro ejeneti.

Nzira yekugadzirisa kupora kwako mushure mekuvhiyiwa kwemidzi yeaortic?

Kupora kubva mukuvhiyiwa kwemidzi yeaortic inzira inononoka iyo inowanzo tora mwedzi yakati wandei. Vanhu vazhinji vanogara muchipatara kwemazuva 5-7 mushure mekuvhiyiwa, nemazuva ekutanga 1-2 muchikamu chekuchengetwa kwakanyanya kuti vatariswe zvakanyanya.

Panguva yaunenge uri muchipatara, timu yako yezvokurapa ichakubatsira kutanga kufamba-famba, kudzidzira kufema, uye zvishoma nezvishoma kuwedzera basa rako. Iwe unozotangawo kutora mishonga yekudzivirira moyo wako uye kudzivirira matambudziko.

Nguva yako yekupora inowanzo tevera iyi pateni:

• Mavhiki maviri ekutanga: Zorora kumba, kufamba kwemaminitsi mashoma, kusasimudza zvinopfuura mapaundi gumi
• Mavhiki 2-6: Zvishoma nezvishoma wedzera nzendo dzekufamba, mabasa emumba akareruka
• Mavhiki 6-12: Dzokera kumabasa mazhinji akajairika, unogona kudzokera kubasa
• Mwedzi 3-6: Kupora zvizere, tangazve zvese zviitiko zvinosanganisira kurovedza muviri

Iwe uchada kutora mushonga wekutapudza ropa kana iwe wakagamuchira vharuvhu yemuchina, uye iwe uchave nekuongororwa nguva dzose kuti utarise kufambira mberi kwako. Vanhu vazhinji vanonzwa zviri nani mukati memwedzi mishoma uye vanogona kudzokera kumaitiro avo akajairika.

Chii chinonyanya kubuda zvakanaka paku kuvhiyiwa kwemidzi yeaortic?

Mhedzisiro yakanakisa yekuvhiyiwa kwemidzi yeaortic ndeyekuti maitiro acho anobudirira kudzivirira matambudziko ane njodzi apo achikubvumira kudzokera kumabasa ako akajairika nekuvandudzwa kwebasa remoyo. Mitengo yekubudirira kwekuvhiyiwa kwemidzi yeaortic inokurudzira, nevazhinji vanhu vachiwana mhedzisiro yakanaka kwenguva refu.

Kuvhiwa kwemidzi yemoyo wemazuva ano kunobudirira zvikuru, nevanhu vanopfuura 95% vachipona mushure mekuvhiwa vachirarama upenyu hwakajairika, hunoshingaira. Kuvhiwa kunobvisa zvachose njodzi yekutsemuka kwemoyo uye kazhinji kunovandudza zviratidzo zvaungave uchisangana nazvo.

Mhedzisiro yakanaka yenguva refu inowanzo sanganisira:

• Kubviswa kwakakwana kwenjodzi yekutsemuka kweaneurysm
• Kuvandudzwa kwekushivirira kwekurovedza muviri uye mazinga esimba
• Kurerukirwa kubva kuzviratidzo zvakaita sekurwadziwa muchipfuva kana kufema zvishoma
• Kudzokera kumabasa emazuva ese mukati memwedzi mitatu kusvika mitanhatu
• Mazinga akanaka ekurarama kwemakore gumi (anopfuura 90%)

Mhedzisiro yako yega yega inoenderana nezvinhu zvakaita sezera rako, hutano hwese, uye rudzi rwekuvhiwa rwaunoda. Vanhu vazhinji vanoshamiswa nekuti vanonzwa sei zviri nani mushure mekupora kubva mukuvhiwa.

Ndezvipi zvinhu zvine njodzi zvekuda kuvhiwa kwemidzi yemoyo?

Zvimwe zvinhu zvine njodzi zvinogona kuwedzera mukana wako wekuvandudza matambudziko emidzi yemoyo anogona kuda kuvhiwa. Kunzwisisa izvi zvinhu kunogona kukubatsira iwe nachiremba wako kutarisa hutano hwemoyo wako zvakanyanya.

Chinhu chakanyanya njodzi kuva nechinetso chemajini chinokanganisa nyama yako yekubatanidza, senge Marfan syndrome kana bicuspid aortic valve. Izvi zvinowanzo garwa nhaka uye zvinogona kukonzera kuti midzi yemoyo ikure nekufamba kwenguva.

Heano zvinhu zvine njodzi zvikuru zvekuziva nezvazvo:

• Nhoroondo yemhuri yeaneurysms yemoyo kana kufa kamwe kamwe kwemoyo
• Marfan syndrome kana zvimwe zvirwere zvenyama yekubatanidza
• Bicuspid aortic valve (akazvarwa aine mapepa maviri evalve panzvimbo petatu)
• Kuvhunduka kweropa kwakanyanya, kunyanya kana kusina kudzora zvakanaka
• Zvirwere zvevalve yemoyo zvakapfuura (endocarditis)
• Kuvadzwa kwechipfuva kana kuvhiwa kwemoyo kwakapfuura
• Zvimwe zvirwere zveautoimmune

Zera uye bonde zvinewo basa, nematambudziko e midzi ye aortic achiwanzowanikwa muvarume nevanhu vane makore anopfuura 60. Zvisinei, mamiriro ezvinhu emagene anogona kukonzera kukura kwemidzi ye aortic pazera ripi zvaro, ndosaka nhoroondo yemhuri ichikosha.

Zviri nani kuita kuvhiyiwa kwemidzi ye aortic nekukurumidza here kana kunonoka?

Nguva yekuvhiyiwa kwemidzi ye aortic inoenderana nekuyananisa njodzi dzekumirira pamwe nenjodzi dzekuvhiyiwa pachako. Muzviitiko zvakawanda, kuvhiyiwa nekukurumidza kunokurudzirwa kana zviyero kana zviratidzo zvasvika pamiganhu yakati, pane kumirira mamiriro ekukurumidzira.

Kuvhiyiwa nekukurumidza kunowanzoita nani kana midzi yako ye aortic yasvika zviyero zvakatarwa kana uri kusangana nezviratidzo. Kumirira kwenguva refu kunogona kuwedzera njodzi yematambudziko anotyisa upenyu senge aortic rupture kana dissection.

Chiremba wako achakurudzira kuvhiyiwa nekukurumidza kana uine:

• Midzi yeAortic yakakura kupfuura 50 mm muhupamhi
• Kukura nekukurumidza (kupfuura 5 mm pagore)
• Zviratidzo zvakaita sekurwadziwa muchipfuva kana kufema
• Nhoroondo yemhuri ye aortic dissection
• Mamiriro emagene senge Marfan syndrome
• Zvirongwa zvepamuviri (vakadzi vane midzi ye aortic yakakura)

Kuvhiyiwa kwesarudzo kunoitwa pamberi pemamiriro ekukurumidzira kunowanzoita mhedzisiro iri nani uye njodzi yakaderera ichienzaniswa nemaitiro ekukurumidzira. Chikwata chako chekuvhiya chinogona kuronga zvakanyatsonaka uye unogona kuzvigadzirira zvese mumuviri uye mupfungwa.

Ndezvipi zvinogona kukonzerwa nekusabatwa kwekuwedzera kwemidzi ye aortic?

Kusabatwa kwekuwedzera kwemidzi ye aortic kunogona kutungamira kumatambudziko akakomba, anogona kuisa upenyu panjodzi. Njodzi inonyanya kuita aortic dissection kana rupture, iyo inogona kuitika kamwe kamwe uye inoda kurapwa nekukurumidza.

Sezvo midzi ye aortic ichienderera mberi nekukura, madziro anova matete uye asina simba, zvichiita kuti zvive nyore kubvaruka. Izvi zvinogadzira mamiriro ekukurumidzira ekurapa anogona kuuraya kana asina kurapwa nekukurumidza.

Matambudziko akakomba anosanganisira:

• Kuparara kweaortic (kubvaruka mumadziro e aortic)
• Kutyoka kweaortic (kuparara kwakakwana mumadziro e aortic)
• Kudzoka kwakanyanya kwe aortic valve (kuvharika kwevhavha)
• Kukundikana kwemoyo kubva mukushanda kwakashata kwevhavha
• Mavhiri eropa achiumbwa munzvimbo yakawedzerwa
• Kumanikidzwa kwemaitiro emoyo ari pedyo

Zvimwe zvinhu zvisingawanzoitiki zvinosanganisira kumanikidzwa kwetsinga dzeropa, dzinopa ropa kumhasuru dzemoyo wako, kana kumanikidzwa kwemaitiro ari pedyo se superior vena cava. Izvi zvinoda kutariswa kwekurapa nekukurumidza.

Mashoko akanaka ndewekuti matambudziko aya anogona kudzivirirwa nekushanda kwenguva yakakodzera. Kuongorora nguva dzose uye kutevera mazano echiremba wako kunogona kubatsira kubata matambudziko asati ava nenjodzi.

Ndezvipi zvingaitika mushure mekuvhiyiwa kwe aortic root?

Kufanana nekushanda kukuru kupi zvako, kuvhiyiwa kwe aortic root kunotakura njodzi, kunyangwe matambudziko akakomba asingawanzoitiki nemapoka ekuvhiya ane ruzivo. Kunzwisisa nyaya idzi dzinogona kukubatsira kuti uite sarudzo ine ruzivo uye kugadzirira kupora kwako.

Matambudziko anowanzoitika ndeechinguvana uye anopera panguva yekupora kwako. Izvi zvinogona kusanganisira kusagadzikana kwemoyo kwenguva pfupi, kuchengetwa kwemvura, kana zvirwere zvishoma zvinopindura zvakanaka kurapwa.

Zvingaitika zvinosanganisira:

• Kubuda ropa kungangoda kuwedzerwa ropa
• Kutapukirwa panzvimbo yekuvhiya kana mumuviri wose
• Kusagadzikana kwemoyo (arrhythmias)
• Situroko kana matambudziko ekuongorora
• Matambudziko eitsvo kubva kumuchina wemoyo-mapapu
• Matambudziko nekugadzirisa kuvhiya zvichida kuvhiyiwa kwakawedzerwa

Matambudziko asingawanzoitiki asi akakomba anosanganisira kurwisa kwemoyo, kubuda ropa kwakanyanya, kana matambudziko nevhavha itsva kana graft. Chikwata chako chekuvhiya chichakutarisa zvakanyanya kudzivirira nekukurumidza kurapa chero matambudziko angamuke.

Mupfumbamwe wematambudziko ese mudiki, uye vanhu vazhinji vanopora zvizere vasina matambudziko anogara kwenguva refu. Chiremba wako achakurukura njodzi dzako dzega uye kupindura chero zvinokunetsa zvako.

Ndingashanyira chiremba rini kana ndine matambudziko e aortic root?

Unofanira kuona chiremba kana uine zviratidzo zvingaratidza matambudziko e aortic root, kunyanya kana uine njodzi dzakadai semhuri kana mamiriro emagenetic. Kuona nekucherechedza nekukurumidza kunogona kudzivirira matambudziko akakomba.

Usamirira kana uine kurwadziwa muchipfuva, kunyanya kana kwakanyanya, kamwe kamwe, kana kuchienda kumusana wako. Izvi zvinogona kuva zviratidzo zve aortic dissection, iyo inoda kurapwa nekukurumidza.

Ronga musangano nachiremba wako kana uine:

• Kurwadziwa muchipfuva kana kusagadzikana, kunyanya kana uchiita basa
• Kufema zvishoma panguva yebasa rako remazuva ese
• Kuneta kana kusava nesimba kuri kuwedzera
• Kupererwa kana kupotsa kufa
• Kurova kwemoyo kana kurova kwemoyo kusina kujairika
• Nhoroondo yemhuri yematambudziko e aortic kana rufu rwemoyo kamwe kamwe

Kana uine mamiriro emagenetic anozivikanwa seMarfan syndrome kana bicuspid aortic valve, unofanira kuva nekutarisa kwemoyo nguva dzose kunyangwe ukanzwa zvakanaka. Kuongorora nekukurumidza kunogona kubata matambudziko asati ava akakomba.

Fonera 911 nekukurumidza kana uine kurwadziwa muchipfuva kamwe kamwe, kwakanyanya kunonzwa sekubvaruka, kunyanya kana kuchienda kumusana wako. Izvi zvinogona kuratidza aortic dissection, iyo iri dambudziko rekurapa.

Mibvunzo inowanzo bvunzwa pamusoro pe aortic root surgery

Q.1 Ko aortic root surgery yakanaka here kune bicuspid aortic valve?

Hongu, aortic root surgery inogona kubatsira zvikuru vanhu vane bicuspid aortic valve kana aortic root ikakura. Bicuspid aortic valve imamiriro akajairika ekuzvarwa nawo kwaunozvarwa uine mapepa maviri e valve panzvimbo petatu.

Vanhu vane bicuspid aortic valve vanowanzoita kuti aortic root yavo ikure nekufamba kwenguva. Kuvhiyiwa kunogona kugadzirisa dambudziko revharuvhu nekukura kwemudzi, zvichienderana nemamiriro ako chaiwo. Dzimwe nguva mudzi chete ndipo paunoda kutsiviwa uchichengetedza vharuvhu rako.

Mubvunzo 2. Ko kukura kweaortic root kunokonzera kurwadziwa muchipfuva here?

Kukura kweaortic root kunogona kukonzera kurwadziwa muchipfuva, kunyangwe vanhu vazhinji vasingaone zviratidzo kusvikira mamiriro acho achiwedzera. Kurwadziwa kunganzwa sekumanikidzwa, kusungirirwa, kana kusagadzikana muchipfuva chako.

Kurwadziwa muchipfuva kunowanzoitika nekuti mudzi wakakura unoita kuti moyo wako upombe ropa zvakanaka sei kana nekuti aortic valve haishande zvakanaka. Vamwe vanhu vanoonawo kufema kwemhepo kana kuneta pamwe chete nekusagadzikana kwechipfuva.

Mubvunzo 3. Ndingaita maekisesa here mushure mekuvhiyiwa kweaortic root?

Vanhu vazhinji vanogona kudzokera kune maekisesa enguva dzose mushure mekupora zvizere kubva mukuvhiyiwa kweaortic root, kazhinji mukati memwedzi mitatu kusvika mitanhatu. Chiremba wako achapa gwara rakatarwa zvichienderana nerudzi rwekuvhiyiwa kwako uye kufambira mberi kwekupora.

Uchatanga nekufamba zvinyoro-nyoro uye zvishoma nezvishoma uwedzere mazinga ako ekuita. Vanhu vazhinji vanogona kupinda mumaekisesa epakati senge kushambira, kutenderera, kana kujoga. Chiremba wako angakurudzira kudzivirira zviitiko zvakanyanya-simba kana mitambo yekubatana.

Mubvunzo 4. Kugadzirisa kweaortic root kunogara kwenguva yakareba sei?

Kugadzirisa kweaortic root kunowanzo gara makore mazhinji, kazhinji makumi emakore, kunyanya nemaitiro ekuvhiya emazuva ano uye zvinhu. Hupenyu hunoenderana nezvinhu zvakaita sezera rako, rudzi rwekugadzirisa, uye kuti unotevedza sei chirongwa chako chekutarisira mushure mekuvhiyiwa.

Mavharuvhu emuchina anogona kugara makore makumi maviri kusvika makumi matatu kana kupfuura, nepo mavharuvhu etishu anowanzo gara makore gumi nemashanu kusvika makumi maviri. Chiremba wako achasarudza sarudzo yakanakisa zvichienderana nezera rako, mararamiro, uye zvaunofarira nezvekutora mushonga wekutapudza ropa.

Mubvunzo 5. Ndingada mushonga wehupenyu hwese mushure mekuvhiyiwa kweaortic root here?

Mishonga yaunoda mushure mekuvhiyiwa inoenderana nerudzi rwekugadzirisa kwaunowana. Kana iwe ukawana vharuvhu yemuchina, iwe uchada mushonga wekutapudza ropa hupenyu hwese kudzivirira magwamba kubva pakuumbwa pavharuvhu.

Kana iwe ukawana vharuvhu yematishu kana kugadzirisa kunochengetedza vharuvhu, unogona kungoda mishonga kwenguva pfupi panguva yekupora kwako. Vanhu vazhinji vanozopedzisira vatora mishonga yakajairika yemoyo-ine hutano senge iyo inoshandiswa kudzora BP kana cholesterol.