Chii chinonzi Ventricular Assist Device? Chinangwa, Maitiro & Mhedzisiro

Chishandiso che ventricular assist (VAD) ipombi yemuchina inobatsira moyo wako kutenderedza ropa mumuviri wako kana tsandanyama yemoyo wako yava kusimba zvakakwana kuita basa iri yega. Fungidzira se mubatsiri wemoyo wako, achipinda kuti ave nechokwadi chekuti nhengo dzako dzinowana ropa rakazara neoksijeni ravanoda kuti vashande zvakanaka.

Tekinoroji iyi inoponesa hupenyu yakabatsira zviuru zvevanhu kurarama hupenyu hwakazara, hunoshingaira vachibata kutadza kwemoyo kwakanyanya. Kunyangwe uri kuongorora sarudzo dzekurapa iwe pachako kana mumwe waunoda, kunzwisisa mashandiro eVAD kunogona kukubatsira kuti unzwe wakavimbika nezve sarudzo iyi yakakosha yekurapa.

Chii chinonzi ventricular assist device?

Chishandiso che ventricular assist ipombi yemuchina inofambiswa nebhatiri iyo inoiswa mukati kana kunze kwedada rako kuti ibatsire kupomba ropa kubva mukamuri dzakadzika dzemoyo wako (ventricles) kuenda kune dzimwe nhengo dzemuviri wako. Chishandiso chinoshanda pamwe chete nemoyo wako wechisikigo, kwete kuutsiva zvachose.

Mazhinji eVAD anotsigira ventricle yekuruboshwe, iyo iri kamuri huru yekupomba yemoyo wako inotarisirwa kutumira ropa rakazara neoksijeni mumuviri wako wese. Izvi zvinonzi left ventricular assist devices (LVADs). Vamwe vanhu vangada rutsigiro rwe ventricle yavo yekurudyi (RVAD) kana mativi ese ari maviri (BiVAD), zvichienderana nemamiriro avo emoyo chaiwo.

Chishandiso chacho chine zvikamu zvakati wandei zvikuru zvinoshanda pamwe chete zvisina musono. Iwe uchava ne pombi diki, machubhu anochinjika anonzi cannulas anobatanidza kumoyo wako, driveline inobuda paganda rako, uye mutongi wekunze ane mabhatiri aunozopfeka kana kutakura newe.

Nei ventricular assist device ichiitwa?

VADs inokurudzirwa kana moyo wako wava kushaya simba zvakanyanya nekuda kwekutadza kwemoyo uye dzimwe nzira dzekurapa dzisina kupa kuvandudzwa kwakakwana. Chiremba wako angakurudzira sarudzo iyi kana mishonga, shanduko dzemararamiro, uye mamwe maitiro asingachakwanisi kuchengeta zviratidzo zvako zvichidzoreka kana nhengo dzako dzichishanda nemazvo.

Chishandiso chinoshanda zvinangwa zvakasiyana zvichienderana nemamiriro ako ega uye zvinangwa zvekuchengetwa kwenguva refu. Vamwe vanhu vanoshandisa VAD sebhiriji rekuisa moyo, vachivabatsira kuti vagare vakagadzikana uye vachitenda vakamirira moyo weanopa kuti uwane. Iyi nguva yekumirira dzimwe nguva inogona kutora mwedzi kana kunyange makore.

Vamwe vanogamuchira VAD sekurapa kwenzvimbo, zvinoreva kuti inova kurapwa kusingaperi kana kuisa moyo kusina kukodzera nekuda kwezera, mamwe mamiriro ehutano, kana sarudzo yemunhu. Vanhu vazhinji vari mumamiriro ezvinhu aya vanowana kuti vanogona kudzokera kuzviitiko zvavanofarira uye kupedza nguva yakanaka nemhuri neshamwari.

Kazhinji, VADs inogona kushanda sebhiriji rekupora kune vanhu vane moyo inogona kupora nekufamba kwenguva uye rutsigiro. Iyi nzira dzimwe nguva inoshandiswa mushure mekurwisa kwemoyo, mamwe matenda, kana panguva yekupora kubva pakuvhiyiwa kwemoyo apo vanachiremba vanotenda kuti tsandanyama yemoyo inogona kuwana simba rayo.

Ndeipi nzira yekuiswa kwechishandiso chekubatsira ventricular?

Kuiswa kweVAD ndiko kuvhiyiwa kukuru kwemoyo kunowanzo tora maawa 4 kusvika ku6 uye kunoda kuronga nekugadzirira zvakanyanya. Iwe uchagamuchira general anesthesia uye uchabatana nemuchina wemoyo-mapapu unotora basa remoyo wako nemapapu panguva yacho.

Chiremba wako achaita incision pasi pechiviri chako uye nekungwarira kubatanidza chishandiso kumoyo wako. Pombi inowanzoiswa mudumbu rako repamusoro, pazasi pedyo nedhiaphragm yako, kwaanogara zvakanaka asingapindi mukufamba kwako kwezuva nezuva.

Hezvino zvinoitika panguva yekuvhiyiwa, nhanho nedanho:

1. Chiremba wako anovhura chipfuva chako uye anogona kuda kupatsanura mamwe matishu ane mavanga kana wakambovhiyiwa moyo
2. Muchina wemoyo nemapapu unotora basa rekupomba ropa apo chiremba wako anenge achishanda
3. Chubhu diki (inflow cannula) inosonerwa muventricle yako yekuruboshwe kuti idhonze ropa muchina
4. Imwe chubhu (outflow cannula) inobatana neaorta yako kuti idzore ropa kumuviri wako
5. Pombi inoiswa mudumbu rako uye inoongororwa kuti ive nechokwadi chekushanda zvakanaka
6. Driveline inopfuudzwa pasi peganda rako uye inobuda mudumbu rako
7. Chipfuva chako chinovharwa uye unoendeswa kuintensive care unit kuti uongororwe

Kupora muchipatara kunowanzo tora mavhiki maviri kusvika matatu, kunyangwe izvi zvichisiyana zvichienderana neutano hwako hwese uye nekukurumidza kwaunopora. Uchashanda pedyo nechikwata chakakosha chinosanganisira vanachiremba vekuvhiya moyo, vanachiremba vemoyo, vanamukoti, nevamwe nyanzvi vanonzwisisa kutarisirwa kweVAD.

Nzira yekugadzirira kuvhiyiwa kwemuchina wekubatsira ventricular?

Kugadzirira kuvhiyiwa kweVAD kunosanganisira kugadzirira kwemuviri nekupfungwa, uye chikwata chako chekurapa chichakutungamira kuburikidza nedanho rega rega kuti ikubatsire kunzwa wakagadzirira sezvinobvira. Uchapfuura bvunzo dzakawanda kuti uve nechokwadi chekuti une hutano hwakakwana hwekuvhiyiwa uye kuti VAD ndiyo sarudzo chaiyo yemamiriro ako ezvinhu.

Kugadzirira kwako kunogona kusanganisira bvunzo dzeropa, zvidzidzo zvemaitiro emoyo wako nemamwe nhengo, uye kubvunzana nenyanzvi dzakasiyana. Aya maapointments anobatsira chikwata chako kunzwisisa hutano hwako hwese uye kuronga nzira yakachengeteka yekuvhiyiwa kwako.

Mumavhiki asati kuvhiyiwa, tarisa pakuzvichengeta iwe pachako nematanho aya akakosha:

• Torai mishonga yese yakanyorwa sezvakarairwa, kunyanya mishonga yemoyo
• Idyai chikafu chinovaka muviri kuti mupe muviri wenyu simba rekurapa
• Zororai zvakakwana uye murare kana zvichibvira
• Rambai muchiita basa sezvinokurudzirwa nachiremba wenyu mukati memiganhu yenyu iripo
• Dzivai kusvuta uye deredzai doro, sezvo izvi zvinogona kukanganisa kupora
• Chengetai utsanana hwemazino uye gadzirisai chero matambudziko emeno
• Dzidzai nezve VAD kuchengetwa uye shanduko dzemararamiro dzaunoda kuita

Musazeze kubvunza mibvunzo kana kuratidza kunetseka panguva yekusangana kwenyu kwekuvhiyiwa. Chikwata chenyu chinoda kuti munzwe muchiziva uye muchigadzikana, uye varipo kuti vakutsigirei kuburikidza nesarudzo iyi yakakosha uye maitiro.

Mungaverenga sei mhedzisiro yechishandiso chenyu chekubatsira ventricular?

Mushure mekuiswa kweVAD yenyu, muchadzidza kuongorora zviyero zvakawanda zvakakosha zvinokuudzai iwe nechikwata chako chekurapa kuti chishandiso chiri kushanda sei. Mutongi wenyu weVAD anoratidza ruzivo nezve kumhanya kwepombi, kushandiswa kwesimba, uye kuyerera, izvo zviratidzo zvakakosha zvekuita kwechishandiso chenyu.

Kumhanya kwepombi, kuyerwa mumavhiri paminiti (RPM), kazhinji kunoiswa pakati pe2,400 ne3,200 RPM, kunyangwe huwandu hwenyu chaihwo huchaziviswa nachiremba wenyu zvichienderana nezvido zvenyu. Kumhanya uku kunogona kugadziriswa panguva yekutevera-kuona kuti uwedzere kuyerera kweropa rako uye kubatsirwa kwezviratidzo.

Kushandiswa kwesimba kunoratidza kuti chishandiso chenyu chiri kushandisa simba rakawanda sei uye kazhinji rinobva pa3 kusvika ku8 watts. Shanduko mukushandiswa kwesimba dzimwe nguva dzinogona kuratidza nyaya dzakaita semagwamba eropa kana shanduko mukuti moyo wenyu uri kushanda sei padivi pechishandiso.

Zviyero zvekuyerera zvinofungidzira kuti VAD yenyu iri kupomba ropa rakawanda sei paminiti, kazhinji richibva pa3 kusvika ku6 litita. Kuyerera kwepamusoro kazhinji zvinoreva kutenderera kuri nani kumitezo yenyu, nepo kuyerera kwakaderera kungaratidza kudiwa kwekugadzirisa.

Uchadzidzawo kuziva ruzha rwealarm nemashoko anokuzivisa nezvemamiriro ezvinhu anoda kutariswa. Maalarm mazhinji ane chekuita nenyaya dzebhatiri, matambudziko ekubatanidza, kana shanduko dzenguva pfupi dzinogona kugadziriswa nyore nyore, asi timu yako ichakudzidzisa kuti unotsvaga rubatsiro rwechimbichimbi rini.

Ungaita sei kurarama nehupenyu hwako ne ventricular assist device?

Kurarama neVAD kunoda zvimwe zvishoma zvekugadzirisa muhupenyu hwako hwezuva nezuva, asi vanhu vazhinji vanowana kuti vanogona kudzokera kumabasa mazhinji avanofarira kana vapora kubva mukuvhiyiwa. Chinhu chikuru ndechokudzidza kubatanidza kutarisirwa kwechishandiso muhupenyu hwako uchiramba uchishingaira uye uchibatana nemhuri neshamwari.

Hupenyu hwako hwezuva nezuva huchasanganisira kutarisa michina yako, kuchengeta nzvimbo yako yedriveline yakachena uye yakaoma, uye kubata mabhatiri ako kuti uve nechokwadi chokuti mudziyo wako hauzomborasikirwi nesimba. Uchatakura mabhatiri ekuchengetera uye uchadzidza kuachinja zvakanaka kuitira kuti mabasa ako asakanganiswe.

Kutarisira nzvimbo yako yekubuda yedriveline kwakakosha kudzivirira zvirwere, izvo zviri chimwe chezvinetso zvakakomba. Uchanatsa nzvimbo yacho zuva nezuva nezvinhu zvakakosha uye uchatarisa zviratidzo zvekuita tsvuku, kubuda, kana kunzwa kuti zvinogona kuratidza dambudziko.

Heano mabasa akakosha ezuva nezuva aunozodzidza:

• Tarisa kuratidzwa kwekotroller yako kuti uwane kuverenga kwakajairika uye chero maalarm
• Chenesa nzvimbo yako yekubuda yedriveline nehunyanzvi hwehutachiona
• Chinja uye ucharja mabhatiri zvinoenderana nehurongwa hwako
• Tora mishonga yakarairwa, kunyanya zvinoderedza ropa
• Tarisa uremu hwako uye unoshuma shanduko dzakakosha
• Gara wakanyoroveswa uye idya chikafu chinovaka moyo
• Wana zororo rakakwana uye bata kushushikana

Vanhu vazhinji vane VAD vanogona zvishoma nezvishoma kudzokera kubasa, kufamba, uye mabasa ekuzvivaraidza nekugadzirira kwakakodzera uye matanho ekuchengetedza. Timu yako ichakubatsira kunzwisisa kuti ndeapi mabasa akachengeteka uye maitiro ekugadzirisa mamwe kuti agadzirise mudziyo wako.

Ndezvipi zvinhu zvine njodzi zveVAD matambudziko?

Nepo VADs zviri zviridzwa zvinoponesa hupenyu, semamwe mabasa makuru ekurapa, zvine njodzi dzaunofanira kunzwisisa usati waita sarudzo yako. Chikwata chako chekurapa chichakurukura njodzi idzi zvakavimbika newe uye chichatsanangura kuti chinoshanda sei kudzipfupisa.

Utachiona ndechimwe chezvinetso zvakajairika, kunyanya pedyo nenzvimbo yekubuda yedriveline uko tambo inobuda paganda rako. Izvi zvinogadzira kuvhurika kusingaperi kunoda kutarisirwa kwemazuva ese kunodzivirira mabhakitiriya kupinda mumuviri wako.

Zvimwe zvinhu zvinogona kuwedzera njodzi yako yezvinetso, uye kunzwisisa izvi kunobatsira chikwata chako kupa kutarisirwa kwakanakisa:

• Mavhiyo emoyo apfuura anogadzira nyama yemaronda
• Chirwere cheshuga kana mamwe mamiriro anokanganisa kupora
• Matambudziko eitsvo kana chiropa anokanganisa hutano hwako hwese
• Kushaya chikafu kana kuve nemuviri wakaderera zvakanyanya kana kuwanda
• Utachiona hunoshanda chero kupi mumuviri wako
• Kutadza kutevera zvirongwa zvemishonga zvakaoma
• Rutsigiro rwemagariro rwakaganhurirwa rwekudzidza kutarisirwa kwechishandiso
• Chirwere chakakomba chemapapu kana mamwe matambudziko emuviri

Chikwata chako chinonyatsoongorora zvinhu izvi usati waraira VAD kuti uve nechokwadi chekuti unogona kubatsirwa nechishandiso uchideredza njodzi dzinogona kuitika. Vachashanda newe kuti uvandudze hutano hwako pamberi pekuvhiyiwa pese pazvinogoneka.

Ndezvipi zvinetso zvinogona kuitika zve ventricular assist devices?

Kunzwisisa zvinetso zvinogona kuitika zvinokubatsira kuti uite sarudzo ine ruzivo uye uzive zviratidzo zvekuona mushure mekunge VAD yako yaiswa. Nepo zvinetso zvichigona kuitika, vanhu vazhinji vanorarama zvakabudirira neVADs kwemakore nekutarisirwa kwakakodzera uye kuongorora.

Zvinetso zvakajairika zvinosanganisira kubuda ropa, magwamba eropa, uye utachiona, chimwe nechimwe chichida nzira dzakasiyana dzekudzivirira uye kurapwa. Chikwata chako chekurapa chichakudzidzisa maitiro ekuziva zviratidzo zvekutanga zvezvinetso izvi kuitira kuti zvigone kugadziriswa nekukurumidza.

Hezvino zvinhu zvinogona kukonzera matambudziko zvaunofanira kuziva, zvakarongwa kubva pane zvakajairika kusvika kune zvisingawanzoitiki:

• Zvirwere zvemuviri zvakatenderedza nzvimbo yekubuda, zvichikonzera kutsvuka, kurwadziwa, kana kubuda mvura
• Nyaya dzekubuda ropa nekuda kwemishonga inoderedza ropa inodiwa neVADs
• Mavhiri eropa anogona kuumbwa mumudziyo kana kuenda kune zvimwe zvikamu zvemuviri
• Kukundikana kwemoyo wekurudyi kana ventricle yako yekurudyi isingakwanise kuchengetedza kuyerera kweropa kwakawedzerwa
• Situroko kubva kumavhiri eropa kana shanduko mumaitiro ekuyerera kweropa
• Kukundikana kwemudziyo kunoda kugadziriswa kana kuvhiyiwa kutsva
• Matambudziko eitsvo kubva pakuchinja kuyerera kweropa kana mishonga
• Kubuda ropa mudumbu, izvo zvinogona kuwanda nemhando dzakasiyana dzeVADs

Zvisingawanzoitiki asi zvakakomba zvinosanganisira kukundikana kwemudziyo, zvirwere zvakakomba zvinopararira mumuviri wako wese, uye matambudziko ane chekuita nemishonga inoderedza ropa. Chikwata chako chinokutarisa zvakanyanya kuti uone nyaya idzi uye chine protocol yekuzvigadzirisa nekukurumidza kana dzikaitika.

Rangarira kuti kunyangwe runyorwa urwu ruchitaridzika kunetseka, timu yako yezvokurapa ine ruzivo rwakawanda rwekubata nematambudziko aya, uye mazhinji anogona kudzivirirwa kana kurapwa zvakabudirira kana akabatwa nekukurumidza.

Ndinofanira kuona chiremba rini nezve VAD-related concerns?

Mushure mekuwana VAD yako, uchava nekuongororwa nguva dzose kuti utarise mudziyo wako uye hutano hwako hwese, asi iwe unofanirwawo kuziva kuti ungatsvaga rini rubatsiro rwechimbichimbi. Kudzidza kuziva zviratidzo zvekuyambira kunobatsira kuona kuti unowana kutarisirwa nekukurumidza kana zvichidikanwa.

Unofanira kubata timu yako yeVAD nekukurumidza kana ukaona maalarm emudziyo asingagadziriswe nekugadzirisa matambudziko ekutanga, chero zviratidzo zvechirwere zvakatenderedza driveline yako, kana zviratidzo zvinogona kuratidza matambudziko senge sitiroko kana matambudziko emoyo.

Tsvaga rubatsiro rwechimbichimbi nekukurumidza kune izvi zviratidzo zvakakomba zvekuyambira:

• Alarmu dze mudziyo dzinoramba dzichirira dzisingamire kana kudzima
• Kukundikana kwakakwana kwemudziyo kana kurasikirwa kwesimba
• Kurwadziwa kwemuchipfuwo kwakanyanya kana kuoma kufema
• Zviratidzo zve sitiroko zvakaita sekushaya simba kamwe kamwe, kuvhiringidzika, kana matambudziko ekutaura
• Kubuda ropa kwakanyanya kusingamire nekudzvanywa
• Fivha yakanyanya ine kutonhora kana kunzwa kusagadzikana zvakanyanya
• Driveline yakadzurwa kana kukuvadzwa
• Dizziness yakanyanya kamwe kamwe kana kufenda

Bata timu yako yeVAD mukati me24 maawa eizvi zviratidzo zvinonetesa asi zvisina kukurumidza: kubuda mvura kana kuwedzera kutsvuka kutenderedza saiti yako ye driveline, kuwedzera uremu hweanopfuura mapaundi matatu pazuva, kusvotwa kana kurutsa, kana chero zviratidzo zvitsva zvinokunetsa.

Usazeza kufona uine mibvunzo kana kunetseka, kunyanya mumwedzi yako yekutanga uine mudziyo. Chikwata chako chinoda kunzwa kubva kwauri nezve chimwe chinhu chidiki pane kuti umirire kwenguva refu kuti ugadzirise dambudziko rinogona kuva rakakomba.

Mibvunzo inowanzo bvunzwa nezve ventricular assist devices

Q.1 Ko ventricular assist device yakanaka here pakukundikana kwemoyo kwemagumo?

Hongu, maVAD anogona kuva sarudzo dzakanaka dzekurapa vanhu vane kukundikana kwemoyo kwemagumo vasina kuvandudzwa nemishonga nemamwe marapirwo. Zvishandiso izvi zvinogona kuvandudza zvakanyanya hupenyu, kuwedzera kupona, uye kukubatsira kudzokera kuzviitiko zvaunofarira.

Kune vanhu vazhinji vane kukundikana kwemoyo kwepamusoro, VAD inopa rutsigiro rwekufambisa ropa runodiwa kuti zvikamu zvese zvishande nemazvo vachideredza zviratidzo zvakaita sekufema nekukurumidza uye kuneta. Zvidzidzo zvinoratidza kuti vanhu vane maVAD vanowanzoona kuwedzera kwekuita maekisesaizi uye kugara zvakanaka zvichienzaniswa nekurapa kwemishonga chete.

Q.2 Kuva neVAD zvinoreva here kuti handigoni kufamba kana kuita basa?

Vanhu vazhinji vane VAD vanogona kufamba uye kuramba vachishingaira kana vapora kubva kuvhiyiwa uye vadzidza kubata mudziyo wavo zvakanaka. Unozofanira kuronga pachine nguva uye kutora zvimwe zvishandiso, asi vazhinji vanogamuchira VAD vanofamba mukati menyika uye kunze kwenyika.

Zviitiko zvakaita sekufamba, kushambira mune dzimwe nguva, uye zviitiko zvakawanda zvekuzvivaraidza zvinowanzoitika nekuchenjerera kwakakodzera. Chikwata chako chichakubatsira kunzwisisa kuti ndeapi mabasa akachengeteka uye maitiro ekugadzirisa mamwe kuti akwanise mudziyo wako uchiramba uchishingaira uye kubatikana.

Q.3 Ndichagara kwenguva yakareba sei ndine mudziyo wekubatsira ventricular?

Vanhu vazhinji vanogara kwemakore vaine VAD yavo, uye mitengo yekupona inoramba ichivandudzika sezvo tekinoroji ichifambira mberi. Vamwe vanhu vagara vanopfuura makore gumi nemaviri vaine zvishandiso zvavo, vachichengetedza hupenyu hwakanaka mukati.

Tarisiro yako yega yega inoenderana nezvinhu zvakawanda zvinosanganisira hutano hwako hwese, kuti unochengeta sei mudziyo wako zvakanaka, uye kana iwe ukagadzira matambudziko. Chikwata chako chekurapa chinogona kukupa ruzivo rwakanyanya zvichienderana nemamiriro ako chaiwo uye hutano.

Q.4 Ndichakwanisa kunzwa VAD ichishanda mukati memuviri wangu here?

Vanhu vazhinji vanojaira VAD yavo mukati memavhiki mashoma uye havacherechedzi ichishanda panguva yezviitiko zvemazuva ese. Unogona kutanga kunzwa kumwe kuzunguzira kana kunzwa ruzha rwakanyarara, asi izvi zvinonzwa zvinowanzoita zvishoma nezvishoma nekufamba kwenguva.

Mudziyo wakagadzirirwa kushanda zvakanaka uye nguva dzose, saka haufanire kunzwa kusagadzikana kupomba kana kufamba kunozunza. Vamwe vanhu vanowana kuzunguzira zvinyoro nyoro vachivimbisa nekuti kunovabvumira kuziva kuti mudziyo wavo uri kushanda nemazvo.

Q.5 VAD inogona kubviswa here kana moyo wangu ukapora?

Muzviitiko zvisingawanzoitiki apo basa remoyo rinovandudzika zvakanyanya, VADs dzimwe nguva dzinogona kubviswa, kunyangwe izvi zvichiitika muvanhu vashoma. Mukana uyu unowanzoitika muvanhu vakawana kukundikana kwemoyo kubva mumamiriro ezvinhu anogona kupora, sekutapukirwa kumwe kana kurwisa kwemoyo kwemazuva ano.

Chikwata chako chekurapa chinotarisa basa remoyo wako nguva dzose uye chichakurukura mukana wekubviswa kwechishandiso kana moyo wako ukaratidza kupora kukuru. Zvisinei, vanhu vazhinji vanogamuchira VADs vachazvida kwenguva refu, kungave sechibvumirano chekutapurirana kana semushonga wenguva dzose.