TAVR Kuvhiya paApollo Hospitals, Lucknow

Nei Varwere Vachisarudza Zvipatara zveApollo Lucknow paTAVR

• Chikwata chemwoyo chekuvaka, hapana nyanzvi imwe chete. TAVR kuApollo yakarongwa neChikwata cheMwoyo chinobatanidza vanachiremba vemwoyo, vanachiremba vemwoyo, vanachiremba vanoraramisa mwoyo, nyanzvi dzemifananidzo yemwoyo uye vanachiremba vehutano hwakakosha, inova ndiyo modhi inokurudzirwa nenhungamiro dzepasi rose neIndia dzekudzivirira mavharuvhu.
• Nhaka yeApollo Group yemakore anopfuura makumi mana. Boka reApollo Hospitals rakatanga muna 1983 uye rakura kuva rimwe remasangano makuru ehutano akabatana muAsia, rine zvipatara zvinopfuura makumi manomwe uye rimwe remasangano makuru ekuvhiya mwoyo nekurapa kwemwoyo muIndia.
• Kudzika kwesainzi yemwoyo kuLucknow. Chipatara cheLucknow chine dhipatimendi rezvesainzi dzemwoyo rinoongorora zvehutano hwemwoyo, electrophysiology uye kufamba zvakanaka kwemoyo, kuvhiyiwa kwemwoyo uye kuchengetedzwa kwekutadza kushanda zvakanaka kwemoyo, pamwe nekurapwa kwekurapwa kwemwoyo nguva dzese uye kubatsirwa nevarwere vemoyo vari muchipatara chevarwere vane chirwere chemwoyo. Huwandu chaihwo hwevanopa mazano neruzivo rwavo pachavo hunosimbiswa zviri nani nedhipatimendi rezvesainzi dzemwoyo, sezvo boka richichinja nekufamba kwenguva.
• Kuongororwa kwezvirwere kunosarudza kukodzera kweTAVR kunowanikwa mukati mekambani. Kuongororwa kwemoyo kuburikidza ne transthoracic uye transoesophageal echocardiography, CT aortography ine annulus size uye access-vessel assessment, coronary angiography, uye pulmonary function uye fearty assessment zvese zvinoitwa pasi pedenga rimwe chete, saka varwere vanobva kunze kweLucknow havafanirwe kufamba pakati penzvimbo.
• Nzvimbo yemazuva ano yekurabhoritari yemhando yehybrid cath. TAVR inoitirwa murabhoritari yekurapa ine fluoroscopy yepamusoro-soro, kuongorora ropa, rutsigiro rwekufamba kwenguva uye rubatsiro rwekuvhiya nekukurumidza, izvo zvinobvumira nzira yekurapa varwere vakakodzera kuburikidza ne transfemoral, kunyanya vachiziva.
• Nzira dzekutarisira dzakagadzirwa zvichienderana nezera uye njodzi. Kune nzira dzakasiyana dzevarwere vakwegura nevasina simba (kuongororwa kwechirwere, kudzivirira kuvhiringidzika kwepfungwa, kukurumidza kufamba), kune varwere vane chirwere cheitsvo (maitiro ekuderedza kusiyana), kune varwere vadiki vane chirwere chebicuspid kana rheumatic valve uko kuvhiyiwa kungave kuri sarudzo iri nani, uye kune chirwere chevharuvhu yevana neyakaberekwa nayo, iyo inobatwa nenzira yekurapa mwoyo yevana uye nzira yekuvhiyiwa kwemwoyo pane TAVR.
• Kuenderera mberi mushure mekubuda muchipatara. Kutevera kwakarongwa ne echocardiography, ongororo yerhythm yematambudziko ekufambisa ropa, mazano ekudzivirira mazino ne endocarditis, uye mazano ekugadzirisa mwoyo akagadzirirwa hupenyu hwemuIndia.

tsananguro

Transcatheter Aortic Valve Replacement (TAVR), iyo inonziwo TAVI, inzira inoshandiswa kurapa aortic stenosis, chirwere chinoita kuti aortic valve yemoyo itete uye inoderedza kuyerera kweropa kubva kuruboshwe rwe ventricle. KuApollo Hospitals Lucknow, TAVR inopihwa sebasa rakarongeka, rinobva kuchikwata richishandisa masisitimu emavharuvhu ekugadzirwa kwazvino uye mifananidzo yakadzama yepamberi pekuita. Matimu ezvemwoyo neanovhiya mwoyo anovaka hurongwa hwemunhu wega wega, achinyanya kukoshesa kuchengetedzeka, kunyaradzwa uye kukurukurirana kwechokwadi kwezvingaitwe uye zvisingagoni kuitwa nemaitiro acho.

TAVR haisi mushonga wechirwere chemwoyo uye haina kukodzera munhu wese ane vharuvhu yakamanikana. Basa rayo, sarudzo pakati peTAVR nekutsiva vharuvhu yakavhurika, uye bhenefiti inotarisirwa kune mumwe murwere zvinosarudzwa mushure mekuongororwa. Apollo Hospitals Lucknow izita rinozivikanwa rekutarisira mwoyo muUttar Pradesh, uye chinangwa chepeji rino ndechekubatsira varwere nemhuri kunzwisisa nzira yacho zvakakwana kuti vabvunze mibvunzo chaiyo.

Nei TAVR Kuvhiyiwa kuchidikanwa

Kusarapwa kwe aortic stenosis yakanyanya kunogona kukonzera matambudziko akakomba, anosanganisira kutadza kwemoyo, kusagadzikana kwemoyo, kufenda uye kufa. Kana zviratidzo zvaonekwa, kutsiva mavharuvhu ndiko chete kurapwa kunoratidzwa kushandura nhoroondo yechisikigo yechirwere; mishonga inogona kuderedza zviratidzo asi haigone kuvhurazve vharuvhu. TAVR inoonekwa kune varwere vane zviratidzo zvakaita sekushaya mweya panguva yekushanda nesimba, kusimba kwechipfuva, kuneta kusingawanzoitiki, dzungu kana kudzima magetsi kunokonzerwa ne aortic stenosis yakanyanya. Zvakanakira zvayo zvinosanganisira:

• Maitiro asinganyanyi kupindira: Kusiyana nekuvhiyiwa kwemoyo kwechinyakare, TAVR inowanzoitwa kuburikidza nekuboorwa kudiki kana kuchekwa muhudyu, izvo zvinowanzoderedza nguva yekupora uye kugara muchipatara.
• Hupenyu hwakavandudzwa: Varwere vazhinji vanotaura kuti vanonzwa kushaya simba, simba uye kushanda zvakanaka kwezuva nezuva mushure mekuvhiyiwa.
• Njodzi yakaderera kune varwere vane njodzi huru: TAVR inonyanya kukosha kuvarwere vakwegura uye kune avo vane zvimwe zvirwere zvinoita kuti kuvhiyiwa pachena kuve nengozi, sekuvhiyiwa kwemwoyo kwakamboitwa, kushaya simba kwemapapu kana kushaya simba kwakanyanya.

KuApollo Hospitals Lucknow, tekinoroji yemagetsi yekugadzirwa kwechirwere ichi uye kuronga kwakadzama kwemaitiro ekurapa zvinoshandiswa kushandira mhedzisiro yakanakisisa inogoneka kumurwere wega wega, ukuwo zvichijeka kuti mhedzisiro yacho inoenderana nehutano hwemunhu.

Ngozi dzekunonoka

Kunonoka kurapwa kwechirwere che aortic stenosis chinoratidza zviratidzo zvakanyanya kunogona kuva nemigumisiro yakaipa. Sezvo kuvharika kwemoyo kuchienderera mberi, tsandanyama dzemwoyo dzinokora uye dzinooma, uye ventricle yekuruboshwe inomanikidzwa zvakanyanya. Izvi zvinogona kukonzera:

• Zviratidzo zvinowedzera: Kutadza kufema zvakanyanya, kuneta kunorwadza, kurwadziwa pachipfuva uye nguva dzekuda kufenda.
• Kukundikana kwemoyo: Kugara kwenguva refu kweaortic stenosis kunogona kukonzera kutadza kushanda kwemoyo, izvo zvinokanganisa hupenyu uye zvinogona kuisa hupenyu panjodzi. Kana ventricle yakuvara zvachose, kutsiva mavharuvhu kunogona kuvandudza zviratidzo asi hakugone kudzoreredza kushanda kwakarasika zvizere.
• Njodzi yakakura yemaitiro: Varwere vanosvika kunonoka, vane chirwere chemwoyo chisina kubhadharwa kana kuti vane chirwere cheitsvo nechiropa, vanowanzotarisana nenjodzi huru panguva yekupindira, saka kutumira varwere kuchipatara nenguva kunokosha.

Nekuda kweizvi, Apollo Hospitals Lucknow inosimbisa kuongororwa kwemwoyo nekukurumidza uye kutumirwa kunoongororwa mavharuvhu nekukurumidza pane kumirira wakatarisa kana zviratidzo zvatanga.

Mabhenefiti eTAVR Kuvhiya

• Kurumidza kudzokera kune zvawagara uchiita: Varwere vazhinji vanotangazve kuita mabasa ezuva nezuva mukati memazuva mashoma nekuti hapana cheni yepfupa repazamu inorapwa.
• Kugara kwenguva pfupi muchipatara: Nyaya dzisina kuoma dze transfemoral dzinowanzo buda mukati memaawa makumi maviri nemana kusvika makumi manomwe nemaviri, kunyange hazvo kugara kwechirwere ichi kunoenderana nekuongororwa kwerhythm, mashandiro eitsvo uye kupora kwakajairika.
• Kuvandudzwa kwe hemodynamics yemwoyo: Kuderedza kuvharika kweropa kunowanzo vandudza kuyerera kweropa mberi, kunoderedza kumanikidzwa kweropa mutsinga dzeropa uye kuderedza zviratidzo zvechirwere.
• Kuvimbisa data repakati nepakati: Miedzo isina kurongeka yakatevera varwere veTAVR kwemakore mashanu zvichienda mberi, uye kugara kwenguva refu uye kurarama kwakafanana nekuvhiyiwa muvanhu vakadzidza. Ruzivo rwekugara kwenguva refu, kunyanya muvarwere vadiki, ruchiri kuunganidzwa, uye izvi zvinokurukurwa zvechokwadi panguva yekupa mazano.

Kugadzirira uye Kudzorera

Matipi ekugadzirira

• Kubvunzurudza: Ongororo yakazara nechikwata chevanachiremba vemwoyo kuti vaongorore zviratidzo, nhoroondo yezvekurapa uye mamiriro ekushanda kwemuviri.
• Kuongororwa kwemuviri usati wavhiyiwa: Echocardiography, CT aortography, coronary angiography, kuongororwa kweropa kusanganisira mashandiro eitsvo, uye mimwe mifananidzo sezvinodiwa.
• Kutarisira Mishonga: Tevedzerai mirairo nokungwarira nezvemishonga inodzikisa ropa, mishonga inorwisa maplatelet, mishonga yechirwere cheshuga uye mishonga inobvisa mvura mumuviri, mimwe yacho inoda kugadziriswa usati waita oparesheni.
• Kugadzirisa mararamiro: Kudya kwakanaka uye kusina munyu mushoma, kurega fodya negutka, uye kuita zvinhu zvishoma sezvinorayirwa.

Mazano ekudzorera

• Nguva dzekutevera: Pinda ongororo dzese dzakarongwa kuitira kuti mashandiro evharuvhu uye kurova kwemoyo zvikwanise kuongororwa.
• Zororo uye chiitiko: Ronga zorora nekufamba zvinyoro-nyoro, uchiwedzera zvishoma nezvishoma sezvawarayirwa.
• Ngwarira zviratidzo: Taura nezvekuzvimba kana kubuda ropa muhudyu, kurwadziwa muchipfuva, fivha, kupera simba, kurova kwemoyo zvishoma nezvishoma kana kutadza kufema nekukurumidza.
• Support system: Ronga kuti mumwe wemhuri agare newe, kunyanya mumazuva mashoma ekutanga.

Nguva yeMaitiro uye Chikamu Chekutanga Kuitwa Kwacho

TAVR inenge iri nzira yakarongwa. Pakati pekushanya kwekutanga kwechiremba wemwoyo nezuva rekuvhiyiwa pane danho rekugadzirisa, kazhinji mazuva mashoma kusvika mavhiki maviri kana matatu, apo kukodzera kunoratidzwa.

1. Kusimbisa kuoma: Echocardiography inoyera nzvimbo yevharuvhu, avhareji yegradient uye kumhanya kwejet, uye inoongorora mashandiro eventricular nemamwe mavharuvhu.
2. Kuronga muviri: CT aortography inoyera aortic annulus, saizi yemidzi, kukwirira kwemoyo uye calibre uye calcification yefemoral ne iliac arteries, iyo inosarudza saizi yevharuvhu uye nzira yekupinda.
3. Kuongororwa kweCoronary: Kuongororwa kweCoronary angiography kunoratidza zvivhariso zvingada kupiswa stenting usati wapinda kana panguva imwe chete.
4. Kugwinya kwakajairika: Kushanda kweitsvo, hemoglobin, kudzora shuga, kushanda kwemapapu, mamiriro e carotid, kuongororwa kwemazino uye kuongororwa kwekusasimba kwemuviri.
5. Sarudzo yeChikwata cheMwoyo: Chikwata ichi chinokurudzira TAVR, kutsiva vharuvhu yekuvhiya, kana mune dzimwe nguva manejimendi ekurapa uye kurapa kwekuderedza kushushikana, uye chinotsanangura chikonzero chacho kumhuri.

Varwere vane chirwere chemwoyo chakabviswa mari vanogona kubvumidzwa kupinda muchipatara nekukurumidza kuti vagadzikane, uye mune dzimwe nguva dzisingawanzoitiki, balloon aortic valvuloplasty inoshandiswa senzira yekubatanidza vharuvhu isati yatsiviwa.

Zvinotaurwa Nemirayiridzo Yemazuva Ano

Kutora sarudzo munzvimbo dzine ruzivo muIndia kunotevera musanganiswa wenhungamiro dzeIndia nedzepasi rose:

• The Chirevo cheChinzvimbo cheCardiological Society of India (CSI) paTranscatheter Aortic Valve Implantation muIndia (2022) inotsanangura kusarudzwa kwevarwere, zvinodiwa nesangano, kuumbwa kweChikwata cheMwoyo, kudzidziswa kwevashandisi uye zvinotarisirwa kuongororwa kweTAVI munzvimbo yeIndia, uye inoratidza nyaya dzakanangana neIndia dzakadai sezera diki pakuonekwa, chirwere cherheumatic uye bicuspid valve, uye mutengo.
• The 2021 ESC/EACTS Gwaro reKutarisira Chirwere cheMwoyo cheValvular vanokurudzira kupindira kwechirwere chemwoyo chinonzi aortic stenosis, nesarudzo pakati peTAVI nekuvhiyiwa zvichibva pazera, njodzi yekuvhiyiwa, muviri wemunhu uye zvinodiwa nemurwere. Mugwaro iri, TAVI inowanzo kufarirwa muvarwere vakwegura, kunyanya avo vane makore 75 zvichikwira, kana avo vari panjodzi huru yekuvhiyiwa, nepo kuvhiyiwa kuchifarirwa muvarwere vadiki, vane njodzi shoma.
• The Gwaro re2020 ACC/AHA rekutarisira Varwere vane Valvular Heart Disease, rine 2023 rinotarisa pakuongorora zvinhu zvine chekuita neatrial fibrillation, inoshandisa nzira yakafanana yezera uye njodzi, ichiisa TAVR nekuvhiyiwa senzira dzakakodzera kune varwere vane njodzi yepakati vane makore angangoita 65 kusvika 80.

Zvakachinja munguva pfupi yapfuura: shanduko yakakosha mumakore mashoma apfuura ndeyekuti TAVR haichangogumiri pavarwere vasingarapike kana kuti vane njodzi huru. Humbowo hwekuyedzwa kwevarwere vane njodzi shoma hwakaita kuti mazano acho aendeswe kune sarudzo yakagovaniswa, yakavakirwa pazera, uye kune kusimbiswa kuri kukura pakutarisira hupenyu hwese, ndiko kuti, kuronga izvozvi kuti nzira yechipiri yevharuvhu ingaitwa sei gare gare kana vharuvhu yekutanga ikasashanda zvakanaka. Mirayiridzo ikozvino inosimbisawo kuti kupindira kwevharuvhu kunofanirwa kuitwa panzvimbo dzine huwandu hwakakwana uye Chikwata cheHeart chakarongeka.

Kutungamirirwa kunoshanduka, uye zvinokurudzirwa kumurwere wega wega zvinogona kusiyana nemutemo wekare. Chiremba wemwoyo weApollo achatsanangura kuti nheyo idzi dzinoshanda sei kwauri.

TAVR Kana Ichienzaniswa Nemamwe Masarudzo Ekurapwa

Mapuratifomu emavharuvhu akasiyanawo. Masisitimu anokura nemabharumu uye anozvikudza ega ega ane zvakanakira zvichienderana nehukuru hweannulus, calcium pattern, kukwirira kwemoyo uye kana mukana wekuwana moyo mune ramangwana ungadikanwa. Chikwata cheMwoyo chinosarudza mudziyo; kuwanikwa kwechiratidzo uye mitengo zvinofanirwa kukurukurwa panguva yekuronga.

Maitiro Dzimwe nguva Anoitwa Panguva Imwe Chete Kana Pedyo

• Kuvhiyiwa kweCoronary Angioplasty uye Kuvhiyiwa kweStent: Kuvharika kukuru kwemoyo kunowanzo gadziriswa usati wapinda kana panguva imwe chete.
• Kuisirwa kwepacemaker zvachose: Vamwe varwere vanotanga kuvharika kwemuchina wekufambisa mweya mushure mekuiswa kwevharuvhu uye vanoda pacemaker, kazhinji mukati memushonga mumwe chete.
• Kurapa kwetsinga dzeropa: Dzimwe nguva tsinga yemusana kana yemusana inoda angioplasty kuti ikwanise kupinda zvakachengeteka.
• Kupindira kwechikamu cheatrial kuruboshwe kana mitral: Inotariswa muvarwere vakasarudzwa, kunyange zvazvo inowanzoitwa muzvikamu pane kuitwa pamwe chete.
• Kubviswa kwemazino uye kurapwa: Utachiona hwemazino hunoshanda hunorapwa nguva isati yasvika kuti pave nenjodzi yehutachiona hwevharuvhu.
• TAVR yevharuvhu-iri-muvharuvhu: Kana vharuvhu yenyama yakamboiswa yakamboiswa yaparara, vharuvhu yeTAVR dzimwe nguva inogona kuiswa mukati mayo.

Kupora Kwechikamu Nechikamu

Kupora kunononoka kuvarwere vakanga vasina simba vasati vavhiyiwa, vaida imwe nzira yekuenda nayo, kana kuti vaiva nematambudziko. Nguva idzi dzinoitika kakawanda, hadzina vimbiso.

Kudzokera kuMabasa Akajairika, Basa uye Maitiro Ezuva Nezuva eIndia

• Kufamba: Kufamba-famba kwenguva pfupi mumba kubva pazuva rekutanga kumba, zvichiwedzera kufamba zvakanaka kwemaminitsi makumi maviri kusvika makumi matatu kwemavhiki mana kusvika matanhatu.
• Masitepisi: Kazhinji zvinokwanisika mukati mevhiki imwe kusvika mbiri mushure mekuvhiyiwa kweTAVR ye transfemoral, inotorwa zvishoma nezvishoma uye neruoko.
• Zvimbuzi zvekusvirana uye zverudzi rwechiIndia: Kugara pasi zvakadzama kunonetsa nzvimbo yakaboorwa dumbu uye zviri nani kudzivirirwa kwemavhiki maviri kusvika mana. Kana zvichibvira shandisa chigaro cheWestern commode kana chigaro checommode chakaiswa pamusoro pechimbuzi cheIndia munguva iyi, uye isa bhaa rekubata varwere vakwegura.
• Kugara pasi wakapfugama makumbo: Kazhinji zvinogamuchirwa kana nzvimbo yegumbo yapora zvizere uye isingarwadzi, kazhinji mushure memavhiki maviri kusvika matatu, kunyange zvazvo varwere vakwegura vane majoini akaomarara vangawana chigaro chiri nyore.
• Kurara pasi: Kumuka kubva pasi kunoda kusundidzirwa nemaoko nemuchiuno uye kunogona kunetsa mumavhiki maviri ekutanga. Kuva nemubhedha wemwana kana matiresi akasimba pakukwirira kwemubhedha kwakachengeteka pakutanga, kunyanya kuderedza njodzi yekudonha kwevakwegura.
• Kugeza: Kugeza nechiponji kusvika dumbu raoma uye ravharwa, wozogeza nemvura. Dzivisa kugeza uchigocha kusvika wabvumidzwa; shandisa chituru chekugezera.
• Kutyaira nekutyaira nemavhiri maviri: Kazhinji hazviwanzoitika mavhiki maviri kusvika mana asati asvika, uye gare gare kana pacemaker ikaiswa. Kufamba kwevana vakawanda mumigwagwa yeIndia kunovhundutsa nzvimbo yedumbu uye zvinonyanya kunonoka.
• Shandisa: Basa rekutarisira vanhu rinowanzo tangazve mukati memavhiki maviri kusvika mana. Basa remaoko, kurima, kurodha zvinhu uye kutyaira daro refu zvinoda mvumo yemunhu mumwe nemumwe, kazhinji mushure memavhiki matanhatu kana kupfuura.
• Kusimudza: Dzivisa kusimudza zvinhu zvinorema zvinopfuura 5 kg kwemavhiki maviri kusvika mana ekutanga, kusanganisira mabhaketi emvura, masirinda egasi uye zvizukuru.
• Kurovedza muviri nemitambo: Kufamba-famba kwakarongeka, kutasva bhasikoro usingamire uye yoga yakareruka zvinoenderana nevarwere vazhinji. Mitambo yemakwikwi, kurovedza muviri zvinorema uye asanas dzinoshanda nesimba dzinosanganisira kubata mweya kana kumanikidza zvinoda kucheneswa zvakajeka uye, kuvarwere vadiki, kuongororwa kwekurovedza muviri kwakarongeka.
• Hupenyu hwechitendero nehwemagariro evanhu: Kushanya kutemberi, munamato uye mitambo yemhuri zvinowanzo tangazve mukati memavhiki mashoma. Kuenda kunzvimbo tsvene, kutsanya uye kufamba kwakazara vanhu kunofanira kukurukurwa pakushanya kwechipiri, kunyanya kune varwere vane mishonga yekuderedza ropa.

Kudzivirira Valve Itsva uye Kudzivirira Matambudziko

• Inwa mishonga inorwisa maplatelet kana anticoagulant sezvakarairwa, uye usamborega kuibvisa wega usati watanga kurapwa nemazino kana mamwe maitiro.
• Ramba uine hutsanana hwakanaka uye gara uchiongororwa mazino nguva dzose; udza chiremba wemazino wese nachiremba kuti une vharuvhu yeaortic prosthetic, sezvo kudzivirira mabhakitiriya kunokurudzirwa usati waita mamwe maoperesheni emazino.
• Rapa fivha, utachiona hweganda, utachiona hweweti uye mamota nekukurumidza, uye usaregeredza fivha isingatsanangurike kwenguva refu, iyo inogona kuratidza hutachiona hwevharuvhu.
• Dzivisai kutema nyora munzeve kana mhino zvisina kurongeka uye nzira dzisina utachiona.
• Dzora BP, chirwere cheshuga, cholesterol nehuremu; rega kusvuta, kutsenga fodya uye doro.
• Deredza munyu, papad, magaka, namkeen yakaputirwa uye chikafu cheresitorendi kana paine chirwere chemwoyo.
• Enda ku echocardiography yegore negore kunyangwe uchinzwa zvakanaka, saka kuora kwevharuvhu kunoonekwa nekukurumidza.
• Takura kadhi rako rekuisa vharuvhu uye pfupiso yekubuda kweropa paunenge uchifamba, uye chengeta mufananidzo wazvo pafoni yako.

Vakuru Vakuru, Varwere Vadiki nevana

Vakuru nevasina simba

Varwere vazhinji veTAVR muIndia vane makore anopfuura makumi manomwe. Kuongororwa kunosanganisira kushaya simba, kurangarira, kudya kunovaka muviri, kushayiwa ropa, kushanda kweitsvo uye njodzi yekudonha. TAVR inogona kuderedza zviratidzo zvakanyanya muboka iri, asi kana dementia yakanyanya, kenza yakakura kana kushaya simba kwakakomba zvichireva kuti murwere haabatsirike, Chikwata cheMwoyo chichataura izvozvo nekuvimbika uye chichakurukura nezvekurapa kunotarisa zviratidzo panzvimbo pezvo. Kudzivirira delirium, kushandisa nekungwarira kusiyana kwezviratidzo uye kukurumidza kufamba zvimwe zvezvirongwa zvevakwegura.

Vakuru vadiki nevasina njodzi yakakura

Kune varwere vane makore ekuma40, 50 nekutanga kwema60, kutsiva mavharuvhu ekuvhiya kunowanzo shandiswa nekuti kugara kwenguva refu kwemavharuvhu ekuvhiya kwagara kuri nani uye kuronga hupenyu hwese kunokosha. Mavharuvhu eBicuspid nemavharuvhu epost-rheumatic, ese anowanikwa muIndia, anogona kunge asina kunaka pane TAVR. Ichi chisarudzo chinoitwa nevanhu vose chinoyera kugara kwenguva refu, kudzivirira ropa riyerere, basa rekushanda uye hurongwa hwemhuri.

Vana uye chirwere chevharuvhu chekuzvarwa nacho

TAVR sezvakatsanangurwa pano inzira yekurapa calcific aortic stenosis yevakuru uye haishandiswi kuvana. Vana nevechiri kuyaruka vane chirwere cheaortic valve vanorapwa nekiriniki yemwoyo yevana uye kuvhiyiwa kwemwoyo kwevana nebharuni valvuloplasty, kugadziriswa kwevharuvhu, nzira yeRoss kana kuvhiyiwa, zvichienderana nemuviri wemwana. Mhuri dzinofanira kukumbira kuti vatumirwe kuchikwata chevana chemwoyo pane nzira yeTAVR.

Vakadzi, pamuviri uye anticoagulability

Vakadzi vari pazera rekubereka vane aortic stenosis yakanyanya vanoda kupiwa mazano vasati vabata pamuviri, nekuti kusarudza mavharuvhu kunokanganisa kuchengetedzwa kwekudzivirira ropa panguva yekuzvitakura. Izvi zvinoda kuongororwa kwemwoyo pamwe nekukurukurirana kwevana vasati vaita chero chirongwa chevharuvhu.

Kana Ukasarudza Kusaita Maitiro

Kuchinja vharuvhu zvishoma nezvishoma isarudzo yepamutemo, uye inofanira kunge iri yeruzivo rwakadzama. Pasina kupindira, aortic stenosis ine zviratidzo zvakanyanya inowanzo enderera mberi; nhevedzano dzenhoroondo dzinoratidza kufa kwakanyanya mukati memakore mashoma ezviratidzo, uye tarisiro yacho inozonyanya kuipa kana mwoyo wakundikana, kupera simba kana angina yaonekwa. Mishonga inogona kuderedza kuwanda kwemvura uye kushaya mweya asi haigone kuderedza kuvharika kwemuchina, uye mimwe mishonga inofanira kushandiswa nokungwarira nekuti kudzikira kwakasimba kunoderedza kugona kwemoyo kupindura kuderera kweropa.

Kana ukasarudza kusashandisa TAVR kana kuvhiyiwa, timu inogona kubatsira nekuderedza diuretic titration, kuderedza kupererwa neropa uye chirwere cheshuga, mazano ekuita mabasa anoenderana nezviratidzo, rutsigiro rwekumba, uye rubatsiro rwekurapa palliative pazvinenge zvakakodzera. Unogona kushandura pfungwa dzako, kunyange zvazvo njodzi nerubatsiro zvingachinja kana mwoyo ukanyanya kuderera. Mhuri dzinofanirawo kukurukura zvinangwa zvekutarisira uye zvaunofarira kupinda muchipatara pachine nguva.

Zvinhu Zvinokanganisa Mutengo weTAVR

TAVR ndeimwe yemishonga yemwoyo inodhura zvikuru muIndia, kunyanya nekuda kwemudziyo wevharuvhu pachawo. Apollo Hospitals Lucknow inopa fungidziro yakanyorwa mushure mekuongororwa. Zvinhu zviri pazasi zvinotsanangura kuti sei varwere vaviri vachigona kugamuchira fungidziro dzakasiyana kwazvo.

Zvipatara zveApollo kuLucknow hazviburitse mutengo weTAVR wakatarwa papeji rino, uye nhamba dzakataurwa nemawebhusaiti emitengo yevamwe vanhu hadzivimbike. Ndokumbirawo mubvunze dhipatimendi rezvepfungwa dzemwoyo kana dhipatimendi rekubhadhara neinishuwarenzi kuti muwane fungidziro yemazuva ano, yakanyorwa musati mapinda.

Inishuwarenzi, Kurapwa Pasina Mari uye Maitiro eTPA muIndia

• Kudzivirirwa kwetsaona kwakarongwa, kwete kwezvakarongwa: Aortic stenosis chirwere, saka TAVR inotorwa pasi pechibatsiro chekurwara kana kuti kugara muchipatara kubva kuinishuwarenzi yako, kwete pasi pechifukidziro chenjodzi yemunhu. Mainishuwarenzi enjodzi yemunhu haawanzo kubhadhara chirwere chevharuvhu chinopera simba.
• Nguva yekumirira inokosha: Mazhinji emapolisi eIndia ekudzivirira chirwere anoshandisa nguva yekutanga yekumirira kwemazuva angangoita makumi matatu, nguva yekumirira yechirwere chakati chegore rimwe kusvika maviri kune mamwe mamiriro akanyorwa, uye nguva yekumirira chirwere chiripo iyo pasi pemitemo yeIRDAI iripo inogona kusvika kumwedzi makumi matatu nematanhatu. Kana chirwere chako chevharuvhu chakaonekwa kana kuti chakaratidzwa nemapurisa asati atanga, chiburitse pachena uye bvunza kambani yeinishuwarenzi nekunyora kana ichibhadharwa.
• Mari inobhadharwa neinishuwarenzi kana mutengo wemudziyo: Nekuti jira rekugadzira rinodhura, mari shoma ine inishuwarenzi inogona kupedzwa nekukurumidza. Tarisa kana uine add-up kana super-up, policy yekambani, kana policy yechipiri inogona kushandiswa pamari yasara.
• Kubvumidza kutenga pasina mari: Kuti uite zvakarongwa, tumira magwaro kuTPA kana kukambani yeinishuwarenzi mazuva akati wandei usati wasvika. Kubvumidzwa kunowanzo tora maawa ekushanda makumi maviri nemana kusvika makumi manomwe nemaviri, uye mibvunzo inogona kuwedzera nguva iyi, saka usaronga kupinda pazuva rimwe chete raunonyorera.
• Magwaro anowanzo diwa: kopi yemutemo nekadhi, mufananidzo ID neAadhaar, tsamba yezano rachiremba ine kuongororwa kwechirwere, echocardiography nemishumo yeCT, zvinyorwa zvekurapwa zvekare, uye fungidziro yechipatara.
• Nzira yekudzoserwa mari: Kana mari yako yeinishuwarenzi ikarambidzwa kubhadhara kana kuti kambani yako yeinishuwarenzi ikasabhadharwa, unogona kubhadhara wozokumbira mari gare gare. Chengeta mabhiri ekutanga, invoice yemudziyo yakanyorwa ine chitambi chevharuvhu kana chitambi cheimplant, muchidimbu chekubuda muchikwereti, mishumo yese nemarisiti ekubhadhara.
• Zvinhu zvisingabhadharwe: Zvinhu zvinoshandiswa, magirovhosi, zvimwe zvinoraswa, chikafu chinoshanda, nharembozha nezvinhu zvinonyaradza zvinowanzo bviswa uye zvinobhadharwa nemi. Mubhadharo wekubhadhara imba pamwe nechikamu chekubvisa mari chinoenderana nezvinodiwa zvinogonawo kuderedza mari yekubhadhara kana mukasarudza chikamu cheimba chakakwirira kupfuura chinobvumirwa nepolisi yenyu.
• Zvirongwa zvehurumende nevashandirwi: Kufukidzwa kuri pasi peCGHS, ECHS, zvirongwa zvevashandi vehurumende, zvirongwa zvePSU kana Ayushman Bharat zvinoenderana nekuiswa kwemwana uye kana nzira chaiyo uye kuiswa kwemwana kwakanyorwa. Simbisa mamiriro azvino nedhipatimendi reinishuwarenzi usati wapinda, sezvo mitemo yekuiswa kwemwana uye mapakeji ichichinja.

Nekuti mitemo yemutemo, kubatanidzwa uye mitengo yemapakeji zvakasiyana, ndapota simbisai mibvunzo yese yekuvhara zvakananga neApollo Hospitals Lucknow inishuwarenzi neTPA desk pane kuvimba neruzivo rwese.

Kuronga Kupinda uye Zvekuunza

Usati waenda kuchipatara

• Simbisa zuva rekupinda, nguva yekuzivisa nezvechirwere uye mirairo yekutsanya.
• Inishuwarenzi yakazara isati yapihwa mvumo uye kucheneswa kwemazino kana zvikakurudzirwa.
• Tsanangura mishonga yekumisa uye nguva ipi, kunyanya mishonga inobvisa ropa, metformin uye SGLT2 inhibitors.
• Rongai mubatsiri mukuru mumwe chete pamwe chete nemubatsiri; mumhuri dzakabatana, sarudzai kuti ndiani achabhadhara mari, ndiani acharara uye ndiani achatarisira musha nevana, uye ipai timu yekurapa nhamba imwe chete yekubata kuti musavhiringidzika.

Zvekurongedza

• Mishonga yese yekare, pfupiso dzekubuda muchipatara, maECG, mishumo ye echo neCT iri papepa uye, kana zvichibvira, paCD kana pen drive
• Mitsetse yemishonga iripo iye zvino iri mupakeji yayo yepakutanga
• Aadhaar kana mufananidzo ID, kadhi reinishuwarenzi, magwaro epolisi, tsamba dzemushandirwi kana dzechirongwa
• Mbatya dzakavhurika kumberi, masiraidhi asingatsvedzeri, magirazi ekuona, zvinhu zvinobatsira kunzwa uye bhokisi remazino ekugadzira mazino
• Zvimbuzi, tauro diki, kapu, uye manapukeni evakuru kana mapedhi kana dambudziko rekushaya kuzvidzora
• Nhare ine charger netambo refu, kabhuku kadiki kemirairo
• Mari shoma uye kadhi rechikwereti rinoshanda pazvinhu zvisingabhadharwe

Zvekusiya kumba

• Zvishongo, mari yakawanda nezvinhu zvinokosha
• Chikafu chinobikwa kumba kunze kwekunge nyanzvi yezvekudya yachibvumidza, sezvo munyu nemunyu zvichishandiswa mushure mekuvhiyiwa kwemavharuvhu.

Kugadzirira imba usati wabuda mumba

• Isa mubhedha kana kamubhedha panzvimbo yakasununguka pasi pevhu kana zvichibvira
• Ronga chigaro chekushandisa zvinhu zvechimbuzi kana nzvimbo yekugezera yekumadokero nechituru chekugezera
• Bvisa waya dzakarembera, mameti uye pasi rinotsvedza kudzivirira kudonha
• Iva nechinoronga mapiritsi, chinoongorora BP, chikero chekuyera uye thermometer zviri pedyo.

Zviratidzo Zvenyevero Zvinoda Kuongororwa Nekukurumidza

Bata timu yezvemwoyo kana kuti svika kudhipatimendi rekukurumidzira riri pedyo nekukasika kana ukaona:

• Kutadza kufema zvakanyanya kamwe kamwe, kana kushaya mweya wakarara pasi
• Kurwadziwa kwechipfuva kana kumanikidzwa kunotora nguva inopfuura maminetsi mashoma
• Kufenda, kudzima magetsi, kana kurova kwemoyo nguva dzose kuri pasi pekurova kwe45 paminiti
• Kurova kwemwoyo kutsva, kunyanya kana kuchikurumidza uye kusingawanzoitiki
• Kushaya simba kana kuti kusanzwa kumeso, ruoko kana gumbo, kutaura kusina kunyatsojeka kana kurasikirwa nekuona kamwe kamwe, izvo zvinogona kuratidza sitiroko
• Kuzvimba kuri kuwedzera, bundu rinorwadza, kana kubuda ropa kutsva panzvimbo yakaboorwa dumbu
• Gumbo rinotonhora, rakachenuruka kana kuti rinorwadza parutivi peboorwa
• Fivha iri pamusoro pe100.4°F inoramba iripo kweanopfuura zuva rimwe kana maviri, kutonhorwa, kana kudikitira husiku
• Kuwedzera uremu nekukurumidza kwe2 kg kana kupfuura mumazuva matatu, kana kuwedzera kuzvimba kwemakumbo nedumbu
• Tsvina nhema, ropa muweti kana maronda asingawanzoitiki paunenge uchinwa mishonga inobvisa ropa

Kune Varwere Vari Kufamba Vachibva Kumatunhu Ari Pedyo Nemaguta

Apollo Hospitals Lucknow inoshandira varwere vanobva mhiri kweUttar Pradesh nenyika dzakavakidzana, kusanganisira Kanpur, Unnao, Barabanki, Sitapur, Hardoi, Lakhimpur Kheri, Rae Bareli, Sultanpur, Amethi, Ayodhya, Basti, Gonda, Bahraich, Balrampur, Shravasti, Praunpuryapuryagrah, Varavasti, Praunpuryagrah Bareilly, Shahjahanpur, Farrukhabad, Kannauj, Fatehpur, Banda, Chitrakoot uye Jhansi, uyewo kubva kune dzimwe nzvimbo dzeBihar, Nepal neUttarakhand.

Mazano anoshanda kumhuri dziri kure nemisha