Ukutshintshwa kweMitral Valve kwizibhedlele zeApollo, eLucknow

isishwankathelo

Ukutshintshwa kweMitral Valve (MVR) yinkqubo yotyando ebalulekileyo eyenzelwe ukujongana nokungasebenzi kakuhle kwevalvu yemitral, enokubangela iingxaki ezinkulu zempilo ukuba ayinyangwa. Kwizibhedlele zaseApollo eLucknow, sizingca ngegama lethu lokugqwesa kunyango lwentliziyo, sisebenzisa ubuchwepheshe obuphambili kunye neendlela zotyando ezisele zimiselwe ukusebenzela iziphumo ezilungileyo kwizigulana zethu. Iqela lethu leengcali zentliziyo kunye noogqirha bentliziyo abanobuchule lizinikele ekuboneleleni ngonyango lomntu ngamnye, okwenza izibhedlele zaseApollo eLucknow zibe lukhetho oluhlonitshwayo lokutshintshwa kweMitral Valve kulo mmandla. Sigxile ekuthembekeni nakwilwaneliseko lwesigulana, sizimisele ukukukhokela kuyo yonke inyathelo lohambo lwakho lonyango.

Kutheni iMitral Valve yoTshintsho iyimfuneko

Ivalve ye-mitral idlala indima ebalulekileyo ekulawuleni ukuhamba kwegazi phakathi kwe-atrium yentliziyo yasekhohlo kunye ne-ventricle yasekhohlo. Xa le valve igula okanye yonakaliswe ngenxa yeemeko ezifana ne-mitral valve prolapse, isifo senhliziyo se-rheumatic, okanye utshintsho olubi, kunokukhokelela kwiingxaki ezinzulu, kuquka ukuhluleka kwentliziyo, i-arrhythmias, kunye noxinzelelo lwegazi lwe-pulmonary.

I-Mitral Valve Replacement iyimfuneko xa i-valve ingenakulungiswa kwaye ibangela iimpawu ezibalulekileyo okanye iingxaki. Inkqubo ineenzuzo ezininzi, kuquka:

• Ukuphucula ukusebenza kwentliziyo: Ngokutshintsha ivalvu eyonakeleyo, ukuhamba kwegazi kuyabuyiselwa, nto leyo edla ngokuphucula ukusebenza kwentliziyo iyonke.
• Uncedo lweempawu: Izigulana zihlala zifumana ukwehla okukhulu kweempawu ezifana nokuphefumla kancinci, ukudinwa, kunye nokubetha kwentliziyo.
• Umgangatho wobomi ophucukileyo: Ngokuphucula ukusebenza kwentliziyo kunye nokunciphisa iimpawu, uninzi lwezigulane lunokubuyela kwimisebenzi yazo yemihla ngemihla kwaye lonwabele ubomi obungcono.

Kwisibhedlele sase-Apollo eLucknow, siyakuqonda ukubaluleka kokungenelela ngexesha kunye nefuthe elinokuba nalo kwimpilo yakho.

Imingcipheko yokuLibazisa

Ukulibazisa iMitral Valve Replacement kunokukhokelela kwiziphumo ezibi. Njengoko imeko iqhubela phambili, izigulane zinokufumana iimpawu ezibuhlungu kunye nomngcipheko okhulayo weengxaki, kuquka:

• Ukumelwa yintliziyo: Ukungasebenzi kakuhle kwevalvu ye-mitral ixesha elide kunokukhokelela ekusileleni kwentliziyo, apho intliziyo ingakwazi ukupompa igazi elaneleyo ukuhlangabezana neemfuno zomzimba.
• IiArrhythmias: Ukubetha kwentliziyo okungaqhelekanga okufana ne-atrial fibrillation kunokukhula, nto leyo eyonyusa umngcipheko we-stroke kunye nezinye iziganeko zentliziyo.
• Uxinzelelo lwegazi emiphungeni: Uxinzelelo olongezelelekileyo kwimithambo yemiphunga lunokubangela iingxaki ezingaphezulu, kuquka ukusilela kwentliziyo yasekunene.

Unyango olukhawulezileyo lubalulekile ukunciphisa amathuba ezi ngxaki nokuphucula iziphumo zexesha elide. Kwizibhedlele zaseApollo eLucknow, sigxininisa ukungenelela kwangoko kwaye sinikezela ngovavanyo olupheleleyo ukuze kuchongwe eyona ndlela ilungileyo yokwenza isigulana ngasinye.

Izibonelelo zoTshintsho lweValve ye-Mitral

Ukutshintshwa kweMitral Valve kwiZibhedlele zaseApollo eLucknow kunika iingenelo ezininzi ezinokubakho, kuquka:

• Ukuphucula ukusebenza kwentliziyo: Injongo ephambili ye-MVR kukubuyisela ukuhamba kwegazi okuqhelekileyo kwivalvu, nto leyo enokuphucula ukusebenza kwentliziyo kunye nempilo iyonke.
• Uphuculo lweempawu: Izigulane ezininzi zixela ukwehla okukhulu kweempawu, nto leyo ebavumela ukuba benze imisebenzi ababeyifumanisa inzima okanye ingenakwenzeka ngaphambili.
• Impilo yexesha elide: Emva kokuphumelela kwe-MVR, izigulana zihlala zinokonwabela ubomi obungcono kunye nomngcipheko ophantsi weengxaki ezingakumbi ezinxulumene nentliziyo, ukuba nje iingcebiso zokulandela kunye namayeza ziyahlonitshwa.
• Ukhathalelo olulungiselelwe wena: Iqela lethu libonelela ngezicwangciso zokhathalelo ezenzelwe wena, ukuqinisekisa ukuba iimfuno zesigulana ngasinye ziyahlangatyezwa kulo lonke uhambo lwaso lonyango.

Ukukhetha i-Apollo Hospitals Lucknow ukuze utshintshe i-Mitral Valve yakho kuthetha ukukhetha indlela eya kubomi obusempilweni nobusebenzayo.

Ukulungiselela kunye noBuyiselo

Ukulungiselela ukutshintshwa kweMitral Valve kubandakanya amanyathelo aliqela abalulekileyo ukuqinisekisa amava otyando athambileyo kunye nokuchacha.

Iingcebiso ngokulungiselela

• Ukubonisana: Cwangcisa intlanganiso eneenkcukacha ngeengcali zethu zentliziyo ukuze nixoxe ngemeko yakho, iindlela zonyango, kunye nazo naziphi na iingxaki onokuba nazo.
• Uvavanyo lwangaphambi kotyando: Yenza uvavanyo oluyimfuneko, oluquka i-echocardiography, uvavanyo lwegazi, kunye nezifundo zemifanekiso, ukuze kuhlolwe imeko yentliziyo yakho kunye nempilo iyonke.
• Ulawulo lwamayeza: Landela imiyalelo kagqirha wakho malunga namayeza, kuquka naluphi na utshintsho kwimithi yokunciphisa igazi okanye eminye imithi emiselweyo.
• Uhlengahlengiso kwindlela yokuphila: Yamkela ukutya okunempilo kwentliziyo, wenze umthambo omncinci njengoko kucetyisiwe, kwaye uphephe ukutshaya okanye utywala.

Iingcebiso zokubuyisela

• Ukhathalelo lokulandela: Yiya kuzo zonke iindibano zokulandelela ezicwangcisiweyo ukujonga ukuchacha kwakho kunye nokujongana nayo nayiphi na inkxalabo.
• Ukwanda komsebenzi ngokuthe ngcembe: Qala ngemisebenzi elula kwaye ngokuthe ngcembe wandise umsebenzi wakho womzimba njengoko ucetyiswa liqela lakho lezempilo.
• Ukunamathela kumayeza: Sela amayeza achazwe ngugqirha njengoko eyalelwe ukulawula iintlungu, ukuthintela usulelo, kunye nokuxhasa impilo yentliziyo.
• Inkxaso: Cela uncedo kusapho nakubahlobo ngexesha lokuchacha kwakho ukuze ufumane inkxaso oyifunayo.

Kwisibhedlele saseApollo eLucknow, sizimisele ukubonelela ngenkxaso egcweleyo kuyo yonke inkqubo yakho yokulungisa nokuchacha.

Izikhokelo zangoku ezikhokela isigqibo

Izigqibo malunga notyando lwe-mitral valve eIndiya zikhokelwa yindibaniselwano yamaxwebhu aseIndiya nawamazwe ngamazwe:

• I-Cardiological Society of India (CSI)? Ingxelo yeSimo kwiSifo seNtliziyo esiHlangeneyo (2019) kunye nesikhokelo sokusebenza se-CSI kwisifo sentliziyo se-valvular: igxininisa ukuba isifo se-rheumatic mitral eIndiya sibonakala siselula, sidla ngokuba ne-stenosis exutyiweyo kunye nokubuyela kwesisu, kwaye igxininisa ukuthintela i-penicillin yesibini emva kotyando.
• Umbutho wamaNdiya wooGqirha beNtliziyo neMithambo (IACTS) ixhasa indlela yokusebenzisana kwentliziyo kunye neqela kwaye ibeka phambili ukulungiswa kweevalvu kunokutshintshwa naphi na apho i-anatomy yeevalvu ivumela khona.
• Isikhokelo se-ACC/AHA sika-2020 soLawulo lweZigulana ezineSifo seNtliziyo seValvular (kunye nengcaciso egxile ku-2021): Utshintsho oluphambili kwisikhokelo esidala sisindululo esinamandla nesangaphambili sokungenelela ukuphindaphinda okukhulu kwe-mitral primary, kuquka kwizigulana ezikhethiweyo ezingenazo iimpawu ezineqhezu lokukhupha igazi eligciniweyo xa zisenziwa kumaziko anamava anethuba eliphezulu lokulungiswa ngempumelelo. Ikwaxhasa ukulungiswa kwevalvu ye-mitral kunokuba ithathe indawo yesifo esiwohlokayo, kwaye inika indima ecacileyo yokulungiswa komphetho we-transcatheter kwizigulana ezisengozini enkulu yotyando.
• Izikhokelo ze-ESC/EACTS 2021 zolawulo lwesifo sentliziyo se-valvular: Indlela efanayo yokuhamba, kunye nemida esezantsi yokuthunyelwa kwiziko le-heart-valve kunye nendima echaziweyo ye-percutaneous balloon mitral commissurotomy kwi-rheumatic mitral stenosis efanelekileyo.

Intsingiselo esebenzayo kukuba "linda ude ube neempawu ezininzi" ayiselocebiso eliqhelekileyo. Ukuba i-echocardiogram ibonisa isifo esibi se-mitral, uluvo lweengcali lubalulekile nokuba usaziva uphilile. Ubungqina kwamanye amaqela amancinci, ngakumbi izigulane ezingenazo iimpawu kunye nabo bane-secondary mitral regurgitation, buhlala buxoxwa, kwaye iqela lakho liza kuchaza ukuba ityala lakho liwela phi.

Ixesha lotyando kunye neSigaba sangaphambi kwenkqubo

Ukutshintshwa kwevalvu yeMitral kudla ngokuba lutyando olucwangcisiweyo. Utyando olungxamisekileyo lugcinelwe iimeko ezifana ne-infective endocarditis enevalvu engaguqukiyo, i-chordae eqhekekileyo ene-acute pulmonary edema, okanye ivalvu yokufakelwa ebambekileyo (efakwe i-thrombosed).

• Utyelelo lovavanyo: Uvavanyo lweklinikhi, i-ECG, i-X-ray yesifuba, i-echocardiography ye-transthoracic, kunye ne-transoesophageal echocardiography rhoqo ukuze kufunyanwe iinkcukacha ze-valve anatomy.
• Uqeqesho lomzimba: ukubalwa kwegazi, ukusebenza kwezintso nesibindi, udidi lwegazi kunye nokudibana kwegazi, iprofayili ye-thyroid, i-HbA1c, iimpawu zentsholongwane, inkcubeko yomchamo, kunye novavanyo lokusebenza kwemiphunga kubantu abatshayayo okanye abo baphelelwa ngumphefumlo.
• Ukuhlolwa kweCoronary: I-coronary angiography idla ngokucetyiswa kwizigulana ezingaphezulu kweminyaka engama-40, okanye ezinesifo seswekile, imbali yokutshaya okanye iintlungu zesifuba, ukuze kwenziwe utyando olufanayo xa kuyimfuneko.
• Ukucoca amazinyo: Usulelo lwamazinyo olunganyangwanga luyimvelaphi yosulelo lwevalvu yokufakelwa. Ukuhlolwa kwamazinyo kunye nonyango ngaphambi kotyando yingcebiso eqhelekileyo.
• Ukuphucula: Ukulawula ukusilela kwentliziyo nge-diuretics, ukulawula izinga le-atrial fibrillation, ukulungiswa kwe-anemia (exhaphakileyo kwizigulana zaseIndiya, ingakumbi abafazi), unyango lwalo naluphi na usulelo olusebenzayo, ukulawula iswekile egazini, kunye nokuyeka icuba notywala.
• Ukudibanisa i-anticoagulation: Ukuba sele uthatha i-warfarin okanye i-acitrom, ugqirha wakho uza kucwangcisa ukuba uza kuyiyeka nini na le nto kunye nokuba ingaba iyadingeka na i-heparin cover.

Kwizigulane ezininzi ezizinzileyo, ixesha eliphakathi ukusuka kwingcebiso yokuqala ukuya kutyando lithatha iintsuku ezimbalwa ukuya kwiiveki ezimbalwa, kuxhomekeke kwiimfuno zokuphucula kunye nokufumaneka kweebhedi. Ixesha elibekiweyo lixhomekeke kumntu ngamnye kwaye liqinisekiswa liqela elinyangayo.

Ukhetho loBuchule kunye neValve luthelekiswa

Ukhetho lokugqibela luxhomekeke kukwakheka kwevalvu ebonwa kwi-echo nakwi-eye ngexesha lotyando, ubudala bakho, isigqi sakho, ukusebenza kwezintso, ukukwazi kwakho ukujonga i-INR, kunye nezicwangciso zokukhulelwa. Nceda uqinisekise neqela le-cardiac ukuba zeziphi iindlela ezisebenzayo kuwe kwesi sibhedlele.

Iinkqubo Ngamanye amaxesha zenziwa ngaxeshanye

• Ukulungiswa kwevalve ye-Tricuspid xa kukho ukurhawuzelelwa okukhulu kwesisu okanye i-annulus evulekileyo.
• Ukutshintshwa okanye ukulungiswa kwevalvu ye-Aortic kwisifo samathambo esidibeneyo (ukutshintshwa kweevalvu ezimbini).
• I-Coronary artery bypass grafting ukuba i-angiography ibonisa ukuvaleka okukhulu.
• Ukuvalwa okanye ukususwa kwesitho sasekhohlo se-atrial kwi-atrial fibrillation, ukunciphisa umngcipheko wokuqhekeka kwegazi.
• Ukususwa kwesisu ngotyando (inkqubo yohlobo lwe-maze) kwi-atrial fibrillation ehlala ixesha elide kwizigulane ezikhethiweyo.
• Ukususwa kwehlwili le-atrial ekhohlo kwaye kwashiya ukuncipha kwe-atrial kwi-atria enkulu kakhulu.
• Ukuvalwa kwe-atrial septal defect okanye i-patent foramen ovale ukuba ifunyenwe.

Ukudibanisa iinkqubo kongeza ixesha lotyando kodwa kuthintela utyando lwesibini. Ugqirha wakho uza kuchaza umngcipheko owongezelelekileyo kwimeko yakho.

Isigaba-nge-Sigaba soBuyiselo lweXesha

Olu luhlu luqhelekile endaweni yokuba luqinisekiswe. Isifo seswekile, ukusebenza kakubi kwemiphunga, ukutyeba kakhulu, isifo sezintso kunye nokusilela kwentliziyo okukhoyo kunokucothisa ukuchacha.

Ukubuyela kwimisebenzi eqhelekileyo, emsebenzini nakwimisebenzi yemihla ngemihla yamaNdiya

Ithambo lesifuba lidibene kwaye lisebenza njengethambo eliphilisayo. Uninzi lwemiqathango kwiiveki ezintandathu ukuya kwezisibhozo zokuqala ikhona ukuze likhuseleke.

• Ukuhlala phantsi unqamleze imilenze kwaye ugobile: I-sternum ayixinezelekile ngokuthe ngqo, kodwa umgudu wokuvuka phantsi utyhala iingalo nesifuba. Sebenzisa isitulo kwiiveki ezintandathu zokuqala, uze ubuye kancinci kancinci, usebenzisa udonga okanye igxalaba lomncedisi endaweni yokutyhala phezulu ngezandla zombini.
• Izindlu zangasese (ezine-squat) zesitayile samaNdiya: Kuphephe ubuncinane iiveki ezintandathu. I-commode, okanye isihlalo esiphakanyisiweyo se-commode phezu kwendlu yangasese yaseIndiya, sikhuselekile. I-bag bar okanye isitulo esibekwe kufutshane siyanceda.
• Ukulala phantsi: Kungcono ukuba irhoxiswe kangangeeveki ezintandathu ukuya kwezisibhozo, kuba ukuqengqeleka nokuvuka kumatrasi ophantsi kuthwala isifuba neengalo. Kulula ukuba nebhedi eqinileyo xa iphezulu esinqeni.
• Ukuhlamba: Ukuhlamba ngebhakethi uhleli esitulweni kungcono kunokuma phantsi kweshawa kwiiveki zokuqala. Gcina inxeba lomile de kuchazwe ngenye indlela.
• Ukuphakamisa: Akukho nto inzima ngaphezu kwe-4?5 kg kangangeeveki ezintandathu. Oko kuquka iibhakethi zamanzi, iisilinda zegesi, abazukulwana, iingxowa zengqolowa kunye neesutikheyisi ezinzima.
• Ukuqhuba: ngesiqhelo akuvumelekanga ngaphambi kweeveki ezine ukuya kwezintandathu kwaye kuphela emva kokususwa kwesisu, kuba ukuxhuzula ngequbuliso okanye i-airbag inokonakalisa i-sternum ephiliswayo. Iimoto ezinamavili amabini kungcono zithintelwe ixesha elide.
• Umsebenzi: Umsebenzi wedesika nowokubeka iliso uhlala uqaliswa kwakhona malunga neeveki ezintandathu; ukulima, ukwakha, ukulayisha kunye neminye imisebenzi enzima yezandla idla ngokufuna iinyanga ezintathu nangaphezulu kunye nokususwa kwempahla ethile.
• Ukuzilolonga kunye nemidlalo: ukuhamba ukusuka kwiveki yokuqala, ukuzilolonga ngokuhlaziya intliziyo njengoko kuchaziwe, emva koko ukudada okanye ukukhwela ibhayisekile emva kokulimala kunye nokususwa kwesisu. Uqeqesho lobunzima, ikhilikithi, i-kabaddi, i-wrestling kunye nemidlalo yokudibanisa umzimba zifuna ukususwa ngokupheleleyo, kwaye izigulana ezisebenzisa i-warfarin kufuneka ziphephe imidlalo yokudibanisa umzimba ngenxa yomngcipheko wokopha.
• Imisebenzi yenkolo neyentlalo: Ukutyelela etempileni kunye nemisebenzi kulungile xa ukwazi ukuhamba ngokukhululeka, kodwa kuphephe ukuxinana kwesihlwele kwiiveki zokuqala ezimbalwa, ukuhlala phantsi ixesha elide, kunye nokuhambahamba phantsi ude ucoceke.
• Ukuzila ukudla: Xoxa nogqirha wakho ngazo naziphi na izinto ezicetywayo zokuzila ukutya, kuquka uKarva Chauth, uNavratri okanye uRamzan, kuba amayeza okukhupha isisu kunye newarfarin asebenzisana notshintsho kulwelo kunye nokutya.

Ukuthintela Ukuphinda Kubuye Nokukhusela Ivalvu Entsha

• Uthintelo lwesibini lwesifo samathambo: Ukuba isifo sakho sevalvu besisifo samathambo, inaliti ye-benzathine penicillin okanye i-penicillin yomlomo rhoqo ngenyanga zihlala ziqhubeka iminyaka, njengoko kucetyiswa yi-CSI kunye nesikhokelo se-WHO. Ukuyeka kwangoko iingozi zokuhlaselwa kwamathambo amatsha.
• Ukhathalelo lwamazinyo nosulelo: Ibhrashi kunye nefloss imihla ngemihla, unyange isifo seentsini, kwaye uxelele ugqirha wamazinyo nogqirha ukuba unevalvu yokufakelwa. Uthintelo lwee-antibiotics ngaphambi kokuba kwenziwe iinkqubo ezithile zamazinyo luyacetyiswa kwiivalvu zokufakelwa.
• Kuphephe ukugqobhoza okungacocekanga, iitattoo kunye neenaliti ezingabulali ntsholongwane, enokuhlwayela ivalvu.
• Uqeqesho lokulwa nokugabha kwegazi: thatha i-warfarin okanye i-acitrom ngexesha elinye yonke imihla, gcina irekhodi ye-INR ebhaliweyo, gcina ukutya imifuno eluhlaza kungaguquguquki kunokuba kuqhubeke ngokungaguqukiyo, kwaye uphephe amayeza okudambisa iintlungu amiselwe nguwe kunye neemveliso zemifuno okanye ze-Ayurvedic ngaphandle kokujonga ukuba akukho ntsebenziswano na.
• Uxinzelelo lwegazi, iswekile, amafutha kunye nokulawula ubunzima, kunye nokuyeka ngokupheleleyo ukutshaya.
• Ungaze ulibale i-echocardiography yokulandelela, nokuba uzive uphilile.
• Umphimbo obuhlungu ebantwaneni ekhaya: fumana unyango olufanelekileyo losulelo lwe-streptococcal throat, kuba ukuthintela umkhuhlane wamathambo kukhusela lonke usapho.

Abantwana, Abasetyhini Abaselula kunye Nezigulane Ezikhulileyo

Abantwana kunye nentsha

Isifo se-rheumatic mitral sinokubonakala kwabantwana abancinci eIndiya. Ukulungiswa kwesifo kukhethwa kakhulu kubantwana abasakhulayo kuba i-prosthesis enobukhulu obumiselweyo ayikhuli nomntwana kwaye kunzima ukuyilawula i-warfarin kumntu oselula osebenzayo. Iimeko zentliziyo zabantwana zithunyelwa ngaphakathi kwenethiwekhi ye-Apollo kwiiyunithi ezinezibonelelo ze-ICU zentliziyo yabantwana; iqela laseLucknow liza kunika isikhokelo sokudluliselwa apho kuyimfuneko.

Abafazi abaceba ukukhulelwa

Le yenye yezona ngxoxo zixhaphakileyo nezinzima. I-Warfarin inokulimaza umntwana osakhulayo, ngakumbi kwi-trimester yokuqala, ngelixa iivalvu zezicubu ziwohloka ngokukhawuleza kubasetyhini abancinci kwaye zinokungaphumeleli ngexesha okanye emva kokukhulelwa. Ukulungiswa kweevalvu, apho kunokwenzeka, kudla ngokuba lolona khetho lufanelekileyo ekukhulelweni. Nabani na umfazi osebudaleni bokuzala kufuneka axoxe ngale nto ngaphambi kotyando, kwaye ukukhulelwa kufuneka kucwangciswe kunye nogqirha wentliziyo kunye nogqirha wokubelekisa, kungaze kuqalwe ngaphandle kwengcebiso.

Izigulana ezindala

Kwizigulana ezingaphezulu kweminyaka engama-65 ukuya kwengama-70 ubudala, iivalvu zezicubu zihlala zithandwa kuba ukuqina akubalulekile kangako kwaye ukuphepha i-warfarin kubaluleke kakhulu, ingakumbi apho ukuwa, ukungaboni kakuhle, iingxaki zenkumbulo okanye ubunzima bokuhamba ukuya kuvavanyo lwe-INR zizinto ezixhalabisayo. Ubuthathaka, ukusebenza kwezintso, isifo semiphunga kunye nesondlo zihlolwa ngononophelo, kwaye kwizigulana ezisengozini enkulu ukhetho lwe-transcatheter okanye ulawulo lwezonyango lunokuba lolona khetho luthembekileyo.

Ukuba Ukhetha Ukungasebenzi

Ukwala okanye ukulibazisa utyando lilungelo lakho, kwaye kukho iimeko apho ulawulo lwezonyango lufanelekile ngokwenene, njengobuthathaka obuphezulu kakhulu okanye isifo esibi kakhulu semiphunga okanye sesibindi. Kuyanceda ukwazi ukuba kwenzeka ntoni ngaphandle kokungenelela kwisifo esibi se-mitral:

• Ukungakwazi ukuphefumla xa uzama ngamandla kudla ngokuqhubekela ekubeni kukungakwazi ukuphefumla xa uphumle kwaye ulele phantsi.
• I-atrium yasekhohlo iyanda, i-atrial fibrillation iba nokwenzeka ngakumbi, kwaye kunye nayo kukho umngcipheko we-stroke.
• Uxinzelelo lwemithambo yegazi yemiphunga luyenyuka, kwaye ukungasebenzi kakuhle kwentliziyo yasekunene kunokulandela ukudumba kwemilenze, ukudumba kwesisu kunye nokuxinana kwesibindi.
• Ukwamkelwa rhoqo esibhedlele ngenxa yokusilela kwentliziyo kuyanda, kwaye utyando, ukuba luyazanywa kamva, lunomngcipheko omkhulu.
• Amayeza anjenge-diuretics, amayeza okulawula izinga lokunyuka kwegazi kunye ne-anticoagulants anokunciphisa iimpawu kwaye anciphise umngcipheko we-stroke, kodwa awalungisi i-valve.

Ukuba ugqiba ekubeni ulinde, cela isicwangciso esichaziweyo sokulandelela nge-echocardiography rhoqo endaweni yokuyeka nje unyango.

Yintoni etshintsha ixabiso lokutshintshwa kwevalvu yeMitral

Asipapashi amanani kweli phepha, kwaye singacebisa ukuba singathembeli kwiiwebhusayithi zokuthelekisa amaxabiso zabantu besithathu. Ezi zinto zilandelayo zimisela uqikelelo lokugqibela, olunokuthi iofisi yokuhlawula yesibhedlele ilungiselele ityala lakho.

Ukuze ufumane uqikelelo olubhaliweyo, uhlalutyo lwezinto ezikhoyo nezingekhoyo kuyo nayiphi na iphakheji, kunye namaxabiso angoku eklasi yegumbi, nceda uthethe neofisi yokwamkela iindwendwe okanye yokuhlawulisa kwi-Apollo Hospitals Lucknow.

I-inshurensi, unyango olungenamali kunye nenkqubo ye-TPA eIndiya

• Icwangciswe ngokuchasene nengxamiseko: Ukutshintshwa kwevalvu ye-mitral kudla ngokucwangciswa, ngoko ke imvume kwangaphambili kufuneka iqalwe kwiintsuku ezintathu ukuya kwezisixhenxe zokusebenza ngaphambi kokungeniswa. Utyando lwevalvu olungxamisekileyo lunyangwa kuqala kwaye imvume ilandelwa ngaxeshanye.
• Amaxesha okulinda: Uninzi lwemigaqo-nkqubo yokhuseleko lwaseIndiya lusebenzisa ixesha lokuqala lokulinda leentsuku ezingama-30 kunye nexesha elithile lokulinda, eliqhele ukuba yiminyaka emibini ukuya kwemine, kwisifo esele sikhona kunye neemeko ezithile ezidwelisiweyo. Isifo se-rheumatic okanye se-degenerative valve esichongiweyo ngaphambi kokuba ipolisi iqale sidla ngokuphathwa njengesikhoyo. Ukwenzakala ngengozi kudla ngokugutyungelwa ukususela kusuku lokuqala, kodwa isifo se-valve phantse asikaze sibe ngengozi, ngoko ke icandelo elikhoyo lelona libalulekileyo apha.
• Amaxwebhu aqhelekileyo afunekayo: ikhadi lepolisi okanye le-e, i-ID yefoto karhulumente, amanqaku okuqala okubonisana, ingxelo ye-echocardiography, ingxelo ye-angiography ukuba yenziwe, icebiso likagqirha onyangayo malunga notyando, kunye nemiyalelo yangaphambili ebonisa ukuba iimpawu zaqala nini.
• Indlela engenamali: Idesika yeinshorensi yesibhedlele ithumela imvume kwangaphambili kwi-inshorensi yakho okanye kwi-TPA, ekhupha imvume yesixa esithile. Ukuncitshiswa kwezinto ezisetyenziswayo ezingahlawulelwayo, imida yerenti yegumbi, iziqendu zokuncitshiswa okulinganayo kunye nentlawulo kunye ziqhelekile, ngoko cela uqikelelo olucacileyo lwesabelo sakho esinokwenzeka ngaphambi kokungena.
• Indlela yokubuyisela imali: Ukuba i-inshorensi yakho ayifakwanga apha, uya kuhlawula uze ufake ibango kamva. Gcina amatyala okuqala, isishwankathelo sokukhululwa kwityala, isitikha sokufakelwa okanye ikhadi lokuchonga ivalvu, kunye nazo zonke iingxelo zophando.
• Izicwangciso zikarhulumente kunye neenkampani: Ukhuseleko phantsi kwe-Ayushman Bharat PM-JAY, iinkqubo zikarhulumente, i-CGHS, i-ECHS, oololiwe okanye iphaneli yenkampani kuxhomekeke kwinkxaso ekhoyo ngoku kunye nokufumaneka kwephakheji. Nceda uqinisekise imeko yenkxaso ekhoyo kwisibhedlele kwidesika yeinshorensi ngaphambi kokuba uhambe.
• Ikhadi levalvu: Emva kotyando uza kufumana ikhadi lokuzazisa le-prosthesis. Ligcine kuwe ngonaphakade; liyafuneka kwiibango zexesha elizayo, umsebenzi wamazinyo, imibuzo ye-MRI kunye nongxamiseko.

Ukucwangcisa ukwamkelwa kunye noko uza kuzisa

• Zonke ii-ECG zangaphambili, iingxelo ze-echo, ii-CD ze-angiography, izishwankathelo zokukhupha kunye nemicu yamayeza yangoku okanye uluhlu olubhaliweyo oluneedosi.
• Isazisi esinefoto kunye nobungqina bedilesi yesigulana kunye nomntu oyintloko oza kujongana nesigulane, kunye nekhadi leinshorensi kunye namaphepha epolisi.
• Iikurtas okanye iihempe ezivulekileyo ngaphambili, kuba impahla ebekwe phezu kwentloko inzima emva kotyando lwe-sternotomy; izihlangu ezityibilikayo ezinebhanti engasemva.
• Ibhrashi yamazinyo, ikama, iitawuli, izinto zokucoca umzimba kunye nebhakethi okanye ikomityi encinci ukuba ukhetha eyakho.
• Ibhokisi yeglasi, isixhobo sokuva, ibhokisi yamazinyo okufakelwa kunye nentonga yokuhamba ukuba isetyenzisiwe.
• Umqamelo oqinileyo wokuwola xa ukhohlela, kunye nencwadi yokubhala ukufundwa kwe-INR kunye nemiyalelo kagqirha.
• Umntu omnye okanye ababini kuphela abancedisi ngexesha lesigaba se-ICU. Kwiintsapho ezidibeneyo, gqiba kwangaphambili ukuba ngubani oza kuba ngumntu omnye oza kunxibelelana noogqirha, ngubani oza kujongana neentlawulo, kwaye ngubani oza kulawula ukutya kunye nokuphumla. Oku kuthintela ukudideka xa kuvunyelwana kunye neengcebiso zokukhululwa esibhedlele.
• Lungisa ibhedi ephakame esinqeni ekhaya, isitulo sokuhlamba, ilungiselelo lempahla yokunxiba, kunye nomntu oza kukunceda ubuncinane iiveki ezine ngaphambi kokuba uye esibhedlele.
• Yeka ukutshaya nokuhlafuna icuba ngaphambi kokuba ungene esibhedlele; oku kuchaphazela ngqo ukubuyiselwa kwemiphunga kunye nokuphiliswa kwamanxeba.
• Landela imiyalelo yokuzila ukutya kanye ngobusuku bangaphambi kotyando, kwaye ucacise ukuba zeziphi iipilisi zakho, ingakumbi amayeza okunciphisa igazi, amayeza eswekile kunye namayeza oxinzelelo lwegazi, ekufuneka zithathwe kusasa kotyando.

Iimpawu Zesilumkiso Ezifuna Ukuhlolwa Ngokukhawuleza

Nxibelelana neqela lentliziyo okanye uxele kwisebe likaxakeka ukuba uqaphela oku:

• Umkhuhlane, ukubanda, okanye ukubomvu, ukudumba, ukufudumala okanye ukuphuma kwamanzi esifubeni.
• Ukuziva uxinezelekile, uqhekeko okanye ukungazinzile kwithambo lesifuba, okanye ukunyuka ngequbuliso kwentlungu yesifuba.
• Ukungakwazi ukuphefumla xa uphumle, ukungakwazi ukulala phantsi, okanye ukuvuka ebusuku uphefumla kancinci.
• Ukutyeba ngokukhawuleza, umlenze omtsha okanye ukudumba kwesisu.
• Ukubetha kwentliziyo, ukuquleka, isiyezi, okanye ukubetha kwentliziyo okukhawulezayo okanye okucothayo kakhulu.
• Ubuthathaka okanye ukungacaci kwecala elinye, ukuthetha okungacacanga, ukulahlekelwa ngumbono ngequbuliso okanye intloko entsha ebuhlungu, nto leyo enokubonisa ukuba umntu unesifo sohlangothi kwaye ufuna unyango olungxamisekileyo.
• Iintsini eziphuma igazi, igazi kumchamo okanye kwindle, indle emnyama, ukudumba okungaqhelekanga, okanye ukopha kakhulu exesheni ngelixa usebenzisa i-warfarin.
• Ukuphosa idosi ye-anticoagulant, i-INR efundeka ngaphezulu okanye ngaphantsi kwenjongo yakho, okanye utshintsho kwisandi sokuklikha sevalvu yomatshini.
• Ukuhlanza okungapheliyo, urhudo okanye ukungakwazi ukusela amayeza, nto leyo ebangela ukuba i-INR ingahlali kakuhle ngokukhawuleza.
• Umkhuhlane omtsha okanye oqhubeka usiba mandundu ngenxa yokwehla kobunzima kangangeeveki, nto leyo enokubonisa usulelo lwevalvu.

Ukuvela Ngaphandle eLucknow

Izibhedlele ze-Apollo uLucknow ufumana ukuhanjiswa kwentliziyo ukusuka kumbindi kunye nempuma ye-Uttar Pradesh kunye namazwe angabamelwane, kubandakanya iKanpur, Unnao, Barabanki, Sitapur, Hardoi, Rae Bareli, Sultanpur, Ayodhya, Gonda, Bahraich, Balrampur, Basti, Gorakhpur, Pratapgrajpurh, Jaunpurya, Lakhiranasi I-Shahjahanpur, i-Bareilly, i-Jhansi, kunye neenxalenye ze-Bihar, izithili ze-Nepal kunye ne-Uttarakhand.

• Hlanganisa utyelelo: thumela iingxelo ze-echo kunye ne-angiography ezikhoyo kwangaphambili nge-imeyile okanye nge-WhatsApp ukuze iqela likwazi ukucebisa ukuba zeziphi iimvavanyo