Uqhaqho lweTAVR kwizibhedlele zeApollo, eLucknow

Kutheni Izigulana Zikhetha Izibhedlele zaseApollo eLucknow kwiTAVR

• Iqela lentliziyo eliyilwe kakuhle, akukho ngcali inye. I-TAVR e-Apollo icetywe liQela leeNtliziyo elidibanisa oogqirha bentliziyo abangenelelayo, oogqirha bentliziyo, iingcali zokunciphisa iintlungu zentliziyo, iingcali zokuthatha imifanekiso yentliziyo kunye noogqirha abangonyango oluqatha, oluyimodeli ecetyiswayo sisikhokelo sokungenelela kwiivalvu zamazwe ngamazwe naseIndiya.
• Ilifa leqela le-Apollo leminyaka engaphezu kwama-40. Iqela le-Apollo Hospitals laqala ngo-1983 kwaye likhule laba lelinye lawona manethiwekhi amakhulu eenkonzo zempilo ezidibeneyo e-Asia, anezibhedlele ezingaphezu kwama-70 kunye nelinye lawona manani makhulu otyando lwentliziyo kunye nokungenelela kwentliziyo kwicandelo labucala eIndiya.
• Ubunzulu besayensi yentliziyo eLucknow. Iyunithi yaseLucknow iqhuba icandelo elipheleleyo lesayensi yentliziyo eliquka i-interventional cardiology, i-electrophysiology kunye ne-pacing, utyando lwentliziyo kunye nokhathalelo lokusilela kwentliziyo, kunye nelebhu yonyango esebenza imini nobusuku kunye ne-ICU yentliziyo. Inani elichanekileyo labacebisi kunye namava abo ngabanye liqinisekiswa ngcono kwidesika yesayensi yentliziyo, njengoko iphaneli itshintsha ngokuhamba kwexesha.
• Iingcali zokuxilonga ezigqiba ekubeni kufanelekile na i-TAVR ziyafumaneka ngaphakathi. I-Transthoracic kunye ne-transoesophageal echocardiography, i-CT aortography enobungakanani be-annulus kunye novavanyo lokufikelela kwinqanawa, i-coronary angiography, kunye nomsebenzi wemiphunga kunye novavanyo lobuthathaka zonke zenziwa phantsi kophahla olunye, ngoko ke izigulana ezivela ngaphandle kweLucknow akufuneki zihambe phakathi kweziko.
• Indawo yanamhlanje yelabhoratri ye-hybrid cath. I-TAVR yenziwa kwilabhoratri yonyango ene-fluoroscopy ephezulu, ukujonga i-hemodynamic, inkxaso yokuhamba ngokukhawuleza kunye nonyango olukhawulezileyo, nto leyo evumela indlela yokwelapha izigulane ezifanelekileyo ngokusebenzisa i-transfemoral, ikakhulu ingqondo.
• Iindlela zokhathalelo ezilungiselelwe ubudala kunye nomngcipheko. Kukho iindlela ezahlukeneyo zabantu abadala nababuthathaka (ukufumana amanqaku abuthathaka, ukuthintela i-delirium, ukuhamba kwangethuba), kubantu abanesifo sezintso (iindlela zokunciphisa umahluko), kubantu abancinci abanesifo se-bicuspid okanye se-rheumatic valve apho utyando lusenokuba lolona khetho lungcono, nakwisifo se-valve sabantwana kunye nesokuzalwa, esiphathwa yindlela yotyando lwentliziyo lwabantwana kunye notyando lwentliziyo endaweni ye-TAVR.
• Ukuqhubeka emva kokukhululwa. Ulandelelwano olucwangcisiweyo nge-echocardiography, uphononongo lwesingqisho seengxaki zokuhambisa umoya, iingcebiso zokuthintela amazinyo kunye ne-endocarditis, kunye neengcebiso zokulungisa intliziyo ezilungiselelwe ubomi basekhaya baseIndiya.

isishwankathelo

Ukutshintshwa kweValve ye-Aortic yeTranscatheter (TAVR), ekwabizwa ngokuba yiTAVI, yinkqubo esekelwe kwi-catheter esetyenziselwa ukunyanga i-aortic stenosis, imeko apho ivalve ye-aortic yentliziyo incipha kwaye ithintela ukuhamba kwegazi kwi-ventricle yasekhohlo. Kwizibhedlele zase-Apollo eLucknow, i-TAVR inikezelwa njengenkonzo ecwangcisiweyo, esekelwe kwiqela kusetyenziswa iinkqubo zevalvu zesizukulwana sangoku kunye nomfanekiso oneenkcukacha wangaphambi kwenkqubo. Amaqela e-cardiology kunye notyando lwentliziyo akha isicwangciso somntu ngamnye kwisigulana ngasinye, ngokugxininisa kukhuseleko, intuthuzelo kunye nengxoxo enyanisekileyo malunga noko inkqubo enokuyenza nengenako ukuyenza.

I-TAVR ayilonyango lwesifo sentliziyo kwaye ayilungelanga wonke umntu onevalvu enciphileyo. Indima yayo, ukhetho phakathi kwe-TAVR kunye nokutshintshwa kwevalvu yotyando oluvulekileyo, kunye nenzuzo elindelekileyo kwisigulana esithile kugqitywa emva kovavanyo. Izibhedlele zase-Apollo iLucknow ligama elaziwayo lokhathalelo lwentliziyo e-Uttar Pradesh, kwaye injongo yale phepha kukunceda izigulana kunye neentsapho ziqonde inkqubo kakuhle ukuze zibuze imibuzo efanelekileyo.

Kutheni i-TAVR iyimfuneko

I-aortic stenosis enzulu enganyangwayo inokukhokelela kwiingxaki ezinkulu, kubandakanya ukusilela kwentliziyo, ukungasebenzi kakuhle kwentliziyo, ukuquleka kunye nokufa. Nje ukuba kuvele iimpawu, ukutshintshwa kwevalvu lolona nyango lubonakalisiweyo olutshintsha imbali yendalo yesi sifo; amayeza anokunceda iimpawu kodwa awakwazi ukuvula ivalvu kwakhona. I-TAVR ithathelwa ingqalelo kwizigulana ezineempawu ezifana nokungaphefumli xa zisebenza nzima, ukuqina kwesifuba, ukudinwa okungaqhelekanga, isiyezi okanye ukucima kombane okubangelwa yi-aortic stenosis enzulu. Iingenelo zayo ziquka:

• Indlela engeyiyo ehlaselayo kangako: Ngokungafaniyo notyando lwentliziyo oluqhelekileyo, i-TAVR idla ngokwenziwa ngokugqobhoza okanye ukunqunyulwa okuncinci kwi-groin, okunciphisa ixesha lokuchacha kunye nokuhlala esibhedlele.
• Umgangatho wobomi obuphuculweyo: Izigulane ezininzi zixela ukuphucuka okubonakalayo kokungakwazi ukuphefumla, amandla kunye nokusebenza kwemihla ngemihla emva kwenkqubo.
• Umngcipheko ophantsi kwizigulane ezisengozini enkulu: I-TAVR ibaluleke kakhulu kwizigulane ezindala kunye nezo zinezinye izifo ezenza utyando oluvulelekileyo lube yingozi, njengotyando lwentliziyo lwangaphambili, ukusebenza kakubi kwemiphunga okanye ubuthathaka obukhulu.

Kwizibhedlele zaseApollo eLucknow, iteknoloji yevalvu yesizukulwana sangoku kunye nocwangciso oluneenkcukacha lwangaphambi kwenkqubo zisetyenziselwa ukusebenzela iziphumo ezilungileyo ezinokwenzeka kwisigulana ngasinye, ngelixa kucacile ukuba iziphumo zixhomekeke kwimpilo yomntu ngamnye iyonke.

Imingcipheko yokuLibazisa

Ukulibazisa unyango lwe-aortic stenosis ebuhlungu eneempawu ezinzima kunokuba nemiphumo emibi kakhulu. Njengoko ukuvaleka kuqhubeka, izihlunu zentliziyo ziyaqina kwaye ziqine, kwaye i-ventricle yasekhohlo iphantsi koxinzelelo olukhulayo. Oku kunokubangela oku kulandelayo:

• Iimpawu ezixhasayo: Ukungakwazi ukuphefumla kakhulu, ukuphelisa ukudinwa, iintlungu zesifuba kunye neziganeko zokuphelelwa ngamandla.
• Ukumelwa yintliziyo: I-aortic stenosis enzima ehlala ixesha elide inokubangela ukungasebenzi kakuhle kwentliziyo, nto leyo echaphazela umgangatho wobomi kwaye inokuba yingozi ebomini. Xa i-ventricle yonakele ngonaphakade, ukutshintshwa kwevalvu kunokuphucula iimpawu kodwa akunakubuyisela ngokupheleleyo ukusebenza okulahlekileyo.
• Umngcipheko ophezulu wenkqubo: Izigulana ezifika kade, zinesifo sentliziyo esingasebenzi kakuhle okanye zichaphazeleke zizintso nesibindi, zihlala zijongene nomngcipheko omkhulu ngexesha lokungenelela, ngoko ke ukudluliselwa kwamayeza ngexesha elifanelekileyo kubalulekile.

Ngenxa yesi sizathu, i-Apollo Hospitals Lucknow igxininisa ukuxilongwa kwangethuba kwe-echocardiographic kunye nokudluliselwa ngokukhawuleza ukuze kuhlolwe ivalvu endaweni yokulinda ngononophelo xa iimpawu ziqala.

Izibonelelo zoTyando lwe-TAVR

• Ukubuyela ngokukhawuleza kwindlela oqhele ukwenza ngayo izinto: Izigulane ezininzi ziphinda ziqalise ukwenza imisebenzi elula yemihla ngemihla kwiintsuku ezimbalwa kuba akukho nxeba lesifuba elinokuphola.
• Ukuhlala ixesha elifutshane esibhedlele: Amatyala angenangxaki e-transfemoral adla ngokukhutshwa kwiiyure ezingama-24 ukuya kuma-72, nangona ukuhlala kwenyani kuxhomekeke ekujongeni isigqi somzimba, ukusebenza kwezintso kunye nokuchacha ngokubanzi.
• Ukuphucula i-hemodynamics yentliziyo: Ukunciphisa ukuvaleka kudla ngokuphucula ukuhamba phambili, kunciphisa uxinzelelo lwe-ventricular kwaye kunciphisa iimpawu.
• Ukuqinisekisa idatha yexesha eliphakathi: Uvavanyo olucwangcisiweyo luye lwalandela izigulane ze-TAVR kangangeminyaka emihlanu nangaphezulu, ukuqina nokusinda kufana kakhulu notyando kubantu abafundwayo. Idatha yokuqina kwexesha elide, ingakumbi kwizigulane ezincinci, isaqokelelana, kwaye oku kuxoxwa ngokunyaniseka ngexesha lokunika iingcebiso.

Ukulungiselela kunye noBuyiselo

Iingcebiso ngokulungiselela

• Ukubonisana: Uvavanyo olupheleleyo kunye neqela le-cardiology ukuze kuhlolwe iimpawu, imbali yezonyango kunye nesimo sokusebenza.
• Uvavanyo lwangaphambi kotyando: I-Echocardiography, i-CT aortography, i-coronary angiography, uvavanyo lwegazi oluquka ukusebenza kwezintso, kunye neminye imifanekiso njengoko kufuneka.
• Ulawulo lwamayeza: Landela imiyalelo ngononophelo malunga nezinto ezinciphisa igazi, amayeza okunciphisa iiplatelets, amayeza esifo seswekile kunye ne-diuretics, ezinye zazo ezifuna ukulungiswa ngaphambi kwenkqubo.
• Uhlengahlengiso kwindlela yokuphila: Ukutya okunempilo kwentliziyo, ukutya okungenatyuwa ingako, ukuyeka icuba kunye ne-gutka, kunye nokwenza izinto ezilula njengoko kucetyisiwe.

Iingcebiso zokubuyisela

• Ukuqeshwa kokulandelela: Yiya kuzo zonke iireviews ezicwangcisiweyo ukuze kujongwe ukusebenza kwevalvu kunye nesingqisho sentliziyo.
• Ukuphumla kunye nomsebenzi: Linganisa ukuphumla ngokuhamba kancinci, unyuse kancinci njengoko kucetyisiwe.
• Lumka kwiimpawu: Xela ukudumba okanye ukopha emqolo, iintlungu zesifuba, umkhuhlane, ukuquleka, ukubetha kwentliziyo kancinci okanye ukungakwazi ukuphefumla ngequbuliso kwangoko.
• Inkxaso: Lungiselela ukuba ilungu losapho lihlale nawe, ingakumbi kwiintsuku zokuqala ezimbalwa.

Ixesha leNkqubo kunye neSigaba sangaphambi kweNkqubo

I-TAVR isoloko iyindlela ecwangcisiweyo. Phakathi kotyelelo lokuqala lwe-cardiologist kunye nomhla wokwenziwa kwenkqubo kukho inqanaba lokuhlolwa, ngokuqhelekileyo iintsuku ezimbalwa ukuya kwiiveki ezimbini okanye ezintathu, apho kuqinisekiswa khona ukuba ufanelekile na.

1. Ukuqinisekisa ubukhali: I-Echocardiography ilinganisa indawo yevalvu, i-gradient ephakathi kunye nesantya sejet, kwaye ivavanya umsebenzi we-ventricular kunye nezinye iivalvu.
2. Ucwangciso lokwakheka komzimba: I-CT aortography ilinganisa i-aortic annulus, ubungakanani beengcambu, ukuphakama kwentliziyo kunye nobukhulu kunye ne-calcification yemithambo ye-femoral kunye ne-iliac, emisela ubungakanani bevalvu kunye nendlela yokufikelela.
3. Uvavanyo lweCoronary: I-Coronary angiography ichonga imiqobo enokufuna ukutshizwa ngaphambi okanye ngexesha lokungeniswa okufanayo.
4. Ukomelela komzimba ngokubanzi: Umsebenzi wezintso, i-hemoglobin, ulawulo lweswekile, umsebenzi wemiphunga, imeko ye-carotid, uphononongo lwamazinyo kunye novavanyo lobuthathaka.
5. Isigqibo seQela leNtliziyo: Iqela licebisa i-TAVR, ukutshintshwa kwevalvu yotyando, okanye kwezinye iimeko ulawulo lwezonyango kunye nonyango lokudambisa iintlungu, kwaye lichaza isizathu kusapho.

Izigulana ezinesifo sentliziyo esingasebenzi kakuhle zingangeniswa kwangethuba ukuze zihlale zizinzile, kwaye kwiimeko ezingaqhelekanga, i-balloon aortic valvuloplasty isetyenziswa njengebhulorho ngaphambi kokutshintshwa kwevalvu.

Oko Kuthethwa Zizikhokelo Zangoku

Ukwenziwa kwezigqibo kumaziko anamava aseIndiya kulandela indibaniselwano yesikhokelo saseIndiya nesamazwe ngamazwe:

• The Ingxelo yeSimo seCardiological Society of India (CSI) malunga nokufakelwa kweTranscatheter Aortic Valve eIndiya (2022) ichaza ukukhethwa kwesigulane, iimfuno zesikhungo, ukwakheka kweQela leNtliziyo, uqeqesho lwabaqhubi kunye nokulindelekileyo kokuhlolwa kwe-TAVI kwindawo yaseIndiya, kwaye igxininisa imiba ethile yaseIndiya efana nobudala obuncinci ekubonakalisweni, isifo se-rheumatic kunye ne-bicuspid valve, kunye neendleko.
• The Izikhokelo ze-ESC/EACTS zika-2021 zoLawulo lweSifo seNtliziyo seValvular Ndicebisa ukungenelela kwi-aortic stenosis enzulu eneempawu, ngokukhetha phakathi kwe-TAVI kunye notyando olusekelwe kwiminyaka, umngcipheko wotyando, umzimba kunye nokukhetha kwesigulana. Kule khokelo, i-TAVI ithandwa kakhulu kwizigulana ezindala, ngokubanzi abo baneminyaka engama-75 nangaphezulu, okanye abo basengozini enkulu yotyando, ngelixa utyando luthandwa kwizigulana ezincinci nezinomngcipheko omncinci.
• The Isikhokelo se-ACC/AHA sika-2020 soLawulo lweZigulana ezineSifo seNtliziyo seValvular, kunye nohlaziyo olugxile ku-2023 kwiinkalo ezinxulumene ne-atrial fibrillation, ithatha indlela efanayo esekelwe kwiminyaka nakwimingcipheko, ibeka i-TAVR kunye notyando njengeendlela ezifanelekileyo kwizigulana ezisengozini ephakathi ezineminyaka emalunga nama-65 ukuya kuma-80.

Okutshintshileyo kutshanje: utshintsho olubaluleke kakhulu kwiminyaka embalwa edlulileyo kukuba i-TAVR ayisapheleli kwizigulane ezingasebenziyo okanye ezisengozini enkulu. Ubungqina bovavanyo kwizigulane ezisengozini encinci buhambise iingcebiso kwisigqibo esabelwana ngaso, esisekelwe kubudala, kwaye kukho ugxininiso olukhulayo kulawulo lobomi bonke, oko kukuthi, ukucwangcisa ngoku indlela inkqubo yesibini yevalvu enokwenziwa ngayo kamva ukuba ivalvu yokuqala iyawohloka. Izikhokelo ngoku zigxininisa ukuba ukungenelela kwevalvu kufuneka kwenziwe kumaziko anevolumu eyaneleyo kunye neQela leNtliziyo elisemthethweni.

Isikhokelo siyatshintsha, kwaye ingcebiso yaso nasiphi na isigulana inokwahluka kumgaqo oqhelekileyo. Ingcali yakho yentliziyo yeApollo iya kukuchazela indlela esebenza ngayo le migaqo kuwe.

I-TAVR xa ithelekiswa nezinye iindlela zonyango

Iiplatifomu zeevalvu nazo zahlukile. Iinkqubo ezikhula ngeebhaluni nezizikhulisayo nganye nganye ineengenelo ngokuxhomekeke kubungakanani be-annulus, ipateni ye-calcium, ukuphakama kwe-coronary kunye nokuba ukufikelela kwi-coronary kwixesha elizayo kunokufuneka na. Iqela leNtliziyo likhetha isixhobo; ukufumaneka kophawu kunye namaxabiso kufuneka kuxoxwe ngawo ngexesha lokucwangcisa.

Iinkqubo Ngamanye amaxesha zenziwa ngexesha elinye okanye kufutshane

• I-Coronary angioplasty kunye ne-stenting: Ukuvaleka okukhulu kwentliziyo kudla ngokuphathwa ngaphambi okanye ngexesha lokungeniswa okufanayo.
• Ukufakelwa kwe-pacemaker esisigxina: Ezinye izigulana ziba ne-conduction block emva kokufakwa kwevalvu kwaye zifuna i-pacemaker, ngokuqhelekileyo ngaphakathi kwe-admission efanayo.
• Unyango lwemithambo yegazi ejikelezayo: Ngamanye amaxesha umthambo we-iliac okanye we-femoral udinga i-angioplasty ukuze kungeneke ngokukhuselekileyo.
• Ukungenelela kwe-atrial yasekhohlo okanye ukungenelela kwe-mitral: Ithathwa njengengqalelo kwizigulana ezikhethiweyo, nangona idla ngokwenziwa ngezigaba endaweni yokuba yenziwe kunye.
• Ukucoca amazinyo kunye nonyango: Usulelo lwamazinyo olusebenzayo lunyangwa kwangaphambili ukuze kuncitshiswe umngcipheko wosulelo lwevalvu.
• I-TAVR yevalvu ekwivalvu: Xa ivalvu yezicubu zotyando ebifakelwe ngaphambili yonakele, ivalvu yeTAVR ngamanye amaxesha inokufakwa ngaphakathi kuyo.

Ukubuyiselwa Kwenqanaba Ngenqanaba

Ukuchacha kuhamba kancinci kwizigulana ezazibuthathaka ngaphambi kwenkqubo, ezazifuna olunye uncedo, okanye ezazineengxaki. La maxesha aqhelekileyo, akaqinisekiswa.

Ukubuyela kwimisebenzi eqhelekileyo, emsebenzini nakwimisebenzi yemihla ngemihla yamaNdiya

• Ukuhamba: Ukuhambahamba okufutshane ngaphakathi ukusuka kusuku lokuqala ekhaya, okwakha imizuzu engama-20 ukuya kwengama-30 yokuhambahamba ngokukhululeka kwiiveki ezine ukuya kwezintandathu.
• Izinyuko: Ihlala ilawuleka kwiiveki ezimbini emva kwe-TAVR ye-transfemoral, ithathwa kancinci kwaye iphathwa ngesandla.
• Iindawo zangasese zokuzihlalela phantsi kunye nezindlu zangasese zesitayile samaNdiya: Ukuquleka nzulu kuyayicinezela indawo ebhobokileyo esinqeni kwaye kungcono ukuba kuthintelwe kangangeeveki ezimbini ukuya kwezine. Apho kunokwenzeka sebenzisa i-Western commode okanye isitulo se-commode esibekwe phezu kwendlu yangasese yaseIndiya ngeli xesha, kwaye ufake i-grab bar yezigulane ezindala.
• Ukuhlala phantsi unxibe imilenze enqamlezileyo: Ngokwesiqhelo yamkelekile xa indawo yesinqe ipholile ngokupheleleyo kwaye ingenantlungu, ngesiqhelo emva kweeveki ezimbini ukuya kwezintathu, nangona izigulana ezindala ezinamalungu aqinileyo zinokufumana lula ukuhlala nesihlalo.
• Ukulala phantsi: Ukuvuka phantsi kufuna ukutyhala iingalo kunye nezinqe kwaye kunokudinisa kwiiveki ezimbini zokuqala. Umandlalo oqinileyo okanye umatrasi oqinileyo ofikelela ebhedini ukhuselekile ekuqaleni, ngakumbi ukunciphisa umngcipheko wokuwa kubantu abadala.
• Ukuhlamba: Ukuhlamba ngesiponji ude indawo yesinqe yome kwaye ivalwe, uze uhlambe. Kuphephe ukuhlamba ngebhakethi ude uvumeleke ukuqubha; sebenzisa isitulo sokuhlamba.
• Ukuqhuba kunye neemoto ezinamavili amabini: Ngokwesiqhelo akudluli kwiiveki ezimbini ukuya kwezine, kwaye kamva ukuba kufakelwe i-pacemaker. Ukuhamba ngeepillion kwiindlela zaseIndiya kuyayishukumisa indawo yesinqe kwaye kungcono ukulibaziseka.
• Umsebenzi: Umsebenzi wedesika nowokubeka iliso udla ngokuqala kwakhona kwiiveki ezimbini ukuya kwezine. Umsebenzi wezandla, ukulima, ukulayisha imithwalo kunye nokuqhuba umgama omde kufuna imvume yomntu ngamnye, rhoqo kwiiveki ezintandathu nangaphezulu.
• Ukuphakamisa: Kuphephe ukuphakamisa ubunzima obungaphezulu kwe-5 kg ​​kwiiveki ezimbini ukuya kwezine zokuqala, kuquka iibhakethi zamanzi, iisilinda zegesi kunye neenzala.
• Ukuzilolonga kunye nemidlalo: Ukuhamba ngendlela ecwangcisiweyo, ukukhwela ibhayisekile engashukumiyo kunye neyoga elula zilungele uninzi lwezigulane. Imidlalo yokhuphiswano, uqeqesho olunzima kunye ne-asanas enzima equka ukubamba umphefumlo okanye ukuzola zifuna ukususwa ngokupheleleyo kwaye, kwizigulane ezincinci, uvavanyo olusemthethweni lomthambo.
• Ubomi benkolo nobentlalo: Ukutyelela etempileni, umthandazo kunye nemisebenzi yosapho idla ngokuqala kwiiveki ezimbalwa. Uhambo olude, ukuzila ukutya kunye nokuhamba okuxineneyo kufuneka kuxoxwe ngako kutyelelo olulandelayo, ngakumbi kwizigulana ezisebenzisa amayeza okunciphisa igazi.

Ukukhusela iValve entsha kunye nokuthintela iingxaki

• Sela amayeza okulwa neeplatelet okanye amayeza okulwa nokugabha igazi njengoko kuchaziwe, kwaye ungaze uwayeke wedwa ngaphambi kokuba wenze amazinyo okanye ezinye iinkqubo.
• Gcina ucoceko oluhle kakhulu lwamazinyo kwaye uhlolwe amazinyo rhoqo; xelela ugqirha wamazinyo ngamnye kunye nogqirha ukuba unevalvu ye-aortic yokufakelwa, njengoko kucetyiswa ukuba kuthintelwe amazinyo ngaphambi kokuba kwenziwe iinkqubo ezithile zamazinyo.
• Nyanga umkhuhlane, usulelo lolusu, usulelo lomchamo kunye namathumba ngokukhawuleza, kwaye ungawutyesheli umkhuhlane ongapheliyo ongachazwanga, onokubonisa usulelo lwevalvu.
• Kuphephe ukwenza iitattoo ezingalawulwayo, ukugqobhoza indlebe okanye impumlo kunye neenkqubo ezingabulali zintsholongwane.
• Lawula uxinzelelo lwegazi, isifo seswekile, i-cholesterol kunye nobunzima; yeka ukutshaya, ukuhlafuna icuba kunye notywala.
• Nciphisa ityuwa, ipapad, iipickles, ukutya okupakishwe ngepakeji kunye nokutya kwerestaurant ukuba kukho ukungasebenzi kakuhle kwentliziyo.
• Yiya kwi-echocardiography yonyaka nokuba uzive uphilile ngokupheleleyo, ngoko ke ukuwohloka kwevalvu kuyaqapheleka kwangethuba.
• Phatha ikhadi lakho lokufakelwa kwevalvu kunye nesishwankathelo sokukhupha xa useluhambeni, kwaye ugcine ifoto yazo kwifowuni yakho.

Abantu abadala, izigulane ezincinci kunye nabantwana

Abantu abadala nababuthathaka

Uninzi lwezigulane ze-TAVR eIndiya zingaphezulu kwama-70 eminyaka ubudala. Uvavanyo lubandakanya ubuthathaka, inkumbulo, ukutya okunesondlo, i-anemia, ukusebenza kwezintso kunye nomngcipheko wokuwa. I-TAVR inokunceda kakhulu iimpawu kweli qela, kodwa ukuba isifo sengqondo esibi, umhlaza oqhubele phambili okanye ubuthathaka obukhulu kuthetha ukuba isigulana asinakukwazi ukuxhamla, iQela leeNtliziyo liya kuthetha ngokunyaniseka kwaye lixoxe ngonyango olujolise kwiimpawu endaweni yoko. Ukuthintela i-Delirium, ukusetyenziswa ngononophelo komahluko kunye nokunyakaza kwangethuba yinxalenye yendlela yabantu abadala.

Abantu abadala abancinci nabancinci abasengozini

Kwizigulane ezikwiminyaka yazo yamashumi amane, amahlanu kunye nasekuqaleni kweminyaka engamashumi amathandathu, ukutshintshwa kweevalvu zotyando kuhlala kuyindlela ekhethwayo kuba ukuqina kwexesha elide kweevalvu zotyando kusekwe ngcono kwaye ucwangciso lobomi bonke lubalulekile. Iivalvu zeBicuspid kunye neevalvu zePost-rheumatic, zombini ezixhaphakileyo eIndiya, zinokuba ne-anatomy engathandekiyo kune-TAVR. Esi sisigqibo esabiweyo esilinganisa ukuqina, ukuthintela ukujiya kwegazi, umsebenzi kunye nezicwangciso zosapho.

Abantwana kunye nesifo se-congenital valve

I-TAVR njengoko ichaziwe apha yinkqubo ye-calcific aortic stenosis yabantu abadala kwaye ayisetyenziswa ebantwaneni. Abantwana kunye nolutsha olunesifo se-aortic valve lulawulwa yi-cardiology yabantwana kunye notyando lwentliziyo lwabantwana nge-balloon valvuloplasty, ukulungiswa kwevalvu, inkqubo yeRoss okanye ukutshintshwa kotyando, kuxhomekeke kwi-anatomy. Iintsapho kufuneka zicele ukudluliselwa kwiqela lentliziyo labantwana endaweni ye-TAVR.

Abafazi, ukukhulelwa kunye nokuthintela ukujiya kwegazi

Abafazi abakwiminyaka yokuzala abane-aortic stenosis enzima badinga iingcebiso ngaphambi kokukhulelwa, kuba ukukhetha ivalvu kuchaphazela ukhuseleko lokuthintela ukujiya kwegazi ngexesha lokukhulelwa. Oku kufuna i-cardiology yamalungu kunye nengxoxo yokubeleka ngaphambi kokuba kuqhutywe nayiphi na inkqubo yevalvu.

Ukuba Ukhetha Ukungayi Kwenziwe Le Nqubo

Ukutshintsha ivalvu ngendlela engafanelekanga lukhetho olufanelekileyo, kwaye kufuneka lube lolwazi oluchanekileyo. Ngaphandle kokungenelela, i-aortic stenosis eneempawu ezinzima iyaqhubeka; uthotho lwembali lubonisa ukufa okuphezulu kwiminyaka embalwa emva kokuba iimpawu ziqalile, kwaye imeko imbi kakhulu xa kuvela ukusilela kwentliziyo, ukuquleka okanye i-angina. Amayeza anokunciphisa ubuninzi bolwelo kunye nokuphefumla kodwa akanakunceda ekuthinteleni ukuvaleka komatshini, kwaye amanye amayeza kufuneka asetyenziswe ngononophelo kuba ukuncitshiswa okumiselweyo kuthintela amandla entliziyo okuphendula kuxinzelelo lwegazi oluwayo.

Ukuba ugqiba ekubeni ungasebenzisi i-TAVR okanye utyando, iqela lisenokukunceda ngokunciphisa umchamo, ukulawula i-anemia kunye nesifo seswekile, iingcebiso zomsebenzi osekelwe kwiimpawu, inkxaso yasekhaya, kunye negalelo lonyango lokudambisa apho kufanelekileyo. Ungatshintsha ingqondo yakho, nangona ulungelelwano lomngcipheko kunye nenzuzo lunokutshintsha ukuba intliziyo iba buthathaka ngakumbi. Iintsapho kufuneka zixoxe ngeenjongo zokhathalelo kunye nokukhetha ukungena esibhedlele kwangaphambili.

Izinto Ezichaphazela Ixabiso le-TAVR

I-TAVR yenye yezona ndlela zibiza kakhulu zokungenelela kwentliziyo eIndiya, ikakhulu ngenxa yesixhobo sevalvu ngokwaso. Izibhedlele zase-Apollo eLucknow zibonelela ngoqikelelo olubhaliweyo emva kovavanyo. Ezi zinto zilandelayo zichaza ukuba kutheni izigulana ezimbini zinokufumana uqikelelo olwahlukileyo kakhulu.

Izibhedlele zaseApollo eLucknow azipapashi ixabiso elimiselweyo le-TAVR kweli phepha, kwaye amanani acatshulwe ziiwebhusayithi zamaxabiso zomntu wesithathu awathembekanga. Nceda ubuze idesika yesayensi yentliziyo okanye idesika yokuhlawula kunye neyomshuwalense ukuze ufumane uqikelelo lwangoku nolucwangcisiweyo ngaphambi kokungena.

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

• Ukhuseleko olucwangcisiweyo, kungekhona ingozi: I-Aortic stenosis sisifo, ngoko ke i-TAVR ibangwa phantsi kwesibonelelo sokugula okanye sokulaliswa esibhedlele sepolisi yakho, kungekhona phantsi kwesibonelelo sengozi yomntu. Iipolisi zengozi yomntu azihlawuleli isifo sevalvu esiwohlokayo.
• Amaxesha okulinda abalulekile: Uninzi lwemigaqo-nkqubo yokhuseleko lwaseIndiya isebenzisa ixesha lokuqala lokulinda elimalunga neentsuku ezingama-30, ixesha lokulinda isifo esithile elimalunga nonyaka omnye ukuya kwemibini kwiimeko ezithile ezidwelisiweyo, kunye nexesha lokulinda isifo esele likho elinokuthi phantsi kwemigaqo yangoku ye-IRDAI lidlule ukuya kwiinyanga ezingama-36. Ukuba isifo sakho sevalvu safunyaniswa okanye sineempawu ngaphambi kokuba ipolisi iqale, sityhile kwaye ubuze umshwalense ngokubhaliweyo ukuba siyahlawulwa na.
• Isixa semali esinomshuwalense xa kuthelekiswa nexabiso lesixhobo: Ngenxa yokuba i-prosthesis ibiza kakhulu, imali encinci efakwe kwi-inshurensi ingaphelelwa ngokukhawuleza. Jonga ukuba unayo i-top-up okanye i-super-up, ipolisi yenkampani, okanye ipolisi yesibini enokusetyenziswa kwibhalansi.
• Ugunyaziso lwangaphambili olungenamali: Kwinkqubo ecwangcisiweyo, faka amaxwebhu kwi-TPA okanye kwi-inshorensi kwiintsuku ezimbalwa kwangaphambili. Iimvume zihlala zithatha iiyure ezingama-24 ukuya kuma-72 zokusebenza, kwaye imibuzo inokwandisa oku, ngoko ke musa ukucwangcisa ukwamkelwa ngaloo mini ufaka isicelo ngayo.
• Amaxwebhu adla ngokufuneka: ikopi yomgaqo-nkqubo kunye nekhadi, i-ID enefoto kunye ne-Aadhaar, inqaku leengcebiso likagqirha elinokuxilongwa, i-echocardiography kunye neengxelo ze-CT, iirekhodi zonyango zangaphambili, kunye noqikelelo lwesibhedlele.
• Indlela yokubuyisela imali: Ukuba awufumani mali okanye i-inshorensi yakho ayihlawulwanga, ungahlawula uze ufake ibango kamva. Gcina amatyala okuqala, i-invoyisi yesixhobo esineziqendu kunye nestikha sevalvu okanye istikha se-implant, isishwankathelo sokukhululwa, zonke iingxelo kunye neerisithi zentlawulo.
• Izinto ezingahlawulelwayo: Izinto ezisetyenziswayo, iiglavu, ezinye izinto ezilahlwayo, ukutya okusecaleni, izinto zefowuni kunye nezinto ezithuthuzelayo zihlala zingabandakanywa kwaye zihlawulwa nguwe. Umlinganiselo wokuqeshisa igumbi kunye nezigaba zokutsalwa kwexabiso elilinganayo nazo zinokunciphisa ukuhlawulwa ukuba ukhetha udidi lwegumbi oluphezulu kunokuba umgaqo-nkqubo wakho uvumela.
• Izikimu zikarhulumente kunye nabaqeshi: Ukhuseleko phantsi kwe-CGHS, i-ECHS, izicwangciso zabasebenzi bakarhulumente, izicwangciso ze-PSU okanye i-Ayushman Bharat kuxhomekeke ekufakweni nasekufakweni nasekubeni inkqubo ethile kunye nokufakelwa kudwelisiwe na. Qinisekisa imeko yangoku kwidesika yomshuwalense ngaphambi kokungeniswa, njengoko imithetho yokufakelwa kunye neephakheji itshintsha.

Ngenxa yokuba imiqathango yomgaqo-nkqubo, amaxabiso okufakelwa kunye namaxabiso eepakeji ahlukile, nceda uqinisekise yonke imibuzo yokugubungela ngqo kwi-Apollo Hospitals Lucknow insurance kunye ne-TPA desk endaweni yokuthembela kulwazi oluqhelekileyo.

Ukucwangcisa ukwamkelwa kunye noko uza kuzisa

Ngaphambi kokuba uye esibhedlele

• Qinisekisa umhla wokungeniswa, ixesha lokufaka ingxelo kunye nemiyalelo yokuzila ukutya.
• Ukuqinisekiswa okupheleleyo kwangaphambili kwe-inshorensi kunye nokucoca amazinyo ukuba kucetyisiwe.
• Cacisa amayeza omawuyeke kwaye nini, ingakumbi amayeza okunciphisa igazi, i-metformin kunye ne-SGLT2 inhibitors.
• Lungiselela umlindi omnye oyintloko kunye nomnye umntu oza kuncedisa; kwiintsapho ezidibeneyo, gqibani ukuba ngubani oza kujongana neendleko, ngubani oza kuhlala ubusuku bonke kwaye ngubani oza kulawula ikhaya nabantwana, kwaye ninike iqela elinyangayo inombolo enye yoqhagamshelwano ukuze kuthintelwe ukudideka.

Yintoni ekufuneka uyipakishe

• Zonke iiresiphi zangaphambili, izishwankathelo zokukhululwa esibhedlele, ii-ECG, iingxelo ze-echo kunye ne-CT ezikwiphepha kwaye, ukuba kunokwenzeka, kwi-CD okanye kwi-pen drive
• Imicu yamayeza akhoyo ngoku kwiphakheji yawo yokuqala
• I-Aadhaar okanye i-ID enefoto, ikhadi le-inshorensi, amaxwebhu epolisi, iileta zomqeshi okanye zenkqubo
• Impahla evulekileyo ngaphambili, izihlangu ezingatyibilikiyo, iiglasi zeglasi, isixhobo sokuva kunye nebhokisi yamazinyo okufakelwa
• Izinto zokuhlamba, itawuli elula, ikomityi, kunye neenabukeni zabantu abadala okanye iiphedi ukuba ingxaki yokungakwazi ukuzibamba
• Ifowuni enetshaja kunye nentambo ende, incwadi encinci yemiyalelo
• Imali encinci kunye nekhadi ledebithi okanye letyala elisebenzayo kwizinto ezingahlawulelwayo

Yintoni omawuyishiye ekhaya

• Ubucwebe, imali eninzi kunye nezinto ezixabisekileyo
• Ukutya okuphekiweyo ekhaya ngaphandle kokuba ingcali yokutya ikuvumile, kuba imiqathango yetyuwa kunye nolwelo iyasebenza emva kweenkqubo zevalvu.

Ukulungisa indlu ngaphambi kokuba iphume

• Beka ibhedi okanye ibhedi yomntwana kwindawo efikelelekayo kumgangatho ophantsi ukuba kunokwenzeka
• Lungiselela isitulo sempahla yasekhaya okanye indawo yokungena yangasese yaseNtshona kunye nesitulo sokuhlambela
• Susa iingcingo ezikhululekileyo, iimathi kunye nemigangatho etyibilikayo ukuze uthintele ukuwa
• Yiba nomatshini wokucwangcisa iipilisi, isixhobo sokujonga i-BP, isikali sokulinganisa kunye ne-thermometer kufutshane.

Iimpawu Zesilumkiso Ezifuna Uphononongo Olungxamisekileyo

Nxibelelana neqela lezonyango lwentliziyo okanye uqhagamshelane necandelo likaxakeka elikufutshane nawe ngoko nangoko ukuba uqaphela oku:

• Ukuphelelwa ngumoya ngequbuliso, okanye ukungakwazi ukuphefumla xa ulele phantsi
• Intlungu yesifuba okanye uxinzelelo oluhlala ixesha elingaphezu kwemizuzu embalwa
• Ukuquleka, ukuphelelwa ngamandla, okanye ukubetha kwentliziyo okungapheliyo okungaphantsi kwama-45 ngomzuzu
• Intliziyo entsha ibetha ngamandla, ingakumbi xa ikhawuleza kwaye ingaqhelekanga
• Ubuthathaka okanye ukungaziva kobuso, ingalo okanye umlenze, intetho engavakaliyo okanye ukulahleka kombono ngequbuliso, okunokubonisa ukuba umntu unesifo sohlangothi.
• Ukudumba okwandayo, iqhubu elibuhlungu, okanye ukopha okutsha kwindawo yokubhoboza i-groin
• Umlenze obandayo, okhanyayo okanye obuhlungu ecaleni kwenxeba elihlatyiweyo
• Umkhuhlane ongaphezulu kwe-100.4°F oqhubeka ixesha elide ngaphezu kosuku okanye ezimbini, ukubanda, okanye ukubila ebusuku
• Ukunyuka ngokukhawuleza kobunzima obuyi-2 kg okanye ngaphezulu kwiintsuku ezintathu, okanye ukwanda kokudumba kwemilenze nesisu
• Indle emnyama, igazi emchameni okanye ukudumba okungaqhelekanga ngelixa usebenzisa izinto zokunciphisa igazi

Kwabaguli Abahambayo Abavela Kwizithili Nezixeko Ezikufutshane

Izibhedlele zeApollo uLucknow unceda izigulana ezisuka kulo lonke elase-Uttar Pradesh nakumazwe angabamelwane, kubandakanya iKanpur, Unnao, Barabanki, Sitapur, Hardoi, Lakhimpur Kheri, Rae Bareli, Sultanpur, Amethi, Ayodhya, Basti, Gonda, Bahraich, Balrampur, Shravasti, Praunpuryapuryagrah, Varavasti, Praunpuryapuryagrah Bareilly, Shahjahanpur, Farrukhabad, Kannauj, Fatehpur, Banda, Chitrakoot kunye neJhansi, kunye nakwiindawo zaseBihar, eNepal nase-Uttarakhand.

Iingcebiso ezisebenzayo kwiintsapho zasemakhaya