Ukubekwa Kwedivayisi ye-Impella - Izindleko, Izinkomba, Ukulungiselela, Izingozi, Nokululama

Ukufakwa kwedivayisi ye-Impella kuyindlela encane kakhulu eyenzelwe ukusekela iziguli ezinezimo zenhliziyo ezinzima. Idivayisi ye-Impella ngokwayo iyiphampu encane, esekelwe ku-catheter esiza inhliziyo ukuthi ipompe igazi ngempumelelo. Ngokuvamile isetshenziswa ezigulini ezibhekene nokwehluleka okukhulu kwenhliziyo noma ukushaqeka kwenhliziyo, izimo lapho inhliziyo ingakwazi ukupompa igazi elanele ukuhlangabezana nezidingo zomzimba. Idivayisi ifakwa ngemithambo yegazi, ngokuvamile emlenzeni, bese iqondiswa enhliziyweni, lapho isiza khona ekugcineni ukugeleza kwegazi.

Inhloso eyinhloko yedivayisi ye-Impella ukuhlinzeka ngokusekelwa kwesikhashana kokujikeleza kwegazi. Lokhu kungabaluleka kakhulu ezimweni ezibucayi, njengangemva kokuhlaselwa yinhliziyo noma ngesikhathi sezinqubo zenhliziyo eziyingozi kakhulu. Ngokuthuthukisa ukugeleza kwegazi, idivayisi ye-Impella isiza ekuqiniseni iziguli, ivumela izinhliziyo zazo ukuba zilulame noma inikeze isikhathi sokungenelela okwengeziwe, njengokuhlinzwa noma okunye ukwelashwa.

Idivayisi ye-Impella iwusizo kakhulu ezigulini ezisengozini enkulu yezinkinga ngesikhathi sezinqubo ezifana ne-coronary artery bypass grafting (CABG) noma i-percutaneous coronary interventions (PCI). Ingasetshenziswa futhi ezigulini ezilinde ukufakelwa inhliziyo noma lezo ezingasabeli ekwelashweni kwendabuko kwezokwelapha.
 

Kungani Ukufakwa Kwedivayisi Ye-Impella Kwenziwa?

Isinqumo sokwenza ukufakwa kwedivayisi ye-Impella ngokuvamile sisekelwe esimweni sesiguli kanye nobunzima bokwehluleka kwenhliziyo yabo. Iziguli zingase zibe nezimpawu ezifana nokuphelelwa umoya, ukukhathala, ubuhlungu besifuba, noma ukugcinwa koketshezi. Lezi zimpawu zingabonisa ukuthi inhliziyo ayisebenzi kahle, okuholela ekugelezeni kwegazi okwanele ezithweni ezibalulekile.

Idivayisi ye-Impella ivame ukunconywa ezimweni zokushaqeka kwenhliziyo, isimo esisongela ukuphila esenzeka lapho inhliziyo ingakwazi ukupompa igazi elanele ukuhlangabezana nezidingo zomzimba. Lokhu kungenzeka ngemva kokuhlaselwa yinhliziyo, ukushaya kwenhliziyo okukhulu, noma ezinye izehlakalo zenhliziyo. Kulezi zimo, idivayisi ye-Impella inganikeza ukwesekwa okusheshayo, isize ekuqiniseni isiguli ngenkathi kucatshangelwa ezinye izindlela zokwelapha.

Ngaphezu kwalokho, idivayisi ye-Impella ingaboniswa iziguli ezenza izinqubo zenhliziyo ezinobungozi obukhulu. Isibonelo, ngesikhathi se-PCI, idivayisi ingasiza ekugcineni ukugeleza kwegazi kuya emisipheni yenhliziyo, kuncishiswe ingozi yezinkinga. Ingasetshenziswa futhi ezigulini ezinesifo senhliziyo esithuthukile ezingezona iziguli zokwelapha zendabuko, okuhlinzeka ngebhuloho lokululama noma ukufakelwa.
 

Izinkomba Zokubekwa Kwedivayisi Ye-Impella

Izimo eziningana zezokwelapha kanye nokutholakele kokuxilonga kungenza isiguli sibe yilungu lohlelo lokufakwa kwedivayisi ye-Impella. Lokhu kufaka phakathi:
 

• I-Cardiogenic Shock: Lesi yisibonakaliso esivame kakhulu sedivayisi ye-Impella. Iziguli ezithola ukushaqeka kwenhliziyo zivame ukuba nomfutho wegazi ophansi, ukugeleza kwegazi okungekuhle ezithweni zomzimba, kanye nokungasebenzi kahle kwenhliziyo.
• Ukwehluleka Kwenhliziyo Okukhulu: Iziguli ezinesifo senhliziyo esithuthukile ezingasabeli ekwelashweni kwezokwelapha zingase zizuze kudivayisi ye-Impella. Lokhu kufaka phakathi labo abane-ejection fraction encishisiwe kanye nezimpawu zokwehluleka kwenhliziyo naphezu kokuphathwa kahle kwezokwelapha.
• Izinqubo Zenhliziyo Eziyingozi Kakhulu: Iziguli ezisebenzisa izinqubo eziyingozi kakhulu, njenge-PCI noma i-CABG, zingadinga ukwesekwa yidivayisi ye-Impella ukuqinisekisa ukugeleza kwegazi okwanele ngesikhathi nangemva kwenqubo.
• I-Acute Myocardial Infarction: Ezimweni zokuhlaselwa yinhliziyo okukhulu, idivayisi ye-Impella ingasetshenziswa ukusekela inhliziyo ngenkathi kubhekwana nezinkinga eziyisisekelo.
• Ibhuloho Lokutshala Izitshalo: Ezigulini ezilindele ukufakelwa inhliziyo, idivayisi ye-Impella inganikeza ukwesekwa okudingekayo, ithuthukise amathuba azo okusinda kuze kube yilapho kutholakala inhliziyo efanelekile yomnikeli.
• I-Arrhythmia Enkulu: Iziguli ezine-arrhythmias esongela ukuphila ezibeka engcupheni ukuphuma kwenhliziyo nazo zingase zibe ngabantu abazofakwa kudivayisi ye-Impella.

Ngamafuphi, ukufakwa kwedivayisi ye-Impella kuyindlela ebalulekile yokungenelela kweziguli ezinezimo zenhliziyo ezinzima, okunikeza ukwesekwa okubalulekile ngesikhathi sezimo ezisongela ukuphila kanye nezinqubo eziyingozi kakhulu. Ngokuqonda izinkomba kanye nenhloso yale nqubo, iziguli kanye nemindeni yazo zingabhekana kangcono nobunzima bokuphathwa kwezifo zenhliziyo.
 

Izimo Zokubekwa Kwedivayisi Ye-Impella

Nakuba idivayisi ye-Impella ingaba yindlela yokusindisa impilo yeziguli eziningi ezinezimo zenhliziyo ezinzima, izici ezithile zingenza isiguli singafaneleki kule nqubo. Ukuqonda lezi ziphazamiso kubalulekile kokubili ezigulini nakubahlinzeki bezempilo ukuqinisekisa ukuphepha nokusebenza kahle.
 

• Isifo esibi kakhulu se-Peripheral Vascular: Iziguli ezivinjiwe noma ezilimele kakhulu emithanjeni yegazi zingase zingafaneleki ukufakwa kwe-Impella. Lesi simo singaphazamisa ikhono lokufinyelela enhliziyweni nge-femoral artery, okuyindawo evame kakhulu yokungena kule divayisi.
• Ukutheleleka Okusebenzayo: Uma isiguli sinesifo esithathelwanayo esisebenzayo, njenge-sepsis, ingozi yezinkinga iyanda. Ukuba khona kwesifo kungathinta nekhono lomzimba lokuphulukisa ngemva kwenqubo.
• Ukungasebenzi kahle kwe-aorta enkulu: Iziguli ezine-aorta regurgitation enkulu zingase zingazuzi ngedivayisi ye-Impella. Lesi simo singaholela ekugelezeni kwegazi okungalungile futhi singase senze kube nzima ukusebenzisa idivayisi.
• Izifo Zokopha Ezingalawuleki: Abantu abane-coagulopathy noma ezinye izinkinga zokopha bangase babhekane nezingozi ezengeziwe ngesikhathi nangemva kwenqubo. Ukufakwa kwedivayisi ye-Impella kuhilela ukufakwa kwe-catheter, okungaholela ezinkingeni zokopha.
• I-Myocardial Infarction yakamuva: Iziguli ezike zaba nokuhlaselwa yinhliziyo muva nje zingase zingabi abantu abafanelekile ukusebenzisa idivayisi ye-Impella, ikakhulukazi uma zisabhekene nomonakalo omkhulu wemisipha yenhliziyo.
• Ukuvalwa Okukhulu Kwendlela Yokuphuma Kwemithambo Yesobunxele: Izimo ezivimbela ukugeleza kwegazi kusuka e-ventricle yesobunxele zingenza kube nzima ukusebenzisa idivayisi ye-Impella, okwenza ingasebenzi kahle noma ibe yingozi.
• Isifo Senhliziyo Esiyisigaba Sokugcina: Iziguli ezinesifo senhliziyo esingapheli noma labo abangebona abantu abazofakelwa inhliziyo kungenzeka bangazuzi ukwesekwa kwesikhashana okunikezwa yidivayisi ye-Impella.
• Ukungasebenzi Kakhulu Kwezinso: Iziguli ezinokukhubazeka okukhulu kwezinso zingase zibhekane nezingozi ezengeziwe ngesikhathi senqubo, njengoba udayi wokungafani osetshenziswa ezifundweni zezithombe ungafaka kakhulu ukusebenza kwezinso engozini.
• Ukwenqaba Kwesiguli: Uma isiguli singafisi ukwenza inqubo noma sikhathazekile ngezingozi ezihilelekile, singase sibhekwe njengesingafaneleki ukufakwa kwe-Impella.

Kubalulekile ukuthi abahlinzeki bezempilo benze ukuhlolwa okujulile komlando wezokwelapha wesiguli ngasinye kanye nesimo sempilo samanje ukuze kutholakale ukufaneleka kokufakwa kwedivayisi ye-Impella.
 

Indlela Yokulungiselela Ukubekwa Kwedivayisi Ye-Impella

Ukulungiselela ukufakwa kwedivayisi ye-Impella kuhilela izinyathelo eziningana ezibalulekile ukuqinisekisa ukuthi inqubo ihamba kahle futhi iphephile. Nakhu iziguli ezingakulindela ngokwemiyalelo yangaphambi kwenqubo, izivivinyo, kanye nezinyathelo zokuphepha.
 

• Ukuhlolwa Kwezempilo: Ngaphambi kwenqubo, iziguli zizohlolwa ngokuphelele ngokwezokwelapha. Lokhu kungafaka ukuhlolwa ngokomzimba, ukubuyekezwa komlando wezokwelapha, kanye nezingxoxo mayelana nemithi yamanje kanye nokungezwani komzimba.
• Ukuhlolwa kokuxilonga: Iziguli kungadingeka zenze izivivinyo eziningana ukuze kuhlolwe ukusebenza kwenhliziyo kanye nempilo iyonke. Izivivinyo ezivamile zifaka:
  • I-Electrocardiogram (ECG): Ukuqapha isigqi senhliziyo.
  • I-Echocardiogram: Ukubona ngeso lengqondo izakhiwo zenhliziyo nokuhlola ukusebenza.
  • Ukuhlolwa Kwegazi: Ukuhlola ukusebenza kwezinso, ama-electrolyte, kanye nezinye izimpawu ezibalulekile.
• Ukubuyekezwa Kwemithi: Iziguli kufanele zazise ithimba lazo lezokunakekelwa kwempilo ngayo yonke imithi eziyithathayo, okuhlanganisa imithi kanye nezithasiselo ezitholakala ngaphandle kwemithi kadokotela. Eminye imithi ingadinga ukulungiswa noma imiswe okwesikhashana ngaphambi kwenqubo, ikakhulukazi imithi yokunciphisa igazi.
• Imiyalelo yokuzila ukudla: Iziguli zivame ukwelulekwa ukuthi ziyeke ukudla noma ukuphuza isikhathi esithile ngaphambi kwenqubo. Lokhu kuvame ukuba cishe amahora angu-6-8, kodwa ithimba lezempilo lizonikeza imiyalelo ethile.
• Ukuhlela ezokuthutha: Njengoba inqubo ingase ihilele ukudambisa ubuhlungu noma ukubulala izinzwa, iziguli kufanele zihlele ukuba othile azishayele ekhaya ngemva kwalokho. Kubalulekile ukungashayeli noma ukusebenzisa imishini esindayo okungenani amahora angama-24 ngemva kwenqubo.
• Ukuxoxa ngezinto ezikhathazayo: Iziguli kufanele zizizwe zikhululekile ukubuza imibuzo noma ukuveza noma yikuphi ukukhathazeka okungenzeka zibe nakho mayelana nenqubo. Ukuqonda okufanele ukulindele kungasiza ekudambiseni ukukhathazeka.
• Imithi Engaphambi Kwenqubo: Kwezinye izimo, iziguli zingase zinikezwe imithi yokubasiza ukuba baphumule ngaphambi kwenqubo. Le mithi izonikezwa yithimba lezempilo.
• Amalungiselelo Enhlanzeko: Iziguli zingase ziyalwe ukuba zigeze ngensipho yokubulala amagciwane ngobusuku bangaphambi noma ekuseni kwenqubo ukuze kuncishiswe ingozi yokutheleleka.

Ngokulandela lezi zinyathelo zokulungiselela, iziguli zingasiza ekuqinisekiseni ukuthi ukufakwa kwedivayisi yazo ye-Impella kuphephile futhi kusebenza kahle ngangokunokwenzeka.
 

Ukubekwa Kwedivayisi ye-Impella: Inqubo Yesinyathelo Ngesinyathelo

Inqubo yokubeka idivayisi ye-Impella ivame ukwenziwa esibhedlela, ngokuvamile elabhorethri ekhethekile yokwelapha inhliziyo. Nasi isifinyezo sesinyathelo ngesinyathelo salokho okwenzekayo ngaphambi, ngesikhathi, nangemva kwenqubo.
 

Ngaphambi Kwenqubo:

• Ukufika nokungena: Iziguli zizofika esibhedlela bese zibhalisa. Zingase zicelwe ukuthi zishintshe zigqoke ingubo yasesibhedlela.
• Ukubekwa Komugqa we-IV: Umugqa womjovo (IV) uzobekwa engalweni yesiguli ukuze kunikezwe imithi kanye noketshezi ngesikhathi senqubo.
• Ukuqapha: Iziguli zizoxhunywa kumamonitha alandelela ukushaya kwenhliziyo, umfutho wegazi, namazinga komoyampilo.

Ngesikhathi Senqubo:

• I-sedation: Iziguli zizothola umuthi wokudambisa ubuhlungu ukuze ziphumule. Kwezinye izimo, kungasetshenziswa umuthi wokubulala izinzwa ojwayelekile.
• Ukufinyelela ku-Femoral Artery: Umhlinzeki wezempilo uzokwenza i-incision encane endaweni ye-groin ukuze afinyelele umthambo we-femoral. Lokhu kuvame ukwenziwa kusetshenziswa i-anesthesia yendawo.
• Ukufakwa kwe-Catheter: I-catheter ifakwa ngokucophelela emthanjeni we-femoral bese iqondiswa enhliziyweni kusetshenziswa i-fluoroscopy (i-X-ray imaging yesikhathi sangempela).
• Ukubekwa Kwedivayisi ye-Impella: Uma i-catheter isikhona, idivayisi ye-Impella ifakwa nge-catheter bese ibekwa ku-ventricle yesobunxele yenhliziyo. Idivayisi ibe isisebenza ukuze iqale ukusiza ekugelezeni kwegazi.
• Ukuqapha: Kuyo yonke inqubo, ithimba lezokunakekelwa kwempilo lizoqapha izimpawu ezibalulekile zesiguli kanye nokusebenza kwedivayisi ye-Impella.

Ngemva Kwenqubo:

• Ukubuyisela: Uma inqubo isiqediwe, iziguli zizothuthelwa endaweni yokululama lapho zizoqashwa khona ngokucophelela. Izimpawu ezibalulekile zizoqhubeka nokuhlolwa njalo.
• Imiyalo yangemva kwenqubo: Iziguli zizothola imiyalelo ethile mayelana nemikhawulo yemisebenzi, ukuphathwa kwemithi, kanye nokuqokwa kokulandelela.
• Ukuhlala Esibhedlela: Kuye ngesimo sesiguli kanye nesizathu sokubekwa kwe-Impella, kungadingeka ukuthi umuntu ahlale esibhedlela ukuze aqashwe futhi anakekelwe.

Yonke inqubo ivame ukuthatha cishe ihora elilodwa kuya kwamabili, kodwa isikhathi esiphelele esichithwa esibhedlela singase sibe side ngenxa yokulungiselela nokululama.
 

Izingozi Nezinkinga Zokubekwa Kwedivayisi Ye-Impella

Njenganoma iyiphi inqubo yezokwelapha, ukufakwa kwedivayisi ye-Impella kunezingozi ezithile kanye nezinkinga ezingaba khona. Kubalulekile ukuthi iziguli ziqaphele lezi zingozi, yize iziguli eziningi zithola imiphumela ephumelelayo.
 

Izingozi Ezivamile:

• Ukuphuza: Ingozi evame kakhulu ehambisana nenqubo ukopha endaweni yokufaka. Lokhu ngokuvamile kungalawulwa ngokucindezela nokuqapha.
• ukutheleleka: Kukhona ingozi yokutheleleka endaweni yokufaka i-catheter noma ngaphakathi kwegazi. Ukuhlanzeka okufanele nokunakekelwa kungasiza ekunciphiseni le ngozi.
• Ukulimala Komkhumbi Wegazi: I-catheter ingabangela umonakalo emithanjeni yegazi, okungaholela ezinkingeni ezifana ne-hematoma (ukuqoqwa kwegazi endaweni ethile ngaphandle kwemithambo yegazi).
• Ukungasebenzi Kwezinso: Ukusetshenziswa kodayi wokuhlukanisa ngesikhathi sokuthwebula izithombe kungathinta ukusebenza kwezinso, ikakhulukazi ezigulini ezinezinkinga zezinso ezikhona kakade.

Izingozi Ezingavamile:

• Istroke: Kukhona ingozi encane yokushaywa yisifo sohlangothi ngenxa yokuqhekeka kwegazi okungase kwakheke ngesikhathi senqubo.
• Ukungasebenzi Kwedivayisi: Nakuba kungavamile, idivayisi ye-Impella ingase ingasebenzi kahle, okungadinga ukungenelela okwengeziwe.
• I-Arrhythmias: Ezinye iziguli zingase zibe nokushaya kwenhliziyo okungajwayelekile ngesikhathi noma ngemva kwenqubo.
• I-Thrombosis: Ukwakheka kwamahlule egazi ngaphakathi kwedivayisi noma i-catheter kungenzeka, okungase kuholele ezinkingeni ezinkulu.

Iziguli kufanele zixoxe ngalezi zingozi nomhlinzeki wazo wezempilo ukuze ziqonde izici zazo zobungozi kanye nezinyathelo ezithathwayo zokunciphisa lezi zingozi ngesikhathi senqubo. Sekukonke, izinzuzo zokubekwa kwedivayisi ye-Impella zivame ukwedlula izingozi ezingaba khona ezigulini ezinezimo zenhliziyo ezinzima.
 

Ukubuyiselwa Kwedivayisi Ngemva Kokubekwa Kwedivayisi Ye-Impella

Ngemva kokufakwa kwedivayisi ye-Impella, iziguli zingalindela isikhathi sokululama esihlukahluka ngokuya ngezimo zempilo zomuntu ngamunye kanye nobunzima benqubo. Ngokuvamile, isikhathi sokuqala sokululama esibhedlela sithatha cishe izinsuku ezi-3 kuya kweziyi-7, lapho abahlinzeki bezempilo bezoqapha khona ukusebenza kwenhliziyo kanye nokusebenza kwedivayisi eduze.

Uma seziphumile esibhedlela, iziguli zivame ukuqhubeka nokululama kwazo ekhaya. Amasonto ambalwa okuqala abalulekile, futhi iziguli kufanele zilandele amathiphu athile okunakekelwa kwangemva kokuhlinzwa ukuqinisekisa ukuthi zilulama kahle. Kubalulekile ukugcina indawo yokufaka ihlanzekile futhi yomile, uqaphela noma yiziphi izimpawu zokutheleleka njengokwanda kokubomvu, ukuvuvukala, noma ukuphuma kwegazi. Kuzohlelwa ama-aphoyintimenti okulandelela njalo ukuze kuhlolwe ukusebenza kwedivayisi kanye nempilo yesiguli iyonke.

Ngesikhathi sokululama, iziguli zikhuthazwa ukuthi zikhuphule kancane kancane amazinga azo okusebenza. Imisebenzi elula, njengokuhamba, ngokuvamile ingaqalwa kabusha zingakapheli izinsuku ezimbalwa ngemva kokuphuma esibhedlela, kodwa imisebenzi enzima kakhulu kufanele igwenywe okungenani amasonto amane kuya kwayisithupha. Iziguli kufanele zilalele imizimba yazo futhi zibonane nethimba lazo lezempilo ngaphambi kokuqala imisebenzi evamile, okuhlanganisa umsebenzi nokuzivocavoca.
 

Izinzuzo Zokubekwa Kwedivayisi Ye-Impella

Idivayisi ye-Impella inikeza ukuthuthukiswa okuningana kwezempilo okubalulekile kanye nemiphumela yekhwalithi yempilo yeziguli ezinezimo zenhliziyo ezinzima. Enye yezinzuzo eziyinhloko ikhono layo lokuhlinzeka ngokusekelwa kwesikhashana kwenhliziyo, okungathuthukisa kakhulu ukugeleza kwegazi futhi kunciphise umthwalo womsebenzi enhliziyweni. Lokhu kuzuzisa kakhulu iziguli ezibhekene nokushaqeka kwenhliziyo noma labo abalindele ukuhlinzwa kwenhliziyo.

Iziguli zivame ukubika amazinga athuthukisiwe wamandla kanye nokubekezelela ukuvivinya umzimba okuthuthukisiwe ngemva kokufakwa kwedivayisi. Idivayisi ye-Impella ingazinzisa iziguli, izivumele ukuthi zilulame kahle futhi mhlawumbe zigweme izinqubo ezihlaselayo, njengokufakelwa inhliziyo. Ngaphezu kwalokho, idivayisi ingasiza ekubuyiseleni ukusebenza kwenhliziyo, okuholela emiphumeleni engcono yesikhathi eside.

Ngaphezu kwalokho, idivayisi ye-Impella ayihlaseli kakhulu, okusho isikhathi esifushane sokululama uma kuqhathaniswa nezinketho zokuhlinzwa zendabuko. Lesi sici asigcini nje ngokunciphisa ukuhlala esibhedlela kodwa futhi sinciphisa ingozi yezinkinga ezihlobene nokuhlinzwa kwenhliziyo evulekile. Sekukonke, idivayisi ye-Impella ingaholela ekuthuthukisweni okukhulu kwekhwalithi yokuphila kweziguli ezihlushwa izinkinga ezinkulu zenhliziyo.
 

Ukubekwa Kwedivayisi ye-Impella vs. Ezinye Izinqubo

Nakuba idivayisi ye-Impella iyindlela ehamba phambili yokusekela inhliziyo yesikhashana, ivame ukuqhathaniswa nezinye izinqubo ezifana nokwelashwa nge-intra-aortic balloon pump (IABP). Ngezansi ukuqhathaniswa kwalokhu okubili:

Izindleko Zokubekwa Kwedivayisi Ye-Impella eNdiya

Izindleko ezimaphakathi zokubeka idivayisi ye-Impella eNdiya zisukela ku-₹3,00,000 kuya ku-₹5,00,000. Ukuze uthole isilinganiso esiqondile, xhumana nathi namuhla.
 

Imibuzo Evame Ukubuzwa Mayelana Nokubekwa Kwedivayisi Ye-Impella

• Yini okufanele ngiyidle ngemva kokufakwa kwedivayisi ye-Impella?
  Ngemva kwenqubo, gxila ekudleni okunempilo kwenhliziyo okucebile ngezithelo, imifino, okusanhlamvu okuphelele, namaprotheni angenamafutha amaningi. Gwema ukudla okune-sodium ephezulu kanye namafutha amaningi. Ukuhlala unamanzi emzimbeni nakho kubalulekile. Xhumana nomhlinzeki wakho wezempilo ukuze uthole izincomo zokudla ezenzelwe wena.
• Ngizoba isikhathi esingakanani esibhedlela ngemva kokuhlinzwa?
  Iningi leziguli lihlala esibhedlela cishe izinsuku ezi-3 kuya kweziyi-7 ngemva kokufakwa kwedivayisi ye-Impella. Lesi sikhathi singahluka kuye ngokululama komuntu ngamunye kanye nanoma yiziphi izinkinga ezingase zivele. Ithimba lakho lezokunakekelwa kwempilo lizokunikeza izibuyekezo ngentuthuko yakho.
• Ngingakwazi yini ukuthatha imithi yami evamile ngemva kwenqubo?
  Kufanele uqhubeke nokuthatha imithi yakho oyinikezwe ngumhlinzeki wakho wezempilo ngaphandle kokuthi uyalelwe ngenye indlela. Eminye imithi kungadingeka ilungiswe ngokusekelwe esimweni sakho kanye nomsebenzi wedivayisi ye-Impella.
• Yimiphi imisebenzi engingayenza ngesikhathi sokululama?
  Imisebenzi elula njengokuhamba ingavuselelwa zingakapheli izinsuku ezimbalwa ngemva kokuphuma esibhedlela. Kodwa-ke, gwema ukuphakamisa izinto ezisindayo, ukuzivocavoca okunzima, nokushayela okungenani amasonto amane kuya kwayisithupha. Njalo xhumana nomhlinzeki wakho wezempilo ngaphambi kokuqala noma yimiphi imisebenzi.
• Ngingayinakekela kanjani indawo yokufaka?
  Gcina indawo yokufaka ihlanzekile futhi yomile. Shintsha ibhandeji njengoba kuyalelwe futhi uqaphele izimpawu zokutheleleka, njengokubomvu okwenyukayo, ukuvuvukala, noma ukuphuma kwamanzi. Uma ubona noma yiziphi izimpawu eziphathelene nalokhu, xhumana nomhlinzeki wakho wezempilo ngokushesha.
• Ngingabuyela nini emsebenzini?
  Isikhathi sokubuyela emsebenzini siyahlukahluka kuye ngomsebenzi wakho kanye nenqubekela phambili yokululama. Iziguli eziningi zingabuyela emsebenzini olula zingakapheli amasonto amabili kuya kwamane, kanti imisebenzi enzima kakhulu ngokomzimba ingadinga isikhathi eside sokululama. Xoxa ngesimo sakho esithile nomhlinzeki wakho wezempilo.
• Ingabe ikhona imikhawulo yokudla ngaphambi kwenqubo?
  Ngaphambi kokufakwa kwedivayisi ye-Impella, ungase welulekwe ukuthi ugweme ukudla okuqinile isikhathi esithile, ikakhulukazi uma unikezwa umuthi wokudambisa noma wokubulala izinzwa. Landela imiyalelo yomhlinzeki wakho wezempilo mayelana nokuzila ukudla kanye nemikhawulo yokudla.
• Yini okufanele ngiyenze uma ngizwa ubuhlungu esifubeni ngemva kwenqubo?
  Uma uzwa ubuhlungu esifubeni, ukuphelelwa umoya, noma ezinye izimpawu eziphathelene nalokhu ngemva kwenqubo, funa usizo lwezokwelapha ngokushesha. Lezi kungaba izimpawu zezinkinga ezidinga ukuhlolwa ngokushesha.
• Ingabe iziguli esezikhulile zingafakwa kudivayisi ye-Impella?
  Yebo, iziguli esezikhulile zingazuza ngokufakwa kwedivayisi ye-Impella, ikakhulukazi uma zinezimo zenhliziyo ezinzima. Kodwa-ke, isinqumo sizoncika empilweni yazo iyonke kanye nanoma yiziphi izinkinga ezihambisana nayo. Ukuhlolwa okuphelele ngumhlinzeki wezempilo kubalulekile.
• Ingabe idivayisi ye-Impella iphephile ezigulini zezingane?
  Idivayisi ye-Impella yenzelwe ikakhulukazi iziguli ezindala, kodwa kunezinhlobo ezithile kanye nezindlela zokusebenzisa izingane. Uma ukhathazekile ngengane edinga ukwesekwa kwenhliziyo, xhumana nodokotela wenhliziyo wezingane ukuze uthole iseluleko esikhethekile.
• Idivayisi ye-Impella ihlala isikhathi esingakanani endaweni yayo?
  Idivayisi ye-Impella ingahlala izinsuku eziningana kuya emavikini, kuye ngesimo sesiguli kanye nendlela esisabela ngayo ekwelashweni. Ithimba lakho lezokunakekelwa kwempilo lizonquma isikhathi esifanele ngokusekelwe ekululameni kwakho.
• Yiziphi izimpawu zokutheleleka okufanele ngizibheke?
  Izimpawu zokutheleleka zifaka phakathi ukubomvu okwenyukayo, ukuvuvukala, ukufudumala, noma ukuphuma kwamanzi endaweni yokufaka, kanye nomkhuhlane noma ukubanda. Uma ubona noma yiziphi zalezi zimpawu, xhumana nomhlinzeki wakho wezempilo ngokushesha.
• Ingabe ngizodinga ama-aphoyintimenti okulandelela ngemva kwenqubo?
  Yebo, ama-aphoyintimenti okulandelela abalulekile ukuze kuqashwe ukusebenza kwedivayisi kanye nempilo yenhliziyo yakho. Umhlinzeki wakho wezempilo uzohlela lokhu kuvakasha futhi anikeze isiqondiso salokho ongakulindela ngesikhathi sokululama.
• Ngingakwazi yini ukuhamba ngemva kokufakwa kwedivayisi ye-Impella?
  Ukuhamba kungase kuvinjelwe isikhathi esithile ngemva kwenqubo, ikakhulukazi uma usalulama. Xoxa ngezinhlelo zakho zokuhamba nomhlinzeki wakho wezempilo ukuqinisekisa ukuthi kuphephile ukwenza kanjalo.
• Kwenzekani uma idivayisi ye-Impella ingasebenzi kahle?
  Uma kwenzeka ukungasebenzi kahle, ithimba lakho lezokunakekelwa kwempilo lizoba nezinqubo zokubhekana nalolu daba. Kubalulekile ukubika noma yiziphi izimpawu noma izinguquko ezingavamile esimweni sakho ngokushesha.
• Idivayisi ye-Impella ithinta kanjani ukusebenza kwenhliziyo yami?
  Idivayisi ye-Impella inikeza ukwesekwa kwemishini enhliziyweni, okuyenza iphumule futhi ilulame. Lokhu kusekelwa kungathuthukisa ukusebenza kwenhliziyo ngokuhamba kwesikhathi, okungaholela emiphumeleni engcono yempilo iyonke.
• Ngingakwazi yini ukuhlanganyela ekwelashweni ngokomzimba ngemva kwenqubo?
  Yebo, ukwelashwa ngokomzimba kungaba wusizo ngesikhathi sokululama. Umhlinzeki wakho wezempilo uzokuqondisa ukuthi uqale nini nokuthi yiziphi izinhlobo zokuzivocavoca ezifanele ngokusekelwe esimweni sakho.
• Yiziphi izinguquko zendlela yokuphila okufanele ngizicabange ngemva kwenqubo?
  Ngemva kokufaka idivayisi ye-Impella, cabanga ngokuphila impilo enempilo yenhliziyo, okuhlanganisa ukuzivocavoca njalo, ukudla okulinganiselayo, nokugwema ukubhema. Lezi zinguquko zingayithuthukisa kakhulu impilo yenhliziyo yakho kanye nenhlalakahle iyonke.
• Ingabe ikhona ingozi yokuqhekeka kwegazi ngedivayisi i-Impella?
  Yebo, kunengozi yokuqhekeka kwegazi nganoma iyiphi idivayisi efakwa emzimbeni. Umhlinzeki wakho wezempilo uzokuqapha eduze futhi angase akunike imithi yokunciphisa le ngozi ngesikhathi sokululama kwakho.
• Ngingakuphatha kanjani ukukhathazeka okuhlobene nesimo senhliziyo yami?
  Kuvamile ukuzizwa ukhathazekile ngemva kokuhlinzwa kwenhliziyo. Cabanga ukukhuluma nochwepheshe wezempilo yengqondo, ukujoyina iqembu lokusekela, noma ukuzijwayeza amasu okuphumula njengokuphefumula okujulile noma ukuzindla ukuze usize ekulawuleni ukukhathazeka.
   

Isiphetho

Ukufakwa kwedivayisi ye-Impella kuyintuthuko ebalulekile ekuphathweni kwezimo zenhliziyo ezinzima, okunikeza iziguli ithuba lokululama kanye nekhwalithi yokuphila ethuthukisiwe. Ukuqonda inqubo yokululama, izinzuzo, kanye nezingozi ezingaba khona kubalulekile ezigulini nasemindenini yazo. Uma wena noma othandekayo wakho nicabangela le nqubo, kubalulekile ukukhuluma nochwepheshe wezokwelapha ukuze nixoxe ngezimo zomuntu ngamunye futhi nithathe izinqumo ezinolwazi.