Izifo ezivamile ze-valve yenhliziyo
Isifo senhliziyo se-Valvular
1, Ukuzalwa: ukukhubazeka kokuzalwa
2. Okulandelayo:
1) Isifo senhliziyo esine-Rheumatic
Imbangela enkulu
I-Mitral stenosis / ukungasebenzi kahle kwe-Mitral
I-senosis ye-aortic / ukungasebenzi kahle kwe-aortic
Ukuvuvukala kwe-mitral
2) Isifo senhliziyo esingelona isifo samathambo
Njenge-ischemia yasebekhulile engapheli; Isifo senhliziyo se-myocardial infarction; ukuhlukumezeka okukhulu; ukutheleleka kwebhaktheriya kwe-valve
Okubi komugqa wendabuko wokushintsha i-valve
-Amandla okulawula aguquguqukayo we-suture ngokwayo esibambiso ngokuyisisekelo ayiziro.
-Isibambiso sinezikhombisi-ndlela ezinhle nezingezinhle
-I-suture twine kalula
-Isibambiso sigingqika kalula
-Isibambiso sithambile, futhi kulula ukusiminyanisa nokonakala lapho ufipha.Ngemuva kokuthunga nokubopha, iziphetho zombili ze-gasket zikhuphukele phezulu futhi azikwazi ukuqiniswa
Ama-valve e-anti-entanglement sutures yohlobo olusha
● Isethembiso ngaphandle kwesiqondiso :Asikho isidingo sokulungisa isiqondiso sesibambiso ngokukhethekile
●Suture ngaphandle kokusonta
●Okufanele kakhulu udokotela ohlinzayo abe nolwazi olungcono lokuhlinza
●Ifanele ukushintshwa kwevalvu yenhliziyo engenele kancane
Ukuhlinzwa okuyinhloko kokubuyisela i-aortic valve Izinyathelo eziqondile:
1. Ukusika nokusungulwa kokujikeleza kwe-extracorporeal
2. Ukusikwa kwe-aortic.Ngemva kokuhlinzwa kwe-cardiopulmonary bypass , lapho izinga lokushisa lehla laya ku-30℃, i-aorta ekhuphukayo yayivinjiwe, futhi kwafakwa i-cardioplegia ebandayo, kuyilapho ukupholisa kwenhliziyo kwenziwa.Ngemuva kokuboshwa kwenhliziyo, i-aorta eguquguqukayo noma e-oblique yenziwa, futhi isiphetho esiphansi sokusika sasicishe sibe ngu-1-1.5cm ukusuka ekuvulekeni komthambo we-coronary ongakwesokudla.Ukuvuleka komthambo we-coronary kwesokunxele nakwesokudla kwabonwa ukuze kuqinisekiswe isidingo se-valve. ukushintshwa kwesifo se-aortic valve
3. Ulayini wokudonsa uxhunywe ekuhlanganeni ngakunye kwezintathu ze-aortic valve.
4. Ukususwa kwevalvu Amalobe amathathu akhishwe ngokuhlukana, kwashiya u-2mm emaphethelweni.Kwabe sekukhishwa izicubu ezibaliwe eringini.Iringi ikalwe ngemitha yevalvu ukuze kutholwe inani levalvu yokufakelwa
5.I-Suture Intambo engu-2-0 yokubuyisela i-polyester yasetshenziselwa ukuthungatha kukamatilasi ngezikhathi ezithile ukusuka phezulu kuye phansi.Ngemva kokuba indandatho ithungiwe, imigqa ye-suture kufanele isakazwe ngokulinganayo futhi ihlukaniswe phakathi kwendandatho ne-valve yenhliziyo yokwenziwa.Ibanga lenaliti ngokuvamile lalingu-2mm
6. ukufakwa kwawo Wonke ama-sutures afinyezwa futhi i-valve yokwenziwa yaphushwa ngaphansi kweringi ye-valve ukuze kuqinisekiswe ukuthi ukufakelwa kwakusendaweni nokuthi i-valve yokwenziwa yayingavimbeli ukuvuleka kwe-coronary kwesokunxele nesokudla.Kwabe sekuboshwa ifindo ngalinye.Ukuhlolwa kokugcina kwaqinisekisa ukuthi ukuvuleka kwe-coronary kwesokunxele nakwesokudla kwakucacile
7.Ukugeza Gcoba kahle i-aorta ne-ventricle yesokunxele ngenhla nangaphansi kwevalvu yokufakelwa bese ugcwalisa i-aorta ne-ventricle yesokunxele ngosawoti ojwayelekile.
I-8.I-Suturing Ukusebenzisa i-4-0 noma i-5-0 i-polypropylene ukuze ifake, Ukucutshungulwa kwe-aortic okubili kwahlanganiswa ngokulandelana.Ukukhipha umoya kufanele kwenziwe ngaphambi kokuba umthungo wokugcina uqiniswe.
I-aortic valve replacement suture- I-Polyester, i-polyester ene-pledget, i-Polypropylene
