Izifo zevalvu yentliziyo eqhelekileyo
Isifo sentliziyo yeValvular
1, Ukuzalwa: isiphene sokuzalwa
2. Ukungasemva:
1) Isifo sentliziyo seRheumatic
Owona nobangela
I-Mitral stenosis / ukungasebenzi kakuhle kweMitral
I-senosis ye-Aortic / ukungakwazi ukusebenza kwe-Aortic
Ukunyuka kwe-mitral
2)Isifo sentliziyo esingenasifo samathambo
ezifana ischemia abadala ezingapheliyo; Isifo sentliziyo myocardial infarction; ukwenzakala kakhulu; usulelo lwebhaktiriya kwivalvu
Ukungalungi komgca wokutshintsha ivalve yemveli
-Amandla olawulo olunqamlezayo lwe-suture ngokwayo kwi-pledget ngokusisiseko ngu-zero.
-Isibambiso sinezalathiso ezilungileyo nezingalunganga
-I-suture twine ngokulula
-Isibambiso sibhukuqa ngokulula
-Isibambiso sithambile, kwaye kulula ukusicinezela kunye nokonakala xa uqhina.Emva kokuthunga kunye ne-knotting, zombini iziphelo ze-gasket ziphakanyisiwe kwaye azikwazi ukuqiniswa
Iisutures zevalvu ezichasene nokuphonswa kohlobo olutsha
●Isibambiso ngaphandle komkhombandlela :Akukho mfuneko yokulungisa indlela yesibambiso ngokukodwa
●I-Suture ngaphandle kokusonta
● Ifaneleke ngakumbi ugqirha wotyando ukuba abe namava okusebenza angcono
● Ilungele ukutshintshwa kwevalve yentliziyo encinci
Utyando olungundoqo lokutshintshwa kwevalve ye-aorta Amanyathelo athile :
1. Ukusikwa kunye nokusekwa kokujikeleza kwe-extracorporeal
2. Ukusikwa kweAortic.Emva kotyando lwe-cardiopulmonary bypass, xa iqondo lobushushu lehla laya kutsho kuma-30 ℃, i-aorta enyukayo yavalwa, kwaye kwafakwa i-cardioplegia ebandayo, ngelixa ukupholisa umphezulu wentliziyo kwenziwa.Emva kokubanjwa kwentliziyo, i-aorta enqamlekileyo okanye i-oblique i-aortic incision yenziwa, kwaye isiphelo esisezantsi se-incision sasimalunga ne-1-1.5cm ukusuka ekuvuleni kwe-coronary artery ye-right.Ukuvuleka kwe-coronary ekhohlo kunye nekunene kwabonwa ukuze kuqinisekiswe imfuno yevalve. ukutshintshwa kwesifo se-aortic valve
3. Umgca wokutsaleka uthungelwe kwindawo nganye yeendlela ezintathu zevalve ye-aortic.
4. Ukususwa kwevalve I-lobes ezintathu zikhutshwe ngokwahlukeneyo, zishiya i-2mm emphethweni.Emva koko izicubu ezibaliweyo kwiringi zasuswa.Iringi ilinganiswe ngemitha yevalvu ukufumanisa inani levalve yokufakelwa
5.I-Suture I-2-0 intambo yokutshintshwa kwe-polyester yayisetyenziselwa ukuphazamiseka kwe-mattress suture ukusuka phezulu ukuya ezantsi.Emva kokuba i-ring ithungiwe, imigca ye-suture kufuneka ihanjiswe ngokulinganayo kwaye ihlukaniswe phakathi kweringi kunye ne-valve yentliziyo eyenziweyo.Umgama yenaliti wawuyi-2mm ngokubanzi
6. ukufakelwa kwazo zonke iintambo zokuthunga zolule kwaye ivalve eyenziwe yatyhalelwa phantsi kweringi yevalvu ukuqinisekisa ukuba ukufakelwa bekukhona kwaye ivelufa eyenziweyo ibingathinteli ukuvuleka kwecoronary esekhohlo nasekunene.Emva koko iqhina lalibotshwa nganye nganye.Uviwo lokugqibela lwaqinisekisa ukuba ukuvuleka kwe-coronary ekhohlo nasekunene kwakucacile
7.Ukuhlamba Ngokucokisekileyo i-aorta kunye ne-ventricle yasekhohlo ngaphezulu nangaphantsi kwevalve yeprosthetic kwaye ugcwalise i-aorta kunye ne-ventricle yasekhohlo nge-saline eqhelekileyo.
I-8.I-Suturing Ukusebenzisa i-4-0 okanye i-5-0 i-polypropylene kwi-suture, i-aortic incisions ezimbini zixutywe ngokulandelelana.Ukungenisa umoya kufuneka kwenziwe phambi kokuba umthungo wokugqibela uqiniswe.
Ivalve yeAortic replacement suture- Polyester,polyester ene-pledget,Ipolypropylene