Matenda a mtima wamba
Matenda a mtima a Valvular
1, Kobadwa nako: chilema chobadwa nacho
2, Kutsatira:
1) Matenda a mtima a rheumatic
Chifukwa chachikulu
Kulephera kwa Mitral / Mitral stenosis
Aortic senosis / kulephera kwa mtima
Kuchuluka kwa mitral
2) Matenda a mtima osapweteka
Monga okalamba aakulu ischemia ; Matenda a mtima myocardial infarction ; zoopsa zoopsa ; bakiteriya matenda a valavu
Zoyipa za mzere wosinthira ma valve wachikhalidwe
-Mphamvu yowongolera yopingasa ya suture yokha pa pledget kwenikweni ndi ziro.
-Lonjezo limakhala ndi mbali zabwino ndi zoipa
-The suture twine mosavuta
-Lonjezo limagubuduza mosavuta
-Lonjezoli ndi lofewa, ndipo ndi losavuta kufinya ndikupunduka mukamanga mfundo. Pambuyo kusoka ndi knotting, nsonga zonse za gasket zimapindika ndipo sizingalimbikitse
Mitundu yatsopano ya anti-entanglement valve sutures
● Lonjezo lopanda chitsogozo : Palibe chifukwa chowongolera malonjezo mwapadera
● Suture popanda kupota
●Oyenera kuti dokotala azidziwa bwino ntchito yake
●Yoyenera kusintha ma valve amtima pang'ono
Opaleshoni yayikulu yosinthira valavu ya aortic Njira zapadera:
1. Kucheka ndi kukhazikitsa ma circulation extracorporeal
2. Kung'ambika kwa mng'oma. Pambuyo pa opaleshoni ya cardiopulmonary bypass , kutentha kukatsika kufika pa 30 ℃, msempha wokwerawo unatsekedwa, ndipo mtima wozizira umalowetsedwa, pamene kuziziritsa kwa mtima kunkachitika. Pambuyo pa kumangidwa kwa mtima, kutsekemera kwapang'onopang'ono kapena oblique kung'ambika kunapangidwa, ndipo kumapeto kwa m'munsi kwa chigawocho kunali pafupi 1-1.5cm kuchokera pa kutsegula kwa mtsempha wamanja. m'malo mwa matenda a aortic valve
3. Mzere wokokera umalumikizidwa pamagulu atatu aliwonse a valve ya aortic.
4. Kuchotsa valavu Ma lobe atatu anachotsedwa padera, kusiya 2mm m'mphepete. Kenako minofu yowerengeka pa mpheteyo idachotsedwa. Mpheteyo inkayezedwa ndi mita ya valavu kuti mudziwe kuchuluka kwa valve yolumikizira
5.Suture The 2-0 polyester m'malo ulusi unagwiritsidwa ntchito pa intermittent matiresi suture kuchokera pamwamba mpaka pansi. Mpheteyo itasokedwa, mizere ya suture iyenera kugawidwa mofanana ndi kugawidwa pakati pa mphete ndi valavu yamtima yopangira. Kutalika kwa singano nthawi zambiri kunali 2mm
6. kuyika Ma sutures onse adawongoleredwa ndipo valavu yochita kupanga inakankhidwa pansi pa mphete ya valve kuti atsimikizire kuti kuikidwako kunalipo komanso kuti valavu yochita kupanga sinatseke kumanzere ndi kumanja kwa coronary. Kenako mfundo inamangidwa imodzi ndi imodzi. Kufufuza komaliza kunatsimikizira kuti kumanzere ndi kumanja kwa mitsempha ya mitsempha kunali koonekeratu
7.Kutsuka Bwinobwino kutsuka msempha ndi ventricle kumanzere pamwamba ndi pansi valavu prosthetic ndi kudzaza msempha ndi ventricle kumanzere ndi saline wamba.
8.Suturing Pogwiritsa ntchito 4-0 kapena 5-0 polypropylene ku suture, Awiri aortic incisions anali sutured motsatizana. Kutulutsa mpweya kuyenera kuchitidwa musanayambe kukokera komaliza.
Kung'ambika kwa valve m'malo - Polyester, polyester yokhala ndi pledget,Polypropylene
