Kayan aiki mai kwakwalwa na hagu (LVAD) an gina shi ne a cikin kwakwalwa, ƙaddamar da baturi don haɓaka aikin aikin ƙwaƙwalwa na ventricle hagu wanda ya rasa rauni wanda ya zama mai rauni daga zuciya rashin nasara don aiki yadda ya kamata a kansa.
Ta yaya LVADs aiki?
An shirya nau'o'in kayan LVAD iri-iri. Mafi yawansu suna cire jini daga tube wanda aka saka a cikin ventricle na hagu, sa'an nan kuma zub da jini ta hanyar wani bututu da aka saka a cikin mahaifa.
An yi amfani da taro ta tsakiya a cikin zuciya, a cikin ɓangaren ƙananan ciki. Hanya na lantarki (ƙananan kebul) daga LVAD ya shiga cikin fata. Jagoran ya haɗa LVAD zuwa ɗakin sarrafawa na waje kuma zuwa batura da ke da ikon yin famfo.
LVADs suna gaba ɗaya ɗawainiya. Ana buƙatar batir da masu kula da batir masu amfani da belin ko kirji. LVADs ƙyale marasa lafiya su kasance a gida kuma su shiga cikin al'amuran al'ada.
Juyin LVADs
LVAD fasaha ya samo asali tun lokacin da aka fara amfani da waɗannan na'urori a shekarun 1990. Da farko, LVADs yayi ƙoƙari ya sake yin jini ta hanyar jini kamar yadda aka ɗauka cewa bugu zai zama wajibi ga al'ada ta jiki.
Duk da haka, duk wani LVAD wanda ya haifar da buguwa mai mahimmanci yana buƙatar sassa masu motsi, yana amfani da makamashi mai yawa, kuma yana haifar da damar dama ga rashin nasarar injiniya. LVADs na farko sun sha wahala daga duk waɗannan matsalolin.
Ba da daɗewa ba aka gane cewa mutane sun yi kamar yadda jini ya gudana kamar yadda ya kwarara. Wannan ya ba da damar yin amfani da LVADs na biyu wanda ya karami, yana da bangarori guda ɗaya, kuma yana buƙatar yawancin makamashi. Wadannan sabbin LVADs sun fi tsayi kuma sun fi dogara da na'urori na farko.
HeartMate II da Jarvik 2000 su ne ƙarni na biyu, LVADs masu gudana.
Sakamakon ƙarni na uku na LVADs yana zuwa a kan layi wanda ya fi karami kuma ana tsara su don tsawon shekaru 5 - 10. HeartWare da Heartray III LVADs sune na'urori na uku.
Yaushe ake amfani da LVADs?
Ana amfani da LVADS a yanayi uku na asibiti. A duk lokuta, LVADs an adana marasa lafiya waɗanda ke yin talauci duk da rashin lafiyar likita.
1) Hanya zuwa Transplant. LVADs za a iya amfani da su don tallafa wa marasa lafiya da ciwon zuciya mai tsanani wanda ke jiran zuciya da dashi.
2) Yanayin Farko. Ana iya amfani da LVADs a matsayin "farfadowa" a cikin mutanen da ke fama da ciwon zuciya mai tsanani wanda ba su da 'yan takara na dashi (saboda wasu dalilai kamar tsofaffi, cututtukan koda, ko cutar huhu), kuma suna da matsala maras kyau ba tare da inji ba goyon baya. A cikin wadannan marasa lafiya, LVAD shine magani; akwai ƙananan tsammanin cewa LVAD ba za'a iya cire shi ba.
3) Tsarin zuwa farfadowa. A wasu marasa lafiya da ciwon zuciya, saka na'urar LVAD zai iya bada izinin rage cin hanci daga hagu zuwa "hutawa" da kuma gyara kanta ta hanyar " sake sakewa ." Misalai da matsalar matsalar zuciya ta zuciya ta wani lokaci ta dace da hutawa sun hada da ciwon zuciya bayan ƙwaƙwalwar zuciya hanyoyi, ko kuma tare da babban mummunan zuciya , ko kuma tare da ciwon zuciya mai tsanani.
A cikin marasa lafiya da suka fada cikin ɗaya daga cikin waɗannan Kategorien, LVADs suna da tasiri sosai a mayar da adadin jini da farashin zuciya zuwa ga matakan kusa-na al'ada. Wannan ingantaccen yakan rage bayyanar cututtukan zuciya , musamman dyspnea da rauni mai tsanani, muhimmanci. Har ila yau, zai iya inganta aikin wasu gabobin da yawancin zuciya suke yi, kamar kodan da hanta.
Matsaloli Tare da LVADs
An inganta ingantaccen tsaro na LVADs a tsawon shekaru, kuma kamfanonin da suka tsara su sunyi aiki mai wuyar gaske don rage girman su don su dace da kananan yara. Amma har yanzu akwai matsaloli masu yawa da suka shafi LVADs.
Wadannan sun haɗa da:
- LVADs na buƙatar goyon baya na yau da kullum, da kuma kulawa da hankali don tabbatar da cewa suna da alaƙa a duk wata maƙirari mai kyau. Saboda haka masu hakuri - ko dangi - dole ne su iya magance matsalolin da za a ba su.
- Babban cututtuka na jini yana ci gaba da faruwa har zuwa 25% na marasa lafiya tare da LVADs, kuma waɗannan cututtuka suna mutuwa.
- Matsalar jini masu mahimmanci suna faruwa a ƙananan marasa lafiya marasa lafiya.
- Haɗarin bugun jini (daga jini) yana tsakanin 10% da 15% a kowace shekara.
Wadannan matsaloli suna da mahimmanci sosai, don haka yanke shawara don saka LVAD shine ainihin lamari. Wannan yanke shawara ya kamata a dauki kawai idan mutuwar farko ya bayyana shine mafi kusantar sakamako ba tare da daya ba.
Ko yin amfani da LVAD a matsayin "farfadowa na manufa" wani yanke shawara ne mai wuya, saboda a wannan yanayin, akwai ɗan bege na iya cire na'urar. A cikin mafi yawan gwaji da aka gudanar a yau ta amfani da LVADs a matsayin mafita, kawai kashi 46% na masu karɓar LVAD sun kasance da rai kuma ba su da jin dadi a shekaru biyu.
Ko da tare da matsalolin da suka kasance tare da LVADS, waɗannan na'urori suna ba da fataccen fata ga marasa lafiya da yawa da rashin ci gaba na ƙarshe wanda ba su da wani bege kamar 'yan shekaru da suka wuce.
Birks EJ, George RS, Hedger M, et al. Kashewar ciwon zuciya mai tsanani tare da kayan aiki na ventricular hagu mai guba wanda ya ci gaba da gudana: nazari mai yiwuwa. Yanayin 2011; 123: 381.
Sources:
Rose, EA, Gelijns, AC, Moskowitz, AJ, et al. Yin amfani da na'ura na ventricular hagu don amfani da ƙarancin ƙarshe. N Engl J Med 2001; 345: 1435.
Birks EJ, George RS, Hedger M, et al. Kashewar ciwon zuciya mai tsanani tare da kayan aiki na ventricular hagu mai guba wanda ya ci gaba da gudana: nazari mai yiwuwa. Yanayin 2011; 123: 381.