I-Revascularization isethi yezinqubo zokuhlinza ezihlose ukubuyisa ukujikeleza kwegazi. Ukujikeleza kwegazi okungakhubazekile, okuyingxenye noma okuphelele, kungaba umphumela we-coronary syndrome.

I-Revascularization ifaka amasu amaningi asetshenziselwa ukwelapha i-coronary syndrome. Lezi izinqubo zokuhlinza ezihlose ukubuyisa ukujikeleza kwegazi. Ukuguqulwa kwegazi kungaba okuyingxenye noma okuphelele. I-Revascularization inikele eminyakeni yamuva nje ekwenzeni ngcono izinga lempilo nobude bempilo yeziguli ezinesifo senhliziyo. Kunezinhlobo ezahlukahlukene ze-coronary syndrome lapho i-revascularization ingasetshenziswa khona.

I-acute coronary syndrome

I-acute coronary syndrome ibangelwa ukuvinjelwa okuncane noma okuphelele komthambo. Lokhu kuvinjelwa kungenxa yokuba khona kwamacwecwe e-atheroma, okufaka idiphozi yezinto ezahlukahlukene njengamafutha, igazi, izicubu ezinemicu noma i-lime deposits, engxenyeni yodonga lwangaphakathi lomthambo. Izingcwecwe ze-Atheroma zivame ukuba yimiphumela ye-cholesterol embi, isifo sikashukela, ugwayi, umfutho wegazi ophakeme noma ukukhuluphala. Kwesinye isikhathi ucezu loqweqwe luyaqhekeka, lubangele ukuhlangana kwegazi, kuvimbe umthambo. I-acute coronary syndrome ihlanganisa imicimbi emibili ehlukene yenhliziyo:

• I-Angina, noma i-angina pectoris, ukuvinjelwa okuncane komthambo. Uphawu olukhulu ubuhlungu be-sternum, njengokuqina, i-vise esifubeni. I-Angina ingenzeka lapho uphumule noma ingabangelwa ukuzivocavoca noma imizwa, bese iyahamba lapho iphumula. Kubalulekile ukubiza abali-15 ezimweni zombili;
• I-Myocardial infarction, noma isifo senhliziyo, ukuvimba okuphelele komthambo. I-myocardium yisicubu senhliziyo esibhekele ukusikwa. Isifo senhliziyo sizwakala njenge-vise esifubeni futhi sidinga ukwelashwa ngokuphuthumayo.

Isifo esingalapheki se-coronary syndrome

I-chronic coronary syndrome yisifo senhliziyo esizinzile. Kungaba yi-angina pectoris ezinzile edinga noma ngabe yikuphi ukulandelwa okubandakanya ukwelashwa kwezimpawu nokuvimbela ukugwema okunye ukuhlaselwa. Ngo-2017, yathinta abantu abayizigidi eziyi-1,5 eFrance.

Endabeni yesifo esibucayi se-coronary syndrome, odokotela bazokwenza i-revascularization ngokuphuthumayo ukuze babuyisele ukujikeleza kwegazi ngangokunokwenzeka emthanjeni ovaleke kancane noma ngokuphelele.

Endabeni yesifo esingapheliyo se-coronary syndrome, kwenziwa i-revascularization uma inzuzo elindelekile idlula ingozi yesiguli. Kungenziwa ngezinhloso ezimbili:

• ukunciphisa noma ukunyamalala kwezimpawu ze-angina;
• ukunciphisa ubungozi besigameko esibi senhliziyo njenge-infarction noma ukwehluleka kwenhliziyo.

Ukuvuselelwa kwemithambo kungenziwa ngezindlela ezimbili: ukuhlinzwa ngokudlula kwenhliziyo noma i-angioplasty.

Ukuhlinzwa kokudlula kweCoronary

Ukuhlinzwa kwe-Coronary bypass kuhilela ukudala indawo edlula ekugelezeni kwegazi ukuhlinzeka inhliziyo ngegazi elanele. Ngenxa yalokhu, kufakwa umthambo noma umthambo enhla nomfula endaweni evinjiwe ukuvumela ukujikeleza kwegazi kudlule isithiyo. Umthambo noma umthambo uvame ukuthathwa esigulini. Ingxenye evinjiwe nayo ingadlulwa nge-vascular prosthesis.

Angioplasty

I-Angioplasty ifaka ukwethulwa kwe-catheter noma iphenyo encane emthanjeni esihlakaleni noma emgodini. Uphenyo lube selwenza ukuthi kube khona ukwethula ibhaluni elincane elizofuthwa ezingeni lokuvinjelwa. Ibhaluni landisa ububanzi bomthambo futhi likhiphe ihlwili. Lo mshini ubuyisela ukujikeleza kwegazi uma ibhaluni selisusiwe. Ezimweni eziningi, i-angioplasty ihambisana nokubekwa kwe-stent. Lesi isiphethu esincane esifakwa emthanjeni ukuze sihlale sivulekile.

Endabeni ye-angina noma i-angina pectoris, ukuvuselelwa kwemithambo yegazi kuzokwenziwa kungakapheli amahora ayisithupha kuya kwayisishiyagalombili ngemuva kokuvinjelwa ukugwema ukukhishwa kobuthi kuleyo ndawo okukhulunywa ngayo nokugwema umthelela ongaba khona ezindlovukazi.

Ukujikeleza kwegazi kuqala kabusha ngokujwayelekile ngangokunokwenzeka, ngokubambezeleka okufushane noma okude kuye ngobukhulu besithintelo. Ukwelashwa kubekwa ukunciphisa izimpawu futhi kuvimbele ukuqala kokunye ukuhlaselwa noma ukuwohloka kwesifo senhliziyo. Kuzo zonke izimo, ukubhekwa njalo ngudokotela wenhliziyo nakho kuyanconywa.

Ukunciphisa ubungozi bokuphazamiseka okusha, kubalulekile ukulawula izinto ezinobungozi ngangokunokwenzeka:

• ukuyeka ukubhema;
• lawula isifo sikashukela;
• ukulawula i-cholesterol embi;
• umfutho wegazi ophakeme ngokulinganisela.

Imiphumela engathandeki yokuvuselelwa kwemithambo yegazi incike kunqubo esetshenzisiwe, kanye nohlobo lokwelashwa olusetshenziswe ngudokotela wenhliziyo. Uma uhlangabezana nesinye isibonakaliso noma esinye, into ebaluleke kakhulu ukukhuluma nodokotela.