{"id":12557,"date":"2016-09-16T10:24:40","date_gmt":"2016-09-16T10:24:40","guid":{"rendered":"http:\/\/medical-clinic.cmsmasters.net\/?page_id=12557"},"modified":"2020-06-17T20:02:53","modified_gmt":"2020-06-17T18:02:53","slug":"kirurgjia-e-valvulave","status":"publish","type":"page","link":"https:\/\/kojqiqi.com\/sherbimet\/kirurgjia-e-valvulave\/","title":{"rendered":"Kirurgjia e Valvulave"},"content":{"rendered":"
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Kirurgjia e Valvulave<\/h2>\n<\/div>
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Informacion i p\u00ebrgjith\u00ebsh\u00ebm\u00a0<\/strong><\/div>\n<\/div>\n
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N\u00ebse valvulat e zemr\u00ebs jan\u00eb t\u00eb d\u00ebmtuara, \u00a0intervenimi kirurgjik \u00ebsht\u00eb e vetmja m\u00ebnyr\u00eb e trajtimit t\u00eb tyre. Pas korrigjimit t\u00eb valvulave, ankesat e m\u00ebhershme do largohen dhe\u00a0gj\u00ebndja sh\u00ebnd\u00ebt\u00ebsore do p\u00ebrmir\u00ebsohet duksh\u00ebm.<\/p>\n

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Funkcioni i valvulave t\u00eb zemr\u00ebs\u00a0<\/strong><\/p>\n

Zemra \u00ebsht\u00eb nj\u00eb pomp\u00eb me kat\u00ebr dhoma. Gjaku me okisgjenim t\u00eb ul\u00ebt q\u00eb vjen nga trupi mblidhet n\u00eb atriumin e djatht\u00eb, kalon p\u00ebrmes valvules trikuspidale n\u00eb ventrikulin e djatht\u00eb dhe prej k\u00ebtu p\u00ebrmes valvul\u00ebs pulmonale shkon n\u00eb mushk\u00ebri. N\u00eb mushk\u00ebri gjaku mbushet me oksigjen,\u00a0 kthehet prap n\u00eb zem\u00ebr, p\u00ebrmes venave pulmonale n\u00eb atriumin e majt\u00eb, kalon p\u00ebrmes valvul\u00ebs mitrale n\u00eb ventrikulin e majt\u00eb dhe m\u00eb pas p\u00ebrmes valvul\u00ebs aortale \u00a0n\u00eb aort\u00eb, ku shp\u00ebrndahet n\u00ebp\u00ebr organe tjera (tru, veshk\u00eb, m\u00eblqi, trakti digjestiv, muskulatur\u00eb, l\u00ebkur\u00eb etj) p\u00ebr furnizimin e tyre me oksigjen.<\/p>\n

Pra zemra \u00ebsht\u00eb e ndar n\u00eb dy pjes\u00eb, ne pjes\u00ebn e djatht\u00eb \u00a0q\u00eb merr gjakun nga trupi dhe d\u00ebrgon n\u00eb mushk\u00ebri, sidhe n\u00eb pjes\u00ebn e majt\u00eb e cila e merr gjakun nga mushk\u00ebria dhe e shp\u00ebrndan n\u00eb trup p\u00ebr furnizim t\u00eb organeve tjera me gjak.<\/p>\n

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Cilat jan\u00eb valvulat e zemr\u00ebs ?<\/strong><\/p>\n

Valvulat e zemr\u00ebs jan\u00eb sikur dyert e nj\u00eb dhome dhe hapen vet\u00ebm n\u00eb nj\u00eb drejtim. Zemra ka kat\u00ebr dhoma dhe poashtu kat\u00ebr valvula. Funkcioni i tyre \u00ebsht\u00eb hapja dhe mbyllja.<\/p>\n

Valvula trikuspidale: porta q\u00eb ndan atriumin e djatht\u00eb me ventrikulin e djatht\u00eb<\/p>\n

Valvula pulomanle: porta q\u00eb ndan ventrikulin e djatht\u00eb me mushk\u00ebrit<\/span><\/p>\n

Valvula mitrale: porta q\u00eb ndan atriumin e majt\u00eb me ventrikulin e majt\u00eb<\/p>\n

Valvula aortale: porta \u00a0kryesore q\u00eb ndan zemr\u00ebn me organet tjera, dmth porta dal\u00ebse e zemr\u00ebs.<\/p>\n

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Valvula aortale<\/strong><\/p>\n

\u00cbsht\u00eb porta dal\u00ebse e zemr\u00ebs. Gjendet mu n\u00eb fillim t\u00eb aort\u00ebs apo direkt nga dalja e ventrikulit t\u00eb majt\u00eb. Ajo p\u00ebrbehet nga tri flet\u00ebza n\u00eb form\u00eb gjys\u00ebm h\u00ebne apo form\u00eb\u00a0gjepi, t\u00eb cilat pasi t\u00eb kaloj gjaku p\u00ebrmes saj mbush\u00ebn me gjak dhe mbyllen. K\u00ebto flet\u00ebza var\u00ebsisht nga pozita jan\u00eb:Valvula semilunaris\u00a0dextra, sinistra dhe septalis<\/strong> q\u00eb do t\u00eb \u00a0thot\u00eb flet\u00ebza gjys\u00ebmh\u00ebne e djatht\u00eb, e majt\u00eb dhe flet\u00ebza e murit. Mbi flet\u00ebz\u00ebn e djatht\u00eb dhe t\u00eb majt\u00eb dalin arteriet koronare e djatht\u00eb dhe e majt\u00eb nga ku edhe mbushen dhe furnizojn\u00eb muskulin e zemr\u00ebs me gjak.<\/p>\n

S\u00ebmundja e k\u00ebsaj valvule mund t\u00eb jet\u00eb ne form\u00eb t\u00eb stenoz\u00ebs<\/strong>(ngushtimit) dhe insuficienc\u00ebs <\/strong>(zgj\u00ebrimit) t\u00eb saj. Infekcionet e k\u00ebsaj valvule jan\u00eb poashtu te shpeshta dhe quhen endokarditis<\/strong>.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Valvula mitrale<\/strong><\/p>\n

Ndan\u00eb atriumin e majt\u00eb me ventrikulin e majt\u00eb. Ajo hapet kur atriumi \u00ebsht\u00eb mbushur me gjak dhe mbyllet kur ventrikuli mbushet me gjak, dmth n\u00eb koh\u00ebn e diastoles \u00ebsht\u00eb e hapur ne koh\u00ebn e sistol\u00ebs mbyllet dhe hapet valvula aortale.<\/p>\n

Valvula mitrale p\u00ebrbehet nga dy flet\u00ebza ( cuspis) dhe ndryshe quhet edhe Valvula bikuspidalis\u00a0<\/strong>apo Valvula atrioventricularis sinistra<\/strong>. Forma e flet\u00ebzave t\u00eb saj ka form\u00ebn e mitr\u00ebs apo ndryshe kapel\u00ebs s\u00eb bishofit.\u00a0 K\u00ebto flet\u00ebza jan\u00eb Cuspis anterior dhe cuspis posterior ( flet\u00ebza e p\u00ebrparme dhe flet\u00ebza e pasme). Ato jan\u00eb te fiksuara p\u00ebrmes aparatit valvular (chordae tendinea) n\u00eb muskujt papillar t\u00eb zemr\u00ebs, t\u00eb cil\u00ebt jan\u00eb poashtu dy muskuj. Muskuli papillar anterior dhe posterior. Muskujt papillar te ventrikulit te majt dalin nga muri i zemr\u00ebs (muri i p\u00ebrparm\u00eb dhe muri i pas\u00ebm).Forma e k\u00ebsaj valvule ngjan me velat e anijeve me er\u00eb. Fiziologjia e k\u00ebtyre Valvulave \u00ebsht\u00eb perfekte. Gjat\u00eb sistol\u00ebs (tkurrj\u00ebs s\u00eb zemr\u00ebs), muskuli papillar kontraktohet s\u00eb bashku me muskulin e zemr\u00ebs. Chordae tendinea (penj\u00ebt q\u00eb kapen nga valvula n\u00eb muskulin papillar) t\u00ebrhiqen dhe nuk lejojn, p\u00ebrkund\u00ebr presionit t\u00eb lart n\u00eb ventrikulin e majt\u00eb, q\u00eb t\u00eb hapen n\u00eb drejtim t\u00eb atriumit t\u00eb majt\u00eb. N\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb gjaku nga ventrikuli i majt\u00eb l\u00ebviz\u00eb vet\u00ebm para dhe mund t\u00eb dal vet\u00ebm p\u00ebrmes valvul\u00ebs aortale dhe jo te kthehet prapa n\u00eb atriumin e majt\u00eb.<\/p>\n

Nj\u00eb m\u00ebnyr\u00eb perfekte e mbushjes dhe zbrazjes s\u00eb zemr\u00ebs vet\u00ebm n\u00eb nj\u00eb drejtim.<\/p>\n

S\u00ebmundja e k\u00ebsaj valvule mund t\u00eb jet\u00eb ne form\u00eb t\u00eb stenoz\u00ebs<\/strong>(ngushtimit) dhe insuficienc\u00ebs <\/strong>(zgj\u00ebrimit) t\u00eb saj. Infekcionet e k\u00ebsaj valvule jan\u00eb poashtu te shpeshta dhe quhen endokarditis<\/strong>.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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S\u00ebmundjet e valvulave t\u00eb zemr\u00ebs<\/strong><\/p>\n

Q\u00eb n\u00eb lindje valvulat mund t\u00eb ken\u00eb ndryshime t\u00eb cilat mund t\u00eb shkaktojn tek f\u00ebmijet simptoma t\u00eb ndryshme. S\u00ebmundjet e valvave zakonisht paraqiten n\u00eb mosh\u00eb m\u00eb t\u00eb shtyer. Infekcionet bakteriale apo reumatike mund t\u00eb prekin k\u00ebto valvula n\u00eb mosh\u00eb t\u00eb re dhe pas kalimit t\u00eb nj\u00eb kohe, ato humbin funkcionin e tyre. Flet\u00ebzat e valvulave mund t\u00eb trash\u00ebn, t\u00eb kalcifikohen dhe t\u00eb ngushtohen dmth nuk hapen mjaftueshem, kjo s\u00ebmundje quhet stenoz\u00eb e valvulave (ngushtim).<\/strong> Mir\u00ebpo ato edhe mund t\u00eb zgj\u00ebrohen n\u00ebse k\u00ebput\u00ebn fijet q\u00eb i mbajn valvulat apo n\u00ebse flet\u00ebzat shqyhen. Si pasoj\u00eb e k\u00ebsaj valvat nuk mbyllen mir\u00eb dhe rrjedhin gjakun q\u00eb kalon p\u00ebrmes tyre, kjo s\u00ebmundje quhet insuficienc\u00eb e valvulave (zgj\u00ebrim)<\/strong>.<\/p>\n

N\u00eb t\u00eb dyja rastet si stenoza (ngushtimi) ashtu edhe insuficenca (zgjerimi) shkaktojn me koh\u00eb nj\u00eb mbingarkes\u00eb t\u00eb zemr\u00ebs q\u00eb manifestohet me zgjerim dhe ulje t\u00eb funksionit t\u00eb saj. Kjo v\u00ebrehet pastaj n\u00eb frym\u00ebmarrje t\u00eb v\u00ebshtir\u00ebsuar, lodhje t\u00eb shpejt, \u00e7rregullime t\u00eb ritmit apo edhe me dhimbje gjoksi. N\u00eb fund fillon \u00ebnjtje e k\u00ebmb\u00ebve ndjenja e fryrjes n\u00eb stomak dhe dhimbje t\u00eb m\u00eblqis\u00eb.<\/p>\n

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Mund\u00ebsit dhe trajtimi i valvulave t\u00eb zemr\u00ebs<\/span><\/strong><\/p>\n

Tek shum\u00eb pacient p\u00ebrkund\u00ebr problemit me valvula ata\/ato \u00a0b\u00ebjn\u00eb nj\u00eb jet\u00eb normale. Kur aktivitetet \u00a0normale ditore nuk mund te kryhen m\u00eb, si pasoj\u00eb e frym\u00ebz\u00ebnjes, lodhjes s\u00eb shpejt apo dhimbjeve n\u00eb gjoks at\u00ebher\u00eb \u00ebsht\u00eb \u00a0koha m\u00eb e von\u00eb kur duhet b\u00ebr\u00eb intervenimi p\u00ebr rregullim te tyre. Intervenimet n\u00eb valvula jan\u00eb operacionet kirugjike apo trajtimi i tyre p\u00ebrmes en\u00ebve t\u00eb gjakut q\u00eb quhet intervenim angiografik. K\u00ebto dy metoda zgjedhen dhe aplikohen individualisht duke pasur parasysh\u00eb shum\u00eb faktor. Zakonisht trajtimi\u00a0 angiografik i valvulave p\u00ebrmes en\u00ebve t\u00eb gjakut preferohet tek pacientet e shtyr\u00eb n\u00eb mosh\u00eb, tek ata q\u00eb kan\u00eb s\u00ebmundje t\u00eb tjera dhe n\u00eb rastet kur klinikisht pacienti nuk do mund t\u00eb p\u00ebrballoj nj\u00eb operacion t\u00eb hapur kirugjik. N\u00eb t\u00eb gjitha rastet tjera preferohet operacioni kirugjik.<\/span><\/p>\n

Aktualisht n\u00eb Kosov\u00eb mund t\u00eb realizohen vet\u00ebm nd\u00ebrhyrjet kirugjike, operacionet n\u00eb zem\u00ebr t\u00eb hapur. Intervenimet angiografike t\u00eb vendosjes s\u00eb valvulave p\u00ebrmes en\u00ebve t\u00eb gjakut nuk mund te realizohen, si pasoj\u00eb e mungeses se shume faktoreve.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Kontrollet paraprake \/ Diagnostika\u00a0<\/strong><\/p>\n

Para \u00e7do intervenimi duhet t\u00eb realizohen disa ekazaminime. Duhet b\u00ebr\u00eb nj\u00eb echokardiografi e detajuar, mund\u00ebsisht transosefageale, koronografia dhe nj\u00eb CT- compjuter tomografi e thoraxit. Kontrollet tjera caktohen var\u00ebsisht nga intervenimi. Nj\u00eb konsult\u00eb e stomatologut \u00ebsht\u00eb e preferuar. Pasi t\u00eb \u00ebsht\u00eb p\u00ebrfunduar e gjith\u00eb diagnostika bisedohet me ekip\u00ebn e zemr\u00ebs (q\u00eb p\u00ebrb\u00ebhet nga Kardiokirugu, Kardiologu dhe Anestezisti) p\u00ebr m\u00ebnyren e intervenimit.<\/p>\n

Duhet p\u00ebrseritur se n\u00eb Kosov\u00eb aktualisht mund te realizohen vet\u00ebm nderhyrjet klasike kirugjike, dmth operacionet n\u00eb zem\u00ebr t\u00eb hapur.<\/p>\n

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Llojet e valvulave artificiale<\/span><\/strong><\/p>\n

N\u00eb p\u00ebrgjith\u00ebsi kemi dy lloje te protezave-valvulave artificiale: mekanike dhe biologjike.<\/span><\/p>\n

Valvulat mekanike jan\u00eb nga karboni dhe jan\u00eb shum\u00eb rezistente me nj\u00eb q\u00ebndrueshm\u00ebri shum\u00eb t\u00eb gjat\u00eb. Ato zakonisht kan\u00eb dy flet\u00ebza q\u00eb hapen. M\u00ebnyra e vendosjes se tyre \u00ebsht\u00eb vet\u00ebm p\u00ebrmes operacionit t\u00eb hapur kirugjik. Dob\u00ebsia e k\u00ebtyre valvave \u00ebsht\u00eb marrja gjat\u00eb gjith\u00eb jet\u00ebs s\u00eb medikamenteve kund\u00ebr trashjes s\u00eb gjakut, Cumarine (Phenprocumone,Warfarine).<\/span><\/p>\n

Valvulat biologjike p\u00ebrb\u00ebhen nga inde t\u00eb kafsh\u00ebve (derri, lop\u00ebt, kuajt). Ato p\u00ebrb\u00ebhen nga tri flet\u00ebza dhe jan\u00eb t\u00eb v\u00ebndosura n\u00eb nj\u00eb unaz\u00eb metalike. <\/span>Ka edhe lloje te valvulave q\u00eb nuk jan\u00eb t\u00eb vendosura fare n\u00eb unaz\u00eb. M\u00ebnyra e vendosjes s\u00eb tyre \u00ebsht\u00eb p\u00ebrmes operacionit t\u00eb hapur kirugjik apo p\u00ebrmes kateterve dhe en\u00ebve t\u00eb gjakut. K\u00ebto valvula nuk jan\u00eb aq rezistenste sa valvulat mekanike. Jet\u00ebgjatesia e tyre varet nga shum\u00eb faktor dhe shkon maksimalist deri n\u00eb 20 vjet. P\u00ebrparesia e ketyre valvulave \u00ebsht\u00eb se nuk kane nevoj\u00eb t\u00eb marrjes se medikamenteve kund\u00ebr trashjes s\u00eb gjakut.<\/p>\n

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Operacionet kirurgjike<\/strong><\/p>\n

Prej mbi 60 vite kan\u00eb filluar t\u00eb b\u00ebhen operacionet e zemr\u00ebs p\u00ebrmes kirugjis\u00eb s\u00eb hapur apo siq quhet ndryshe klasike ose konvencionale. Kjo \u00ebsht\u00eb ende edhe metoda me e p\u00ebrhapur e intervenimeve n\u00eb zem\u00ebr. Gjat\u00eb operacioneve klasike sternumi(gjoksi) duhet t\u00eb hapet dhe me ndihm\u00ebn e makin\u00ebs ekstrakorporale b\u00ebhet realizimi i tyre. N\u00eb 15 vitet e fundit k\u00ebto operacione realizohen edhe me prerje t\u00eb vog\u00ebla pa pasur nevoj\u00eb t\u00eb hapet Sternumi. K\u00ebto operacione qe ndryshe quhen edhe MIC-Minimal invasiv Chirurgji k\u00ebrkojn instrumente specifike dhe realizohen edhe tek ne. Tek k\u00ebto operacioni b\u00ebhet nj\u00eb prerje rreth 4-5 cm n\u00eb an\u00ebn e djatht\u00eb n\u00eb hapsir\u00ebn nd\u00ebrbrinjore. P\u00ebrmes operacioneve MIC mund t\u00eb b\u00ebhet z\u00ebvendesimi dhe riparimi i valvul\u00ebs mitrale, aortale dhe trikuspidale.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Z\u00ebvend\u00ebsim apo riparim\/rekonstruktim i valvulave t\u00eb zemr\u00ebs ?<\/span><\/strong><\/p>\n

Var\u00ebsisht nga lloji i defektit t\u00eb valvulave mund edhe t\u00eb b\u00ebhet z\u00ebvend\u00ebsimi apo riparimi i tyre. Riparimi i valvulave n\u00ebse \u00ebsht\u00eb i mundur ka gjithmon\u00eb p\u00ebrparsi duke pasur parsysh fiziologjin e tyre e cila \u00ebsht\u00eb e pakrahasur me t\u00eb gjitha llojet e protezave artificiale (biologjike apo mekanike). Rikonstukcionet e valvulave t\u00eb zemr\u00ebs mund t\u00eb realizohen tek patologjia e insuficencave (zgjerim) te tyre. Zakonisht preferohet riparimi i valvules mitrale, trikuspidale por edhe i asaj aortale. Z\u00ebvend\u00ebsimet e valvulave t\u00eb zemr\u00ebs indikohen n\u00eb rastet e stenozave (ngushtimit) apo kur fletezat e tyre jan\u00eb t\u00eb d\u00ebmtuara dhe rekonstrukcioni i tyre \u00ebsht\u00eb i pamundur. \u00a0Se \u00e7fare lloji i \u00a0valvul\u00ebs mund t\u00eb implantohet, kjo vendoset individualisht dhe dallon nga pacienti n\u00eb pacient duke marr gjith\u00ebmon parasysh shum\u00eb faktor si: mosha, gjinia, profesioni, s\u00ebmundjet p\u00ebrcjell\u00ebse dhe s\u00eb fundi d\u00ebshira e pacientit. Zakonisht deri n\u00eb mosh\u00ebn 60 vjeqare preferohen valvat mekanike nd\u00ebrsa prej mosh\u00ebs mbi 60 vjet, preferohet proteza biologjike p\u00ebr implantim.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Intervenimet angiografike p\u00ebrmes kateterve<\/span><\/strong><\/p>\n

Jan\u00eb intervenime q\u00eb realizohen me kateter dhe metodes s\u00eb Seldingerit duke kaluar p\u00ebrmes arterieve femorale apo p\u00ebrmes maj\u00ebs s\u00eb zemr\u00ebs apikal. Llojet e k\u00ebtyre valvulave jan\u00eb te gjitha biologjike dhe t\u00eb v\u00ebndosura n\u00eb nj\u00eb rrjet metalike (form\u00eb stenti) e cila hapet p\u00ebrmes nj\u00eb balloni pasi t\u00eb pozicionohet sakt\u00ebsisht n\u00eb vendin e valvul\u00ebs aortale. K\u00ebto nd\u00ebrhyrje realizohen n\u00ebn ndihmen e rrezeve x (r\u00ebntgen) dhe quhen TAVI.<\/span><\/p>\n

TAVI- Transkatheter Aortic Valve Implantation <\/span><\/p>\n

N\u00eb t\u00eb njejt\u00ebn metod\u00eb mund t\u00eb b\u00ebhen edhe intervenimet n\u00eb valvular tjera siq \u00ebsht\u00eb ajo mitrale duke v\u00ebndosur clipa metalike tek insuficenca e valvules mitrale. <\/span><\/p>\n

K\u00ebto intervenime indikohen tek pacient\u00ebt e moshuar apo tek ajo grup e pacienteve q\u00eb nuk mund t\u00eb p\u00ebrballojn nj\u00eb operacion te hapur kirurgjik. <\/span><\/p>\n

\u00a0<\/span><\/strong><\/p>\n

Akut apo kronik\u00a0<\/strong><\/p>\n

S\u00ebmundjet e zemr\u00ebs sikur edhe s\u00ebmundjet tjera ndahen n\u00eb akute dhe kronike. S\u00ebmundjet akute jan\u00eb rastet kur simptomat apo s\u00ebmundja shfaqen p\u00ebrnjeh\u00ebr, edhe pse ndoshta ajo s\u00ebmundje ka koh\u00eb q\u00eb ka filluar t\u00eb zhvillohet.<\/p>\n

S\u00ebmundjet kronike jan\u00eb ato s\u00ebmundje ku zhvillimi i tyre zgjat\u00eb dhe simptomet e tyre shkojn\u00eb gradualisht me stadin e s\u00ebmundjes.<\/p>\n

Kalimi nga akut n\u00eb kronik dhe anasjelltas ndodh n\u00eb shum\u00eb raste.<\/p>\n

\u00a0<\/strong><\/p>\n

Urgjenc\u00eb apo elektiv\u00a0<\/strong><\/p>\n

Trajtimi i s\u00ebmundjeve t\u00eb zemr\u00ebs ndahet n\u00eb urgjente dhe elektive. Nd\u00ebrhyrjet urgjente jan\u00eb t\u00eb gjitha ato raste ku k\u00ebrkohet nj\u00eb intervenim i menj\u00ebhersh\u00ebm, pasi q\u00eb s\u00ebmundja zemr\u00ebs q\u00eb pacienti ka, n\u00eb \u00e7do moment mund te rrezikoj jet\u00ebn e tij\u00eb. Rastet elektive jan\u00eb ato raste ku s\u00ebmundja e zemr\u00ebs nuk e rrezikon aktualisht jet\u00ebn e pacientit dhe n\u00eb k\u00ebto raste kemi koh\u00eb p\u00ebr planifikim t\u00eb operacionit.<\/span><\/p>\n

Rastet urgjente\u00a0<\/span><\/b>jan\u00eb zakonisht mbyllja e arterieve koronare t\u00eb zemr\u00ebs te cilat pasojn me nj\u00eb Infarkt \/ vdekje t\u00eb muskulit t\u00eb zemr\u00ebs. Raste akute q\u00eb k\u00ebrkojn\u00eb operacion t\u00eb menj\u00ebhershem jan\u00eb \u00e7arjet e aort\u00ebs apo t\u00eb arterieve koronare. N\u00eb raste akute poashtu futet edhe Endokarditis q\u00eb \u00ebsht\u00eb nj\u00eb infekcion i cili prek valvulat e zemr\u00ebs dhe formon vegetacione q\u00eb mund t\u00eb shkatojn\u00eb nj\u00eb infarkt n\u00eb tru apo organe tjera. Poashtu nd\u00ebrhyrje akute k\u00ebrkojn s\u00ebmundjet e zemr\u00ebs kur kemi t\u00eb bejm me k\u00ebputje t\u00eb muskulit papillar q\u00eb mban aparatin valvular. Rastet akute jan\u00eb t\u00eb gjitha ato raste kur jeta e pacientit \u00ebsht\u00eb shum\u00eb e rrezikuar dhe faktori koh\u00eb \u00ebsht\u00eb vdekjeprur\u00ebs.<\/span><\/p>\n

Rastet elektive\u00a0<\/span><\/b>jan\u00eb zakonisht s\u00ebmundjet e valvulave t\u00eb zemr\u00ebs nga t\u00eb cilat pacienti ende nuk ka kufizime t\u00eb aktiviteve ditore. <\/span>Dmth kur simptomet e pacienteve si frym\u00ebz\u00ebnija apo dhimbjet nuk kufizojn aktivitet normale. Poashtu ngushtimet e arterieve koronare duke mos kaluar 90 % dhe pa prekur en\u00ebt kryesore siq \u00ebsht\u00eb trungu i AKM- Arteria Koronare e Majt\u00eb apo (LCA -Left main). Aneurizmat ( zgj\u00ebrimet) e aort\u00ebs apo en\u00ebve koronare poashtu futen n\u00eb trajtimin elektiv. Rastet elektive jan\u00eb t\u00eb gjitha ato raste ku jeta e pacientit nga s\u00ebmundja q\u00eb ai ka nuk \u00ebsht\u00eb e rrezikuar aktualisht. K\u00ebto raste planifikohen p\u00ebr intervenime.<\/p>\n

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Q\u00ebndrimi hospitalor<\/strong><\/p>\n

Zakonisht pacient\u00ebt duhet t\u00eb shtrihen nj\u00eb dit\u00eb para operacionit n\u00eb Spital. Gjat\u00eb k\u00ebsaj dite b\u00ebhet pregaditja optimale p\u00ebr operacion. Pas operacionit b\u00ebhet transferimi n\u00eb statcionin intensiv. Trajtimi n\u00eb statcionin intensiv do t\u00eb thot\u00eb monitorim 24 or\u00eb nga stafi medicional i p\u00ebrgaditur. N\u00eb statcionin intensiv b\u00ebhet \u00a0kontrollimi i rregullt\u00eb i parametrave jetik dhe analizave t\u00eb gjakut. Disa or\u00eb pas operacionit fillon zgjimi dhe marrja e kontrollit t\u00eb organeve (frymarrjes) nga vet pacienti. Pas zgjimit dhe kthjellj\u00ebs s\u00eb plot\u00eb t\u00eb pacientit nga medikamentet e narkoz\u00ebs, b\u00ebhet edhe extubimi ose siq thuhet heqja nga aparati i frymarrjes. Dit\u00ebn e par\u00eb pas operacionit pacient\u00ebt mobilizohen, q\u00eb do t\u00eb thot\u00eb ecin n\u00eb dhom\u00eb apo korridor. Q\u00ebndrimi n\u00eb statcionin intensiv \u00ebsht\u00eb rreth 3 dit\u00eb. Gjat\u00eb k\u00ebsaj kohe dhimbjet do jen\u00eb n\u00eb shkall\u00ebn e durimit, q\u00eb do thot\u00eb se terapia ndaj dhimbjeve aplikohet n\u00eb m\u00ebnyr\u00eb t\u00eb rregullt. N\u00eb raste t\u00eb ve\u00e7ant\u00eb jepet edhe terapia shtes\u00eb kund\u00ebr dhimbjes.<\/span><\/p>\n

N\u00eb dit\u00ebn e kat\u00ebrt pas operacionit b\u00ebhet transferimi n\u00eb statcion normal. Aty b\u00ebhet mobilizimi i plot\u00eb n\u00ebn kontrollin e fizioterapeuteve dhe heqja e gjithe kateterve dhe drenazh\u00ebve. <\/span><\/p>\n

Prej dit\u00ebs s\u00eb shtat\u00eb zakonisht b\u00ebhet edhe transferimi i Paceinteve n\u00eb sht\u00ebpi apo siq preferoeht n\u00eb vendet e bashkimit evropian n\u00eb nj\u00eb qend\u00ebr rehabilitimi p\u00ebr tri deri ne kat\u00ebr jav\u00eb. K\u00ebto qendra rehabilitimi postoperimi mungojn n\u00eb Kosov\u00eb.<\/span><\/p>\n

Kontrollet postoperative 14 dit\u00eb dhe 30 dit\u00eb pas operacionit jan\u00eb t\u00eb parapara dhe do realizohen tek ne.<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Medikamentet<\/strong><\/p>\n

Gjat\u00eb gjith\u00eb q\u00ebndrimit hospitalor ju nuk keni nevoj p\u00ebr medikamentet e juaja p\u00ebrpos n\u00ebse ju keni medikamente specifike, gj\u00eb p\u00ebr t\u00eb cilien ju duhet edhe t\u00eb konsultoheni me stafin mjek\u00ebsor. Para lirimit nga Spitali \u00a0t\u00eb gjith\u00eb pacient\u00ebt marrin Flet\u00ebl\u00ebshimin apo Raportin e detajuar t\u00eb q\u00ebndrimit hospitalor. N\u00eb k\u00ebt\u00eb raport \u00ebsht\u00eb e p\u00ebshkruar e gjith\u00eb procedura operative sidhe diagnostika para dhe pas operacionit, poashtu terapia medikamentoze me informacionet shtes\u00eb rreth trajtimit t\u00eb plag\u00ebs apo rekomandimet jan\u00eb obligative.<\/p>\n

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Doktor\u00eb profesionist p\u00ebr sh\u00ebndetin tuaj<\/h2>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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\"Dr.<\/a><\/figure>

Dr. med. Fatos Kojqiqi<\/a><\/h3>
Kardiokirurg<\/h6><\/header><\/div>\t<\/div>\r\n<\/article>\r\n\r\n\r\n\r\n
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\"Dr.<\/a><\/figure>

Dr. med. Arben Kojqiqi<\/a><\/h3>
Kardiokirurg - Kirurg Torakal<\/h6><\/header><\/div>\t<\/div>\r\n<\/article>\r\n\r\n\r\n\r\n
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\"Dr.<\/a><\/figure>

Dr. med. Besnik Kojqiqi<\/a><\/h3>
Kirurg-Kardiovaskular<\/h6><\/header><\/div>\t<\/div>\r\n<\/article>\r\n\r\n\r\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":12208,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_oct_exclude_from_cache":false,"_glsr_average":0,"_glsr_ranking":0,"_glsr_reviews":0,"footnotes":""},"class_list":["post-12557","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/12557","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/comments?post=12557"}],"version-history":[{"count":16,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/12557\/revisions"}],"predecessor-version":[{"id":15051,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/12557\/revisions\/15051"}],"up":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/12208"}],"wp:attachment":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/media?parent=12557"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}