{"id":14589,"date":"2019-11-07T14:30:31","date_gmt":"2019-11-07T14:30:31","guid":{"rendered":"http:\/\/kojqiqi.com\/?page_id=14589"},"modified":"2020-05-22T21:22:53","modified_gmt":"2020-05-22T19:22:53","slug":"rekonstruktimi-i-aortes","status":"publish","type":"page","link":"https:\/\/kojqiqi.com\/sherbimet\/rekonstruktimi-i-aortes\/","title":{"rendered":"Rekonstruktimi i Aort\u00ebs"},"content":{"rendered":"
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Rekonstruktimi i baz\u00ebs s\u00eb aort\u00ebs me z\u00ebvend\u00ebsim \/ riparim t\u00eb valvul\u00ebs aortale<\/h2>\n<\/div>
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\"\"<\/p>\n

Zgj\u00ebrimi i aort\u00ebs ascendente (Aneurisma) apo \u00e7arja e aort\u00ebs (Disekcioni Tip A) shum\u00eb her\u00eb shkaktojn\u00eb insuficienc t\u00eb valvul\u00ebs aortale, q\u00eb do t\u00eb thot\u00eb, se valvula aortale nuk mbyllet mir\u00eb. \u00a0Si pasoj\u00eb e Insuficienc\u00ebs s\u00eb \u00a0saj gjaku rrjedh nga Aorta prap n\u00eb ventrikel. N\u00eb k\u00ebto raste kur flet\u00ebzat e valvul\u00ebs aortale nuk takohen n\u00eb mes, preferohet rekonstruktimi i baz\u00ebs apo rr\u00ebnj\u00ebs s\u00eb aort\u00ebs.<\/p>\n

Rekonstruktimet e baz\u00ebs s\u00eb aort\u00ebs b\u00ebh\u00ebn n\u00eb disa m\u00ebnyra:<\/p>\n

\u00a0\u00a0Bentall-Operacion (Conduid)<\/strong>: Rkonstruktimi i baz\u00ebs s\u00eb aort\u00ebs duke ndrruar valvul\u00ebn aortale dhe aorten ascendente me reimplantim t\u00eb arterieve koronare.<\/p>\n

\u00a0\u00a0David-Operacion<\/strong>: Rekonstruktim i baz\u00ebs s\u00eb aort\u00ebs duke stabilizuar rr\u00ebnjen e aort\u00ebs dhe duke riparuar valvul\u00ebn aortale me reimplantim te arterieve koronare.<\/p>\n

\u00a0Yacoub Operacion<\/strong>: Remodelim i baz\u00ebs s\u00eb aort\u00ebs pa stabilizuar rr\u00ebnj\u00ebn e aort\u00ebs duke riparuar valvulen aortale me reimplantim t\u00eb arterieve koronare.<\/p>\n

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\u00a0Bentall-Operacion<\/strong><\/p>\n

\u00a0<\/strong>Ky operacion u realizua p\u00ebr here t\u00eb par\u00eb ne vitin 1968 nga Hugh Bentall dhe Antony de Bonno.<\/p>\n

Gjat\u00eb k\u00ebtij operacioni b\u00ebh\u00ebt nd\u00ebrrimi i valvul\u00ebs aortale, nd\u00ebrrimi i aort\u00ebs ascendente dhe nd\u00ebrrimi i rr\u00ebnj\u00ebs s\u00eb aort\u00ebs me reimplantim t\u00eb arterieve koronare.<\/p>\n

Realizim i k\u00ebtij Operacioni preferohet n\u00eb rastet kur valvula aortale \u00ebsht\u00eb e d\u00ebmtuar dhe riparimi i saj \u00ebsht\u00eb i pamundur apo \u00a0jo i suksessh\u00ebm. Poashtu \u00a0edhe kur aorta ascendente, baza e aort\u00ebs \u00a0dhe flet\u00ebzat e valvul\u00ebs aortale jan\u00eb \u00a0t\u00eb d\u00ebmtuara apo t\u00eb zgj\u00ebruara nga \u00e7arja (disekcioni) jan\u00eb indikacione p\u00ebr k\u00ebt\u00eb procedur operative.<\/p>\n

Conduid<\/strong> jan\u00eb protezat e aort\u00ebs ascendente me valvul\u00ebn aortale t\u00eb implantuar mbrenda. Valvula \u00ebsht\u00eb mekanike Conduid klasik apo mund te jet\u00eb edhe biologjike Bio-Bentall.<\/p>\n

\"\"<\/p>\n

Yacoub Operacion<\/strong><\/p>\n

Ky operacion u realizua n\u00eb vitin 1979 nga Kardiokirugu Magdi Yacoub. Q\u00ebllimi i k\u00ebtij operacioni \u00ebsht\u00eb riparimi i valvul\u00ebs aortale duke mos vendosur proteze mekanike apo biologjike. Mundesia e riparimit dhe mbajtj\u00ebs s\u00eb valvul\u00ebs s\u00eb Pacientit ( valvula native) ka p\u00ebrparsi n\u00eb shum\u00eb aspekte dhe tani me dihet, se asnj\u00eb protez\u00eb e huaj nuk \u00ebsht\u00eb ideale q\u00eb t\u00eb zavendsoj at\u00eb. T\u00eb gjitha protezat (valvulat) qofshin ato mekanike apo biologjike jan\u00eb kompromis i valvul\u00ebs native dhe kan\u00eb mang\u00ebsit e tyre, mir\u00ebpo jan\u00eb nj\u00eb zgjidhje perfekte kur valvula native \u00ebsht\u00eb e d\u00ebmtuar dhe nuk mund t\u00eb riparohet.<\/p>\n

Gjat\u00eb ketij operacioni b\u00ebh\u00ebt nd\u00ebrrimi i aort\u00ebs ascendente duke e fiksuar protez\u00ebn e aort\u00ebs direkt n\u00eb sinusin e aort\u00ebs dhe pa nd\u00ebrruar valvul\u00ebn aortale. Proteza e aort\u00ebs riformohet duke i dh\u00ebn\u00eb form\u00eb t\u00eb gjuh\u00ebs (sikur tri gjuh\u00eb, shif foton). Gjate k\u00ebsaj procedure nuk beh\u00ebt nd\u00ebrrimi dhe fiksim i rr\u00ebnj\u00ebs s\u00eb aort\u00ebs, por t\u00eb themi nj\u00eb rimodelim i rr\u00ebnj\u00ebs me qepje direkte t\u00eb protez\u00ebs me aort\u00eb. Arteriet koronare reimplantohen n\u00eb form\u00eb t\u00eb butonit n\u00eb protez\u00ebn e aort\u00ebs. Sinus valsalve ruan gjeometrin\u00eb e saj.<\/p>\n

Kjo metod\u00eb operative p\u00ebr nd\u00ebrrim t\u00eb aort\u00ebs ascendente dhe rimodelim t\u00eb rr\u00ebnj\u00ebs s\u00eb aort\u00ebs\u00a0 ka nj\u00eb dob\u00ebsi, q\u00eb \u00ebsht\u00eb zgjerimi i baz\u00ebs s\u00eb aort\u00ebs dhe mund\u00ebsia e insuficences s\u00eb valvul\u00ebs aortale n\u00eb planin afatgjat\u00eb postoperativ.<\/p>\n

Operacionet Yacoub nuk preferohen tek pacientet me smundje gjentike t\u00eb indeve siq jan\u00eb pacientet me Marfan Sindrom.<\/p>\n

\"\"<\/p>\n

David Operacion<\/strong><\/p>\n

Ky operacion u realizua \u00a0n\u00eb vitin 1980 nga Tirrone David n\u00eb Toronto. David me ekip\u00ebn e tij\u00eb propozuan nj\u00eb alternative tjet\u00ebr operative p\u00ebr rekonstruktim t\u00eb valvul\u00ebs aortale. Q\u00ebllimi ishte i njejt\u00eb, ruajtja e valvul\u00ebs native t\u00eb pacientit, pra valvula t\u00eb mos nd\u00ebrrohet. Kjo metod\u00eb parashef nj\u00eb rekonstruktim t\u00eb baz\u00ebs t\u00eb aort\u00ebs, valvul\u00ebs aortale dhe aort\u00ebs ascendente.<\/p>\n

Gjat\u00eb k\u00ebtij operacioni, valvula aortale me komisuret e saj futet brenda protez\u00ebs s\u00eb aort\u00ebs, duke fiksuar protez\u00ebn direkt n\u00eb rr\u00ebnj\u00ebn e saj. Arteriet koronare n\u00eb form\u00eb t\u00eb butonit reimplantohen prap n\u00eb protez\u00eb.<\/p>\n

P\u00ebrparsia e k\u00ebtij operacioni n\u00eb krahasim me operacionin sipas Yacoub, \u00ebsht\u00eb stabilizimi i rr\u00ebnj\u00ebs s\u00eb aort\u00ebs. Mir\u00ebpo, tek ky operacion gjeometria e sinus valsalve t\u00eb aort\u00ebs nuk mund t\u00eb ruhet siq ishte m\u00eb par\u00eb dhe kjo mund t\u00eb shkaktoj nj\u00eb stres tek flet\u00ebzat e valvul\u00ebs aortale.<\/p>\n

Rezulatet 10 vjeqare t\u00eb k\u00ebsaj metode jan\u00eb excellente.<\/p>\n

Aktualisht kemi disa modifikime te Operacionit David, q\u00eb jan\u00eb klasifikuar sipas Millerit:<\/p>\n

Ato jan\u00eb metodat David I deri David V q\u00eb parashohin rekonstruktim dhe remodelim t\u00eb rr\u00ebnj\u00ebs s\u00eb aort\u00ebs.<\/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":14594,"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-14589","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/14589","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=14589"}],"version-history":[{"count":7,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/14589\/revisions"}],"predecessor-version":[{"id":14606,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/14589\/revisions\/14606"}],"up":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/pages\/12208"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/media\/14594"}],"wp:attachment":[{"href":"https:\/\/kojqiqi.com\/wp-json\/wp\/v2\/media?parent=14589"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}