Koronarografia \u00ebsht\u00eb p\u00ebrkufizuar si nj\u00eb procedur\u00eb invazive me an\u00eb t\u00eb s\u00eb cil\u00ebs vizualizohen arteret koronare t\u00eb zemr\u00ebs me ndihm\u00ebn e l\u00ebnd\u00ebs s\u00eb kontrastit t\u00eb injektuar tek arteret. Rekomandohet p\u00ebr pacient\u00ebt e diagnistikuar m\u00eb par\u00eb me s\u00ebmundje koronare me ndonj\u00eb nga metodat diagnostikuese jo invazive si\u00e7 \u00ebsht\u00eb stres testi koronar, eko e zemr\u00ebs, 24 or\u00eb monitorim i zemr\u00ebs, tomografi kompjuterike \u2013 angiografike. Tek k\u00ebta pacient\u00eb nuk ka urgjenc\u00eb, prandaj koronarografia b\u00ebhet n\u00eb m\u00ebnyr\u00eb t\u00eb planifikuar n\u00eb nj\u00eb periudh\u00eb t\u00eb caktuar kohore.<\/p>\n

Koronarografia urgjente<\/h2>\n

Koronarografia urgjente kryhet tek pacient\u00ebt t\u00eb cil\u00ebt kan\u00eb sindrom\u00eb n\u00eb form\u00eb akute dhe shenja t\u00eb infarktit akut miokardiak. Nuk ekzistojn\u00eb kundraindikime absolute t\u00eb koronarografis\u00eb. Tek kundraindikimet b\u00ebjn\u00eb pjes\u00eb: dob\u00ebsimi akut i veshkave, gjendje e paqart\u00eb febrile, goditje akute n\u00eb tru, anemi e r\u00ebnd\u00eb, dekompensim i r\u00ebnd\u00eb kardiak, psikoz\u00eb akute, reaksion alergjik ndaj l\u00ebnd\u00ebs s\u00eb kontrastit, koagulopati dhe gjakderdhje nga stomaku.<\/p>\n

P\u00ebrgatitja<\/h2>\n

Koronarografia kryhet n\u00eb kushte sterile n\u00eb sall\u00eb t\u00eb ve\u00e7ant\u00eb angiografike. Pas p\u00ebrgatitjes paraprake, marrjes s\u00eb analiz\u00ebs s\u00eb gjakut, p\u00ebrgatitjes s\u00eb vendit n\u00eb t\u00eb cilin do t\u00eb b\u00ebhet punktimi (shpimi), premedikimi, pacienti vendoset i shtrir\u00eb me shpin\u00eb, dhe mbulohet me nj\u00eb kompresim steril. Zakonisht punktimi b\u00ebhet n\u00eb krahun radial, n\u00eb pjes\u00ebn femorale (pjesa e bikinit), n\u00eb arteren e sip\u00ebrme t\u00eb krahut. N\u00eb departamentin ton\u00eb, 95% e rasteve t\u00eb koronarografis\u00eb b\u00ebhen n\u00ebp\u00ebrmjet arteres radiale n\u00eb krah, me an\u00eb t\u00eb s\u00eb cil\u00ebs pacientit i ofrohet m\u00eb tep\u00ebr komoditet gjat\u00eb intervenimit dhe mobilizimit menj\u00ebher\u00eb pas kryerjes s\u00eb procedur\u00ebs si dhe m\u00eb pak komplikime.<\/p>\n

Gjat\u00eb intervenimit<\/h2>\n

Pas injektimit t\u00eb anestezis\u00eb lokale n\u00eb vendin ku do t\u00eb b\u00ebhet punktimi, arteria shpohet me an\u00eb t\u00eb gjilp\u00ebr\u00ebs n\u00ebp\u00ebrmjet t\u00eb cil\u00ebs vendoset nj\u00eb tel i shkurt\u00ebr n\u00eb arterie. Gjilp\u00ebra hiqet dhe n\u00eb telin e shkurt\u00ebr vendoset nj\u00eb tub plastik i cili q\u00ebndron deri n\u00eb p\u00ebrfundimin e procedur\u00ebs. N\u00ebp\u00ebrmjet tubit b\u00ebhet kalimi i telit t\u00eb gjat\u00eb dhe katet\u00ebr e cilat i mban pacienti , t\u00eb cilat ndiqen n\u00ebp\u00ebrmjet monitorit dhe arrijn\u00eb deri n\u00eb pjes\u00ebn fillestare t\u00eb aort\u00ebs n\u00eb t\u00eb cil\u00ebn gjenden hapjet e dy artereve koronare \u2013 arteria koronare e majt\u00eb dhe e djatht\u00eb. Me disa l\u00ebvizje standarde, katetra vendoset tek hyrja e arteries koronare, dhe m\u00eb pas injektohet l\u00ebnda e kontrastit, dhe n\u00eb k\u00ebt\u00eb m\u00ebnyr\u00eb vizualizohet arteria me t\u00eb gjitha deg\u00ebt e saj, n\u00eb form\u00ebn e nj\u00eb shfaqje angiografike n\u00eb monitor. B\u00ebhet filmimi angiografik me imazhe t\u00eb shumta nga k\u00ebnde t\u00eb ndryshme, p\u00ebr t\u00eb marr\u00eb nj\u00eb pamje m\u00eb t\u00eb qart\u00eb dhe m\u00eb reale t\u00eb arterieve koronare. E gjith\u00eb procedura zgjat 15 minuta, pas s\u00eb cil\u00ebs kryhet analiza e imazhit angiografik, p\u00ebrcaktohet shkalla e ngushtimit t\u00eb arteries, cil\u00ebsia dhe gjat\u00ebsia e ngushtimit, dhe merret vendimi n\u00eb baz\u00eb t\u00eb gjetjeve apo zezultatit i cili mund:<\/p>\n

\n
• T\u00eb mos ket\u00eb ngushtim t\u00eb artereve koronare me rekomandim p\u00ebr kryerjen e trajtimit medikamentoz, dhe pas 3 or\u00ebsh pacienti mund t\u00eb kthehet n\u00eb sht\u00ebpi.<\/li>\n
• N\u00eb rast se ekzistojn\u00eb ngushtime serioze mbi 60-70% t\u00eb nj\u00ebr\u00ebs apo dy artereve koronare, procedura kryhet me an\u00eb t\u00eb zgjerimit balon\u00eb, dhe vendosjen e nj\u00eb stenti q\u00eb mund\u00ebson rrjedh\u00ebn optimale t\u00eb gjakut n\u00eb arterien koronare. Zakonisht, pacienti q\u00ebndr\u00ebn nj\u00eb dit\u00eb n\u00ebn v\u00ebzhgim p\u00ebr t\u00eb par\u00eb n\u00ebse ka nevoj\u00eb p\u00ebr terapi intravenoze.<\/li>\n
• Mund\u00ebsia e tret\u00eb \u00ebsht\u00eb gjetja e shum\u00ebfisht\u00eb e arteres koronare t\u00eb s\u00ebmur\u00eb ku m\u00eb shum\u00eb se tre artere koronare kan\u00eb kufizime kritike, ku pacienti merr rekomandim p\u00ebr kryerjen e kirurgjis\u00eb kardiake ose kryerjen e operacionit bajpas.<\/li>\n<\/ul>\n

  Komplikimet<\/h2>\n

  Komplikime t\u00eb mundshme nga koronarografia shfaqen n\u00eb nj\u00eb p\u00ebrqindje shum\u00eb t\u00eb vog\u00ebl. Kjo p\u00ebrqindje \u00ebsht\u00eb m\u00eb e ul\u00ebt n\u00eb rast se koronarografia kryhet nga ekip me p\u00ebrvoj\u00eb dhe n\u00eb kushte standarde. Komplikimet m\u00eb t\u00eb zakonshme jan\u00eb:<\/p>\n

  \n
  • Rrjedhje e vog\u00ebl lokale n\u00eb vendin e shpimit<\/li>\n
  • Aritmi t\u00eb zemr\u00ebs<\/li>\n
  • Reaksion alergjik i shkaktuar nga l\u00ebnda e kontrastit<\/li>\n<\/ul>\n

    Koronarografia kryhet n\u00eb salla t\u00eb ve\u00e7anta angiografike, n\u00eb kushte sterile dhe nga nj\u00eb ekip i p\u00ebrb\u00ebr\u00eb nga nj\u00eb mjek, dy infermiere, nga nj\u00eb teknik radiokrafik\u00a0 dhe nj\u00eb ndihm\u00ebs mjek. Departamenti i kardiologjis\u00eb n\u00eb spitalin klinik \u201cAcibadem Sistina\u201d disponon dy salla angiografike, nj\u00ebsi koronare intenzive me gjasht\u00eb shtret\u00ebr, disa dhoma spitalore si dhe nj\u00eb departament diagnostikues ambulator. Departamenti kardiologjik p\u00ebrb\u00ebhet nga nj\u00eb ekip mjek\u00ebsh me p\u00ebrvoj\u00eb dhe nga nj\u00eb staf tjet\u00ebr mjek\u00ebsor t\u00eb cil\u00ebt kryejn\u00eb procedura intervente t\u00eb nd\u00ebrlikuara si\u00e7 \u00ebsht\u00eb diagnostikimi koronarografik, dilatimet e balonave dhe stentimi i artereve koronare, stentimi i artereve periferike n\u00eb k\u00ebmb\u00eb dhe artereve karotide, studimet elektrofiziologjike me ablatim, implantimi i stimuluesve kardiak (pacemaker) dhe debrifilator\u00ebve t\u00eb zemr\u00ebs dhe aparate t\u00eb risinkronizimit kardiak. K\u00ebtu p\u00ebrfshihet edhe departamenti kardiokirurgjik n\u00eb t\u00eb cilin kryhen edhe operacionet m\u00eb t\u00eb komplikuara t\u00eb zemr\u00ebs.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Koronarografia \u00ebsht\u00eb p\u00ebrkufizuar si nj\u00eb procedur\u00eb invazive me an\u00eb t\u00eb s\u00eb cil\u00ebs vizualizohen arteret koronare t\u00eb zemr\u00ebs me ndihm\u00ebn e l\u00ebnd\u00ebs s\u00eb kontrastit t\u00eb injektuar tek arteret. Rekomandohet p\u00ebr pacient\u00ebt e diagnistikuar m\u00eb par\u00eb me s\u00ebmundje koronare me ndonj\u00eb nga metodat diagnostikuese jo invazive si\u00e7 \u00ebsht\u00eb stres testi koronar, eko e zemr\u00ebs, 24 or\u00eb monitorim […]<\/p>\n","protected":false},"author":4,"featured_media":4117,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[342],"tags":[],"doktori":[],"class_list":["post-5686","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-srce-vaskularno-zdravje-sq"],"acf":[],"_links":{"self":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts\/5686","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/comments?post=5686"}],"version-history":[{"count":0,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/posts\/5686\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/media\/4117"}],"wp:attachment":[{"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/media?parent=5686"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/categories?post=5686"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/tags?post=5686"},{"taxonomy":"doktori","embeddable":true,"href":"https:\/\/healthacibadem.unet.mk\/wp-json\/wp\/v2\/doktori?post=5686"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}