Implan Dwi-stent Untuk Jantung

SITI, dalam usia 50-an, sentiasa sibuk dengan tugas beliau sebagai ketua pegawai eksekutif untuk sebuah syarikat. Terlalu sibuk hinggakan tidak mempunyai masa untuk menjaga kesihatan diri.

Pada suatu pagi, sewaktu beliau hendak ke pejabat, Siti mengalami rasa sakit dada yang amat sangat dan akhirnya dia terus tidak sedarkan diri.

Apabila pulih dan sedar semula, Siti mendapati dirinya berada di hospital. Apakah yang telah berlaku?

“Siti, anda telah mengalami serangan jantung dan disahkan menghidap penyakit jantung koronori (CAD). Kami mendapati saluran darah jantung anda menjadi sempit. Anda perlu rawatan segera untuk mengelak komplikasi yang lebih teruk,” terang doktor.

Arteri Siti, iaitu saluran darah yang membawa darah mengandungi oksigen keluar dari jantung untuk mengalir ke seluruh badan menjadi sempit disebabkan pembentukan plak pada bahagian dalam dinding arteri.

Halangan ini menyebabkan kekurangan pengaliran darah yang membawa oksigen ke jantung, mengakibatkan sakit dada, degupan jantung tidak tetap (arrhythmias), serangan jantung dan mungkin maut.

Untuk merawat CAD, stent membebaskan ubat (perancah) dimasukkan ke dalam saluran darah.

“Implan ini direka khas bagi membantu melebarkan saluran darah untuk pengaliran darah yang lebih lancar ke jantung,” jelas Profesor Madya Jabatan Kardiologi, Fakulti Perubatan Universiti Teknologi Mara (UiTM), Prof. Dr. Sazzli Kasim.

Bercerita lanjut tentang statistik terkini penyakit jantung,

Punca penyakit

Dalam satu laporan yang dikeluarkan oleh Kementerian Kesihatan pada 2009 menunjukkan penyakit jantung menyumbang sebanyak 16.09 peratus daripada jumlah kadar kematian di hospital-hospital di Malaysia.

Penyakit jantung yang paling lazim berlaku ialah penyakit jantung koronari (CHD). Ini berlaku apabila lebihan lemak yang dipanggil plak bergumpal pada dinding arteri lalu menyebabkan saluran tersebut semakin menyempit. Apabila ia berlaku, jantung tidak mendapat darah dan oksigen yang mencukupi lalu berlakunya episod CHD.

Memandangkan setiap pesakit mempunyai lokasi dan tahap stenosis koronari (penyempitan koronari) serta keadaan fizikal yang berbeza, doktor akan menilai risiko bagi setiap pesakit sebelum mengesyorkan jenis rawatan yang sewajarnya. PCI ialah sejenis rawatan pembesaran penyempitan arteri koronari yang dijalankan tanpa memerlukan pembedahan. Prosedur tersebut biasanya disyorkan oleh doktor apabila 70 peratus arteri pesakit mengecil atau tersumbat.

Tambah dr. Sazzli, kebanyakan penyakit jantung berpunca daripada gaya hidup tidak sihat contohnya, sebelum seseorang berkahwin, dia minat bersukan tetapi selepas berkahwin, mereka tidak lagi aktif bersukan. Tambahan pula, pemakanan sering terabai di samping tabiat merokok yang masih berterusan. Faktor-faktor inilah yang boleh menyebabkan saluran jantung tersumbat.

Walaupun penyakit ada penawarnya, Dr. Sazzli tetap menekankan tentang amalan gaya hidup sihat.

“Saya selalu menasihatkan pesakit saya supaya berhenti merokok. Bagi pesakit yang mungkin mengalami sakit jantung kronik, mereka mungkin melakukannya. Masalah akan timbul apabila golongan muda khususnya 35 tahun ke bawah, tidak mahu berwaspada. Saya sendiri pernah berhadapan dengan pesakit muda yang berumur 23 tahun,” jelasnya.

Oleh itu, kesedaran awal sangat penting dalam kalangan masyarakat untuk menjaga pemakanan selain bersenam atau melakukan aktiviti mengeluarkan peluh, tidak merokok atau menghisap shisha.

Tambah Dr. Sazzli, gaya hidup sihat sangat penting untuk mengurangkan kes kematian akibat serangan jantung yang tidak sempat dihantar atau mendapatkan rawatan di hospital.

Jenis-jenis stent

Ketika ini terdapat beberapa stent di Malaysia. Jenis-jenis stent utama yang digunakan ialah Bare Metal Stent (BMS), Drug-eluting Stent (DES), Bio-engineered Stent (BES) dan Dual Therapy Stent (DTS).

DTS merupakan stent teknologi baharu dibangunkan oleh OrbusNeich yang kini boleh didapati di Malaysia serta pasaran terpilih di Asia Pasifik, Asia Barat dan Eropah selepas syarikat tersebut menerima CE Mark. Stent Combo Dual Therapy menangani kelewatan penyembuhan arteri koronari berkaitan dengan DES, yang merupakan penjagaan standard kini untuk merawat penyakit arteri koronari.

Ia merupakan stent yang pertama bagi melaksanakan dua fungsi iaitu mempercepatkan liputan endothelial dan kawalan terhadap perkembangan neo-intimal melalui gabungan teknologi propenyembuhan dengan elusi abluminal sirolimus dihantar dari polimer terbiodegradasi yang mencapai pelesapan sepenuhnya dalam masa 90 hari.

DTS yang pertama di dunia itu menggabungkan dua stent yang sudah diakui dan terbukti teknologinya iaitu DES dan BES. DES merupakan stent logam yang secara perlahan-lahan membebaskan ubat ke dalam dinding saluran darah tempat ia diimplan bagi menghalang hiperplasia (peningkatan bilangan sel atau pertumbuhan pesat sel) yang mengurangkan risiko restenosis (penyempitan semula dinding arteri).

BES pula disalut dengan antibodi untuk mempercepatkan pemulihan semula jadi permukaan sten dengan membentuk endotelium (lapisan sel epitelium yang melapik jantung, saluran darah. limfa dan dinding rerambut) baharu.

Menurut Dr. Sazzli, dwi-stent ini merupakan satu perkembangan baik kerana stent ini bersalut dengan ubat.

“Dalam selaput itu pula terdapat antibodi. Ini bermakna stent ini mempunyai dua fungsi iaitu sentiasa memastikan saluran darah membesar dan membaik pulih dengan cepat. Dalam pada itu, stent baharu tersebut boleh mengurangkan kedua-dua risiko restenosis dan trombosis (pembentukan darah beku)

dengan ketara.

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