So wo koma aortic valve no wɔ flap biako? (Unicuspid Aortic Valve) - Momma yɛnka eyi ho asɛm!

Ɛtɔ da bi a yɛte sɛ, ‘Oo, me ba no wɔ komayare ketewaa bi, wɔde koma nwiinwii na ɛwoo no’? Anaasɛ, sɛ ɛyɛ den ma aberante bi sɛ ɔbɛhome anaasɛ ne koko yɛ no yaw a, nnuruyɛfo ka sɛ, ‘Ɔhaw ketewaa bi wɔ koma no mu ntini bi ho.’ Saa na yɛrebɛka komayareɛ bi a ɛntaa nsi koraa, nanso ɛho hia paa sɛ yɛbɛhunu ho asɛm.

Dɛn ne saa aortic valve a ɛwɔ krataa biako (`Unicuspid Aortic Valve`) yi?

Sɛ yɛbɛka no tiawa a, aortic valve a ɛwɔ wo koma mu no wɔ kratasin biako pɛ sen abiɛsa a ɛtaa nya no. Asɛmfua "unicuspid" kyerɛ "kratasin biako." Fa no sɛ ɛte sɛ ɔpon a wɔato mu biako pɛ na ɛnyɛ abien.

Saa nkrataa yi te sɛ apon nketewa. Wobue na wɔto mu na ama mogya a ɛho tew a oxygen pii wom atumi afi koma no benkum so - benkum dan a ɛwɔ koma no ase - akɔ aorta no mu . Afei aorta no de mogya kɔ nipadua no nyinaa mu. Enti, sɛ nkrataa dodow a ɛwɔ saa valve yi mu no so tew a, akwanside nketenkete betumi aba wɔ mogya a ɛbɛkɔ no mu.

Ebia nnipa binom a wɔwɔ saa tebea yi, Unicuspid Aortic Valve, nso benya komayare afoforo. Nhwɛsoɔ:

• Aortopathy : Eyi kyerɛ mmerɛwyɛ wɔ aorta no afasu mu.
• Ventricular Septal Defect (VSD) : Tokuru a ɛwɔ ɔfasu no mu wɔ koma no ase adan abien no ntam.
• Patent Ductus Arteriosus (PDA) : Mogya ntini a anka ɛsɛ sɛ ɛto mu wɔ awo akyi no da so ara bue.
• Coronary Artery Anomalies : Nsakrae bi a ɛba ntini a ɛde mogya kɔ koma no mu no mu.

Eyi yɛ tebea a ɛntaa nsi koraa. Ɛka nnipa dodow bɛyɛ 0.02% . Afei nso, ɛtaa ba mmarima mu.

So eyi ahorow bi wɔ hɔ?

Yiw, ``Unicuspid Aortic Valve'' ahorow atitiriw abien na ɛwɔ hɔ. Nsonsonoeɛ a ɛda saa ahodoɔ mmienu yi ntam ne nsonsonoeɛ a ɛwɔ baabi a nkrataa mmienu (nkrataa) no bata valve fasuo no ho, a wɔfrɛ no ``Commissure'' . Wubetumi ate eyi ase saa. Fa no sɛ w’anofafa abata w’anim daa, nanso ebetumi abom na atetew, ɛnte saa? Ɛno ne nea ``Commissure'' yɛ.

Saa ahorow abien yi ne:

1. Acommissural type: Eyi ne type a emu yɛ den sen biara . Wɔ eyi mu no, commissure biara nni hɔ, kyerɛ sɛ, nsonsonoe biara nni hɔ. Na ɛne aorta no nni abusuabɔ. Nkratawa no nyinaa abata ho, ɛkame ayɛ sɛ wɔde weld abɔ mu. Mogya no fa tokuru ketewaa bi mu nkutoo, te sɛ pinhole.

2. Unicommissural type: Ɔde ne nsa kyerɛɛ ne so.Eyi mu nyɛ den kakra sen foforo no, na ɛno nso ne nea abu so sen biara . Ɛwɔ ``Commissure`` biako, kyerɛ sɛ, ɔkwan biako. Ɛne aorta no nso wɔ abusuabɔ. Sɛ wobue valve a ɛte sɛɛ a, ɛte sɛ nhama. Nnipa binom de toto apataa ano ho.

Nsɛnkyerɛnne bɛn na wubetumi ahu?

Sɛ ɔpanyin bi wɔ saa tebea yi (Unicuspid Aortic Valve) a, sɛnkyerɛnne ahorow a wɔtaa hu ne:

• Ahome tiaa : Sɛ wobrɛ kakra a, ebia wobɛte nka sɛ wobɛtotɔ piti bere a woreforo antweri no.
• Adwene a ɛyɛ wo yaw : Sɛ wosɔre mpofirim a, ebia wobɛte nka sɛ wo ho ayɛ wo yaw.
• Angina : Eyi yɛ ɛyaw anaasɛ ɛyɛ den wɔ koko mu. Wɔ nnipa binom fam no, eyi betumi atrɛw akɔ anom, kɔn, anaa abasa mpo mu.
• Fainting/fainting : Mpofirim ara a obi ntumi nhu hwee.

Mmofra nkumaa a wɔwɔ saa tebea yi taa nya tebea horow te sɛ benkum fam koma a entumi nyɛ adwuma yiye . Wɔn mu duru nso taa so tew te sɛ mmofra afoforo a wɔne wɔn bɔ tipɛn, a ɛkyerɛ sɛ wɔn mu duru sua koraa.

``Acommissural`` type a yɛadi kan aka ho asɛm, a ɛyɛ type a emu yɛ den no, da sɛnkyerɛnne ahorow adi wɔ nkokoaa nkumaa paa mu . Nanso ebia wɔn a wɔwɔ ``Unicommissural`` type no renkyerɛ sɛnkyerɛnne biara kosi sɛ wobedi mfe 20 anaa 30, kyerɛ sɛ, kosi sɛ wobedu mpanyin afe so.

Dɛn nti na eyi rekɔ so? Dɛn nti na ɛte saa?

Saa tebea yi a wɔfrɛ no ``Unicuspid Aortic Valve'' no ba bere a nhaban abiɛsa a ɛsɛ sɛ ɛyɛ no fi ase nyin bere a akokoaa no da so ara wɔ awotwaa mu, na afei sɛ́ anka ɛbɛtetew mu no, ɛka bom na ɛbɛyɛ biako. Eyi si ansa na wɔawo akokoaa no mpo .

Ɛwom sɛ nhwehwɛmufo ntumi nkyerɛ sɛ ɛyɛ nokware de, nanso wosusuw sɛ ebia eyi yɛ ``tebea a wonya fi awo mu.'' Ɛno kyerɛ sɛ ebia awosu mu nkɛntɛnso bi wɔ hɔ.

Nsɛnnennen bɛn na eyi betumi de aba?

Obi a ɔwɔ unicuspid aortic valve betumi anya nsɛnnennen ahorow bere a bere kɔ so no. Wɔn titiriw ne:

• Aortic valve stenosis : Eyi ba bere a valve no mmue yiye, na esiw mogya no kwan. Eyi ma koma no yɛ adwumaden de bɔ mogya.
• Aortic valve regurgitation : Valve no ntumi nto mu yiye, na ɛma mogya a wɔde pam no bi san kɔ koma no mu.
• Infective Endocarditis : Ɔyare mmoawa a ɛba koma no mu, titiriw no ntini a ɛwɔ ntini no mu. Nnipa a wɔwɔ valve ahorow a ɛnyɛ ne kwan so no wɔ asiane kɛse mu.
• Asiane a ɛkɔ soro sɛ Aortic Dissection : Eyi yɛ tebea a ɛba mpofirim na emu yɛ den a ɛma aorta no fasu tetew fi mu.

Nea ɛho hia: Ɛho hia paa sɛ wohu yare no na wɔsa no yare no wɔ bere a ɛsɛ mu, ansa na saa nsɛnnennen yi aba.

Wobɛyɛ dɛn ahu eyi?

Sɛ wokɔ oduruyɛfo nkyɛn a, ɔde afiri a wɔde tie asɛm betie wo koma bere a woreyɛ wo nipadua mu nhwehwɛmu no . Sɛ oduruyɛfo no te koma nnyigyei a ɛnteɛ (``koma mu nwiinwii``) wɔ baabi a ɛbɛn wo aorta a, ebia obesusuw sɛ eyi. Afei, ebia ɔbɛkamfo sɔhwɛ afoforo bi akyerɛ.

Sɔhwɛ ahorow bɛn na wɔreyɛ?

Sɔhwɛ titiriw a wɔyɛ de si so dua pɛpɛɛpɛ sɛ saa ``Unicuspid Aortic Valve'' tebea yi wɔ hɔ ne:

• Transthoracic Echocardiogram (TTE) : Eyi te sɛ koma no mu mfonini a wɔde ultrasound yɛ. Wɔyɛ no wɔ koko no ani. Ebetumi asusuw sɛnea koma no te ne sɛnea ne ntini ahorow no yɛ adwuma no ho yiye.
• Transesophageal Echocardiogram (TEE) : Eyi nso yɛ echocardiogram. Nanso, wɔde afiri ketewaa bi fa menewa no mu na wɔfa aduan no mu hwɛ koma no. Eyi betumi ama mfonini ahorow a emu da hɔ asen TTE.
• Cardiac Computed Tomography (CT) scan : Eyi betumi ama wɔanya koma ne aorta mfonini a wɔatwa no 3D.
• Heart MRI (Magnetic Resonance Imaging) : Eyi nso betumi ama woanya nsɛm a ɛkɔ akyiri afa koma no nhyehyɛe ne ne dwumadi ho.

Ɔkwan bɛn so na wɔsa?

Ɛsono ayaresa a wɔde sa eyi wɔ mfe a obi adi ne sɛnea yare no ho sɛnkyerɛnne no mu yɛ den no.

Ayaresa a wɔtaa fa so ma mmofra nkumaa ne:

• Oprehyɛn Valvotomy : Eyi hwehwɛ sɛ wɔyɛ oprehyɛn de twa valve ntini a ɛbata ho no na wɔyɛ nkrataa foforo.
• Valvuloplasty : Nea ɛka eyi ho ne sɛ wɔde biribi te sɛ balloon bedi dwuma de abue valve no.
• Commissurotomy : Oprehyɛn a wɔde tetew ``Commissure'' no mu, baabi a wɔde nhama no bata ho.
• Ross Procedure : Eyi yɛ oprehyɛn a ɛyɛ den kakra. Yɛbɛka eyi ho asɛm pii akyiri yi.

Wɔ mpanyimfo fam no , mpɛn pii no, ɛho hia sɛ wɔyɛ oprehyɛn de siesie aortic valve no (Unicuspid Aortic Valve repair) anaasɛ wɔde valve foforo si ananmu (a wɔde besi ananmu) .

So nsunsuanso bɔne/nsɛnnennen bi wɔ ayaresa no mu?

Sɛnea ɛte wɔ oprehyɛn biara ho no, nsɛnnennen bi wɔ hɔ a ebetumi de saa ayaresa yi aba. Nanso ɛnyɛ obiara na obenya eyinom mu osuahu. Mma ɛnhaw wo, wo duruyɛfo bɛma woahu eyinom ho nsɛm yiye.

Nsɛnnennen bi a ɛtaa ba a ebetumi aba ne:

• Nsaneɛ
• Mogya a ɛtwetwe
• Mogya a ɛtɔ dodo (`Mogya a ɛtɔ`) .
• Endocarditis (aduru a ɛma obi nya valve) .
• Ɔhaw ahorow a ɛwɔ patch a wɔde di dwuma wɔ valve a wosiesie mu.
• Complete Heart Block : Koma no anyinam ahoɔden nsɛnkyerɛnne a ɛde kɔ no mu a wɔtwa.
• Koma mu yare
• Mogya a ɛretu fi valve no mu akɔ ɔfã a ɛnteɛ.
• Koma mu Nnyigyei a Ɛnyɛ Ne kwan so

Bere tenten ahe na egye ansa na asa?

Eyi bɛyɛ soronko a egyina oprehyɛn ko a woyɛɛ no ​​so. Ebetumi agye dapɛn biako kosi asram pii ansa na ne ho atɔ no. Wo duruyɛfo bɛkyerɛ wo bere tenten a ɛsɛ sɛ wogye w’ahome ne bere a wubetumi asan afi dwumadi ahorow a woyɛ daa ase bio.

Asetra bɛyɛ dɛn wɔ tebea yi mu?

Sɛ wowɔ Unicuspid Aortic Valve a, ɛda adi sɛ ebehia sɛ wɔyɛ wo oprehyɛn . Nokwarem no, ebia ebehia sɛ wosiesie wo valve no anaasɛ wosesa bɛboro pɛnkoro wɔ wo nkwa nna mu. Ebia wowɔ komayare afoforo nso. Ebia ɛho behia nso sɛ wokɔ so nom nnuru a ɛma mogya tu (nnuru a ɛma mogya tu) bere a wɔayɛ wo oprehyɛn awie no, a egyina valve ko a wowɔ so.

Nanso ɛsɛ sɛ yɛka nso sɛ saa ``Unicuspid Aortic Valve'' yi nyɛ biribi a ɛbɛma ayɛ yiye ara kwa . Tebea no kɔ so yɛ nea ɛte saa ara kosi sɛ wɔbɛyɛ wo oprehyɛn de asiesie.

Asɛmpa bi wɔ hɔ. Nhwehwɛmu bi daa no adi sɛ nnipa a wɔyɛɛ wɔn aortic valve oprehyɛn maa tebea bi a wɔfrɛ no ``Unicuspid Aortic Valve'' no mu 97% da so te ase mfe 10 akyi .

Nanso, adwene bi nso wɔ hɔ sɛ sɛ wɔma obi a onnii mfe 65 aortic valve a wɔde yɛ nipadua no esiane tebea yi nti a, ebetumi atew nkwa nna so bɛboro mfe 10. Ɛno nti na nhwehwɛmufo ka sɛ Ross Adeyɛ no ye ma mmerante ne mmabaa a wɔyɛ nnam no. Wɔ saa ``Ross procedure`` yi mu no, wofa w'ankasa ahurututu mu valve na wode kɔ baabi a aortic valve a yare no wɔ no. Afei, wɔde ahurututu mu homograft a efi obi a wawu hɔ kɔ baabi a na ahurututu mu ntini a wɔayi afi hɔ no wɔ no. Ɛwom sɛ eyi yɛ den kakra de, nanso wɔka sɛ nea efi mu ba no ye.

Dɛn na wopɛ sɛ woyɛ wɔ wo fam?

Sɛ woyɛ oprehyɛn wie a, ɛsɛ sɛ wudi wo duruyɛfo akwankyerɛ akyi yiye wɔ sɛnea wobɛhwɛ wo ntwitwiridii/ntwitwagye no ho . Ɔbɛkyerɛ wo bere tenten a ɛsɛ sɛ wogye w’ahome ne bere a wubetumi afi ase aka kar ne da biara da dwumadi afoforo nso akyerɛ wo.

Mma wo werɛ mmfi: Ɛho hia paa sɛ wobɛnom wo nnuru no bere ano, sɛnea oduruyɛfo no akyerɛ wo no, na wokɔ ayaresabea wɔ nna a wɔahyɛ da ayɛ no mu.

Ɛtɔ da bi a wususuw sɛ, "Oh, minnya nnyinii sɛ menya komayare," nanso woda so ara wɔ wo koko mu yaw na ɛyɛ den sɛ wobɛhome.Sɛ wowɔ nea edidi so yi bi a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn. Sɛ wɔyɛ no oprehyɛn de hwehwɛ Unicuspid Aortic Valve wie a, wobɛkɔ so ne wo duruyɛfo ayɛ nhyehyɛe a ɛbɛma woadi akyi . Sɛ ɔhaw bi (te sɛ ɔyare mmoawa) ba wɔ oprehyɛn akyi a, ebia wubehia ayaresa ntɛm ara.

Nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Sɛ wokɔ oduruyɛfo nkyɛn a, nsuro sɛ wubebisa nsɛm biara a wowɔ. Nsɛmmisa bi a wubetumi abisa ni:

• Dɛn ne ayaresa a eye sen biara ma me?
• Nsonsonoe bɛn na ɛwɔ valve ahorow a wɔde si ananmu no ntam? (i.e., valve a wɔde nsa ayɛ vs. biovalve) .
• Ɛho hia sɛ wɔyɛ me oprehyɛn ntɛm dɛn?
• Valve a wɔde ahyɛ mu foforo no di bere tenten ahe?

Sɛ wote sɛ biribi a ɛwɔ wo komam nnyɛ adwuma yiye a, ɛnyɛ mmerɛw. Nanso, bere kɔ so no, nnuruyɛfo ayɛ ayaresa a eye ma saa tebea yi. Wo ne wo duruyɛfo nkasa mfa nea eye ma wo ho. Esiane sɛ eyi yɛ tebea a ɛntaa nsi , ɛyɛ wo yiyedi sɛ wubenya oduruyɛfo a ɔwɔ osuahu wɔ ho. Sɛ nhwɛso no, nhwehwɛmufo ka sɛ anyɛ yiye koraa no, ɛsɛ sɛ oduruyɛfo a ɔyɛ oprehyɛn yɛ Ross oprehyɛn 15 afe biara.

Nea etwa to no, ade a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti mewɔ anidaso sɛ seesei woanya ntease pa wɔ saa komayare yi a wɔfrɛ no `(Unicuspid Aortic Valve)` a yɛkaa ho asɛm nnɛ no ho. Kae sɛ eyi yɛ biribi a wɔde wo awo na wɔntaa nhu. Nanso, sɛ wohu yare no yiye na wɔsa wo yare wɔ bere ano a, wubetumi abɔ bra pa . Sɛ wo anaa obi a wunim no wɔ saa sɛnkyerɛnne yi a, nsuro sɛ wobɛkɔ oduruyɛfo nkyɛn na woanya afotu. Titiriw no, ɛho hia yiye sɛ wunya mmoa fi nnuruyɛfo kuw a wɔn ho akokwaw hɔ bere a woresa tebea horow a ɛntaa nsi a ɛte saa no. Hwɛ wo koma so yiye. Ɛyɛ agyapade a ɛsom bo sen biara wɔ w’asetra mu!

` Koma Yare, Aortic Valve, Unicuspid Aortic Valve, Koma Oprehyɛn, Koma Yare a Wɔde Wo Awo, Ɔhome Tiaa, Koma mu Ɛyaw