Omwana wo omuto alina ekizibu ky’omutima? Ka twogere ku Hypoplastic Aortic Arch!

Omwana wo omuto oluusi afuna obuzibu okuyonsa? Awulira ng’akooye okusinga bulijjo ng’assa? Oba alabika nga muddugavu era ng’atuuyanye? Kya bulijjo ggwe ng’omuzadde okuwulira nga weeraliikirira nnyo ng’ebintu bino bituuse ku mwana wo omuto. Oluusi ekivaako kino kiyinza okuba embeera y’omutima gy’azaalibwa. Olwaleero, tugenda kwogera ku mbeera ebeerawo mu mutima gw’abalongo, naye ng’esobola okuwona singa etegeera nga bukyali n’ejjanjabibwa obulungi.

Hypoplastic Aortic Arch kye ki?

Mu ngeri ennyangu, Hypoplastic Aortic Arch , oluusi eyitibwa Aortic Arch Hypoplasia (AAH) , bulwadde bwa kuzaalibwa nga bubeera mu kitundu ky’omutima gw’omwana wo , aorta . Lowooza ku kino, omusuwa oguyitibwa aorta gulinga omusuwa omukulu ogutambuza omusaayi mu mubiri gwaffe gwonna. Butandikira ku mutima ne gutambuza omusaayi ogulimu omukka gwa oxygen mu mubiri gwonna. Kikoleddwa ng’omuggo, nga kikoona katono. Ekikoona ekiri waggulu ku muggo kiyitibwa aortic arch , ekitegeeza ‘ekikondo ky’omusuwa.’

Ekigambo ‘hypoplastic’ kitegeeza ‘obutakula bulungi’, ‘kitono’. Kale, omwana alina hypoplastic aortic arch alina aortic arch etakula bulungi. Kwe kugamba, ekifo ekiggule oba dayamita, munda mu kitundu ekyo kifunda nnyo okusinga bwe kirina okuba. Nga payipu y’amazzi bw’ezibikira, omusuwa gw’omusuwa bwe gufunda, kizibu omusaayi okukulukuta okuva ku mutima okutuuka mu bitundu by’omubiri ebya wansi, okuyita mu musuwa ogukka . Kino kiyinza okukendeeza ku musaayi ogutuuka mu mubiri gwonna.

Ani asinga okukosebwa embeera eno? Waliwo akakwate n’endwadde z’omutima endala?

Obulwadde bwa Aortic arch hypoplasia (AAH) busobola okubaawo ku bwayo. Kyokka, kitera okulabibwa n’ekizibu ekirala eky’omutima ekizaalibwamu , ekiyitibwa coarctation of the aorta . Eno mbeera ng’ekitundu ekirala eky’omusuwa omunene, ebiseera ebisinga okumpi n’omusuwa gw’omusaayi ogw’enjawulo ogutera okubeera mu lubuto, kifunda.

Kale omusawo w'omwana wo ayinza okugamba nti, "Omwana wo alina obulwadde bwa coagulopathy of the aorta with aortic arch hypoplasia." Ekyo kitegeeza nti waliwo okufunda kw’omusuwa gw’omusaayi, si mu kifo kimu kyokka, wabula okuyita mu kitundu ekiwanvu.

Okugatta ku ekyo, abalongo abalina AAH bayinza okuba n’embeera endala ez’omutima. Okugeza nga:

• Atrial Septal Defect (ASD) : Ekituli mu bbugwe wakati w’ebisenge bibiri ebya waggulu eby’omutima.
• Atrioventricular Septal Defect : Ekizibu ekizibu mu bisenge wakati w’ebisenge by’omutima.
• Bicuspid Aortic Valve ne Aortic Valve Stenosis : Obulema n’okufunda kw’omusuwa gw’omusuwa.
• Hypoplastic Left Heart Syndrome (HLHS) : Oludda olwa kkono olw’omutima terukula bulungi.
• Patent Ductus Arteriosus (PDA) : Omusuwa oguyitibwa ductus arteriosus ogulina okuggalwa oluvannyuma lw’okuzaalibwa gusigala nga guggule.
• Obulwadde bwa Shone’s Syndrome : Obulema obuwerako obugatta omusaayi okutambula ku ludda olwa kkono olw’omutima.
• Ventricular Septal Defect (VSD) : Ekituli mu bbugwe wakati w’ebisenge bibiri ebya wansi eby’omutima.

Okubeera n’embeera z’omutima ezisukka mu emu nga eno kikulu nnyo ng’oteekateeka obujjanjabi. Kubanga enteekateeka y’okulongoosa oba ey’obujjanjabi etuukana n’embeera enzibu, entongole mu mutima gw’omwana yeetaagibwa.

Bubonero ki singa omwana aba n’embeera eno?

Abalongo abalina coarctation of the aorta ne aortic arch hypoplasia batera okutandika okulaga obubonero nga bamaze okuzaalibwa . Teebereza omwana wo eyaakazaalibwa, ng’akooye oluvannyuma lw’okunywa ebitonotono, alabika ng’afuna obuzibu mu kussa. Oluusi zituuyana ne zifuuka langi ya bbululu-enjeru. Kitiisa nnyo maama okulaba ekintu nga kino, nedda?

Obubonero obukulu obuyinza okulabibwa bwe buno:

• Fast pulse : Omutindo gw’okukuba guba gwa mangu nnyo.
• Obukoowu : Omwana awulira ng’akooye mangu naddala ng’ayonsa.
• Olususu enzirugavu oba olumyufu : Oluusi n’olususu luyinza okufuuka bbululu.
• Okutuuyana ennyo .
• Okukaaba ennyo, okunyiiga .
• Okussa amangu oba mu ngeri enzibu .
• Obuzibu mu kuliisa: Agaana okunywa amata, oba alekera awo oluvannyuma lw’okunywa katono.
• Weak pulse mu bitundu by’omubiri ebya wansi : Naddala mu magulu, pulse mu femoral artery eba nnafu nnyo nga ekwatibwako.

Singa omwana wo aba n’obubonero bumu oba obusingawo ku buno, kikulu nnyo okugenda ew’omusawo amangu ddala .

Lwaki kino kigenda mu maaso? Ensonga ze ziruwa?

AAH bulwadde bwa mutima obuzaalibwa nabwo . Kintu ekibaawo ng’omwana akyali mu lubuto. Abanoonyereza bakyagezaako okuzuula ekituufu ekivaako obuzibu bw’omutima obw’ekika kino obuzaalibwa.

Naye ekimanyiddwa nti embeera eno esobola okubaawo singa ekitundu ky’omusuwa gw’omwana tekikula bulungi mu wiiki ezisooka ng’ali lubuto .

Kino okisanga otya? Ebigezo bye biruwa?

Kino abasawo bakikozesa okuzuula embeera eno.Ebigezo eby’enjawulo eby’okukuba ebifaananyi. Ebiseera ebisinga okukebera kuno kukolebwa amangu ddala ng’omwana amaze okuzaalibwa.

Ebigezo ebikulu ebikozesebwa okuzuula AAH bye bino:

• Okukebera omutima mu kompyuta (CT scan) .
• Ekifaananyi ky’emisuwa ekiyitibwa Magnetic Resonance Angiogram (MRA) .
• Transthoracic Echocardiogram (TTE) : Kino kiringa okukebera omutima mu ddoboozi ery’omwanguka.
• Cardiac Catheterization : Oluusi n’okukebera kuno kwetaaga okukolebwa.

Ebigezo bino bisobola okutunuulira ensengeka y’omutima gw’omwana, kwe kugamba, engeri ebitundu by’omunda gye bitegekeddwamu, mu bujjuvu ennyo. Era basobola okuzuula oba omwana alina obulema obulala ku mutima. Mu kukungaanya amawulire gano gonna abasawo mwe bateekateeka obujjanjabi obusinga okusaanira omwana.

Okusobola okuzuula oba waliwo AAH, abasawo batunuulira obunene bw’ekisenge ky’omusuwa gw’omwana. Okusingira ddala, zipima obuwanvu bwayo , nga buno bwe bugazi bw’ekisenge ekiggule munda. Okupima kuno kugeraageranyizibwa ku dayamita y’ebitundu ebirala eby’omusuwa gw’omwana (okugeza, omusuwa ogulinnya oba omusuwa ogukka). Emiwendo gino gikozesebwa okuzuula oba dayamita y’ekisenge ky’omusuwa omufunda nnyo.

Ka tuyige katono ku bitundu eby’enjawulo eby’ekisenge ekiyitibwa aotic arch.

Omusawo w’omwana wo bw’ayogera ku mbeera eno, ayinza okwogera ku bitundu eby’enjawulo eby’omusuwa gw’omusaayi. Oyinza okuba nga weebuuza nti, "Aortic arch eyawukana mu bitundu ebirala? Ekyo si kitundu kya aorta ennene?" Yee, ekyo kituufu. Aortic arch kitundu kitono, "eringa omuggo" ku aorta. Naye, okufaananako ebitundu byonna eby’omusuwa, ekitundu ky’omusuwa ekiyitibwa aortic arch kirina emisuwa (emisuwa) egitabikira mu njuyi ez’enjawulo. Nga oluguudo olukulu bwe lulina enguudo ez’ebbali. Abasawo bakozesa emisuwa gino egy’enjawulo ng’ensalo, nga balaga ekitundu ekimu eky’omusuwa gw’omusaayi we kitandikira n’okukoma. "Maapu" eno eyamba nnyo mu kuzuula AAH n'okuteekateeka obujjanjabi.

Bino bye bimu ku bitundu by’ekisenge ky’amatu omusawo w’omwana wo by’ayinza okwogerako:

• Proximal Transverse Arch : Eno esangibwa wakati w’omusuwa gw’omwana ogwa Brachiocephalic Artery (oluusi oguyitibwa Innominate Artery) ne Left Common Carotid Artery . Kino kye kitundu ekisinga okubeera okumpi n’omutima.
• Distal Transverse Arch : Kino kisangibwa wakati w'omusuwa gwa kkono ogwa common carotid artery n'omusuwa ogwa kkono ogwa subclavian artery .
• Aortic Isthmus : Eno esangibwa wakati w'omusuwa ogwa kkono ogwa subclavian n'omusuwa ogwayogeddwako emabegako oguyitibwa Ductus Arteriosus .

Omusawo w’omwana wo ajja kusalawo ddala ekifo ekifunda we kiri mu kisenge ky’amatu g’omwana wo, awamu n’obunene bw’okufunda. Amawulire gano gajja kulungamya enteekateeka y‟obujjanjabi.

Bujjanjabi ki obukolebwa ku kino?

Abalongo abalina hypoplastic aortic arch bajja kwetaaga okulongoosebwa omutima okutereeza embeera eno. Omusawo alongoosa omutima gw’omwana wo ajja kukunnyonnyola ekika ky’okulongoosebwa omwana wo ky’anaaba yeetaaga. Enkola y’okulongoosa eyinza okwawukana okusinziira ku bulema obulala n’ensengeka y’omutima gw’omwana wo. Oyinza okwetaaga okusalako ekifuba , nga kino kye kitundu ekitono ekisaliddwa ku ludda olwa kkono olw’ekifuba ky’omwana wo, oba okusalako sternotomy, nga kino kye kitundu ekisaliddwa wansi wakati mu kifuba.

Enkola eya bulijjo ey’okulongoosa eyitibwa resection with extended end-to-end anastomosis . Okulongoosa kuno kuyamba nnyo abalongo abalina okuzimba omusuwa gw’omusaayi (coarctation of the aorta) n’okukendeera kw’omusuwa gw’omusaayi (aortic arch hypoplasia). Mu nkola eno, omusawo alongoosa aggyawo ekitundu ky’omusuwa ekifunda, n’atwala ekitundu ekya wansi eky’omusuwa (omusuwa ogukka), n’agukwata ku kifo ekiwanvuko katono mu kisenge ky’omusuwa.

Essuubi ly’okulongoosebwa kuno kwe kulongoosa entambula y’omusaayi mu musuwa gw’omwana, okukakasa nti ebitundu by’omwana n’ebitundu by’omubiri bifuna omusaayi ogumala ogulimu omukka gwa oxygen.

Essuubi litya eri omwana wange okuwona?

Eky’okuddamu ekisinga obulungi mu kibuuzo kino ye musawo w’omwana wo. Kubanga obulamu obulungi bw’omwana businziira ku bintu bingi. Okusingira ddala, oba waliwo obulema obulala obw’omutima obuzaalibwa nabwo kikwata kinene.

Okutwalira awamu, abalongo abajjanjabiddwa embeera eyitibwa aotic arch hypoplasia balina emikisa mingi egy’okufuna ebizibu bino wammanga nga bakuze:

• Okufunda kw'omusuwa gwabwe oguddirira .
• Puleesa (Peesa) .
• Okukaluubirirwa okulya oba okumira : Kino kiyinza okubaawo singa obusimu bwonoonese ng’olongoosebwa (kino tekitera kubaawo).

Yogerako n’omusawo w’omwana wo ku bulabe buno n’engeri y’okubuddukanyaamu.

Embeera eno esobola okuziyizibwa?

Obulema bw'omutima obuzaalibwa nga hypoplastic aortic arch buyinza obutaziyizibwa ddala . Wabula okugoberera amagezi g’omusawo okukufunira olubuto olulungi kiyinza okuyamba okukendeeza ku bulabe bw’okufuna embeera eno oba obulema obulala.

Okutwaliza awamu, ebintu bino mazima ddala birina okwewalibwa ng’oli lubuto:

• Omwenge .
• Weewale okunywa sigala, okunywa sigala n’ebintu byonna ebikolebwa mu taaba . Ate era, weewale omukka ogw’okukozesa .
• Ebiragalalagala ebimenya amateeka naddala cocaine .

Era era, ebibyo.Era kikulu nnyo okugenda mu kukeberebwa nga tonnazaala buli kiseera. Bw’oba ​​olina embeera endala yonna ey’obulamu, funa amagezi g’abasawo okuddukanya embeera ezo nga tonnafuna lubuto n’olubuto lwonna.

Omwana olabirira otya ng’amaze okulongoosebwa?

Ebyetaago bya buli mwana biyinza okuba eby’enjawulo oluvannyuma lw’okulongoosebwa, n’olwekyo kirungi n’obuuza ttiimu y’abasawo b’omwana wo engeri y’okulabirira omwana wo mu bbanga ettono n’ery’ewala.

Bino bye bimu ku bibuuzo by’oyinza okubuuza omusawo wo:

• Nnalabirira ntya omwana wange nga nzirayo eka?
• Ddagala ki lye nnina okuwa omwana wange? Nnina kugiwa bbanga ki?
• Waliwo obujjanjabi bwonna obwetaagisa okuyamba omwana okukola emirimu gy’omubiri oba obusimu?
• Waliwo obukwakkulizo bwonna ku mirimu gy’omwana?
• Ddi lwe kiba kya bulabe okusindika omwana wange mu daycare? Bulagirizi ki obw’enjawulo bwe nsaanidde okubawa?
• Omwana wange anaayeetaaga okwongera okujjanjabibwa oba okulongoosebwa?

Okubeera omuzadde bulijjo kizibu. Naye okubeera n’omwana alina embeera y’omutima nga hypoplastic aortic arch (AAH) kiyinza okuleeta okusoomoozebwa okupya buli lunaku. Ebimu ku bigambo abasawo bye boogera n’enteekateeka z’obujjanjabi biyinza okulabika ng’ebizibu okutegeera. Ekyo kya bulijjo era toli wekka. Buuza omusawo w’omwana wo ku bikozesebwa n’ebibiina ebiyamba omwana wo ebiyinza okukuyamba. Okuzimba ekitundu ekikuwagira ggwe n’ab’omu maka go kiyinza okuyamba okukendeeza ku situleesi n’okukuwa amaanyi okugenda mu maaso n’ebyetaago by’omwana wo.

Katujjukire bujjukire bye twayogeddeko (Take-Home Message)

• Hypoplastic Aortic Arch (AAH) mbeera nga arch of the aorta, omusuwa omukulu mu mutima gw’omwana, tegukula bulungi, ekivaamu okufunda kw’omusuwa.
• Kino kizibuwalira omusaayi okuva ku mutima okudda mu bitundu by’omubiri ebirala.
• Embeera eno etera okulabibwa wamu n'obulwadde bw'omutima obulala obuyitibwa Coarctation of the Aorta .
• Obubonero ng’obukoowu, okukaluubirirwa okussa, n’olususu olumyufu biyinza okulabika ng’omwana akyali muto.
• Embeera eno esobola okuzuulibwa nga bakozesa sikaani ez’enjawulo.
• Obujjanjabi buno kwe kulongoosa omutima .
• Okugoberera ddala ebiragiro by’abasawo n’okugoberera okugoberera okumala ebbanga eddene oluvannyuma lw’okulongoosebwa kikulu nnyo.
• Okugoberera emize emirungi ng’oli lubuto kiyinza okukendeeza ku bulabe bw’okuzaalibwa n’obulema obumu.
• Toli wekka. Funa obuyambi okuva mu basawo n’ebibiina ebiwagira.

Tusuubira nti amawulire gano gakuyamba. Twagaliza omwana wo omuto okuwona amangu!

` Hypoplastic Aortic Arch, Aortic Arch Hypoplasia, obulema bw’omutima obuzaalibwa, okulongoosa omutima gw’omwana, okuzimba omusuwa gw’omusuwa, endwadde z’omutima gw’omwana, okulongoosa omutima