Omwana wo omuto alina ekizibu kino eky’omutima? Ka tuyige ku bulwadde bw'emisuwa gy'amawuggwe!

Omwana wo oluusi awulira ng’assa bulungi? Oba akoowa mangu nnyo ne bw’amala okuzannya akaseera? Abaana abato abamu bayinza okuba n’endwadde z’omutima ezizaalibwa. Leero tugenda kwogera ku bulwadde bw’omutima obumu obw’engeri eyo, obutatera kulabika, naye nga bukulu nnyo okumanya. Kino tukiyita `(Okuzimba kw'emisuwa gy'amawuggwe)`. Mu ngeri ennyangu, kwe kuzibikira kw’omusuwa omukulu ogutwala omusaayi mu mawuggwe.

Obulwadde bw’emisuwa gy’amawuggwe kye ki?

Mu ngeri ennyangu, waliwo omusuwa omunene ogutwala omusaayi okuva ku ludda olwa ddyo olw’omutima gwaffe (lwe tuyita ``right ventricle``) okutuuka mu mawuggwe. Kino kiyitibwa ``omusuwa gw'amawuggwe``. Bwe kituuka mu mawuggwe, omusaayi guno gubaamu omukka gwa oxygen, olwo omusaayi ogwo ogulimu omukka ne gutambuzibwa mu mubiri gwonna.

Kati, mu mbeera eno eyitibwa `(Pulmonary Artery Stenosis)`, omusuwa ogutwala omusaayi mu mawuggwe guzibikira oba ne gufunda mu kifo ekimu oba ku limu ku matabi gaagwo. Kiringa payipu y’amazzi okuzibikira wakati. Kiki ekibaawo olwo? Kifuuka kizibu omusaayi okukulukuta okutuuka mu mawuggwe. Singa omusaayi tegutambula bulungi, omubiri tegufuna mukka gwa oxygen gwe gwetaaga. Olw’ensonga eno, omutima gw’omwana n’omubiri gwonna tebisobola kukola bulungi.

Okuzibikira kuno kuyinza okubaawo mu musuwa omukulu ogw’amawuggwe (`(omusuwa omukulu ogw’amawuggwe)`), oba mu matabi gaago aga kkono oba ku ddyo (`(amatabi ga kkono oba ku ddyo)`). Okuzibikira kuno bwe kubaawo, oludda olwa ddyo olw’omutima (`(right ventricle)`) lulina okukola ennyo okusiba omusaayi okuyita mu kuzibikira. Kiba ng’olina okukozesa amaanyi mangi okusika amazzi mu payipu ezibiddwa. Ekiseera bwe kigenda kiyitawo, okufuba kuno okugenda mu maaso kuyinza okwonoona ebinywa by’omutima.

Bizibu ki ebiyinza okuva mu mbeera eno?

Singa kino tekijjanjabwa bulungi, ekiseera bwe kigenda kiyitawo oludda olwa ddyo olw’omutima luyinza obutakola bulungi. Kwe kugamba, waliwo okusobola okufuna embeera eyitibwa ``Okulemererwa kw'omutima ku ludda olwa ddyo''. N’olwekyo, kikulu nnyo okufaayo ku kino.

Ani asinga okukosebwa embeera eno?

Embeera eno eyitibwa `(Pulmonary Artery Stenosis)` mu butuufu tetera nnyo . Ekyo kitegeeza nti tekituuka ku buli muntu. Abaana abamu basobola okubufuna wamu n'endwadde z'omutima endala (`(congenital heart disease)` - kwe kugamba, endwadde z'omutima ezibeerawo nga bazaalibwa). Oluusi kiyinza okuba nga kye kyokka nga tekirina buzibu bulala bwonna ku mutima. Ate era embeera eno esobola okubaawo oluvannyuma lw’okulongoosebwa omutima ogumu.

Bubonero ki obulaga kino? Laba oba n’omwana wo alina bino.

Obubonero buno businziira ku ngeri ttanka gy’efunda. Oluusi, singa okusannyalala kuba kwa maanyi nnyo (`okusannyalala okutono`), wayinza obutabaawo bubonero bwonna . Naye okusannyalala bwe kweyongera, omwana wo ayinza okulaga ebintu nga:

• Okuwulira nga kizibu okussa (`(Okussa obumpi)`).
• Okuwulira nga okooye buli kiseera (`(Fatigue)`).
• Kiwulikika nga ossa mangu nnyo , oba olyawo ossa nnyo.Kifaanana bwe kiti? (`(Okussa okuzitowa oba okw'amangu)`).
• Omutima gwo guwulira nga gukuba nnyo ? (Omutima okukuba amangu).
• Waliwo okuzimba kwonna mu magulu, enkizi, mu maaso, mu bikoola by’amaaso oba mu lubuto? (`(Okuzimba)`).
• Oluusi owulira ng'oziyira oba okuzirika ? (`(Okuziyira oba okuzirika)`).
• Emimwa gyo, engalo zo, n’ebigere bifuuka bbululu ? Kino kye tuyita mu by'obusawo ``Cyanosis''.
• Okoowa mangu ng’ozannya n’abaana abalala? Tosobola kudduka na kubuuka nga n’abaana abalala? (`(Okukendeeza ku kugumiikiriza dduyiro)`).

Jjukira nti okubeera n’obubonero buno bumu oba bubiri tekitegeeza nti olina obulwadde buno. Naye omwana wo bw’aba alina ekimu ku bintu bino, kirungi n’onoonya omusawo amagezi.

Lwaki omusuwa guno ogw’amawuggwe guzibikira? Biki ebivaako?

Abaana abamu bazaalibwa n’embeera eno (Pulmonary Artery Stenosis), era bayinza n’okufuna obuzibu ku vvaalu, ebisenge oba ebitundu by’omutima ebirala. Abalala bayinza okuba nga bazaalibwa n’embeera eno naye nga tebalina buzibu bulala ku mutima. Okugatta ku ekyo, embeera eno esobola okubaawo oluvannyuma lw’okulongoosebwa omutima oba olw’embeera endala, ezitatera kubaawo nnyo.

Ebivaako obuzaale

Okutwaliza awamu, abantu nga 40% bazaalibwa n’embeera eno (Pulmonary Artery Stenosis), naye tebalina buzibu bulala ku mutima.

Wabula wakati wa 2% ne 3% ku bantu abalina obuzibu obulala obw’omutima obuzaalibwa nabo bayinza okufuna embeera eno (Pulmonary Artery Stenosis). Bino bye bimu ku bisinga okutawaanya omutima:

• (Tetralogy of Fallot): Mu kino, omwana alina ebizibu bina ku mutima, ekitaataaganya omusaayi okutambula.
• (Pulmonary atresia): Mu kino, vvaalu (pulmonary valve) wakati w’ekisenge kya ddyo eky’omutima n’omusuwa gw’amawuggwe (pulmonary artery) tekola. N’olwekyo, omusaayi tegukulukuta mu mawuggwe.
• (Truncus arteriosus): Omusuwa omunene gumu mu kifo ky’emisuwa ebiri egya bulijjo. Kino kireetera omusaayi ogulimu oxygen okutabula n’omusaayi ogutaliimu oxygen.
• Aortic valve stenosis: Ekizibu ekiva ku valve mu musuwa omukulu ogutwala omusaayi okuva ku mutima okutuuka mu mubiri, ekikendeeza ku bungi bw’omusaayi ogukulukuta mu mubiri.
• Atrial septal defect: Ekituli mu bbugwe wakati w’ebisenge bibiri ebya waggulu eby’omutima (atria). Kino kisobozesa omusaayi ogulimu omukka gwa oxygen n’ogutaliimu oxygen okutabula.
• Ventricular septal defect: Ekituli mu bbugwe ekyawula ebisenge bibiri ebya wansi (ventricles) eby’omutima. Kino kiyinza okuvaako omusaayi omungi okukulukuta mu mawuggwe.
• (Transposition of the great vessels): Emisuwa emikulu ebiri egy’omusaayi egitambuza omusaayi okuva ku mutima gidda emabega. Kino kitaataaganya entambula y’omusaayi mu ngeri eya bulijjo era kikendeeza ku bungi bwa oxygen atuuka mu butoffaali bw’omubiri.
• (Patent ductus omusuwa gw’omusaayi):Kino kikwatagana wakati w’omusuwa gw’amawuggwe gw’omwana n’omusuwa omukulu ogutwala omusaayi mu mubiri (omusuwa omunene). Kino kisaana okuggalawo ng’omaze okuzaala, naye bwe kitaggwaawo, omusaayi omungi gujja kukulukuta mu mawuggwe.

Ensonga endala

Ng’oggyeeko kino, wayinza okubaawo ensonga endala eziwerako:

• Obulwadde bwa Rubella: Singa ofuna obulwadde bwa Rubella ng’oli lubuto, omwana wo ayinza okuba n’ebizibu by’omutima n’ebirala.
• (Williams syndrome): Kino kireeta obuzibu obw’enjawulo mu mutima gw’omwana n’ebitundu ebirala.
• (Alagille syndrome): Kino kireeta obuzibu mu kibumba n’endwadde z’omutima.
• Obulwadde bw’emisuwa bwa Takayasu: Buno buzimba obwonoona emisuwa eminene.
• Ensonga ezimu ku ngeri omusuwa gw’amawuggwe g’omwana gye gusika ebweru.

Ebivaako okulongoosa

Abantu abamu bayinza okufuna embeera eno oluvannyuma lw’okulongoosebwa. Okugeza nga:

• Okukyusa amawuggwe.
• Okulongoosa okutereeza obuzibu bw’omutima obuzaalibwa mu mwana, oba okulongoosa entambula y’omusaayi mu mutima.
• Okulongoosa okuyitibwa ``Pulmonary artery banding''. Mu kino, omusuwa gufunza mu bugenderevu okukendeeza ku musaayi ogugenda mu mawuggwe.

Osobola otya okuzuula obulwadde buno?

Omwana wo bw'akeberebwa omusawo, ayinza okuwulira eddoboozi ly'omutima eritali lya bulijjo (a ``murmur''). Bwe kiba bwe kityo, bajja kulagira okukeberebwa okulala okuwerako. Ebimu ku bino mulimu:

• Electrocardiogram - ECG oba EKG: Kino kiwandiika enkyukakyuka mu masannyalaze ezibaawo ng’omutima gukuba. Kisobola okuzuula omutima okukuba obutasalako (arrhythmias) n’okunyigirizibwa ku binywa by’omutima.
• X-ray y’ekifuba: Kino kiyinza okulaga obunene n’enkula y’omutima, amawuggwe n’emisuwa gy’amawuggwe.
• Echocardiogram: Kino kiringa ekifaananyi ky’omutima ekitambula. Ekozesa amaloboozi okutunuulira ebinywa by’omutima ne vvaalu.
• Cardiac magnetic resonance imaging (MRI): Eno nkola ya kukuba bifaananyi mu bitundu bisatu (3D) esobola okulaba engeri omusaayi gye guyitamu mu mutima gw’omwana wo n’emisuwa gy’omusaayi.
• (CT scan): Kino nakyo kigezo kya `(X-ray)`. Kompyuta ekozesa ebifaananyi ebiddiriŋŋana ebya `(X-ray)` eby'omutima gw'omwana okukola ebifaananyi ebisalasala. Langi ey’enjawulo (`(IV contrast)`) efukibwa mu mutima okutunuulira ensengekera n’entambula y’omusaayi gw’omutima.
• Okusiba omutima: Mu nkola eno, ekyuma ekigonvu (catheter) kiyingizibwa mu musuwa oba mu musuwa ne kilungamizibwa mu mutima. Kino kisobozesa omusawo okulondoola omukka gwa oxygen, enkyukakyuka mu puleesa, n’okukuba X-ray z’omutima.
• Pulmonary angiography: Ekifaananyi kya X-ray eky’emisuwa gy’amawuggwe n’emisuwa gy’omutima kikwatibwa nga bakozesa langi.
• (Perfusion scan): Mu kino, kifukibwamu ebintu ebitonotono ebikola amasannyalaze. Oluvannyuma, ekyuma eky’enjawulo kikozesebwa okukebera engeri omusaayi gye gukulukutamu mu buli mawuggwe.

Singa omusawo azuula nti omwana wo alina obulwadde bwa Pulmonary Artery Stenosis, ajja kukusindika ew’omusawo omukugu mu mutima gwe bazaalibwa. Omusawo ow’ekika kino alina obukugu n’okutendekebwa okuzuula obulungi ekizibu ky’omutima gw’omwana wo, okukola okukebera kwonna okwetaagisa, okumuwa obujjanjabi, okulongoosa omutima, n’okukeberebwa okugoberera . Era bayinza okukola ebigezo ebirala bwe kiba kyetaagisa.

Bw’oba ​​oyogera ku mbeera eno, omusawo wo ayinza okugiyita Ekika I, II, III oba IV. Kino kigabanya okusinziira ku bitundu by’omusuwa ebizibiddwa ne bimeka.

Bujjanjabi ki obukolebwa ku kino? (Obujjanjabi)

Obujjanjabi obusinga obulungi businziira ku bubonero bw’omwana wo n’ensonga endala. Singa wabaawo okufunda okutono oba okw’ekigero kw’ettabi erimu oba okusingawo ery’omusuwa gw’amawuggwe, obujjanjabi buyinza obuteetaagisa . Kyokka, singa okufunda kuba kwa maanyi, kyetaagisa okujjanjabibwa .

Obujjanjabi bw'obulwadde bwa `(Pulmonary Artery Stenosis)` bwe buno:

Okugaziya bbaatule / Okulongoosa emisuwa

Mu kino, omusawo akola:

• Ekisumuluzo ekiringa bbaatule (balloon dilation catheter) kiyingizibwa mu mudumu oguzibiddwa.
• Olwo, n’obwegendereza bungi, bbaatule efuumuulwa okuva ku puleesa entono okutuuka ku puleesa eya waggulu.
• Olwo omukutu ogwo ogwazibiddwa ne gugaziwa.
• Oluvannyuma empewo eggyibwa mu bbaatule n’eggyibwamu.

Okugaziya bbaatule n’okuteeka stent (kino kisinga kukolebwa) .

Mu kino, omusawo akola:

• Stent egaziyizibwa mu bbaatule (stent ye ttanka entono ey’akatimba) ekozesebwa okuggulawo omusuwa oguzibiddwa.
• Stent eno eteekebwa ku balloon angioplasty catheter ne bagibikkako ekikuta.
• Stent eno egenda mu kifo ekituufu.
• Ekibikka ku stent-balloon kiggyibwamu.
• Olwo bbaatule n’efuuwa okutuuka ku puleesa entuufu, ne kigaziya stent ne kisigala nga esibidde awo.

Bbaluuni ey'enjawulo eyitibwa ``(The Cutting BalloonTM)``

Bbaluuni eno eringa bbaatule eya bulijjo. Kyokka, erina obuwundo obutonotono obuwerako mu buwanvu bwayo. Omusawo bw’afuuwa bbaatule, ebiso bino bikola ne bisala ekitundu ekizibiddwa. Kino kyanguyiza okugaziya ttanka, ne kivaamu ekifo ekinene.

Abantu abasinga abatalina bulwadde bwa mutima bulala obuzaalibwa nabo bavaamu ebirungi mu nkola eno. Wabula abantu nga 21% bayinza okuddamu okuzibikira omusuwa oluvannyuma lw’emyezi mitono.

Okuloongoosa

Abasawo abalongoosa bakozesa enkola ez’enjawulo okujjanjaba okuzimba emisuwa gy’amawuggwe. Okulonda kisinziira ku ngeri y’okuzibikira, emisuwa egyetooloddewo, n’ebizimbe ebirala.

Waliwo ebizibu byonna ebiva mu bujjanjabi?

Okugaziya bbaatule kikendeeza ku kuzibikira mu bantu abasinga. Wabula ekiseera bwe kigenda kiyitawo, omusuwa gusobola okuddamu okuzibikira ebitundu 15% ku 20%, era enkola eno erina okuddibwamu. Mu kiseera kino abanoonyereza bali mu kunoonyereza ku bika bya bbaatule eby’enjawulo ebiyinza okuvaamu ebirungi, ebiwangaala.

Ebizibu ebiyinza okuva mu kiseera ky’okugaziwa kwa bbaatule:

• Okuzimba emisuwa gy’amawuggwe.
• Okusala emisuwa gy’amawuggwe (Okusala emisuwa gy’amawuggwe).
• Okukutuka kw’omusuwa gw’amawuggwe (`(Pulmonary artery rupture)`).
• Okuzimba amawuggwe (`(Okuzimba amawuggwe)`).
• Tekitera nnyo, wayinza okubaawo abantu abafa.

Ebizibu ebiyinza okuva mu kukozesa stent:

• Okuzimba omusaayi.
• Obutabeera bulungi mu nnyimba z’omutima (`(Ventricular arrhythmias)`).
• Stent eyinza okuba nga yasimbiddwa mu kifo ekikyamu oba nga yasenguddwa.
• Okubeera n’okuddamu okugaziya omusuwa (kino tekitera kubaawo).

Migaso ki egiri mu bujjanjabi?

Abasawo basinga kwagala kuteeka stents ku Pulmonary Artery Stenosis olw’ensonga zino:

• Zikola ebitundu nga 96% mu bwangu .
• Kitwala ekiseera kiwanvu okukuuma omusuwa nga guggule.
• Ekitundu ekifunda kiyinza okugaziwa emirundi nga ebiri .
• Tekigula ssente nnyingi era kikola bulungi okusinga okuyingiza obupiira oba okulongoosa.
• Okusinga okukola obulungi okusinga okulongoosa emisuwa mu bbaatule.

Abasawo bayinza okulonda okulongoosa emisuwa mu bbaatule mu kifo ky’okukozesa stent mu mbeera zino wammanga:

• Singa embeera y'omwana eba ya maanyi nnyo .
• Singa ensengekera y’omubiri gw’omwana ey’omunda eba nzibu (`(complex anatomy)`).
• Singa omwana aba mutono nnyo .

Kiki ekibaawo oluvannyuma lw’okulongoosebwa?

Omwana wo bw’aba alina stent, ajja kwetaaga okumira eddagala eritta obuwuka era nga kiyinzika okuba nga n’eddagala erikendeeza omusaayi okumala akaseera. Eddagala lino liweebwa okutangira obuwuka n’okukomya omusaayi okuzimba.

Omwana ajja kuwulira mangu ki ng’amaze okujjanjabibwa?

Enkola y’okugaziya omusuwa gw’amawuggwe g’omwana wo ekola mangu. Kino kitegeeza nti kyangu nnyo omwana wo okuyingiza omusaayi mu mawuggwe n’afuna omukka gwa oxygen.

Omwana wange bw’aba n’embeera eno, ebiseera eby’omu maaso binaaba bitya? (Okuteebereza)

Olw’obujjanjabi obw’omulembe obw’ennaku zino, abantu bangi abalina embeera eno bawangaala okutuuka mu bukulu. Wabula abantu abalina embeera nga ``Williams syndrome'' ne ``Alagille syndrome'' bayinza obutaddamu bulungi bujjanjabi.

Ddi lw’osaanidde okutwala omwana wo ew’omusawo?

Ojja kwetaaga okutwala omwana wo okwekebejjebwa buli kiseera olabe bw’ali. Era ojja kwetaaga okukola echocardiograms buli kiseera okulaba oba omusuwa gwetaaga okuddamu okugaziwa mu biseera eby’omu maaso.

Kiki kye nsaana okubuuza omusawo?

Osobola okubuuza omusawo ebibuuzo nga bino:

• Lwaki omwana wange yafuna obulwadde bwa `(Pulmonary Artery Stenosis)`?
• Bujjanjabi ki obusinga obulungi eri omwana wange?
• Mikisa ki omwana wange gy’ajja okwetaaga okuddamu okujjanjabibwa olw’ensonga eno?

Singa omwana wo yeetaaga obujjanjabi bw’obulwadde bwa Pulmonary Artery Stenosis, omusawo ajja kulowooza ku bujjanjabi obusinga obulungi ku mbeera y’omwana wo. Tolwawo kubuuza bibuuzo ku kintu kyonna ky’ototegedde ku nkola y’omwana wo.

Obubaka Obutwala Awaka

Bwe kituuka ku mbeera eno eyitibwa `(Pulmonary Artery Stenosis)`, ekisinga obukulu kwe kumanya obubonero nga bukyali n'okunoonya amagezi g'abasawo . Kikulu nnyo okunoonya amagezi okuva eri `(congenital heart specialist)`, naddala nga abaana balina embeera eno.

Tofaayo, waliwo obujjanjabi ku kino . Embeera eno esobola okufugibwa n’ebintu ng’okugaziya bbaatule, okuteeka stent, era bwe kiba kyetaagisa, okulongoosa. Ne bwe kiba nga kimaze okujjanjabibwa, kikulu nnyo obulamu bw’omwana okugenda okwekebejjebwa buli kiseera n’okugoberera ebiragiro by’omusawo . Yogerako n’omusawo ku bibuuzo byonna oba ebikweraliikiriza by’oyinza okuba nabyo.

` Okusannyalala kw’emisuwa gy’amawuggwe, Obulwadde bw’omutima mu baana, Obulema mu mutima obuzaalibwa, Obuzibu mu kussa, Okulongoosa omutima, Stent