Ese ufite akanya gato mu mutima wawe? Reka tuvuge kuri (Patent Foramen Ovale - PFO)!

Ese wigeze wumva ko umutima wawe, cyangwa se hagati y’ibyumba bibiri byo hejuru by’umutima, ushobora kugira umwobo muto ushobora kugumaho nyuma yo kuvuka? Abantu benshi baratungurwa no kumva ibi. Ariko ni ukuri. Iyi ndwara yitwa `Patent Foramen Ovale` cyangwa `(PFO)`. Ntugahangayike, tuzabivugaho mu buryo bworoshye, mu buryo ushobora gusobanukirwa.

PFO ni iki? Reka tubisobanukirwe mu buryo bworoshye

Mu magambo make, patent foramen ovale (PFO) ni umwobo muto, umeze nk'umupfundikizo uri hagati y'ibyumba bibiri byo hejuru by'umutima wawe, atrium y'iburyo n'atrium y'ibumoso. Noneho tekereza ko iyo twese turi mu nda ya ba mama, uyu mwenge, witwa foramen ovale, uba uhari. Ni ngombwa. Ariko ubusanzwe, ufunga nyuma yo kuvuka. PFO ni iyo idafunga nyuma yo kuvuka. Ijambo "patent" risobanura "gufungura."

Akenshi, abantu bafite PFO nta bimenyetso bagira kandi ntibakeneye kuvurwa. Ariko, ni gake cyane, ibibazo bimwe na bimwe, nko gucika intege mu mitsi, bishobora kujyana na PFO.

Kuki iyi foramen ovale ari ingenzi? Ni iki kibaho mu gihe cy'ubuto?

Umwana uri mu nda ya nyina, umwana uri mu nda, ntakoresha ibihaha bye kugira ngo abone amaraso akungahaye kuri ogisijeni. Ahubwo, aya maraso akungahaye kuri ogisijeni aturuka kuri nyina anyuze muri placenta, anyuze ku mugozi w'inkondo y'umura. Ibi nibyo foramen ovale ikora, ikayobora amaraso akungahaye kuri ogisijeni ava mu mugozi w'inkondo y'umura ava mu mugozi w'iburyo w'umwana agana mu mugozi w'ibumoso.

Kuva aho, ayo maraso ajya ibumoso bw'umutima w'umwana, agatanga ogisijeni mu bwonko bw'umwana no mu zindi ngingo z'ingenzi. Ni imikorere itangaje cyane, si byo se?

Nyuma y'uko umwana avutse, iyo atangiye guhumeka wenyine, amaraso ajya mu bihaha kugira ngo afate ogisijeni. Icyo gihe ni bwo iyi "foramen ovale" ikunze gufunga. Hanyuma amaraso arimo ogisijeni ajya ibumoso bw'umutima, hanyuma akava aho agashyirwa mu mubiri wose.

Ni nde ushobora kugira PFO? Ni iki gikunze kugaragara?

Mu by’ukuri, PFO ishobora kugira ingaruka ku muntu uwo ari we wese, hatitawe ku gitsina, ubwoko, cyangwa ibara ry’uruhu. Ariko, ikunze kugaragara cyane mu matsinda amwe n’amwe:

• Abakunda kwibira, cyane cyane abafite indwara ya "Decompression sickness - air embolism", indwara ituma imiyoboro y'amaraso ifunga imiyoboro y'amaraso bitewe n'impinduka z'umuvuduko w'amaraso.
• Mu barwaye indwara yo mu bwonko idashobora kuboneka impamvu nyayo (cryptogenic stroke).

Ku isi yose, hafi umuntu umwe kuri bane (25%) ashobora kuba afite PFO. Byongeye kandi, byagaragaye ko hagati ya 30% na 40% by'abantu barwaye stroke nta mpamvu igaragara bafite PFO. Ariko, ibi ntibivuze ko buri wese ufite PFO azagira stroke. Ni ngombwa kubyibuka.

Ese kugira PFO bigira ingaruka ku mubiri?

Iyo ufite `PFO`, amaraso make ava mu gice cy'iburyo ajya mu gice cy'ibumoso anyuze muri utwo duce duto. Ubusanzwe, ibi ntibibaho kuko utwo duce tuba dufunze.

Akenshi, PFO ntabwo itera ikibazo. Ariko, rimwe na rimwe amaraso ashobora kuva iburyo bw'umutima akajya ibumoso bw'umutima binyuze muri iyi PFO. Iyo bibaye, umutima ushobora kupompa ayo maraso akayajyana mu bindi bice by'umubiri. Tekereza, iyo ayo maraso agiye mu bwonko, amaraso ashobora guhagarara. Icyo gihe ni bwo habayeho indwara yitwa ischemic stroke. Nanone, aya maraso ashobora kwangiza izindi ngingo nk'impyiko n'umutima.

Ese hari impamvu yihariye ituma PFO itera imbere?

Abashakashatsi ntibaramenya neza impamvu ya PFO. Ni ukuvuga ko bitaramenyekana neza niba ari imiterere y’umubiri, ibidukikije, cyangwa ikindi kintu.

Ni ibihe bimenyetso by'indwara ya PFO? Reba niba nawe ufite ibi

Abantu benshi bafite PFO ntibagaragaza ibimenyetso. Ibyo ni ukuri. Ariko, hari igihe ushobora kubona ibintu nk'ibi:

• Indwara yo mu bwonko (stroke).
• Indwara y'igihe gito yo mu mara (TIA) cyangwa indwara ya mini-stroke . Ibi bishobora guteza ingorane mu kwimura urugingo rw'umubiri, kandi bishobora kugira ingaruka ku ngingo z'ingenzi nk'ubwonko, amara mato, amara manini (inkondo y'umura), cyangwa impyiko.

Byongeye kandi, indwara zidasanzwe zirimo:

• Indwara y'umutima.
• Kugabanuka k'umuvuduko wa ogisijeni mu maraso (Hypoxemia).
• Indwara ya Platypnea-orthodeoxia (PO syndrome): Iyi ni indwara aho urugero rwa ogisijeni mu maraso rugabanuka bitewe no guhumeka bigoranye mugihe wicaye uhagaze.

Wamenya ute niba ufite PFO? Ni ibihe bipimo?

Muganga wawe azabanza kukubaza ibimenyetso byawe hanyuma agukorere isuzuma ry’umubiri. Niba ukeka ko hari PFO, ashobora kukugira inama yo gupima ibipimo nka:

• Echocardiogram ya Transthoracic : Echocardiogram (cyangwa echo) ni ikizamini gikoresha imiraba y'amajwi kugira ngo gikore amashusho y'ibyumba by'umutima. Ikizamini gikorwa hakoreshejwe igikoresho gishyirwa hejuru y'igituza.
• Echocardiogram ya Transesophageal (TEE) : Muri iki kizamini, muganga wawe ashyiramo umuyoboro muto ufite kamera mu muhogo wawe. Ibi bishobora gutanga ishusho isobanutse neza ya PFO kuruta ijwi risanzwe.
• Ultrasound ya Transcranial Doppler (TCD) : Ultrasound ya TCD ikoresha amajwi kugira ngo irebe uburyo amaraso atembera mu bwonko bwawe no mu bwonko bwawe. Ishobora kandi gufasha kumenya indwara zo mu bwonko ziterwa no kuzura kw'amaraso.

Hamwe n'ibi bizamini, muganga wawe ashobora kandi kukugira inama yo "gupima ibinure." Ibi bikubiyemo gutera umuti wa saline mu mitsi yawe. Iyo ibi binure binyura mu mwenge ujya ibumoso bw'umutima wawe bidasukuye ibihaha, bashobora kumenya niba ushobora kuba ufite "PFO."

Ese hari uburyo bwo kuvura PFO? Ese buri wese abukeneye?

Abantu benshi bafite PFO ntibakeneye kuvurwa. Ariko, niba ufite amateka yo kurwara indwara yo gucika kw'imitsi cyangwa kubyimba kw'amaraso, cyangwa se ukaba uri mu kaga gakomeye ko kubirwara, muganga wawe ashobora kukugira inama yo kuvura. Uburyo bwo kuvura PFO burimo:

• Imiti ibuza amaraso kuzura : Urugero, aspirine cyangwa warfarin.
• Gufunga umutsi : Muri ubu buryo, umuganga w’indwara z’umutima akoresha umuyoboro muremure kandi muto (catheter) kugira ngo afunge umutsi. Uyu mutsi unyuzwa mu mutsi munini uri mu kibuno ujya mu mutima, hanyuma hagakoreshwa igikoresho cyihariye (icyuma gifunga umutsi). Ubushakashatsi bwagaragaje ko ubu buryo bwa catheter bufite akamaro kurusha kubaga mu kuvura indwara za PFO ku bantu bari munsi y’imyaka 60.
• Kubaga umutima : Umuganga ubaga atera incision hanyuma agafunga agapfundikizo k'ikirenge. Ibi bishobora gukorwa iyo uburyo bwa catheter budafashe neza. Ibi bishobora gukorwa binyuze mu kubaga umutima ufunguye cyangwa binyuze mu gukata gato mu gatuza byitwa minimally invasive robotically assisted patent foramen ovale repair.

Ubushakashatsi buherutse bwerekanye ko ku bantu bafite PFO bahuye n’indwara yo mu bwonko idasobanutse, gufunga PFO bishobora gufasha gukumira indwara yo mu bwonko mu gihe kizaza. Ni byiza kuvugana na muganga wawe ku buryo bwo kuvura bukubereye.

Ese imiti ishobora gutera ingaruka mbi?

Hari abantu bashobora kugira ingorane zikomoka ku kuvurwa na PFO. Izi ngorane ziratandukanye bitewe n'uburyo bwo kuvura:

Ibintu bishobora kubaho hakoreshejwe imiti

Mu gihe ufata imiti nka Aspirine cyangwa Warfarin, ibi bikurikira bishobora kubaho:

• Kuva amaraso.
• Kuva amaraso mu bwonko (kuva amaraso mu bwonko).

Ni iki gishobora kubaho mu gihe cyo kuvurwa na catheter?

Ingorane zikunze kugaragara zo gushyiramo katheta mu mubiri:

• Amaraso apfutse.
• Kwangirika kw'imitsi y'amaraso.
• Igikoresho cyo gufunga cyarafungutse.
• Umutima wanduye cyangwa `endocarditis`.
• `PFO` ntabwo ifunga neza.
• `Amaraso afungana mu bihaha (Pulmonary embolism)`.

Ingorane zidasanzwe:

• Guhagarika umwuka mu kirere.
• Ugutera kw'umutima kutumvikana neza (Arrhythmia).
• `Kubabara mu gice cy'umutima (Afib)`.
• Tamponade y'umutima (amazi yiyongera ku mutima).

Ibintu bishobora kubaho iyo umuntu akorewe operasiyo

Kubagwa kugira ngo hafungwe PFO bishobora guteza ingorane nka:

• `Kubabara mu gice cy'umutima (Afib)`.
• Kuva amaraso.
• Indwara zandurira mu mubiri.
• Indwara yo mu bwonko (stroke).

Ese hari uburyo bwo kugabanya ibyago byo kwirema kwa PFO?

Nta kintu na kimwe ushobora gukora kugira ngo ugabanye ibyago byo kurwara PFO. Ntabwo ari ikintu dushobora kugenzura. Ariko, niba ufite stroke idasobanutse (cryptogenic stroke), ni ngombwa kwipimisha iyi ndwara. Hanyuma, nibiba ngombwa, ushobora kuvurwa vuba.

Ubuzima bw'umuntu urwaye PFO bumeze bute? Ese ni ikintu cyo guhangayikishwa?

Kenshi na kenshi, igipfukisho cy'umwana ufite PFO gifunga burundu mu myaka itatu ya mbere y'ubuzima bwe. Abantu benshi bafite PFO babaho ubuzima bwuzuye kandi bufite ubuzima bwiza nta kibazo bafite bamaze gukura. Rero ntugahangayikishwe nabyo bitari ngombwa .

Niba mfite PFO, nakwitaho nte ku buzima bwanjye?

Ushobora gukomeza kugira umutima wawe umeze neza no kugabanya ibyago byo kurwara indwara yo mu bwonko ukurikije izi ntambwe:

• Irinde gukoresha inzoga cyangwa ibindi biyobyabwenge.
• Kurya indyo yuzuye umutima.
• Kugenzura umuvuduko ukabije w'amaraso (Hypertension) cyangwa urugero rwa cholesterol ruri hejuru.
• Komeza kugira ibiro bizima.
• Reka kunywa itabi no gukoresha ibikomoka ku itabi.
• Shaka ubuvuzi bukwiye ku zindi ndwara zishobora gutuma urwara indwara yo gucika intege mu bwonko, urugero nka atrial fibrillation (Afib).

Nanone, kutaguma mu mwanya umwe igihe kirekire bishobora kugabanya ibyago byo kubyimba kw'amaraso.

Ni ibihe bihe byiza byo kujya kwa muganga?

Niba ufite kimwe mu bimenyetso bya stroke , hita ubonana na muganga cyangwa uhamagare 911 (cyangwa nimero y'ubutabazi bw'ibanze yo mu gace utuyemo). Ibi bimenyetso bishobora kuba birimo:

• Kugorwa no kuvuga cyangwa kumva.
• Kuzungera cyangwa gutakaza uburimbane.
• Kubura ibinya cyangwa intege nke mu maso, ku kuboko, cyangwa ku kuguru.
• Kugorwa no kubona mu maso rimwe cyangwa yombi.
• Kuribwa umutwe cyane mu buryo butunguranye.

Ubutumwa bwo kujyana mu rugo

Ifu ya patent foramen ovale (PFO) ni umwobo muto uri mu mutima uri hagati y’icyumba cy’iburyo n’ibumoso cy’umutima. Igira ingaruka ku muntu umwe kuri bane (25%) . Akenshi, PFO ntabwo itera ibimenyetso kandi ntisaba kuvurwa. Ariko, rimwe na rimwe ishobora kuba ikimenyetso cy’indwara yo mu bwonko cyangwa indwara nto yo mu bwonko. Niba ufite amateka yo kurwara indwara yo mu bwonko cyangwa kubyimba kw’amaraso, muganga wawe ashobora kukugira inama yo kuvura. Uburyo bwo kuvura burimo imiti, gushyiramo kathetateri, no kubagwa. Ikintu cy’ingenzi ni uko abantu benshi bafite PFO bashobora kubaho ubuzima bwiza kandi bwuzuye. Niba ufite impungenge, ntutindiganye kuvugana na muganga wawe.

"PFO, patent foramen ovale, umwobo mu mutima, indwara zo gucika kw'imitsi, amaraso apfutse, indwara z'umutima, foramen ovale