Ingaba umntwana wakho omncinci unengxaki yentliziyo? Masithethe ngeHypoplastic Aortic Arch!

Ngaba umntwana wakho omncinci ngamanye amaxesha unengxaki yokuncancisa? Ngaba uziva ediniwe ngaphezu kwesiqhelo xa ephefumla? Okanye ubonakala ephaphathekile kwaye ebila? Kuqhelekile ukuba wena njengomzali uzive ukhathazekile kakhulu xa ezi zinto zisenzeka kumntwana wakho omncinci. Ngamanye amaxesha unobangela woku unokuba yingxaki yentliziyo yokuzalwa. Namhlanje, siza kuthetha ngemeko eyenzeka entliziyweni yeentsana, kodwa inokunyangeka ukuba iqatshelwe kwangethuba kwaye inyangwe ngokufanelekileyo.

Yintoni iHypoplastic Aortic Arch?

Ngamafutshane, iHypoplastic Aortic Arch , ngamanye amaxesha ebizwa ngokuba yiAortic Arch Hypoplasia (AAH) , sisiphene sokuzalwa esenzeka kwinxalenye yentliziyo yomntwana wakho , i-aorta . Cinga ngale ndlela, i-aorta ifana nomthambo omkhulu othwala igazi emzimbeni wethu. Iqala entliziyweni kwaye ithwala igazi elineoksijini emzimbeni wonke. Imile njengengcongolo, igobile kancinci. Igophe elingaphezulu kwengcongolo libizwa ngokuba yi-aortic arch , oko kuthetha 'i-arch ye-aorta.'

Igama elithi 'hypoplastic' lithetha 'ongakhuliswanga kakuhle', 'mncinci'. Ngoko ke, umntwana one-aortic arch engaphantsi kweplastiki une-aortic arch engaphuhliswanga kakuhle. Oko kukuthi, umngxuma, okanye ububanzi, ngaphakathi kuloo ndawo buncinci kakhulu kunokuba kufanele. Kanye njengokuba umbhobho wamanzi uvalekile, xa i-aortic arch incipha, kuba nzima ukuba igazi liphume entliziyweni liye kwiindawo ezisezantsi zomzimba, nge -aorta ehlayo . Oku kunokunciphisa inani legazi elifikelela emzimbeni wonke.

Ngubani ochaphazeleka kakhulu yile meko? Ngaba kukho unxibelelwano nezinye izifo zentliziyo?

I-Aortic arch hypoplasia (AAH) inokwenzeka yodwa. Nangona kunjalo, idla ngokubonakala nesinye isiphene sentliziyo esizalwa naso , esibizwa ngokuba yi-coarctation of the aorta . Le yimeko apho enye inxalenye ye-aorta, edla ngokuba kufutshane ne-ductus arteriosus, umthambo wegazi okhethekileyo ohlala ukho esibelekweni, incipha.

Ngoko ke ugqirha womntwana wakho usenokuthi, "Umntwana wakho une-coagulopathy ye-aorta ene-aortic arch hypoplasia." Oko kuthetha ukuba kukho ukuncitshiswa kwe-aorta, kungekuphela nje kwindawo enye, kodwa nakwicandelo elide.

Ukongeza, iintsana ezine-AAH zinokuba nezinye iingxaki zentliziyo. Umzekelo:

• I-Atrial Septal Defect (ASD) : Umngxuma eludongeni phakathi kwamagumbi amabini aphezulu entliziyo.
• I-Atrioventricular Septal Defect : Ingxaki enzima kwiindonga eziphakathi kwamagumbi entliziyo.
• I-Bicuspid Aortic Valve kunye ne-Aortic Valve Stenosis : Iziphene kunye nokuncitshiswa kwe-aortic valve.
• I-Hypoplastic Left Heart Syndrome (HLHS) : Icala lasekhohlo lentliziyo alikhuli kakuhle.
• I-Patent Ductus Arteriosus (PDA) : Umthambo wegazi obizwa ngokuba yi-ductus arteriosus omele uvale emva kokuzalwa uhlala uvulekile.
• Isifo sikaShone : Indibaniselwano yeziphene ezininzi eziphazamisa ukuhamba kwegazi ukuya kwicala lasekhohlo lentliziyo.
• I-Ventricular Septal Defect (VSD) : Umngxuma eludongeni phakathi kwamagumbi amabini asezantsi entliziyo.

Ukuba nezimo zentliziyo ezingaphezu kwesinye ngolu hlobo kubaluleke kakhulu xa ucwangcisa unyango. Kuba kufuneka utyando okanye isicwangciso sonyango esilungiselelwe iimeko ezinzima nezithile entliziyweni yomntwana.

Zithini iimpawu ukuba umntwana unale meko?

Iintsana ezine-coarctation ye-aorta kunye ne-aortic arch hypoplasia zihlala ziqala ukubonisa iimpawu emva nje kokuzalwa . Khawuthelekelele umntwana wakho osandul' ukuzalwa, odiniweyo emva kokusela iziselo ezimbalwa, ubonakala enengxaki yokuphefumla. Ngamanye amaxesha uyabila aze atshintshe umbala oluhlaza okwesibhakabhaka-mhlophe. Koyikisa kangakanani kumama ukubona into enje, akunjalo?

Iimpawu eziphambili ezinokubonwa zezi:

• Ukubetha kwentliziyo ngokukhawuleza : Isantya sokubetha kwentliziyo sikhawuleza kakhulu.
• Ukudinwa : Usana luziva ludiniwe ngokukhawuleza, ingakumbi xa luncancisa.
• Ulusu olungwevu okanye oluphaphathekileyo : Ngamanye amaxesha ulusu lunokutshintsha lube luhlaza okwesibhakabhaka.
• Ukubila kakhulu .
• Ukukhala rhoqo, ukucaphuka .
• Ukuphefumla okukhawulezayo okanye okunzima .
• Ingxaki yokuncancisa: Uyala ukusela ubisi, okanye uyeke emva kokusela kancinci.
• Ukubetha kwentliziyo okubuthathaka kwiindawo ezisezantsi zomzimba : Ingakumbi emilenzeni, ukubetha kwentliziyo kumthambo wethambo le-femoral kuba buthathaka kakhulu xa kuthontsizwa.

Ukuba umntwana wakho unenye okanye ngaphezulu kwezi mpawu, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngoko nangoko .

Kutheni oku kusenzeka? Zithini izizathu?

I-AAH sisifo sentliziyo esizalwa naso . Yinto eyenzeka xa umntwana esesesibelekweni. Abaphandi basazama ukufumana unobangela ochanekileyo wolu hlobo lwesi sifo sentliziyo esizalwa naso.

Kodwa into eyaziwayo kukuba le meko inokwenzeka ukuba i-aortic arch yomntwana ayikhuli kakuhle kwiiveki zokuqala zokukhulelwa .

Uyifumana njani le nto? Zithini iimvavanyo?

Oogqirha basebenzisa oku ukuxilonga imeko.Uvavanyo olukhethekileyo lwemifanekiso. Olu vavanyo ludla ngokwenziwa emva nje kokuba umntwana ezelwe.

Iimvavanyo eziphambili ezisetyenziselwa ukuxilonga i-AAH zezi:

• I-Cardiac Computed Tomography (i-CT scan)
• I-Magnetic Resonance Angiogram (MRA)
• I-Transthoracic Echocardiogram (TTE) : Oku kufana ne-ultrasound scan yentliziyo.
• Ukufakwa kweCatheterization yentliziyo : Ngamanye amaxesha olu vavanyo nalo kufuneka lwenziwe.

Olu vavanyo lunokujonga ulwakhiwo lwentliziyo yomntwana, oko kukuthi, indlela amalungu angaphakathi ahlelwe ngayo, ngokweenkcukacha ezinkulu. Lunokufumanisa nokuba umntwana unezinye iziphene zentliziyo na. Kungokuqokelela lonke olu lwazi apho oogqirha baceba unyango olufanelekileyo lomntwana.

Ukuze kuqinisekiswe ukuba kukho i-AAH, oogqirha bajonga ubungakanani be-aortic arch yomntwana. Ngokukodwa, balinganisa ububanzi bayo, obububanzi bomngxuma ongaphakathi. Olu linganiso luthelekiswa nobubanzi bezinye iindawo ze-aorta yomntwana (umzekelo, i-ascending aorta okanye i-descending aorta). La maxabiso asetyenziselwa ukumisela ukuba ububanzi be-aorta arch buncinci kakhulu.

Masifunde kancinci malunga neendawo ezahlukeneyo ze-aotic arch.

Xa ugqirha womntwana wakho ethetha ngale meko, usenokuthetha ngeendawo ezahlukeneyo ze-aortic arch. Usenokuba uzibuza, "Ngaba i-aortic arch yahlulwe yaba ziinxalenye ezithile? Ayilo na elo candelo le-aorta enkulu?" Ewe, yinyani leyo. I-aortic arch yinxalenye encinci, "efana nomhlathi" we-aorta. Kodwa, njengazo zonke iindawo ze-aorta, i-aortic arch inemithambo yegazi (imithambo yegazi) eqhekeka kwiindlela ezahlukeneyo. Njengokuba indlela ephambili ineendlela ezisecaleni. Oogqirha basebenzisa le mithambo yegazi eyahlukeneyo njengemida, bephawula apho inxalenye ethile ye-aortic arch iqala kwaye iphela khona. Le "mephu" iluncedo kakhulu ekuchongeni i-AAH kunye nokucwangcisa unyango.

Nazi ezinye zeendawo ze-aural arch ugqirha womntwana wakho anokuthi athethe ngazo:

• I-Proximal Transverse Arch : Le iphakathi kwe -Brachiocephalic Artery yomntwana (ngamanye amaxesha ibizwa ngokuba yi-Innominate Artery) kunye ne-Left Common Carotid Artery . Le yindawo ekufutshane nentliziyo.
• I-Distal Transverse Arch : Le iphakathi kwe-left common carotid artery kunye ne-left subclavian artery .
• I-Aortic Isthmus : Le iphakathi komthambo we-subclavian wasekhohlo kunye nomthambo wegazi okhankanywe ngaphambili obizwa ngokuba yiDuctus Arteriosus .

Ugqirha womntwana wakho uya kugqiba ngqo ukuba ukuncitshiswa kukuphi na kwi-aural arch yomntwana wakho, kunye nobungakanani bokuncitshiswa. Olu lwazi luya kukhokela isicwangciso sonyango.

Zithini iindlela zonyango zoku?

Iintsana ezine-aortic arch engaphantsi kweplastiki ziya kufuna utyando lwentliziyo ukulungisa imeko. Ugqirha wentliziyo yomntwana wakho uza kukuchazela ukuba loluphi uhlobo lotyando oluya kudingwa ngumntwana wakho. Inkqubo yotyando inokwahluka ngokuxhomekeke kwezinye iziphene kunye nokwakheka kwentliziyo yomntwana wakho. Kusenokufuneka wenze i -thoracotomy , olu lutyando oluncinci olwenziwe kwicala lasekhohlo lesifuba somntwana wakho, okanye i-sternotomy, olutyando olwenziwa embindini wesifuba.

Inkqubo yotyando eqhelekileyo ibizwa ngokuba yi-resection ene-extended end-to-end anastomosis . Olu tyando luluncedo kakhulu kwiintsana ezine-coarctation ye-aorta kunye ne-aortic arch hypoplasia. Kule nkqubo, ugqirha wotyando ususa inxalenye encinci ye-aorta, athathe inxalenye esezantsi ye-aorta (i-descending aorta), aze ayincamathisele kwi-incision ende kancinci kwi-aortic arch.

Ithemba lolu tyando kukuphucula ukuhamba kwegazi kwi-aorta yomntwana, ukuqinisekisa ukuba amalungu omzimba kunye nezicubu zomntwana zifumana igazi elaneleyo elineoksijini eninzi.

Lithini ithemba lokuba umntwana wam uza kuphila?

Impendulo engcono kulo mbuzo ngugqirha womntwana wakho. Kuba impilo-ntle yomntwana ixhomekeke kwizinto ezininzi. Ngokukodwa, ukuba kukho ezinye iziphene zentliziyo zokuzalwa zinempembelelo enkulu.

Ngokubanzi, iintsana eziye zanyangwa ngenxa yesifo esibizwa ngokuba yi-aotic arch hypoplasia zinethuba eliphezulu lokufumana ezi ngxaki zilandelayo kamva ebomini:

• Ukuncitshiswa rhoqo kwe-aorta yabo .
• Uxinzelelo lwegazi oluphezulu (iHypertension) .
• Ubunzima bokutya okanye ukuginya : Oku kunokwenzeka ukuba umthambo wonakele ngexesha lotyando (oku kunqabile kakhulu).

Thetha nogqirha womntwana wakho ngale mingcipheko kunye nendlela yokuyilawula.

Ngaba le meko ingathintelwa?

Iziphene zentliziyo ezizalwa nazo ezifana ne-hypoplastic aortic arch zisenokungathintelwa ngokupheleleyo . Nangona kunjalo, ukulandela icebiso likagqirha wakho ukuze ukhulelwe kakuhle kunokunceda ukunciphisa umngcipheko wokuba nale meko okanye ezinye iziphene.

Ngokubanzi, ezi zinto ngokuqinisekileyo maziphetshwe ngexesha lokukhulelwa:

• Utywala .
• Kuphephe ukutshaya, ukusebenzisa i-vaping kunye nazo zonke iimveliso zecuba . Kwakhona, kuphephe ukutshaya umsi osetyenziswa ngabanye abantu .
• Iziyobisi ezingekho mthethweni, ingakumbi i-cocaine .

Kwaye kwakhona, eyakho.Kubaluleke kakhulu ukuya rhoqo kuhlolo lwangaphambi kokukhulelwa. Ukuba unezinye iingxaki zempilo, funa ingcebiso kagqirha ukuze ukwazi ukulawula ezo meko ngaphambi nakulo lonke ixesha lokukhulelwa.

Indlela yokunyamekela umntwana emva kotyando?

Iimfuno zomntwana ngamnye zingahluka emva kotyando, ngoko ke kungcono ukubuza iqela lezonyango lomntwana wakho indlela yokunyamekela umntwana wakho kwixesha elifutshane nelide.

Nantsi eminye imibuzo onokuyibuza ugqirha wakho:

• Ndingamnyamekela njani umntwana wam xa ndibuyela ekhaya?
• Ngawaphi amayeza endifanele ndiwanike umntwana wam? Ndifanele ndiwanike ixesha elingakanani?
• Ngaba kukho naluphi na unyango olufunekayo ukunceda ukusebenza komzimba okanye kwemithambo-luvo yomntwana?
• Ngaba kukho naziphi na izithintelo kwimisebenzi yomntwana?
• Kukhuselekile nini ukuthumela umntwana wam kwindawo yokugcina abantwana? Ngawaphi amanyathelo akhethekileyo endifanele ndimnike wona?
• Ngaba umntwana wam uya kufuna olunye unyango okanye utyando?

Ukuba ngumzali kuhlala kunzima. Kodwa ukuhlala nomntwana onesifo sentliziyo esifana ne-hypoplastic aortic arch (AAH) kunokuzisa imingeni emitsha yonke imihla. Amanye amagama athethwa ngoogqirha kunye nezicwangciso zonyango zinokubonakala kunzima ukuwaqonda. Yinto eqhelekileyo leyo, kwaye awuwedwa. Buza ugqirha womntwana wakho ngezixhobo kunye namaqela enkxaso anokukunceda. Ukwakha uluntu oluxhasa wena nosapho lwakho kunokunceda ukunciphisa uxinzelelo kwaye kukunike amandla okuqhubela phambili neemfuno zomntwana wakho.

Masikhumbule nje into ebesithetha ngayo (Umyalezo Wokubuyela Ekhaya)

• I-Hypoplastic Aortic Arch (AAH) yimeko apho i-arch ye-aorta, umthambo wegazi oyintloko entliziyweni yomntwana, ingakhuli kakuhle, nto leyo ebangela ukuba i-arch inciphe.
• Oku kwenza kube nzima ukuba igazi liphume entliziyweni liye kwezinye iindawo zomzimba.
• Le meko idla ngokubonwa kunye nesinye isifo sentliziyo esibizwa ngokuba yiCoarctation of the Aorta .
• Iimpawu ezinje ngokudinwa, ubunzima bokuphefumla, kunye nolusu olukhanyayo zinokubonakala kwasekuqaleni kobomi bomntwana.
• Le meko ingafunyanwa ngokuskena okukhethekileyo.
• Unyango lutyando lwentliziyo .
• Ukulandela imiyalelo yezonyango ngokuchanekileyo nokulandela ulandelelwano lwexesha elide emva kotyando kubaluleke kakhulu.
• Ukulandela imikhwa esempilweni ngexesha lokukhulelwa kunokunciphisa umngcipheko wezinye iziphene zokuzalwa.
• Awuwedwa. Fumana uncedo koogqirha nakumaqela enkxaso.

Siyathemba ukuba olu lwazi luza kukunceda. Sinqwenela umntwana wakho aphile ngokukhawuleza!

I- Hypoplastic Aortic Arch, i-Aortic Arch Hypoplasia, isiphene sentliziyo esizalwa naso, utyando lwentliziyo yomntwana, ukuhlangana kwe-aorta, izifo zentliziyo yomntwana, utyando lwentliziyo