Ngamanye amaxesha siva kusithiwa, 'Owu, umntwana wam unengxaki yentliziyo encinci, wazalwa enesingqala sentliziyo'? Okanye, xa umntu oselula enengxaki yokuphefumla okanye ebuhlungu esifubeni, oogqirha bathi, 'Kukho ingxaki encinci ngevalvu yentliziyo.' Yile ndlela esiza kuthetha ngayo ngesifo sentliziyo esingaqhelekanga, kodwa esibaluleke kakhulu ukwazi ngaso.
Yintoni le valve ye-aortic enephetshana elinye (`Unicuspid Aortic Valve`)?
Ngamafutshane, ivalvu ye-aorta entliziyweni yakho inencwadana enye endaweni yezintathu eziqhele ukuba nazo. Igama elithi "unicuspid" lithetha "incwadana enye." Cinga ngayo njengocango olunesitshixo esinye endaweni yezimbini.
La maphetshana afana neengcango ezincinci. Ayavuleka aze avalwe ukuze igazi elicocekileyo nelicebileyo ngeoksijini lidlule lisuka kwi-ventricle yasekhohlo yentliziyo - igumbi lasekhohlo elisezantsi kwentliziyo - liye kwi-aorta . I-aorta emva koko ipompa igazi emzimbeni wonke. Ngoko ke, xa inani lamaphetshana kule valve lincipha, kunokubakho izithintelo ezincinci ekuhambeni kwegazi.
Abanye abantu abanale meko, i-Unicuspid Aortic Valve, banokuba nezinye iingxaki zentliziyo. Umzekelo:
- I-Aorta : Oku kuthetha ubuthathaka kwiindonga ze-aorta.
- I-Ventricular Septal Defect (VSD) : Umngxuma eludongeni phakathi kwamagumbi amabini asezantsi entliziyo.
- I-Patent Ductus Arteriosus (PDA) : Umthambo wegazi obekufanele ukuba uvaliwe emva kokuzalwa uhlala uvulekile.
- Iingxaki zemithambo yentliziyo : Utshintsho oluthile kwimithambo yegazi ehambisa igazi entliziyweni.
Le yimeko engaqhelekanga kakhulu. Ichaphazela malunga ne- 0.02% yoluntu ngokubanzi. Kwakhona, ixhaphake kakhulu kumadoda.
Ngaba kukho iintlobo zezi?
Ewe, kukho iintlobo ezimbini eziphambili ze-"Unicuspid Aortic Valve". Umahluko phakathi kwezi ntlobo zimbini ngumsantsa apho la maphetshana mabini (amaphetshana) adibana khona nodonga lwevalvu, olubizwa ngokuba yi-"Commissure" . Ungakuqonda oku ngolu hlobo. Khawuthelekelele ukuba imilebe yakho inamathele ngokusisigxina ebusweni bakho, kodwa ingadibana ize yahlukane, akunjalo? Yiyo loo nto i-"Commissure" iyiyo.
Ezi ntlobo zimbini zezi:
1. Uhlobo lwe-Acommissural: Olu lolona hlobo lunzima kakhulu . Kule meko, akukho commissure, oko kukuthi, akukho gap. Kwaye aluqhagamshelwanga kwi-aorta. Amaphetshana anamathelene, phantse ngokungathi adityanisiwe. Igazi lihamba kuphela ngomngxuma omncinci, njengomngxuma wepin.
2. Uhlobo lwe-Unicommissural:Olu alunzima kangako kunelunye, kwaye lolona hlobo luqhelekileyo . Lune "Commissure" enye, oko kukuthi, isithuba esinye. Lukwaqhagamshelwe kwi-aorta. Xa olu hlobo lwevalvu luvuliwe, lubonakala ngathi lumgca. Abanye abantu bayithelekisa nomlomo wentlanzi.
Zeziphi iimpawu onokuzibona?
Ukuba umntu omdala unale meko (i-Unicuspid Aortic Valve), iimpawu ezinokubonwa zezi:
- Ukuphefumla kancinci : Xa udiniwe kancinci, ungaziva ngathi uza kutyhafa xa unyuka izinyuko.
- Ukudinwa : Xa usukuma ngequbuliso, ungaziva unesizungu.
- I-Angina : Le yimvakalelo yentlungu okanye ukuqina esifubeni. Kwabanye abantu, oku kunokusasazeka emhlathini, entanyeni, okanye nakwiingalo.
- Ukutyhafa/ukutyhafa : Ukulahlekelwa zingqondo ngequbuliso.
Abantwana abancinci abanale meko badla ngokuba neemeko ezifana nokusilela kwentliziyo kwicala lasekhohlo . Bakwathanda ukwehlisa ubunzima njengabanye abantwana abaneminyaka yabo, nto leyo ethetha ukuba abafumani bunzima bungako.
Uhlobo lwe- "Acommissural" olukhankanyiweyo ngaphambili, oluluhlobo olunzima, lubonisa iimpawu kwiintsana ezincinci kakhulu . Kodwa abo banohlobo lwe- "Unicommissural" basenokungabonakalisi zimpawu de babe neminyaka engama-20 okanye engama-30 ubudala, oko kukuthi, bade babe ngabantu abadala.
Kutheni oku kusenzeka? Yintoni unobangela?
Le meko, ebizwa ngokuba yi-``Unicuspid Aortic Valve'', yenzeka xa amaphecana amathathu afanele ukuba akheke ngokuqhelekileyo eqala ukukhula ngelixa umntwana esesesibelekweni, aze endaweni yokuba ahlukane, adibane aze abe yinto enye. Oku kwenzeka ngaphambi kokuba umntwana azalwe .
Nangona abaphandi bengenakukungqina ngokuqinisekileyo oku, bacinga ukuba oku kusenokuba "yimeko ezuzwe njengelifa." Oko kuthetha ukuba kusenokubakho impembelelo yemfuza.
Zeziphi iingxaki ezinokubangela oku?
Umntu onevalvu ye-aortic ye-unicuspid unokufumana iingxaki ezahlukeneyo ngokuhamba kwexesha. Ezona ziphambili zezi:
- I-Aortic valve stenosis : Oku kwenzeka xa ivalvu ingavuli kakuhle, nto leyo ethintela ukuhamba kwegazi. Oku kubangela ukuba intliziyo isebenze nzima ukupompa igazi.
- Ukubuyela kwevalvu ye-aorta: Ivalvu ayivali kakuhle, nto leyo ebangela ukuba inxalenye yegazi elimpontshiweyo ivuzele entliziyweni.
- I-Infective Endocarditis : Usulelo lwengaphakathi lentliziyo, ingakumbi iivalvu. Abantu abaneevalvu ezingaqhelekanga basengozini enkulu.
- Umngcipheko okhulayo wokuqhekeka kwe-Aortic : Le yimeko eyenzeka ngequbuliso neqatha apho udonga lwe-aorta lukrazuka ngaphakathi.
Kubalulekile: Kubaluleke kakhulu ukuxilonga nokunyanga isifo ngexesha elifanelekileyo, ngaphambi kokuba ezi ngxaki zenzeke.
Uyifumana njani le nto?
Xa usiya kugqirha, uza kumamela intliziyo yakho nge-stethoscope ngexesha lovavanyo lwakho lomzimba . Ukuba ugqirha uva isandi sentliziyo esingaqhelekanga ("ukugquma kwentliziyo" kufutshane ne-aorta yakho, unokukukrokrela oku. Emva koko, unokucebisa ezinye iimvavanyo.
Zeziphi iimvavanyo ezenziwayo?
Uvavanyo oluphambili olwenziweyo ukuqinisekisa ngokuchanekileyo ukuba ikhona le meko ye-"Unicuspid Aortic Valve" zezi:
- I-Transthoracic Echocardiogram (TTE) : Oku kufana ne-ultrasound scan yentliziyo. Kwenziwa phezu kwesifuba. Kunokuvavanya ngcono ukuma kwentliziyo kunye nomsebenzi weevalvu zayo.
- I-Transesophageal Echocardiogram (TEE) : Le ikwayi-echocardiogram. Nangona kunjalo, ityhubhu encinci ifakwa ngomqala kwaye intliziyo ijongwa nge-esophagus. Oku kunokuvelisa imifanekiso ecacileyo kune-TTE.
- I-Cardiac Computed Tomography (CT) scan : Oku kunokuvelisa imifanekiso ye-3D yentliziyo kunye ne-aorta.
- I-MRI yentliziyo (iMagnetic Resonance Imaging) : Oku kunokubonelela ngolwazi oluneenkcukacha malunga nolwakhiwo kunye nomsebenzi wentliziyo.
Iphathwa njani?
Unyango loku luyahluka ngokweminyaka kunye nobunzima beempawu.
Iindlela zonyango eziqhelekileyo zabantwana abancinci zezi:
- Utyando lweValvotomy : Oku kuquka ukwenza utyando lokusika izicubu zevalvu ezinamathele kunye nokudala amaphecana amatsha.
- I-Valvuloplasty : Oku kuquka ukusebenzisa into efana nebhaluni ukuvula ivalvu.
- I-Commissurotomy : Ukwahlula ngotyando iindawo ezibizwa ngokuba yi-"Commissures" apho iinkophe zincamathele khona.
- Inkqubo kaRoss : Olu lutyando oluyinkimbinkimbi kancinci. Siza kuthetha ngakumbi ngalo mba kamva.
Kubantu abadala , utyando ludla ngokufuneka ukuze kulungiswe ivalvu ye-aortic (Unicuspid Aortic Valve repair) okanye kufakwe ivalvu entsha (ukutshintshwa) .
Ngaba kukho naziphi na iziphumo/iingxaki zonyango?
Njengakwezinye iindlela zotyando, kukho iingxaki ezithile ezinokubakho ngolu nyango. Kodwa ayinguye wonke umntu oza kuhlangabezana nazo ezi ngxaki. Ungakhathazeki, ugqirha wakho uza kukwazisa kakuhle ngezi ngxaki.
Ezinye zeengxaki eziqhelekileyo ezinokwenzeka zezi:
- Usulelo
- Amahlwili egazi
- Ukopha kakhulu (`Ukopha`)
- I-Endocarditis (usulelo lwevalvu)
- Iingxaki ngepatch esetyenziswa ekulungiseni iivalvu.
- Ibloko yentliziyo epheleleyo : Ukuphazamiseka kokudluliselwa kwesignali yombane yentliziyo.
- Ukuhlaselwa yintliziyo
- Igazi eliphuma kwivalvu liye kwicala elingalunganga.
- Isingqisho sentliziyo esingaqhelekanga
Kuthatha ixesha elingakanani ukuphiliswa?
Oku kuya kwahluka ngokuxhomekeke kuhlobo lwenkqubo oyenzileyo. Kungathatha naphi na ukusuka kwiveki ukuya kwiinyanga ezininzi ukuze uphile. Ugqirha wakho uza kukuxelela ukuba kufuneka uphumle ixesha elingakanani kwaye ungaqhubeka nini nemisebenzi yakho yesiqhelo.
Buza kuba njani ubomi kule meko?
Ukuba une-Unicuspid Aortic Valve, kusenokwenzeka ukuba kuya kufuneka utyando . Enyanisweni, kunokufuneka ukuba ivalvu yakho ilungiswe okanye itshintshwe izihlandlo ezingaphezu kwesinye ebomini bakho. Usenokuba nezinye iingxaki zentliziyo. Kusenokufuneka uqhubeke nokuthatha amayeza okunciphisa igazi (i-anticoagulants) emva kotyando, kuxhomekeke kuhlobo lwevalvu onayo.
Kodwa kufanele kuthiwe le "Unicuspid Aortic Valve" ayisiyonto eza kuba ngcono ngokuzenzekelayo . Imeko ihlala ifana de ube utyando ukuze uyilungise.
Kukho iindaba ezimnandi. Olunye uphando lufumanise ukuba ama-97% abantu abatyandwa i-aortic valve ngenxa yemeko ebizwa ngokuba yi-"Unicuspid Aortic Valve" babesaphila emva kweminyaka eli-10 .
Nangona kunjalo, kukho nembono yokuba ukuba umntu ongaphantsi kweminyaka engama-65 ubudala unikwa ivalvu ye-aortic yokufakelwa ngenxa yesi simo, inokunciphisa ubomi bakhe ngaphezu kweminyaka eli-10. Yiyo loo nto abaphandi besithi iRoss Procedure yeyona ilungileyo kubantu abancinci nabasebenzayo. Kule ``Ross procedure``, uthatha ivalvu yakho ye-pulmonary uze uyifake kwindawo apho ivalvu ye-aortic enesifo ikhona. Emva koko, i-pulmonary homograft evela kumntu oswelekileyo ifakelwa kwindawo apho ivalvu ye-pulmonary esusiweyo yayikhona. Nangona oku kunzima kancinci, iziphumo kuthiwa zilungile.
Ufuna ukwenza ntoni kwicala lakho?
Emva kotyando, kufuneka ulandele imiyalelo kagqirha wakho ngononophelo malunga nendlela yokunyamekela amanxeba akho . Uza kukuxelela nokuba kufuneka uphumle ixesha elingakanani kwaye ungaqala nini ukuqhuba imoto kunye neminye imisebenzi yemihla ngemihla.
Ungalibali: Kubaluleke kakhulu ukusela amayeza akho ngexesha, njengoko ugqirha emyalele, nokuya ekliniki ngeentsuku ezimiselweyo.
Ngamanye amaxesha ucinga, "Owu, andikakhuli ngokwaneleyo ukuba ndibe nesifo sentliziyo," kodwa usenentlungu esifubeni kwaye kunzima ukuphefumla.Ukuba unayo nayiphi na kwezi zilandelayo, qiniseka ukuba ubona ugqirha. Emva kotyando lwe-Unicuspid Aortic Valve, uya kuqhubeka nokuba ne -aphoyintimenti yokulandelela nogqirha wakho. Ukuba kukho ingxaki (njengosulelo) emva kotyando, unokufuna unyango olungxamisekileyo.
Yeyiphi imibuzo omele uyibuze ugqirha?
Xa usiya kugqirha, ungoyiki ukubuza nayiphi na imibuzo onayo. Nazi ezinye zemibuzo onokuyibuza:
- Yeyiphi indlela engcono yonyango kum?
- Zithini umahluko phakathi kweentlobo ezahlukeneyo zokutshintshwa kweevalvu? (oko kukuthi, ivalvu yokwenziwa kunye ne-biovalve)
- Kufuneka ndenze utyando ngokukhawuleza kangakanani?
- Ivalvu esandul’ ukufakwa ihlala ixesha elingakanani?
Xa usiva ukuba kukho into engasebenzi kakuhle entliziyweni yakho, akulula. Nangona kunjalo, ngokuhamba kwexesha, oogqirha baye baphuhlisa unyango olungcono lwale meko. Thetha nogqirha wakho malunga nokuba yintoni ekulungeleyo. Ekubeni le yimeko engaqhelekanga , kungcono ukuba ufumane ugqirha onamava ngayo. Umzekelo, abaphandi bathi ugqirha otyandayo kufuneka enze iinkqubo zikaRoss ubuncinane ezili-15 ngonyaka.
Okokugqibela, eyona nto ibalulekileyo ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)
Kulungile, ngoko ke ndiyathemba ukuba ngoku uyaqonda kakuhle esi sifo sentliziyo esibizwa ngokuba yi-`(Unicuspid Aortic Valve)` esithethe ngaso namhlanje. Khumbula, le yinto ezalwa nayo kwaye ingabonakali rhoqo. Nangona kunjalo, ukuba ichongiwe ngokuchanekileyo kwaye inyangwa ngexesha, ungaphila ubomi obuhle . Ukuba wena okanye umntu omaziyo unezi mpawu, ungoyiki ukubona ugqirha kwaye ufumane ingcebiso. Ingakumbi, kubaluleke kakhulu ukufumana inkxaso yeqela lezonyango elinamava xa unyanga ezi meko zingaqhelekanga. Nyamekela intliziyo yakho. Yeyona nto ixabisekileyo ebomini bakho!
Isifo sentliziyo , i-Aortic Valve, i-Unicuspid Aortic Valve, utyando lwentliziyo, isifo sentliziyo esizalwa naso, ukungakwazi ukuphefumla, iintlungu zesifuba
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