Ingabe umthambo wegazi oyinhloko wenhliziyo yengane yakho uvaliwe? Ake sifunde ngalokhu (Ukuhlanganiswa kwe-Aorta)!

Wake wazibuza ukuthi izinhliziyo zethu ezincane zisebenza kahle kangakanani? Kodwa ngezinye izikhathi, ngenxa yezinkinga ezithile zokuzalwa, ukusebenza kwale nhliziyo kungaphazamiseka kancane. Esinye isimo senhliziyo esinjalo esingaba khona kwezinye izingane sibizwa ngokuthi `(Ukuhlangana kwe-Aorta)`. Ngisho noma igama lingase lizwakale liyinkimbinkimbi kancane, ungakhathazeki. Ake sixoxe ngalokhu kalula.

Kuyini `(Ukuhlanganiswa kwe-Aorta)`? Kalula nje...

Kalula nje, ukuhlangana kwe-Aorta kuwukuncipha noma ukuncipha kwe-aorta, umthambo wegazi oyinhloko othwala igazi elinomoya-mpilo lisuka enhliziyweni yengane yakho liye emzimbeni wonke. Lokhu kuyiphutha lenhliziyo elizalwa nalo.

Cabanga nje, izimoto eziningi zihamba ngesivinini esikhulu emgwaqweni omkhulu. Kodwa kwenzekani uma unciphisa umgwaqo endaweni eyodwa bese uvumela umzila owodwa kuphela wethrafikhi? Kuvela isiminyaminya sethrafikhi, futhi abashayeli baqale ukuhamba, akunjalo? Yilokho okwenzekayo nakuleso simo. Kuba nzima ukuthi igazi ligeleze kahle ngokuvaleka kwe-aorta.

Ngokuvamile, lokhu kuncipha (ukubumbana) kwenzeka ngaphambi kokuba amagatsha athwala igazi lisuka ku-aorta liye emzimbeni ongezansi, njengemilenze, ahlukane. Yini ebangela lokhu? Umfutho wegazi uyanda engxenyeni engenhla yomzimba womntwana, njengezingalo, kodwa uyancipha engxenyeni engezansi yomzimba, njengemilenze. Lo mehluko omkhulu womfutho wegazi phakathi kwezingxenye ezingaphezulu nezingezansi zomzimba uyisici esibalulekile salesi sifo. Ngisho noma kungekho ezinye izimpawu, odokotela bangase basole lapho bebona lo mehluko womfutho wegazi.

Ngokwezibalo e-United States, cishe ingane eyodwa kwezingu-1,700 ezizalwa minyaka yonke ingaba nalesi simo (i-Aortic Coarctation). Ezinye izingane zingase zibe nezinye izifo zenhliziyo ezizalwa nazo kanye nalesi simo.

Yiziphi izimpawu izingane ezizibonisayo uma ziqala lesi simo?

Lezi zimpawu zincike ekutheni i-aorta incishisiwe kangakanani. Ngokuvamile, uma kukhona ukuncishiswa okuncane, izimpawu zizoqala ukuvela zingakapheli isonto noma amabili ngemva kokuzalwa. Kodwa-ke, uma ukuncishiswa kuncane kakhulu, izimpawu zingase zingaveli kuze kube yilapho ingane isikhulile, noma zingase zingaveli nhlobo.

Izimpawu zezingane ezisanda kuzalwa

Uma umntwana osanda kuzalwa enalesi simo, angase abe nezimpawu ezifana nalezi:

• Ukozela njalo kanye nokungathandi ukuphuza ubisi
• Ukushaya kwenhliziyo okusheshayo (ukushaya kwenhliziyo okusheshayo)
• Ukujuluka ngokweqile
• Ukucasuka okuqhubekayo, ukukhala
• Isikhumba esimpunga noma esiphuzi
• Ukuphefumula okusheshayo noma okukhandlekayo
• Ubunzima bokuphuza ubisi

Uma ingane inenkinga enkulu yokuqina komthambo wegazi , ingashaqeka futhi ibe yingozi empilweni uma ingaqashelwa futhi yelashwe ngokushesha. Kodwa-ke, ezinye izingane zingase zingabonisi zimpawu ngoba ukuvaleka kuncane kakhulu.

Izimpawu ezinganeni ezincane nakubantu abadala abasebasha

Izingane ezindala kanye nabantu abadala abasebasha abane-Aortic Coarctation bangase babe nezimpawu ezifana nalezi:

• Ubuhlungu bekhanda obuvamile
• Umfutho wegazi ophakeme
• Ukopha igazi njalo
• Ubuhlungu emilenzeni lapho uzivocavoca, ugijima, noma ugxuma

Ezinye izingane zingase zingabi nazimpawu nhlobo. Kunalokho, inkinga iqala ukubonwa njengomfutho wegazi ophezulu ngesikhathi sokuhlolwa njalo.

Uma umuntu omdala eba nalezi zimpawu, kuvame ukubangelwa ukuphindeka kwe-aorta encipha ngemva kokwelashwa kwangaphambilini. Akuvamile ukuthi lesi simo singatholakali kuze kube yilapho umuntu emdala.

Kungani lesi simo senzeka? Yiziphi izizathu?

Ochwepheshe abakayazi imbangela eqondile ye-CoA. Kodwa-ke, kukholelwa ukuthi kukhona ingxenye yezakhi zofuzo . Okusho ukuthi, izinguquko ezithile zezakhi zofuzo ezenzeka ngesikhathi umntwana esesibelethweni zingabangela ukuthi i-aorta yengane ingakhuli kahle.

Ngezinye izikhathi lezi zinguquko zofuzo zingadluliselwa ngemindeni. Ucwaningo lukhombisile ukuthi uma une-CoA, ingane yakho inamathuba amaningi okuthola i-CoA noma esinye isifo senhliziyo kunomuntu ongenayo i-CoA.

Futhi, ingozi yokuthola i-CoA iphakeme uma kunezimo ezithile zofuzo. Isibonelo, izingane ezizalwa zinesimo sofuzo i-Turner syndrome cishe azigcini nje ngokuba ne-Coarctation ye-Aorta, kodwa futhi nezinye izinkinga zokuzalwa ezifana ne-bicuspid aortic valve, isici kuma-valve enhliziyo.

Imbangela ye-`(CoA)` yodwa ngaphandle kwezinye izinkinga zenhliziyo

Imbangela eyinhloko ye-CoA ehlukanisiwe ukuvalwa okungavamile komthambo wegazi omncane obizwa ngokuthi i-ductus arteriosus ngesikhathi sokukhula komntwana. I-ductus arteriosus umthambo wegazi omncane oxhumanisa i-fetal aorta nomthambo wamaphaphu. Amaphaphu awasebenzi ngesikhathi umntwana esesibelethweni, ngakho-ke leli payipi lisiza umntwana ukuthola igazi elicebile ngomoya-mpilo alidingayo.

Ngemva kokuzalwa kwengane, amaphaphu aqala ukusebenza. Ngemuva kwalokho, njengoba le `(ductus arteriosus)` ingasadingeki, iqala ukuvala yodwa zingakapheli izinsuku ezimbalwa. Kodwa-ke, lapho ivala, ezinye zezicubu ezikulowo msele zingahlangana nezicubu ze`(Aorta)`. Kuleso simo, lapho `(ductus arteriosus)` iphoqeleka ukuvala, i-aorta nayo ingaba mfushane (coarctation)`.

Yiziphi izinkinga ezingaba khona ngenxa yalesi simo?

Uma lesi simo (i-Coarctation of the Aorta) sishiywa singelashwa isikhathi eside, izinkinga ezifana nalezi:

• Umfutho wegazi ophakeme (umfutho wegazi ophakeme) kuwo wonke umzimba.
• Imisipha yenhliziyo iba mikhulu kunejwayelekile (i-left ventricular hypertrophy).
• Ukuqongelela kwe-plaque emithanjeni yenhliziyo, ehlinzeka ngegazi enhliziyweni, kwenzeka ngaphambi kwesikhathi esijwayelekile - lokhu kubizwa ngokuthi isifo semithambo yenhliziyo.
• Ukuvuvukala okungavamile (i-aneurysm) noma ukudabuka (ukuqhekeka) ku-aorta.
• Ukuvuvukala kobuchopho (ukuvuvuka komthambo wegazi ebuchosheni).
• Ukwehluleka kwenhliziyo yisimo lapho inhliziyo ingakwazi ukupompa igazi ngendlela efanele.

Lesi simo `(CoA)` siyingozi kakhulu uma singabonwa futhi singalashwa. Ngakho-ke, kubaluleke kakhulu ukusibona ngokushesha ngangokunokwenzeka, sisebancane, futhi sithole ukwelashwa okudingekayo kanye nokuhlolwa njalo (ukuqapha).

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Odokotela bezifo zenhliziyo bezingane bavame ukuxilonga lesi simo (i-Coarctation of the Aorta) besebancane noma besebancane. Ukuthi sisheshe sixilongwe kuncike ekutheni izimpawu zimbi kangakanani.

Izingane ezinezimpawu ezingatheni ziyabonakala zingakapheli izinsuku ezimbalwa zizelwe. Kodwa-ke, izingane ezinezimpawu ezingatheni, noma ezingezona nhlobo, zingase zingabonwa kuze kube yilapho sezikhulile futhi zibe nomfutho wegazi ophakeme. Akuvamile kakhulu ukuthi lokhu kubonakale lapho sezikhulile.

Lesi simo sivame ukutholakala ezinsaneni nasezinganeni ezincane ngenxa yezici ezithile ezisolisayo (amafulegi abomvu) ezibonakala ngesikhathi sokuhlolwa komzimba. Izici ezinjalo zifaka:

• Ingane inomfutho wegazi ophezulu ezingalweni nasemzimbeni ongaphezulu, kodwa umfutho wegazi ophansi emilenzeni nasemzimbeni ongezansi.
• Kukhona umehluko phakathi kwesilinganiso sokushaya kwenhliziyo entanyeni kanye nesilinganiso sokushaya kwenhliziyo esinqeni.
• Lapho udokotela ebeka i-stethoscope emhlane wengane futhi elalele, kuzwakala umsindo ohlukile nonamandla ovela enhliziyweni ('ukububula kwenhliziyo okunamandla') .

Ezinye izingane ezisanda kuzalwa zitholakala zinalesi sifo ngaphambi kokuba zibonise izimpawu. Wazi kanjani? Ukuhlolwa okubizwa ngokuthi ``pulse oximetry`` okulinganisa amazinga omoya-mpilo egazini lazo kubonisa ukuthi amazinga omoya-mpilo aphansi. Amazinga aphansi omoya-mpilo angaba uphawu lwesifo senhliziyo esibi sokuzalwa naso, ngakho-ke lezi zingane ziyahlolwa ukuze kutholakale ukuthi yini ngempela engalungile.

Ukuqinisekisa lesi simo `(CoA)`, odokotela bavame ukusebenzisa `(Echocardiogram)`, ukuskena kwenhliziyo, noma `(echo)`. Bangase benze nokuhlolwa okufana `(CT scan)` noma `(MRI scan)` ukuze bafunde kabanzi ngesimo kanye nesakhiwo se-aorta yengane.

Ingabe zikhona ezinye izifo zenhliziyo ezihlobene "nokuhlangana kwe-Aorta"?

Yebo, izingane ezine-CoA zingatholakala zinezinye izimo zenhliziyo. Isibonelo, phakathi kuka-45% no-75% wabantu abane-CoA nabo banesifo esibizwa ngokuthi i-bicuspid aortic valve. Lokhu kusho ukuthi i-valve ethwala igazi lisuka enhliziyweni liya e-aorta inamapheshana amabili kuphela esikhundleni salawo amathathu okufanele ibe nawo ngokuvamile.

Akukhona lokho kuphela, kodwa `(CoA)` ingahambisana nezimo ezilandelayo:

• Ukuba nembobo enhliziyweni - lokho kubizwa ngokuthi `(i-atrial septal defect)` noma `(i-ventricular septal defect)`.
• Umthambo wegazi owawukhona ngesikhathi sokuphila kombungu (`ductus arteriosus`) uhlala uvulekile isikhathi eside kunokulindelekile - lokhu kubizwa ngokuthi ``patent ductus arteriosus``.
• I-Aortic arch hypoplasia noma i-hypoplastic left heart syndrome.
• Ukuqina kwevalvu yenhliziyo - okungukuthi, i-aortic valve stenosis noma i-mitral valve stenosis.

Odokotela abahlinza inhliziyo babheka zonke lezi zinto enhliziyweni yengane yakho bese bedala uhlelo lokwelapha oluqondene nayo ngqo. Lokhu kusho ukuthi ukwelapha ingane enezinkinga eziningi zenhliziyo kungaba nzima kakhulu kunokwelapha ingane ene-CoA eyodwa kuphela.

Yiziphi izindlela zokwelapha lokhu?

Izinketho zokwelapha zincike eminyakeni yengane yakho, izinga lokuncipha kwe-aorta, nokuthi ngabe inezinye izinkinga zenhliziyo. Ukuhlinzwa kuyindlela engcono kakhulu yokwelapha i-coagulopathy ezinsaneni nasezinganeni ezincane. Ezinganeni ezindala, uma ukuncipha kungakabi kubi kakhulu, i-catheterization yenhliziyo, inqubo engangenisi kakhulu kunokuhlinzwa, ingafaneleka. Iphinde isetshenziswe ezinganeni nakubantu abadala abaye baphinde bancipha ngemva kokwelashwa kwangaphambilini.

Ukuhlinzwa

Kunezinhlobo eziningana eziyinhloko zokuhlinzwa ezenziwayo ukulungisa lesi simo `(CoA)`:

• Ukususwa kabusha nge-anastomosis kusukela ekuqaleni kuya ekugcineni: Uma i-coarctation incane, udokotela ohlinzayo angase asuse ingxenye evinjiwe ye-aorta yengane futhi aphinde ahlangane nezinhlangothi ezisele.
• Ukususwa kabusha nge-anastomosis ende kusukela ekuqaleni kuya ekugcineni:Uma i-aorta arch yengane ivaliwe, udokotela ohlinzayo angasika ingxenye evinjiwe ye-aorta bese exhumanisa ingxenye engezansi ye-aorta ehlayo nomgodi omude ku-aorta arch. Lena inketho engcono kakhulu uma ingane ine-aortic arch hypoplasia evundlile kanye ne-aortic coarctation.

Izingane ezibonisa izimpawu ezinzima ngemva kokuzalwa nazo zingadinga ukunikezwa imithi ngaphambi kokuhlinzwa. Isibonelo:

• Umuthi obizwa ngokuthi `(Prostaglandin (PGE-1))` unganikezwa ukugcina i-`(ductus arteriosus)` yengane ivulekile. Lokhu kuzovumela ingane ukuthi ithole umoya-mpilo eyidingayo futhi ihlale izinzile kuze kube yilapho isilungele ukuhlinzwa.
• Ungamnika futhi umntwana umuthi wokusiza inhliziyo yakhe ukuthi ipompe igazi.

Ukufakwa kwe-catheter kwenhliziyo

Uma ingane yakho inciphile ukuncipha komthambo i-aorta, noma uma ukuncipha sekuphinde kwavela ngemva kokuhlinzwa, udokotela angase asikisele ukwelashwa okufana nalokhu:

• I-angioplasty yebhaluni: Udokotela ohlinzayo usebenzisa ibhaluni elincane ukuze andise ingxenye encane ye-aorta yengane.
• I-angioplasty yebhaluni enokubekwa kwe-stent: Ngesikhathi udokotela ohlinzayo enweba i-aorta yengane, ufaka nethubhu elincane, elibizwa ngokuthi i-stent, ukuze lingaphinde livaleke.

Kufanele ngiyise nini ingane yami kudokotela? (Ukuhlolwa kabusha)

Ithimba lezokwelapha lengane yakho lizokutshela ukuthi kufanele uyilethe nini ingane yakho. Kuyo yonke impilo yengane yakho, kuzodingeka ukuthi ilandelelwe nguchwepheshe wezifo zenhliziyo ozalwa nazo. Lochwepheshe uzokwenza okulandelayo:

• Hlola umfutho wegazi wengane njalo.
• Ukwenza ama-scan (izivivinyo zezithombe) ngezikhathi ezithile ukuhlola ukusebenza kwenhliziyo yengane kanye nezimpawu zezinkinga.
• Ukunikeza izeluleko mayelana nezindlela zokudla ezinempilo kanye nokuzivocavoca umzimba.
• Ukunikeza imithi nokushintsha umthamo wayo njengoba kudingeka.

Umuntu onalesi simo angaphila isikhathi esingakanani?

Ngezindlela zokuxilonga nezokwelapha ezithuthukisiwe, abantu abane-Coarctation of the Aorta manje bangaphila okungenani iminyaka engama-60 ubudala. Esikhathini esidlule, isilinganiso sokuphila kwabantu abanalesi simo sasiyiminyaka engaba ngu-35. Ngakho-ke lezi yizindaba ezinhle ngempela.

Uma ingane yakho ine-Coarctation of the Aorta, ungase uzibuze ukuthi kungani kwenzeke lokho. Asikwazi njalo ukukhomba imbangela eqondile yesifo senhliziyo esizalwa naso. Kodwa siyazi ukuthi ukutholakala kusenesikhathi kanye nokwelashwa kunganciphisa kakhulu umthelela walesi simo empilweni yengane.

Ithimba lezokwelapha lihlala likhona ukusiza ingane yakho. Likulungele ukuphendula noma yimiphi imibuzo ongase ube nayo nokukusiza uqonde ukuthi lokhu kuxilongwa (i-CoA) kuzoyithinta kanjani ingane yakho. Ungase ukuthole kuwusizo futhi ukukhuluma nabanye abazali bezingane ezinalolu hlobo lwesifo senhliziyo.

Izinto ezibalulekile okufanele uzikhumbule (Umyalezo Ofanele Uwuthathe Ekhaya)

Ngiyethemba ukuthi usuyaqonda isimo ebesixoxa ngaso esibizwa ngokuthi "ukuhlanganiswa kwe-Aorta". Nazi ezinye zezinto ezibaluleke kakhulu okufanele uzikhumbule:

• Lokhu kuyisifo senhliziyo esizalwa naso ; ukuvaleka komthambo oyinhloko othwala igazi lisuka enhliziyweni liye emzimbeni.
• Izimpawu zingase zibe khona ebuntwaneni noma zingase zivele kamuva. Uma ubona ukozela ngokweqile, ubunzima bokuphefumula, noma ukungathandi ukuncelisa ingane yakho, funa iseluleko sezokwelapha ngokushesha.
• Ukuxilongwa nokwelashwa kwalesi sifo kusenesikhathi kunikeza ingane ithuba elikhulu lokuphila impilo evamile nenempilo.
• Lesi simo singaphathwa ngempumelelo ngokuhlinzwa kanye nezinye izindlela zokwelapha.
• Ukuhlolwa kwezokwelapha ochwepheshe impilo yonke kubalulekile ngisho nangemva kokwelashwa.

Ungesabi. Isayensi yezokwelapha ithuthuke kakhulu namuhla. Kukhona odokotela abanekhono abanganikeza ingane yakho ukwelashwa okungcono kakhulu. Into ebaluleke kakhulu ukuthi uyazi ngalokhu, unake izinguquko zengane yakho, futhi ufune iseluleko sezokwelapha ngesikhathi.

Ukuhlanganiswa kwe-Aorta, Isifo Senhliziyo, Ukwelashwa Kwezingane, Isifo Senhliziyo Esizalwa Naso, I-Aortic Stenosis, Impilo Yengane, Umfutho Wegazi