Ingabe ingane yakho encane inobunzima bokuphefumula obunje? Ake sixoxe nge-"Double Aortic Arch"!

Ingabe ingane yakho encane ngezinye izikhathi izizwa sengathi inenkinga yokuphefumula? Ingabe iyaklinywa ngenkathi idla noma incelisa? Noma ingabe yenza imisindo engavamile ngenkathi iphefumula? Nakuba lezi zingase zibe izifo ezivamile zasebuntwaneni, kungaba khona isimo esibi kakhulu, kodwa esingelapheka, ngemuva kwalokhu. Esinye isimo esingavamile kodwa esibalulekile okufanele usiqaphele sibizwa ngokuthi "i-Double Aortic Arch." Ake sixoxe ngakho ngokuningiliziwe namuhla.

Kalula nje, umthambo wegazi oyinhloko othwala igazi lisuka enhliziyweni yengane yakho liye kuwo wonke umzimba wayo yi -aorta . Ngokuvamile kuba umthambo owodwa, omkhulu. Ingxenye egobile yalo mthambo ngaphezu kwenhliziyo ibizwa ngokuthi i-aortic arch .

Kodwa-ke, enganeni ene-"Double Aortic Arch", le "aortic arch" yakhiwa kabili. Okusho ukuthi, umthambo wegazi owengeziwe uxhunywe kule "aortic arch" eyinhloko, yakha i-arch yesibili. Lawa ma-arches amabili ayahlangana, akha indandatho ezungeze umphimbo womntwana (i-trachea) kanye nepayipi lokudla (i-esophagus) . Cabanga nje, kwenzekani uma le ndandatho ivaleka? Yilapho umntwana eqala ukuba nezimpawu ezinzima njengobunzima bokuphefumula, ukwenza imisindo ngenkathi ephefumula, kanye nobunzima bokugwinya ukudla.

Le "aortic arch" yakhiwa ezigabeni zokuqala zokukhulelwa, phakathi kwamasonto amabili kuya kwayisikhombisa. Phakathi nalesi sikhathi, inhliziyo nemithambo yegazi kukhula ngendlela eyinkimbinkimbi kakhulu. Ezinye izingxenye zakhiwa, futhi ngemva kwesikhashana azisadingeki futhi zinyamalale. I-"double aortic arch" yakhiwa ngenxa yento efana nale. Cishe ngesonto lesihlanu lokukhulelwa, umthambo wegazi okwakufanele ukuthi unyamalale, ngesizathu esingaziwa, awunyamalali futhi le "double aortic arch" yakhiwa. Lokhu kuyiphutha lenhliziyo elizalwa nalo , okusho ukuthi umntwana uzalwa nalo.

Lesi simo, esibizwa ngokuthi "i-double aortic arch," singeseqembu leziphazamiso zenhliziyo ezizalwa nazo ezibizwa ngokuthi "ama-vascular rings." Lokhu kubangela ukuthi umphimbo womntwana kanye nomqala wakhe kucindezelwe.

Ziyini lezi "zindandatho zemithambo yegazi"?

Kulungile, "Ama-Vascular Rings", njengoba ngishilo ngaphambili, ayizimo lapho "i-aortic arch" ikhula khona ngendlela engajwayelekile, okungabangela ukuthi i-windpipe yengane (i-trachea), i-food pipe (i-esophagus), noma kokubili kucindezelwe. Lezi yizinkinga zenhliziyo ezingavamile kakhulu. Cabanga ngakho, cishe ingane eyodwa kweziyi-100 izalwa nohlobo oluthile lwezinkinga zenhliziyo ezizalwa nazo. Kodwa "i-vascular ring" ithinta eyodwa kuphela ezinganeni eziyi-10,000. Kuyinto engavamile kangako.

Yiziphi izinhlobo eziyinhloko ze-"Vascular Rings"?

Kunezinhlobo eziningana eziyinhloko zalezi "zindandatho zemithambo yegazi". Ake sibone ukuthi ziyini:

• I-Double Aortic Arch: Kulokhu, "ama-arches amabili e-aortic" (kwesobunxele nakwesokudla) azungeze i-trachea kanye ne-esophagus. Lesi yisihloko esiyinhloko esikhuluma ngaso.
• I-aortic arch yangakwesokudla ene-subclavian artery engafanele kanye ne-left ligamentum: Kukhona i-aortic arch eyodwa lapha, kodwa ingakwesokudla kwe-trachea (ngokuvamile kwesobunxele). Kulesi simo, i-subclavian artery yangakwesokunxele, enikeza igazi ezingalweni zomntwana, iqala ku-aorta bese idlula ngemuva kwe-trachea kanye ne-esophagus. Le ring yemithambo yegazi iqedwa ngokuhlangana ne -left ligamentum arteriosus, insali yomthambo wegazi owawukhona ngesikhathi sokuphila komntwana bese iyanyamalala.
• I-aortic arch yesobunxele ene-subclavian artery engajwayelekile: Lapha, i-subclavian artery yesokudla idlula ngemuva kwe-trachea kanye ne-esophagus, izicindezela.
• Ukucindezelwa kwemithambo yegazi engaphelele: Umthambo wegazi ongaphelele (brachiocephalic) uyigatsha le-aorta. Kulokhu, uqala ohlangothini lwesobunxele lwe-trachea, bese udlula phambi kwe-trachea ngakwesokudla. Lokhu kubeka ingcindezi ku-trachea.
• I-pulmonary artery sling: Umthambo we-pulmonary wesobunxele uqala kusuka kumthambo we-pulmonary wesokudla bese udlula phakathi kwe-trachea kanye ne-esophagus.

Okwenzekayo kuzo zonke lezi zinto ukuthi indlela yokuphefumula noma umphimbo iyathinteka ngandlela thile.

Ingabe kukhona izinhlobo ze-"Double Aortic Arch"?

Yebo, kunezinhlobo ezintathu eziyinhloko "ze-double aortic arch." Lezi zihlukaniswa ngokuthi yiliphi i-arch elikhulu, nokuthi ngabe lelo arch elikhulu lingakwesokudla noma kwesobunxele se-trachea.

• I-arch eyinhloko yesokudla ene-arch encane yesobunxele: Lolu uhlobo oluvame kakhulu, oluvela cishe kumaphesenti angu-80 ezimo.
• I-arch yesobunxele evelele ene-arch encane yesokudla: Lokhu kubonakala cishe kumaphesenti ayi-10 ezimo.
• Ama-arches alinganiselayo: Lokhu kubonakala futhi emacaleni angaba ngu-10%.

Uhlobo luni "lwendandatho yemithambo yegazi" oluvame ukubonakala?

Odokotela babecabanga ukuthi "i-double aortic arch" iwuhlobo oluvame kakhulu "lwendandatho yemithambo yegazi." Kodwa ucwaningo olusha luthole ukuthi "i-right aortic arch" empeleni ivame kakhulu.

Kodwa kukhona okunye. Izingane ezine-"right aortic arch" cishe zizoba nezinye izinkinga zenhliziyo ezizalwa nazo kunezingane ezine-"double aortic arch". Kodwa-ke, cishe azitholakali lapho zizalwa. Lokhu kungenxa yokuthi "right aortic arch" kungenzeka ingazibangeli izimpawu ezigabeni zokuqala. Ngakho-ke, ukuhlinzwa kwale nkinga kungadingeka phakathi kwezinyanga eziyi-6 neziyi-18 ubudala.

Isimo esibizwa ngokuthi "i-Double Aortic Arch" siwuhlobo oluvame kakhulu lwendandatho yemithambo yegazi. Ngakho-ke, udokotela wengane yakho angaxilonga inkinga kusenesikhathi. Uma kuqhathaniswa nezingane ezinezinye izinhlobo zendandatho yemithambo yegazi, izingane ezine-"Double Aortic Arch" zingadinga ukuhlinzwa ngokushesha ngemva kokuzalwa.

Ziyini izimpawu ze-"Double Aortic Arch"?

Izimpawu "ze-double aortic arch" zivame ukwenzeka lapho umphimbo womntwana, umphimbo, noma kokubili kucindezelwa. Lokhu kucindezelwa kungathinta ukuphefumula, ukudla, noma ukusebenza kwenhliziyo yengane.

Ngokuvamile, lezi zimpawu zivela ebuntwaneni (ikakhulukazi uma isimo sibi kakhulu), kodwa ngezinye izikhathi zingavela zisencane kakhulu eminyakeni emithathu ubudala, noma ngisho nasebusheni.

Ezinye izingane zingase zihlonzwe kabi ngokuthi zine-asthma ngoba izimpawu ziyafana. Lesi simo sihlolwa kuphela uma ukwelashwa kwe-asthma kwehluleka futhi kwenziwa ukuhlolwa okwengeziwe.

Izimpawu zokuphefumula

Cishe amaphesenti angama-91 ezinsana nezingane ezine-"double aortic arch" ziba nalezi zimpawu ezihlobene nokuphefumula. Lezi yizi:

• Umsindo ongajwayelekile lapho uphefumula (umsindo ophakeme obizwa ngokuthi `stridor` noma umsindo wokuphefumula obizwa ngokuthi `wheezing`) .
• Ukukhwehlela okuzwakala sengathi “ukukhonkotha kwesivalo.” Lokhu kufana nokukhwehlela okwenzeka ngesikhathi sesimo esibizwa ngokuthi “i-croup.”
• Ukutheleleka okuvamile kwepheshana lokuphefumula eliphansi .

Izimpawu zesisu

Cishe amaphesenti angama-40 ezinsana nezingane ezine-"double aortic arch" zithola lezi zimpawu zokugaya ukudla. Zihlanganisa:

• Ukuminyana ngesikhathi uncelisa noma uncelisa.
• Ubunzima bokugwinya (i-dysphagia) . Lokhu kuvame ukubonakala ngemva kokuba umntwana eqale ukudla ukudla okuqinile.
• Ubunzima bokukhuluphala .
• Ukudla okubuyela phezulu emphinjeni (`Ukubuyela emuva/ukubuyela emuva`) .

Izimpawu zenhliziyo

Cishe amaphesenti angu-30 ezinsana nezingane ezine-"double aortic arch" ziba nezimpawu ezihlobene nenhliziyo. Lezi zimpawu zifaka:

• Ubuhlungu besifuba .
• Umsindo wenhliziyo ongajwayelekile (`Inhliziyo ikhala`) .
• Isikhumba esiluhlaza okwesibhakabhaka (i-cyanosis) .

Yini ebangela "i-Double Aortic Arch"?

Imbangela eqondile ye-"double otic arch" ayikatholakali . Nakuba lesi simo sivame ukubonakala ezinganeni ezikhulelwe "ngokukhulelwa kwe-in-vitro" (IVF) , imbangela eqondile ayaziwa.

I-Double aortic arch ingahlotshaniswa nezinye izimo zezokwelapha. Cishe amaphesenti ayi-12 ezinsana ezine-double aortic arch zinesinye isifo senhliziyo esizalwa naso, njenge- ventricular septal defect (VSD) kanye ne-tetralogy of Fallot . Ngaphezu kwalokho, cishe amaphesenti angama-20 ezinsana ezine-double aortic arch zinezimo zofuzo ezifana ne -chromosome 22q11 deletion kanye ne-trisomy 21 (Down syndrome) .

Ungayibona kanjani i-"Double Aortic Arch"?

I-double aortic arch itholakala ngengozi noma lapho izimpawu ziqala. Ngezinye izikhathi, itholakala ngengozi ngesikhathi sokukhulelwa, ngemva kokuzalwa, noma ngesikhathi sokuhlolwa kwezithombe okwenziwe ngesinye isizathu. Kusukela ngo-2004, inani labantu abatholakala benalesi simo ngokusebenzisa ama-scan ngesikhathi sokukhulelwa liye landa. Lokhu kuwusizo kakhulu, njengoba ukwelashwa kungahlelwa ngokushesha nje lapho umntwana ezalwa.

Noma, kungatholakala uma izimpawu zivela ngemva kokuzalwa komntwana. Udokotela wengane yakho uzokhuluma nawe ngezimpawu bese enza izivivinyo ezithile.

Ukuhlolwa kokuxilonga i-"Double Aortic Arch"

Ukuhlolwa okuyinhloko okusetshenziselwa ukuxilonga lesi simo yile:

• I-X-ray yesifuba: Lokhu kuvame ukuba ukuhlolwa kokuqala okwenziwayo.
• I-CT scan.
• Ukuhlolwa kwe-Echocardiogram (Echo): Lokhu kusiza kakhulu ekutholeni ukuthi kukhona yini ezinye izinkinga zenhliziyo.
• Ukuhlolwa kwe-MRI (MRI).

Ngezinye izikhathi i-bronchoscopy ingenziwa ukuhlola umphimbo womntwana. Lokhu kungenziwa ngenxa yobunzima bokuphefumula ngaphambi kokuba kutholakale i-aorta ephindwe kabili. Noma, kungenziwa ngaphambi kokuhlinzwa ukusiza udokotela ohlinzayo ukuthi anqume ukuthi yini ebangela inkinga.

Ukuhlolwa kwezakhi zofuzo kusiza ekuboneni izimo zezakhi zofuzo.

Indlela yokwelapha "i-Double Aortic Arch"?

Kudingeka ukuhlinzwa ukuze kulungiswe isimo "se-double aortic arch." Ngisho nasezinsaneni ezingenazo izimpawu, ukuhlinzwa kungcono kwenziwe phakathi kwezinyanga eziyi-6 neziyi-9 ubudala. Izingane ezinezimpawu, ikakhulukazi uma izimpawu zinzima, zingadinga ukuhlinzwa ngisho nangaphambi kwesikhathi.

Cabanga nje, isimo esithi "double aortic arch" saqala ukutholakala ngo-1737. Ukuhlinzwa kokuqala kwaso kwenziwa ngo-1947. Sesihambe ibanga elingakanani kusukela ngaleso sikhathi! Izingane ezinalesi sici sokuzalwa zikwazile ukuphila impilo ende nenempilo ngenxa yokwelashwa ngokuhlinzwa.

Ukuhlinzwa kwe-"Double Aortic Arch"

Ukuhlinzwa kwe-"Double Aortic Arch" kuphephile kakhulu, futhi imiphumela iphumelela kakhulu . Ingane yakho ngeke kudingeke ixhunywe ku-"cardiopulmonary bypass" (umshini wenhliziyo namaphaphu) .

Ukuhlinzwa kwenziwa kusetshenziswa indlela ebizwa ngokuthi "i-lateral thoracotomy." Lokhu kusho ukuthi udokotela ohlinzayo wenza i-incision ohlangothini olulodwa lwesifuba somntwana, phakathi kwezimbambo ezimbili. Lokhu kuvame ukwenziwa ohlangothini lwesobunxele, ngoba yilapho izingane eziningi zinekheji elincane "elingeziwe". Ukuhlolwa kwezithombe okwenziwe ngaphambi kokuhlinzwa kuvumela udokotela ohlinzayo ukuba abuke kahle ingaphakathi lomzimba womntwana futhi ahlele ukuhlinzwa ngokufanele.

Udokotela ohlinzayo usebenzisa indlela "yokubopha nokuhlukanisa" . Lokhu kusho ukuthi i-arch encane iboshiwe ukuze kumiswe ukopha kuyo. Bese iyasikwa bese ithungwa. Le nqubo iphindaphindwa kuze kube yilapho i-arch ihlukaniswe ngokuphelele futhi ingcindezi ku-windpipe kanye ne-esophagus isusiwe.

Ingane yakho izohlala esibhedlela cishe isonto lonke, bese ilulama bese ibuya ekhaya.

Ukwelashwa kwe-"Kommerell diverticulum" (`Kommerell diverticulum - KD`)

Akuvamile ukuthi ezinye izingane ezine-"double aortic arch" nazo zingase zibe nokuthile okubizwa ngokuthi "i-Kommerell diverticulum (KD)." Lokhu kuvame kakhulu ezinganeni ezine-"right aortic arch," kodwa futhi akuvamile kakhulu nge-"double aortic arch".

Le `KD` iyi -`aneurysm`, umthambo wegazi okhula ku-`aorta` eyehlayo eduze kwe-`aortic arch`. Lokhu kuqubuka kungathatha isikhala futhi kucindezele umphimbo womntwana kanye nombhobho wokudla. Kungase kungabangela izinkinga ezisheshayo. Kodwa-ke, odokotela abahlinzayo bathanda ukususa lokhu lapho bedala 'i-double aortic arch' ukuze bavimbele izinkinga kamuva.

Ukwelashwa kwezinye izinkinga zenhliziyo

Uma ingane yakho inezinye izinkinga zenhliziyo ezidinga ukuhlinzwa, ingase iphathwe ngesikhathi esifanayo ne-double aortic arch. Lokhu kungadinga inqubo ebizwa ngokuthi "i-median sternotomy" , ehilela ukwenza i-incision maphakathi nesifuba. Udokotela ohlinzayo wengane yakho uzoxoxa ngenketho engcono kakhulu kuwe, kuye ngezinkinga ezidinga ukwelashwa.

Yiziphi izinkinga ezingaba khona ngenxa yokuhlinzwa?

Ingozi yezinkinga ezivela ekuhlinzweni kwe-double aortic arch iphansi kakhulu . Akuvamile ukuthi umntwana abe nobunzima bokudla noma izinkinga zokuphefumula eziqhubekayo. Uma kukhona izinkinga zokuphefumula eziqhubekayo, zivame ukuphela phakathi nonyaka wokuhlinzwa.

Izinkinga zokuhlinzwa ukuze kulungiswe i-double aortic arch kanye nezinye izinkinga zenhliziyo zingahluka. Xoxa ngazo zonke lezi zingozi nezinkinga nodokotela ohlinzayo wengane yakho.

Ingabe i-"Double Aortic Arch" ingavinjelwa?

Cha, isimo esibizwa ngokuthi "i-double aortic arch" asinakuvinjelwa . Kuyinto eqala ekuqaleni kokukhulelwa futhi eba khona ekuzalweni.

Liyini ikusasa labantu abane-"Double Aortic Arch"?

Izinsana nezingane ezike zahlinzwa "i-Double Aortic Arch" zinekusasa eliqhakazile kakhulu . Zingaphila futhi zenze imisebenzi evamile ngaphandle kwemingcele.

Ngemva kokuhlinzwa, ingane yakho ingase iqhubeke nokuphefumula okunomsindo kuze kube unyaka. Lokhu kungenxa yokuthi umphimbo womntwana awukakhuli ngokugcwele ngenxa "ye-double aortic arch." Ngakho-ke, kuzothatha isikhathi ukuthi umphimbo womntwana uqine.

Akuvamile kakhulu ukuthi izinsana nezingane zisenezimpawu zokuphefumula isikhathi esingaphezu konyaka ngemva kokuhlinzwa.

Into ebaluleke kakhulu ukuyisa ingane yakho iyohlolwa njalo bese utshela udokotela wakho uma unezimpawu eziqhubekayo. Ukunakekelwa kokulandelela isikhathi eside kubaluleke kakhulu kuyo yonke ingane eye yahlinzwa inhliziyo.

Kufanele ngishayele nini udokotela wengane yami ucingo?

Uma ubona noma yiziphi izimpawu ezintsha, noma uma izimpawu ezikhona zibonakala ziba zimbi kakhulu, khuluma nodokotela wengane yakho ngokushesha. Izinsana nezingane ezincane ziyashintsha kakhulu kangangokuthi kungaba nzima ngezinye izikhathi ukubona ukuthi yini evamile nokuthi yini engavamile. Kodwa uma ingane yakho inalowo msindo "ofana nowokuvala" noma umsindo wokuphefumula , tshela udokotela wakho ngokushesha. Kungaba ukugula okuvamile kobuntwana. Kodwa akuvamile, kungaba uphawu lwenkinga yenhliziyo ethinta ikhono lengane yakho lokuphefumula.

Kufanele ushayele nini u-911 (inombolo ephuthumayo)?

"I-double aortic arch" ingabeka ingcindezi esongela impilo emgudwini womoya wengane yakho. Uma isikhumba sengane yakho sibonakala siluhlaza okwesibhakabhaka (i-cyanosis) , noma uma ingane yakho inenkinga enkulu yokuphefumula , shayela u-911 ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wengane yami?

Uma ingane yakho itholakala ine-"double aortic arch," kuvamile ukuthi ube nemibuzo eminingi. Kubalulekile ukwazi isimo sengane yakho, okuhlanganisa nokuthi kudingeka nini ukuhlinzwa, nokuthi ingane yakho inayo yini ezinye izinkinga zempilo. Ungase ufune ukubuza imibuzo efana nale:

• Umntwana wami kufanele ahlinzwe nini?
• Ukuhlinzwa kwenziwa kuphi? Ubani okwenzayo?
• Yiziphi izimpawu okufanele ngiziqaphele ekhaya?
• Yini engingayenza ukuze kube lula ngomntwana wami ukuhlala ekhaya?
• Ingabe ingane yami inezinye izinkinga zenhliziyo?
• Ingabe kufanele ngihlolwe izakhi zofuzo zengane yami noma umndeni wami wonke?
• Lizoba njani ikusasa lengane yami?

Iyini i-"Aortic Arch Syndrome"? Ingabe ihlukile ku-"Double Aortic Arch"?

Yebo, ungaziphambanisi lezi ezimbili. I-"Aortic Arch Syndrome" uhlobo olungavamile kakhulu lwe- "Vasculitis" . Yaziwa nangokuthi "i-Takayasu's arteritis" .

I-"Vasculitis" ukuvuvukala kwezindonga zemithambo yegazi yakho. Kungenzeka kunoma yimuphi umthambo wegazi, ngisho nemithambo yegazi emincane kakhulu, ama-capillary. I-"Takayasu's arteritis" ukuvuvukala kwemithambo yegazi ephakathi nendawo kanye nemithambo emikhulu. Ngokuvamile kwenzeka "ku-aortic arch" kanye namagatsha ayo amakhulu. Yingakho ibizwa nangokuthi "i-aortic arch syndrome."

I-Takayasu's arteritis (eyaziwa nangokuthi "i-aortic arch syndrome") yenzeka kubantu abadala abasebasha kanye nabantu abadala abasebasha . Lena inkinga ehluke ngokuphelele kune-"double aortic arch" yokuzalwa esiyixoxe ngayo ngaphambili, futhi ukwelashwa okudingekayo kuhlukile.

Ukuzalwa komntwana kuvame ukuba yisikhathi senjabulo nokugubha. Kodwa-ke, uma uthola ukuthi ingane yakho inesifo senhliziyo, kungaba ngesikhathi sokukhulelwa noma ngemva kokuzalwa, leyo njabulo ithathelwa indawo ukukhathazeka nokungaqiniseki. Uma usanda kuthola ukuthi ingane yakho "ine-double aortic arch," cishe uyazibuza ukuthi yini elandelayo.

Ungakhathazeki. Ithimba lakho lezokwelapha lizokusiza kukho konke lokhu isinyathelo ngesinyathelo. Usuvele uthathe isinyathelo sokuqala, okuwukufunda kabanzi ngesimo somntwana wakho. Izindaba ezinhle ukuthi ukuhlinzwa kwe-double aortic arch kuphephile kakhulu futhi kuyaphumelela. Uma ingane yakho inezinye izinkinga zenhliziyo noma izifo zofuzo, ukwelashwa kungaba nzima kakhulu. Kodwa-ke, ngentuthuko ekunakekelweni kwezingane ezisanda kuzalwa, ungasiza ingane yakho ukuthi ithole ukunakekelwa okufanele ekudingayo, ilulame, futhi ibe nobuntwana obujabulisayo.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okufanele uzikhumbule kulokho esikhulume ngakho? (Umyalezo Wokuya Ekhaya)

Kulungile, ake sifingqe ezinye zezinto okudingeka uzikhumbule kulokho esikhulume ngakho mayelana nale "Double Aortic Arch":

• "I-Double aortic arch" iyisifo senhliziyo esizalwa naso . I-aorta yengane ihlukaniswe yaba ama-arches amabili, okubangela ukucindezelwa kwe-trachea kanye ne-esophagus.
• Izimpawu eziyinhloko ubunzima bokuphefumula, ukuphefumula kanzima, ubunzima bokugwinya, kanye nezifo zokuphefumula ezivame ukwenzeka .
• Lesi simo sitholakala ngokuhlolwa okufana ne-'CT scan', 'MRI', 'Echocardiogram' . Ngezinye izikhathi singatholakala ngisho nangesikhathi sokukhulelwa.
• Ukwelashwa kuwukuhlinzwa . Lokhu kuhlinzwa kuphephile kakhulu futhi kuyaphumelela.
• Komntwana ngemva kokuhlinzwaUngaphila impilo evamile nenempilo.
• Uma ingane yakho inezimpawu ezifana nobunzima bokuphefumula noma ukuminza, funa iseluleko sikadokotela ngokushesha .
• Ungakhathazeki . Ngokuthuthuka kwezokwelapha zesimanje, lesi simo singelashwa ngempumelelo. Ithimba lakho lezokwelapha lizokunikeza ukwesekwa okudingayo.

` I-Double Aortic Arch, Isifo Senhliziyo Esizalwa Naso, Amasongo Emithambo Yegazi, I-Asphyxia Yezinsana, Impilo Yezinsana, Ukuhlinzwa Kwenhliziyo