Ingabe ingane yakho encane inenkinga yenhliziyo? Ake sixoxe nge-Hypoplastic Aortic Arch!

Ingabe ingane yakho encane ngezinye izikhathi iba nobunzima bokuncelisa? Ingabe izizwa ikhathele kakhulu kunokujwayelekile lapho iphefumula? Noma ingabe ibukeka iphaphathekile futhi ijuluka? Kujwayelekile ngawe njengomzali ukuzizwa ukhathazekile kakhulu lapho lezi zinto zenzeka kumntwana wakho omncane. Ngezinye izikhathi imbangela yalokhu ingaba yisifo senhliziyo esizalwa naso. Namuhla, sizokhuluma ngesimo esenzeka enhliziyweni yezingane, kodwa esingelapheka uma sibonakala kusenesikhathi futhi selashwa kahle.

Kuyini i-Hypoplastic Aortic Arch?

Kalula nje, i-Hypoplastic Aortic Arch , ngezinye izikhathi ebizwa ngokuthi i-Aortic Arch Hypoplasia (AAH) , iyisici sokuzalwa esenzeka engxenyeni yenhliziyo yengane yakho , i-aorta . Cabanga ngale ndlela, i-aorta ifana nomthambo omkhulu othwala igazi emzimbeni wethu wonke. Iqala enhliziyweni futhi ithwala igazi elinomoya-mpilo emzimbeni wonke. Ibunjwe njengomhlanga, igobile kancane. Ijika elingaphezulu komhlanga libizwa ngokuthi i-aortic arch , okusho ukuthi 'umhlathi we-aorta.'

Igama elithi 'hypoplastic' lisho ukuthi 'akukhuli kahle', 'kuncane'. Ngakho-ke, umntwana one-aortic arch engaphansi kwe-aortic une-aortic arch engakhuli kahle. Okusho ukuthi, imbobo, noma ububanzi, ngaphakathi kwaleyo ngxenye incane kakhulu kunalokho okufanele ibe yikho. Njengoba nje ipayipi lamanzi livalekile, lapho i-aortic arch incipha, kuba nzima ukuthi igazi ligeleze lisuka enhliziyweni liye ezingxenyeni ezingezansi zomzimba, nge -aorta eyehlayo . Lokhu kunganciphisa inani legazi elifinyelela emzimbeni wonke.

Ubani othinteka kakhulu yilesi simo? Ingabe kukhona ukuxhumana nezinye izifo zenhliziyo?

I-Aortic arch hypoplasia (AAH) ingenzeka yodwa. Kodwa-ke, ivame ukubonakala nesinye isifo senhliziyo esizalwa naso , esibizwa ngokuthi i-coarctation ye-aorta . Lesi yisimo lapho enye ingxenye ye-aorta, ngokuvamile eduze kwe-ductus arteriosus, umthambo wegazi okhethekile ovame ukuba khona esibelethweni, iba mncane.

Ngakho udokotela wengane yakho angase athi, "Ingane yakho ine-coagulopathy ye-aorta ene-aortic arch hypoplasia." Lokho kusho ukuthi kukhona ukuncipha kwe-aorta, hhayi endaweni eyodwa kuphela, kodwa engxenyeni ende.

Ngaphezu kwalokho, izingane ezine-AAH zingase zibe nezinye izinkinga zenhliziyo. Isibonelo:

• I-Atrial Septal Defect (ASD) : Imbobo odongeni phakathi kwamakamelo amabili aphezulu enhliziyo.
• I-Atrioventricular Septal Defect : Iphutha eliyinkimbinkimbi ezindongeni eziphakathi kwamakamelo enhliziyo.
• I-Bicuspid Aortic Valve kanye ne-Aortic Valve Stenosis : Amaphutha kanye nokuncipha kwe-aortic valve.
• I-Hypoplastic Left Heart Syndrome (HLHS) : Uhlangothi lwesobunxele lwenhliziyo alukhuli kahle.
• I-Patent Ductus Arteriosus (PDA) : Umthambo wegazi obizwa ngokuthi i-ductus arteriosus okufanele uvaleke ngemva kokuzalwa uhlala uvulekile.
• I-Shone's Syndrome : Inhlanganisela yeziphambeko eziningana eziphazamisa ukugeleza kwegazi ohlangothini lwesobunxele lwenhliziyo.
• I-Ventricular Septal Defect (VSD) : Imbobo odongeni phakathi kwamakamelo amabili aphansi enhliziyo.

Ukuba nezimo zenhliziyo ezingaphezu kwesisodwa njengalesi kubaluleke kakhulu lapho uhlela ukwelashwa. Ngoba kudingeka uhlelo lokuhlinzwa noma lokwelashwa oluhambisana nezimo eziyinkimbinkimbi neziqondile enhliziyweni yengane.

Yiziphi izimpawu uma ingane inalesi simo?

Izingane ezine-coarctation ye-aorta kanye ne-aortic arch hypoplasia zivame ukuqala ukukhombisa izimpawu ngemuva nje kokuzalwa . Cabanga ngengane yakho esanda kuzalwa, ekhathele ngemva kokuphuza iziphuzo ezimbalwa, ibonakala inenkinga yokuphefumula. Ngezinye izikhathi iyajuluka futhi iphenduke umbala oluhlaza okwesibhakabhaka nomhlophe. Kuyesabeka kangakanani kumama ukubona into efana nale, akunjalo?

Izimpawu eziyinhloko ezingabonakala yilezi:

• Ukushaya kwenhliziyo okusheshayo : Ijubane lokushaya kwenhliziyo lishesha kakhulu.
• Ukukhathala : Ingane izizwa ikhathele ngokushesha, ikakhulukazi lapho incelisa.
• Isikhumba esimpunga noma esikhanyayo : Ngezinye izikhathi isikhumba singaba luhlaza okwesibhakabhaka.
• Ukujuluka okukhulu .
• Ukukhala njalo, ukucasuka .
• Ukuphefumula okusheshayo noma okukhandlekayo .
• Inkinga ngokuncelisa: Uyenqaba ukuphuza ubisi, noma uyeka ngemva kokuphuza kancane.
• Ukushaya kwenhliziyo okubuthakathaka ezingxenyeni ezingezansi zomzimba : Ikakhulukazi emilenzeni, ukushaya kwenhliziyo emthanjeni we-femoral kuba buthakathaka kakhulu uma kushaywa.

Uma ingane yakho inesinye salezi zimpawu noma ngaphezulu, kubaluleke kakhulu ukuthola iseluleko sezokwelapha ngokushesha .

Kungani lokhu kwenzeka? Yiziphi izizathu?

I-AAH iyisifo senhliziyo esizalwa naso . Kuyinto eyenzeka ingane isesesibelethweni. Abacwaningi basazama ukuthola imbangela eqondile yalolu hlobo lwesifo senhliziyo esizalwa naso.

Kodwa okwaziwayo ukuthi lesi simo singaba khona uma i-aorta yomntwana ingakhuli kahle emasontweni ambalwa okuqala okukhulelwa .

Ukuthola kanjani lokhu? Yiziphi izivivinyo?

Odokotela basebenzisa lokhu ukuthola lesi simo.Ukuhlolwa kwezithombe okukhethekile. Lokhu kuhlolwa kuvame ukwenziwa ngokushesha nje ngemva kokuzalwa komntwana.

Ukuhlolwa okuyinhloko okusetshenziselwa ukuxilonga i-AAH yile:

• I-Cardiac Computed Tomography (i-CT scan)
• I-Magnetic Resonance Angiogram (MRA)
• I-Transthoracic Echocardiogram (TTE) : Lokhu kufana nokuskena kwenhliziyo nge-ultrasound.
• Ukufakwa kwe-Catheterization Yenhliziyo : Ngezinye izikhathi lokhu kuhlolwa nakho kuyadingeka.

Lezi zivivinyo zingabheka isakhiwo senhliziyo yengane, okungukuthi, indlela izingxenye zangaphakathi ezihlelwe ngayo, ngokuningiliziwe. Zingathola nokuthi ingane inazo yini ezinye izinkinga zenhliziyo. Kungokuqoqa lonke lolu lwazi lapho odokotela behlela khona ukwelashwa okufanele kakhulu kwengane.

Ukuze kutholakale ukuthi i-AAH ikhona yini, odokotela babheka usayizi we-aortic arch yengane. Ngokukhethekile, balinganisa ububanzi bayo, obuwububanzi bomgodi ongaphakathi. Lokhu kulinganiswa kuqhathaniswa nobubanzi bezinye izingxenye ze-aorta yengane (isibonelo, i-ascending aorta noma i-descending aorta). Lawa manani asetshenziselwa ukunquma ukuthi ububanzi be-aorta arch buncane kakhulu.

Ake sifunde kancane ngezingxenye ezahlukene ze-aotic arch.

Uma udokotela wengane yakho ekhuluma ngalesi simo, angase akhulume ngezingxenye ezahlukene ze-aortic arch. Ungase uzibuze, "Ingabe i-aortic arch ihlukana ibe ezinye izingxenye? Akuyona yini leyo ngxenye ye-aorta enkulu?" Yebo, lokho kuyiqiniso. I-aortic arch iyingxenye encane, "efana nomhlanga" we-aorta. Kodwa, njengazo zonke izingxenye ze-aorta, i-aortic arch inemithambo yegazi (imithambo yegazi) ehlukana ngezindlela ezahlukene. Njengoba nje umgwaqo omkhulu unemigwaqo eseceleni. Odokotela basebenzisa le mithambo yegazi ehlukene njengemingcele, bephawula lapho ingxenye ethile ye-aortic arch iqala futhi iphela khona. Le "mephu" iwusizo kakhulu ekuxilongeni i-AAH nasekuhleleni ukwelashwa.

Nazi ezinye zezingxenye ze-aural arch udokotela wengane yakho angase akhulume ngazo:

• I-Proximal Transverse Arch : Lokhu kutholakala phakathi kwe -Brachiocephalic Artery yomntwana (ngezinye izikhathi ebizwa ngokuthi i-Innominate Artery) kanye ne-Left Common Carotid Artery . Lena yingxenye eseduze nenhliziyo.
• I-Distal Transverse Arch : Lokhu kutholakala phakathi komthambo we-carotid ovamile wesobunxele kanye nomthambo we-subclavian wesobunxele .
• I-Aortic Isthmus : Lokhu kutholakala phakathi komthambo we-subclavian wesobunxele kanye nomthambo wegazi okukhulunywe ngawo ngaphambili obizwa ngokuthi i-Ductus Arteriosus .

Udokotela wengane yakho uzonquma ngqo ukuthi ukuncipha kukuphi e-aural arch yengane yakho, kanye nobukhulu bokuncipha. Lolu lwazi luzoqondisa uhlelo lokwelashwa.

Yiziphi izindlela zokwelapha lokhu?

Izinsana ezine-aortic arch engaphansi kwepulasitiki zizodinga ukuhlinzwa kwenhliziyo ukuze kulungiswe lesi simo. Udokotela ohlinza inhliziyo wengane yakho uzokuchazela ukuthi hlobo luni lokuhlinzwa ingane yakho ezoludinga. Inqubo yokuhlinzwa ingahluka kuye ngezinye izinkinga kanye nokwakheka kwenhliziyo yengane yakho. Kungase kudingeke wenze i -thoracotomy , okuwukusika okuncane okwenziwe ohlangothini lwesobunxele lwesifuba sengane yakho, noma i-sternotomy, okuwukusika okwenziwe phakathi kwesifuba.

Inqubo evamile yokuhlinzwa ibizwa ngokuthi i-resection ene-extended end-to-end anastomosis . Lokhu kuhlinzwa kuyasiza kakhulu ezinganeni ezine-coarctation ye-aorta kanye ne-aortic arch hypoplasia. Kule nqubo, udokotela ohlinzayo ususa ingxenye encane ye-aorta, athathe ingxenye engezansi ye-aorta (i-descending aorta), bese eyinamathisela ekusikeni okude kancane ku-aortic arch.

Ithemba lalokhu kuhlinzwa ukuthuthukisa ukugeleza kwegazi nge-aorta yengane, kuqinisekiswe ukuthi izitho nezicubu zengane zithola igazi elanele elinomoya-mpilo.

Liyini ithemba lokuthi ingane yami izolulama?

Impendulo engcono kakhulu kulo mbuzo udokotela wengane yakho. Ngoba inhlalakahle yengane incike ezintweni eziningi. Ikakhulukazi, ukuthi kukhona yini ezinye izinkinga zenhliziyo ezizalwa nazo kunomthelela omkhulu.

Ngokuvamile, izingane eziye zelashwa ngesimo esibizwa ngokuthi i-aotic arch hypoplasia zinethuba elikhulu lokuthola lezi zinkinga ezilandelayo kamuva ekuphileni:

• Ukuncipha okuphindaphindiwe kwe-aorta yabo .
• Umfutho wegazi ophezulu (i-Hypertension) .
• Ubunzima bokudla noma ukugwinya : Lokhu kungenzeka uma inzwa yonakele ngesikhathi sokuhlinzwa (lokhu akuvamile kakhulu).

Khuluma nodokotela wengane yakho ngalezi zingozi nokuthi ungazisingatha kanjani.

Ingabe lesi simo singavinjelwa?

Ukukhubazeka kwenhliziyo okubangelwa ukuzalwa njenge-hypoplastic aortic arch kungase kungabi yinto engavinjelwa ngokuphelele . Kodwa-ke, ukulandela iseluleko sikadokotela wakho ukuze ube nokukhulelwa okunempilo kungasiza ekunciphiseni ingozi yakho yokuthola lesi simo noma ezinye izinkinga.

Ngokuvamile, lezi zinto kufanele zigwenywe ngesikhathi sokukhulelwa:

• Utshwala .
• Gwema ukubhema, ukubhema i-vaping kanye nayo yonke imikhiqizo kagwayi . Futhi, gwema intuthu ebhemayo .
• Izidakamizwa ezingekho emthethweni, ikakhulukazi i-cocaine .

Futhi, eyakho.Kubaluleke kakhulu futhi ukuya njalo ekuhlolweni kwangaphambi kokubeletha. Uma unezinye izimo zempilo, funa iseluleko sezokwelapha ukuze uphathe lezo zimo ngaphambi nangesikhathi sokukhulelwa.

Ungamnakekela kanjani umntwana ngemva kokuhlinzwa?

Izidingo zomntwana ngamunye zingase zihluke ngemva kokuhlinzwa, ngakho-ke kungcono ukubuza ithimba lezokwelapha lengane yakho ukuthi ungayinakekela kanjani ingane yakho esikhathini esifushane neside.

Nazi ezinye imibuzo ongayibuza udokotela wakho:

• Kufanele ngiyinakekele kanjani ingane yami uma ngibuyela ekhaya?
• Ngimuphi umuthi okufanele ngiwunike ingane yami? Kufanele ngiwunike isikhathi esingakanani?
• Ingabe kukhona ukwelashwa okudingekayo ukusiza ukusebenza komzimba noma kwezinzwa kwengane?
• Ingabe kukhona imikhawulo emisebenzini yengane?
• Kuphephile nini ukuthumela ingane yami enkulisa? Yiziphi iziqondiso ezikhethekile okufanele ngiyinike zona?
• Ingabe ingane yami izodinga ukwelashwa okwengeziwe noma ukuhlinzwa?

Ukuba ngumzali kuhlale kuyinselele. Kodwa ukuhlala nengane enesifo senhliziyo njenge-hypoplastic aortic arch (AAH) kungaletha izinselele ezintsha nsuku zonke. Amanye amagama ashiwo odokotela kanye nezinhlelo zokwelapha kungase kubonakale kunzima ukuwaqonda. Lokho kujwayelekile, futhi awuwedwa. Buza udokotela wengane yakho ngezinsiza kanye namaqembu okusekela angakusiza. Ukwakha umphakathi wokusekela wena nomndeni wakho kungasiza ekunciphiseni ukucindezeleka futhi kukunike amandla okuqhubekela phambili nezidingo zengane yakho.

Masikhumbule nje lokho esikukhulume ngakho (Umyalezo Wokuya Ekhaya)

• I-Hypoplastic Aortic Arch (AAH) yisimo lapho i-arch ye-aorta, umthambo wegazi omkhulu enhliziyweni yomntwana, ingakhuli kahle, okuholela ekuncipheni kwe-arch.
• Lokhu kwenza kube nzima ukuthi igazi ligeleze lisuka enhliziyweni liye kwezinye izingxenye zomzimba.
• Lesi simo sivame ukubonakala kanye nesinye isifo senhliziyo esibizwa ngokuthi i-Coarctation of the Aorta .
• Izimpawu ezifana nokukhathala, ubunzima bokuphefumula, kanye nesikhumba esikhanyayo zingase zivele ekuqaleni kokuphila komntwana.
• Lesi simo singatholakala ngokuskena okukhethekile.
• Ukwelashwa ukuhlinzwa kwenhliziyo .
• Ukulandela imiyalelo yezokwelapha ngqo nokulandela ukulandelwa kwesikhathi eside ngemva kokuhlinzwa kubaluleke kakhulu.
• Ukulandela imikhuba enempilo ngesikhathi sokukhulelwa kunganciphisa ingozi yokukhubazeka okuthile kokuzalwa.
• Awuwedwa. Thola usizo kodokotela kanye namaqembu okusekela.

Sithemba ukuthi lolu lwazi luzokusiza. Sifisela ingane yakho ukululama okusheshayo!

I- Hypoplastic Aortic Arch, i-Aortic Arch Hypoplasia, ukukhubazeka kwenhliziyo okuzalwa nakho, ukuhlinzwa kwenhliziyo yengane, ukuhlangana kwe-aorta, izifo zenhliziyo yengane, ukuhlinzwa kwenhliziyo