Ingabe ivalvu ye-aorta yenhliziyo yakho inesivalo esisodwa? (Ivalvu ye-aorta ye-Unicuspid) - Ake sixoxe ngalokhu!

Ngezinye izikhathi sizwa kuthiwa, 'O, ingane yami inenkinga encane yenhliziyo, yazalwa inokukhala kwenhliziyo'? Noma, lapho umuntu osemusha enenkinga yokuphefumula noma ubuhlungu besifuba, odokotela bathi, 'Kunenkinga encane nge-valve yenhliziyo.' Yileyo ndlela esizokhuluma ngayo ngesimo senhliziyo esingavamile kakhulu, kodwa okubaluleke kakhulu ukwazi ngaso.

Iyini le valve ye-aortic enepheshana elilodwa (`I-Unicuspid Aortic Valve`)?

Kalula nje, ivalvu ye-aorta enhliziyweni yakho inencwajana eyodwa kuphela esikhundleni sezintathu ezivame ukuba nazo. Igama elithi "unicuspid" lisho "incwajana eyodwa." Cabanga ngayo njengomnyango onokhiye owodwa kuphela esikhundleni sezimbili.

Lawa mapheshana afana neminyango emincane. Ayavuleka futhi avalwe ukuze igazi elihlanzekile, eligcwele umoya-mpilo lidlule lisuka e-ventricle yesobunxele yenhliziyo - igumbi lesobunxele phansi kwenhliziyo - liye e-aorta . I-aorta bese ipompa igazi emzimbeni wonke. Ngakho-ke, lapho inani lamapheshana kule valve lehla, kungaba nezithiyo ezincane ekugelezeni kwegazi.

Abanye abantu abanalesi simo, i-Unicuspid Aortic Valve, bangase babe nezinye izinkinga zenhliziyo. Isibonelo:

• I-Aorta : Lokhu kusho ubuthakathaka ezindongeni ze-aorta.
• I-Ventricular Septal Defect (VSD) : Imbobo odongeni phakathi kwamakamelo amabili aphansi enhliziyo.
• I-Patent Ductus Arteriosus (PDA) : Umthambo wegazi obekufanele uvaleke ngemva kokuzalwa uhlala uvulekile.
• I-Coronary Artery Anomalies : Izinguquko ezithile emithanjeni yegazi ezihlinzeka ngegazi enhliziyweni.

Lesi yisimo esingavamile kakhulu. Sithinta cishe u-0.02% wabantu bonke. Futhi, sivame kakhulu kwabesilisa.

Ingabe zikhona izinhlobo zalokhu?

Yebo, kunezinhlobo ezimbili eziyinhloko ze-"Unicuspid Aortic Valve". Umehluko phakathi kwalezi zinhlobo ezimbili igebe lapho amapheshana amabili (amapheshana) exhuma khona odongeni lwe-valve, olubizwa ngokuthi "i-Commissure" . Ungakuqonda lokhu kanje. Cabanga ukuthi izindebe zakho zinamathele unomphela ebusweni bakho, kodwa zingahlangana futhi zihlukane, akunjalo? Yilokho okushiwo yi-"Commissure".

Lezi zinhlobo ezimbili yilezi:

1. Uhlobo lwe-Acommissural: Lolu uhlobo olunzima kakhulu . Kulesi simo, akukho commissure, okungukuthi, akukho gap. Futhi aluxhunyiwe ku-aorta. Amapheshana anamathele ndawonye, ​​cishe sengathi ahlanganiswe ndawonye. Igazi ligeleza kuphela ngembobo encane, njengembobo encane.

2. Uhlobo lwe-Unicommissural:Lokhu akukubi kangako kunenye, futhi futhi uhlobo oluvame kakhulu . Lune-"Commissure" eyodwa, okungukuthi, igebe elilodwa. Luxhunywe ne-aorta. Uma lolu hlobo lwevalvu luvuliwe, lubukeka njengomugqa. Abanye abantu baluqhathanisa nomlomo wenhlanzi.

Yiziphi izimpawu ozibonayo?

Uma umuntu omdala enalesi simo (i-Unicuspid Aortic Valve), izimpawu ezivame ukubonakala yilezi:

• Ukuphelelwa umoya : Uma ukhathele kancane, ungase uzizwe sengathi uzoquleka lapho ukhuphuka izitebhisi.
• Ukuzungeza : Uma usukuma ngokuzumayo, ungase uzizwe uzungeza.
• I-Angina : Lokhu kuwukuzwa ubuhlungu noma ukuqina esifubeni. Kwabanye abantu, lokhu kungasakazekela emhlathini, entanyeni, noma ngisho nasezingalweni.
• Ukuquleka/ukuquleka : Ukulahlekelwa ingqondo ngokuzumayo.

Izingane ezincane ezinalesi simo zivame ukuba nezimo ezifana nokwehluleka kwenhliziyo ohlangothini lwesobunxele . Zivame futhi ukwehlisa isisindo njengabanye abantwana abangontanga yazo, okusho ukuthi azitholi isisindo esiningi kakhulu.

Uhlobo lwe- "Acommissural" olushiwo ngaphambilini, oluwuhlobo olunzima kakhulu, lubonisa izimpawu ezinganeni ezincane kakhulu . Kodwa labo abanohlobo lwe- "Unicommissural" bangase bangakhombisi zimpawu baze babe neminyaka engu-20 noma engu-30 ubudala, okungukuthi, baze bafinyelele ebudaleni obusha.

Kungani lokhu kwenzeka? Iyini imbangela?

Lesi simo, esibizwa ngokuthi ``Unicuspid Aortic Valve'', senzeka lapho amapheshana amathathu okufanele akheke ngokuvamile eqala ukukhula ngenkathi umntwana esesesibelethweni, bese esikhundleni sokuba ahlukane, ehlangana abe yinto eyodwa. Lokhu kwenzeka ngaphambi kokuba umntwana azalwe .

Nakuba abacwaningi bengakakuqinisekisi lokhu ngokuqinisekile, basola ukuthi lokhu kungaba "isimo esizuzwe njengefa." Lokho kusho ukuthi kungase kube nethonya lezakhi zofuzo.

Yiziphi izinkinga ezingabangelwa yilokhu?

Umuntu one-valve ye-aortic ye-unicuspid angase abe nezinkinga ezahlukahlukene ngokuhamba kwesikhathi. Eziyinhloko yilezi:

• I-Aortic valve stenosis : Lokhu kwenzeka lapho i-valve ingavuli kahle, okuvimba ukugeleza kwegazi. Lokhu kubangela inhliziyo ukuthi isebenze kanzima ukupompa igazi.
• Ukubuyiselwa kwevalvu yomthambo i-aorta: Ivalvu ayivali kahle, okwenza ukuthi igazi elimpompiwe liphinde livuze enhliziyweni.
• I-Infective Endocarditis : Ukutheleleka kolwelwesi lwenhliziyo, ikakhulukazi ama-valve. Abantu abane-valve engajwayelekile basengozini enkulu.
• Ingozi eyengeziwe yokuhlukaniswa kwe-Aortic : Lesi yisimo esiphuthumayo nesinzima lapho udonga lwe-aorta luqhekeka ngaphakathi.

Okubalulekile: Kubaluleke kakhulu ukuxilonga nokwelapha lesi sifo ngesikhathi, ngaphambi kokuba kuvele lezi zinkinga.

Ukuthola kanjani lokhu?

Uma uya kudokotela, uzolalela inhliziyo yakho nge-stethoscope ngesikhathi sokuhlolwa kwakho ngokomzimba . Uma udokotela ezwa umsindo wenhliziyo ongajwayelekile ("ukububula kwenhliziyo") eduze kwe-aorta yakho, angase akusole lokhu. Ngemuva kwalokho, angase akuncomele ukuhlolwa okwengeziwe.

Yiziphi izivivinyo ezenziwayo?

Ukuhlolwa okuyinhloko okwenziwa ukuqinisekisa ngokunembile ukuba khona kwalesi simo se-"Unicuspid Aortic Valve" yile:

• I-Transthoracic Echocardiogram (TTE) : Lokhu kufana nokuskena kwenhliziyo nge-ultrasound. Kwenziwa ebusweni besifuba. Kungahlola kangcono ukuma kwenhliziyo kanye nomsebenzi wama-valve ayo.
• I-Transesophageal Echocardiogram (TEE) : Lokhu futhi kuyi-echocardiogram. Kodwa-ke, kufakwa ithubhu elincane ngomphimbo bese inhliziyo ibukwa ngombhobho. Lokhu kungaveza izithombe ezicacile kune-TTE.
• I-Cardiac Computed Tomography (CT) scan : Lokhu kungaveza izithombe ze-3D zenhliziyo kanye ne-aorta ezihlukaniswe ngezigaba.
• I-Heart MRI (I-Magnetic Resonance Imaging) : Lokhu kunganikeza nolwazi oluningiliziwe mayelana nesakhiwo kanye nomsebenzi wenhliziyo.

Iphathwa kanjani?

Ukwelashwa kwalokhu kuyahlukahluka ngokweminyaka kanye nobukhulu bezimpawu.

Izindlela zokwelapha ezivamile zezingane ezincane yilezi:

• I-Valvotomy Yokuhlinzwa : Lokhu kuhilela ukwenza ukuhlinzwa ukuze kusikwe izicubu ze-valve ezinamathele ndawonye nokudala amapheshana amasha.
• I-Valvuloplasty : Lokhu kuhilela ukusebenzisa into efana nebhaluni ukuvula ivalvu.
• I-Commissurotomy : Ukuhlukaniswa kokuhlinzwa kwe-"Commissure", lapho ama-flaps ehlanganiswa khona.
• Inqubo kaRoss : Lokhu ukuhlinzwa okuyinkimbinkimbi kancane. Sizoxoxa kabanzi ngalokhu kamuva.

Kubantu abadala , ukuhlinzwa kuvame ukudingeka ukuze kulungiswe ivalvu ye-aortic (Unicuspid Aortic Valve repair) noma kufakwe ivalvu entsha (esishintshayo) .

Ingabe kukhona imiphumela emibi/izinkinga zokwelashwa?

Njenganoma yikuphi ukuhlinzwa, kunezinkinga ezithile ezingaba khona ngalolu hlobo lokwelashwa. Kodwa akuwona wonke umuntu ozobhekana nalokhu. Ungakhathazeki, udokotela wakho uzokugcina unolwazi oluhle ngalokhu.

Ezinye zezinkinga ezivamile ezingaba khona yilezi:

• Ukutheleleka
• Amahlule egazi
• Ukopha ngokweqile (`Ukopha`)
• I-Endocarditis (ukutheleleka kwe-valve)
• Izinkinga ngesichibi esisetshenziswa ekulungiseni amavalvu.
• Ukuvimba Kwenhliziyo Okuphelele : Ukuphazamiseka kokudluliselwa kwesignali kagesi yenhliziyo.
• Isifo senhliziyo
• Igazi eliphuma ku-valve liye ohlangothini olungafanele.
• Isigqi Senhliziyo Esingavamile

Kuthatha isikhathi esingakanani ukuphulukiswa?

Lokhu kuzohluka kuye ngohlobo lwenqubo oyenzile. Kungathatha noma yikuphi kusukela ngesonto kuya ezinyangeni eziningana ukuze ululame. Udokotela wakho uzokutshela ukuthi udinga ukuphumula isikhathi esingakanani nokuthi ungaqhubeka nini nemisebenzi evamile.

Impilo izoba njani ngalesi simo?

Uma une-Unicuspid Aortic Valve, cishe uzodinga ukuhlinzwa . Eqinisweni, kungase kudingeke ukuthi i-valve yakho ilungiswe noma ishintshwe izikhathi ezingaphezu kwesisodwa empilweni yakho. Ungase ube nezinye izinkinga zenhliziyo. Ungase futhi udingeke uqhubeke nokuthatha imithi yokunciphisa igazi (ama-anticoagulant) ngemva kokuhlinzwa, kuye ngohlobo lwe-valve onayo.

Kodwa kufanele futhi kushiwo ukuthi le "Unicuspid Aortic Valve" akuyona into ezolulama ngokuzenzakalelayo . Isimo sihlala sifana kuze kube yilapho uhlinzwa ukuze silungiswe.

Kunezindaba ezinhle. Ucwaningo olulodwa luthole ukuthi abantu abangu-97% abahlinzwa i-aortic valve ngenxa yesimo esibizwa ngokuthi "i-Unicuspid Aortic Valve" babesaphila eminyakeni eyi-10 kamuva .

Kodwa-ke, kukhona nombono wokuthi uma umuntu ongaphansi kweminyaka engama-65 ubudala enikwa i-prosthetic aortic valve ngenxa yalesi simo, kunganciphisa isikhathi sokuphila ngeminyaka engaphezu kweyi-10. Yingakho abacwaningi bethi i-Ross Procedure ilungele abantu abasebasha, abakhuthele. Kule nqubo "ye-Ross", uthatha i-pulmonary valve yakho bese uyifakela endaweni lapho kukhona i-aortic valve enesifo. Ngemuva kwalokho, i-pulmonary homograft evela kumuntu oshonile ifakelwa endaweni lapho kwakukhona i-pulmonary valve esusiwe. Nakuba lokhu kuyinkimbinkimbi kancane, kuthiwa imiphumela mihle.

Yini ofuna ukuyenza wena?

Ngemva kokuhlinzwa, kufanele ulandele imiyalelo kadokotela wakho ngokucophelela mayelana nendlela yokunakekela ukusikwa/ukusikwa kwakho . Uzokutshela nokuthi udinga ukuphumula isikhathi esingakanani nokuthi ungaqala nini ukushayela kanye neminye imisebenzi yansuku zonke.

Ungakhohlwa: Kubaluleke kakhulu ukuphuza imithi yakho ngesikhathi, njengoba udokotela ekuyalele, nokuya emtholampilo ngezinsuku ezihleliwe.

Ngezinye izikhathi ucabanga ukuthi, "O, angikakhuli ngokwanele ukuba ngithole isifo senhliziyo," kodwa usenezinhlungu esifubeni kanye nobunzima bokuphefumula.Uma unezinye zalezi ezilandelayo, qiniseka ukuthi ubona udokotela. Ngemva kokuhlinzwa kwe-Unicuspid Aortic Valve, uzoqhubeka nokubonana nodokotela wakho ngokulandelana . Uma kuvela inkinga (njengokutheleleka) ngemva kokuhlinzwa, ungadinga ukwelashwa okuphuthumayo.

Yimiphi imibuzo okufanele uyibuze udokotela?

Uma uya kudokotela, ungesabi ukubuza noma yimiphi imibuzo onayo. Nansi eminye imibuzo ongayibuza:

• Yikuphi ukwelashwa okungcono kakhulu kimi?
• Yimuphi umehluko phakathi kwezinhlobo ezahlukene zokufakwa esikhundleni kwamavalvu? (okungukuthi, ivalvu yokwenziwa uma kuqhathaniswa ne-biovalve)
• Kudingeka ngihlinzwe ngokushesha kangakanani?
• Ivalvu esanda kufakwa ihlala isikhathi esingakanani?

Uma uzwa ukuthi kukhona okuthile enhliziyweni yakho okungasebenzi kahle, akulula. Kodwa-ke, ngokuhamba kwesikhathi, odokotela baye bathuthukisa izindlela zokwelapha ezingcono zalesi simo. Khuluma nodokotela wakho ngokuthi yini engcono kakhulu kuwe. Njengoba lesi kuyisimo esingavamile , kungcono kakhulu ukuthola udokotela onolwazi ngaso. Isibonelo, abacwaningi bathi udokotela ohlinzayo kufanele enze okungenani izinqubo ezingu-15 zikaRoss ngonyaka.

Okokugcina, into ebaluleke kakhulu okufanele uyikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke ngithemba ukuthi usuyaqonda kahle lesi sifo senhliziyo esibizwa ngokuthi `(Unicuspid Aortic Valve)` esikhulume ngaso namuhla. Khumbula, lokhu kuyinto ezalwa nayo futhi engabonakali kakhulu. Kodwa-ke, uma uxilongwe kahle futhi welashwa ngesikhathi, ungaphila impilo enhle . Uma wena noma othile omaziyo enalezi zimpawu, ungesabi ukubona udokotela futhi uthole iseluleko. Ikakhulukazi, kubaluleke kakhulu ukuthola ukwesekwa kwethimba lezokwelapha elinolwazi lapho welapha izimo ezinjalo ezingavamile. Nakekela inhliziyo yakho. Iyigugu eliyigugu kakhulu empilweni yakho!

Isifo Senhliziyo , I-Aortic Valve, I-Unicuspid Aortic Valve, Ukuhlinzwa Kwenhliziyo, Isifo Senhliziyo Esizalwa Naso, Ukuphelelwa Ukuphefumula, Ubuhlungu Besifuba