Isiphene se-Atrial septal (ASD)

Isiphene se-Atrial septal (ASD) sisiphene sentliziyo esivela ekuzalweni (kokuzalwa).

Njengokuba umntwana ekhula esibelekweni, udonga (i-septum) lwenza ukwahlula igumbi eliphezulu kwi-atrium yasekhohlo nasekunene. Xa olu donga lungemanga ngokuchanekileyo, kunokubangela isiphene esihlala sikhona emva kokuzalwa. Oku kubizwa ngokuba sisiphene se-atrial septal, okanye i-ASD.

Ngokwesiqhelo, igazi alinakuhamba phakathi kwamagumbi amabini aphezulu entliziyo. Nangona kunjalo, iASD iyakuvumela oku ukuba kwenzeke.

Xa igazi lihamba phakathi kwamagumbi amabini entliziyo, oku kubizwa ngokuba yi-shunt. Igazi lihlala lihamba ukusuka ekhohlo liye ngasekunene. Xa oku kusenzeka icala lasekunene lentliziyo liyakhula. Ngokuhamba kwexesha uxinzelelo kwimiphunga lunokwakha. Xa oku kusenzeka, igazi elihamba ngesiphene liya kuthi ke liye ekunene ukuya ekhohlo. Ukuba oku kuyenzeka, kuya kubakho ioksijini encinci egazini eliya emzimbeni.

Iziphene ze-septal septal zichazwa njenge-primum okanye secundum.

• Iziphene zeprimum zidityaniswe nezinye iziphene zentliziyo ye-ventricular septum kunye ne-mitral valve.
• Iziphene zeSecundum zinokuba ngumngxunya omnye, omncinci okanye omkhulu. Banokuba ngaphezulu komngxunya omnye omncinci kwi-septum okanye eludongeni phakathi kwamagumbi amabini.

Iziphene ezincinci (ezingaphantsi kweemilimitha ezi-5 okanye ii-intshi ¼) azifane zibangele iingxaki. Iziphene ezincinci zihlala zifunyanwa kamva ebomini kunezinkulu.

Kunye nobungakanani be-ASD, apho isiphene sikhona sidlala indima echaphazela ukuhamba kwegazi kunye nenqanaba leoksijini. Ubukho bezinye iziphene zentliziyo kubalulekile.

I-ASD ayiqhelekanga.

Umntu ongenaso nasiphi na isiphene sentliziyo, okanye isiphene esincinci (esingaphantsi kweemilimitha ezi-5) usenokungabi nazimpawu, okanye iimpawu zingenakwenzeka kude kube phakathi kweminyaka okanye kamva.

Iimpawu ezenzekayo zingaqala nanini na emva kokuzalwa komntwana. Banokubandakanya:

• Ubunzima bokuphefumla (iDyspnea)
• Izifo ezenzeka rhoqo zokuphefumla ebantwaneni
• Ukuziva ukubetha kwentliziyo (ukubetha kwentliziyo) kubantu abadala
• Ukuphefumla okufutshane kunye nomsebenzi

Umboneleli wezempilo uyakujonga ukuba lukhulu kwaye lubi kangakanani iASD esekwe kwiimpawu, uvavanyo lomzimba, kunye neziphumo zovavanyo lwentliziyo.

Umboneleli unokuva izandi zentliziyo engaqhelekanga xa umamele isifuba ngestethoscope. Ukumbombozela kunokuviwa kuphela kwizikhundla ezithile zomzimba. Ngamanye amaxesha, ukumbombozela akunakuviwa konke konke. Ukumbombozela kuthetha ukuba igazi alihambi ngaphakathi entliziyweni ngokutyibilikayo.

Uvavanyo lomzimba lunokubonisa iimpawu zokungaphumeleli kwentliziyo kwabanye abantu abadala.

I-echocardiogram luvavanyo olusebenzisa amaza esandi ukwenza umfanekiso ohambayo wentliziyo. Kuhlala kuvavanyo lokuqala olwenziweyo. Uphononongo lweDoppler olwenziwe njengenxalenye ye-echocardiogram luvumela umboneleli wezempilo ukuba avavanye inani lokungxama kwegazi phakathi kwamagumbi entliziyo.

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• Ukucinywa kwentliziyo
• I-Coronary angiography (kwizigulana ezingaphezulu kweminyaka engama-35)
• ECG
• Intliziyo ye-MRI okanye i-CT
• I-transesophageal echocardiography (TEE)

I-ASD isenokungadingi nyango ukuba zimbalwa okanye azikho kwaukubakho iimpawu zayo, okanye ukuba isiphene sincinci kwaye asidibani nokunye okungaqhelekanga. Utyando lokuvala isiphene luyacetyiswa ukuba isiphene sibangela isixa esikhulu sokuyeka, intliziyo idumbile, okanye iimpawu zenzeka.

Inkqubo iye yaphuhliswa ukuvala isiphene (ukuba akukho okunye okukhoyo okukhoyo) ngaphandle kotyando lwentliziyo oluvulekileyo.

• Inkqubo ibandakanya ukubeka isixhobo sokuvalwa kwe-ASD entliziyweni ngokusebenzisa iityhubhu ezibizwa ngokuba zii-catheters.
• Umboneleli ngononophelo lwempilo usika kancinci kwi-groin, emva koko afaka i-catheters kwisitya segazi kwaye inyuke iye entliziyweni.
• Isixhobo sokuvala sibekwa kuyo yonke i-ASD kwaye isiphene sivaliwe.

Ngamanye amaxesha, utyando lwentliziyo evulekileyo lunokufuneka ukulungisa isiphako. Uhlobo lotyando luyafuneka ngakumbi xa kukho ezinye iziphene zentliziyo.

Abanye abantu abaneziphene ze-septal septal banokukwazi ukwenza le nkqubo, kuxhomekeke kubungakanani kunye nendawo yesiphene.

Abantu abanenkqubo okanye utyando lokuvala iASD kufuneka bafumane amayeza okubulala iintsholongwane ngaphambi kwenkqubo yamazinyo abanayo kwithuba elilandelayo lenkqubo. Amayeza okubulala iintsholongwane awafuneki kamva.

Kwiintsana, ii-ASD ezincinci (ezingaphantsi kwe-5 mm) azisoloko zibangele iingxaki, okanye ziya kuvalwa ngaphandle konyango. Ii-ASD ezinkulu (8 ukuya kwi-10 mm), zihlala zingavali kwaye zingadinga inkqubo.

Izinto ezibalulekileyo zibandakanya ubungakanani besiphene, ubungakanani begazi elongezelelekileyo elihamba kuvulwe, ubungakanani becala lasekunene lentliziyo, nokuba umntu unazo naziphi na iimpawu.

Abanye abantu abane-ASD banokuba nezinye iimeko zentliziyo yokuzalwa. Oku kunokubandakanya ivalvu evuzayo okanye umngxuma kwenye indawo yentliziyo.

Abantu abane-ASD enkulu okanye enzima kakhulu basemngciphekweni wokonyuka kwezinye iingxaki, kubandakanya:

• Iingqungquthela zentliziyo engaqhelekanga, ngakumbi i-fibrillation ye-atrial
• Ukumelwa yintliziyo
• Usulelo lwentliziyo (endocarditis)
• Uxinzelelo lwegazi oluphezulu kwimithambo yemiphunga
• Ukubetha

Fowunela umboneleli wakho ukuba uneempawu zesiphene se-atrial septal.

Akukho ndlela yaziwayo yokuthintela isiphene. Ezinye zeengxaki zinokuthintelwa ngokufumanisa kwangoko.

Isiphene sentliziyo esibelekwe - ASD; Isiphene sentliziyo yokuzalwa - ASD; IPrimum ASD; ISecundum ASD

• Ukuhlinzwa kwentliziyo yabantwana-ukukhutshwa

• Isiphene se-Atrial septal

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I-Silvestry FE, iCohen MS, iArmsby LB, et al. Izikhokelo zovavanyo lwe-echocardiographic yovavanyo lwe-atrial septal kunye ne-patent foramen ovale: evela kwi-American Society ye-Echocardiography kunye noMbutho weCardiac Angiography kunye nongenelelo. J NdinguSoc Echocardiogr. 2015; 28 (8): 910-958. IINKCUKACHA: 26239900 pubmed.ncbi.nlm.nih.gov/26239900/.

Sodhi N, Zajarias A, Balzer DT, Lasala JM. Ukuvalwa okwenziwe ngamandla kwepatent formen ovale kunye ne-septal septal defect. Ku: I-Topol EJ, iTeirstein PS, ii-eds. Incwadi yeNdlela yokuNgenelela kweCardiology. Ngomhla we-8. IPhiladelphia, PA: Elsevier; 2020: isahluko 49.

IWebb GD, i-Smallhorn JF, iTherrien J, iRedington AN. Isifo sentliziyo esibelekwe kumntu omkhulu nakwisigulana sabantwana. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 75.