Ukudibanisa i-aorta

I-aorta ithwala igazi lisuka entliziyweni liye kwiinqanawa ezihambisa umzimba ngegazi. Ukuba inxalenye ye-aorta iyancipha, kunzima ukuba igazi lidlule kwimithambo. Oku kubizwa ngokuba kukungqubana kwe-aorta. Luhlobo lwesiphene sokuzalwa.

Isizathu esona sizathu sokujikeleza kwe-aorta asiyazi. Iziphumo zokungaqhelekanga kuphuhliso lwe-aorta ngaphambi kokuzalwa.

I-aortic coarctation ixhaphake kakhulu kubantu abaneengxaki ezithile zemfuza, ezinjengeT Turner syndrome.

I-aortic coarctation yenye yeemeko zentliziyo eziqhelekileyo ezikhoyo ekuzalweni (iziphene zentliziyo yokuzalwa). Okungaqhelekanga kubangela malunga neepesenti ezi-5 zazo zonke iziphene zentliziyo yokuzalwa. Ihlala ichongwa kubantwana okanye kubantu abadala abangaphantsi kweminyaka engama-40.

Abantu abanalo ngxaki nge-aorta yabo banokuba nendawo ebuthathaka eludongeni lwemithambo yegazi kwingqondo yabo. Olu buthathaka lubangela ukuba isitya segazi sikhuphe okanye siphume ngaphandle. Oku kwaziwa njenge-aneurysm yeberry. Inokunyusa umngcipheko wokubetha.

Ukudibanisa i-aorta kunokubonwa nezinye iziphene zentliziyo yokuzalwa, ezinje:

• Ivalicic aortic ivelufa
• I-aortic stenosis
• Isiphene se-Ventricular septal
• Ipatent ductus arteriosus

Iimpawu zixhomekeke ekubeni lingakanani igazi elinokuhamba kumthambo. Ezinye iziphene zentliziyo zinokudlala indima.

Phantse isiqingatha sabantwana abasandul 'ukuzalwa abanengxaki baya kuba neempawu kwiintsuku zokuqala zobomi. Oku kunokubandakanya ukuphefumla ngokukhawuleza, iingxaki zokutya, ukwanda kokucaphuka, kunye nokulala okungalunganga okanye ukungaphenduli kakuhle. Kwiimeko ezinzima, usana lunokukhula ukusilela kwentliziyo kunye nokothuka.

Kwiimeko ezinzima, iimpawu zisenokungakhuli ade umntwana afikelele kwinqanaba lokufikisa. Iimpawu zibandakanya:

• Iintlungu zesifuba
• Iinyawo okanye imilenze ebandayo
• Ukuba nesiyezi okanye ukuphelelwa ngamandla
• Ukwehla kwamandla okwenza umthambo
• Ukungaphumeleli
• Iikram zomlenze ngokwenza umthambo
• Umphunga
• Ukukhula kakubi
• Intloko ebuhlungu
• Ukuqhawukelwa ngumphefumlo

Kusenokungabikho zimpawu.

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye ajonge uxinzelelo lwegazi kunye nokubetha ezingalweni nasemilenzeni.

• Ukubetha kwindawo ye-groin (femoral) indawo okanye iinyawo kuya kuba buthathaka kunokubetha kweengalo okanye entanyeni (carotid). Ngamanye amaxesha, ukubetha kwethokazi kusenokungavakali kwaphela.
• Uxinzelelo lwegazi emilenzeni kuhlala kubuthathaka kuneengalo. Uxinzelelo lwegazi luhlala luphezulu ezingalweni emva kobusana.

Umboneleli uya kusebenzisa i-stethoscope ukumamela intliziyo kwaye ajonge ukukhalaza. Abantu abane-aortic coarctation bahlala benesikhalazo esibuhlungu esinokuviwa phantsi kwethambo lekhola lasekhohlo okanye ngasemva. Ezinye iintlobo zokumbombozela zinokubakho.

Coarctation kudla ngokufunyanwa ngexesha loviwo lokuqala losana olusandul 'ukuzalwa okanye uviwo lweentsana. Ukuthatha ukubetha kwentsana yinxalenye ebalulekileyo yoviwo, kuba akunakubakho naziphi na ezinye iimpawu de umntwana abe mdala.

Uvavanyo lokufumanisa le meko lunokubandakanya:

• I-catheterization ye-Cardiac kunye ne-aortography
• I-x-ray yesifuba
• I-Echocardiography lolona vavanyo luqhelekileyo lokufumanisa le meko, kwaye inokusetyenziselwa ukubeka esweni umntu emva kotyando
• Intliziyo ye-CT inokufuneka kubantwana abadala
• I-MRI okanye i-MR angiography yesifuba inokufuneka kubantwana abadala

Zombini i-Doppler ultrasound kunye ne-catheterization yentliziyo inokusetyenziselwa ukubona ukuba ngaba akukho mahluko kuxinzelelo lwegazi kwiindawo ezahlukeneyo ze-aorta.

Uninzi lweentsana ezisanda kuzalwa ezineempawu ziya kwenziwa utyando kwangoko emva kokuzalwa okanye kungekudala emva koko. Baza kuqala bafumane amayeza okuzinzisa.

Abantwana abafunyaniswa xa sele bebadala kuya kufuneka batyandwe. Kwiimeko ezininzi, iimpawu azikho nzima kangako, kungade kuthathwe ixesha elininzi ukucwangcisa utyando.

Ngexesha lotyando, indawo encinci ye-aorta iya kususwa okanye ivulwe.

• Ukuba indawo yengxaki incinci, iziphelo ezibini zasimahla ze-aorta zinokuphinda zidityaniswe. Oku kubizwa ngokuba yi-anastomosis yokuphela kokuphela.
• Ukuba inxalenye enkulu ye-aorta isuswe, i-graft okanye enye yezigulane zesigulane zingasetyenziselwa ukuzalisa i-gap. Ukudibanisa kungenziwa ngumntu okanye kwi-cadaver.

Ngamanye amaxesha, oogqirha baya kuzama ukolula indawo emxinwa ye-aorta ngokusebenzisa ibhaluni eyandisiweyo ngaphakathi komthambo wegazi. Olu hlobo lwenkqubo lubizwa ngokuba yi-balloon angioplasty. Inokwenziwa endaweni yoqhaqho, kodwa inezinga eliphezulu lokusilela.

Abantwana abadala bahlala befuna amayeza ukunyanga uxinzelelo lwegazi oluphezulu emva kotyando. Abanye baya kufuna unyango lobomi bonke kule ngxaki.

Coarctation of aorta iyanyangeka ngotyando. Iimpawu zikhawuleza zibengcono emva kotyando.

Nangona kunjalo, kukho umngcipheko okhulayo wokufa ngenxa yeengxaki zentliziyo phakathi kwabo baye balungiswa i-aorta yabo. Ukulandelwa kobomi bonke nge-cardiologist kuyakhuthazwa.

Ngaphandle konyango, uninzi lwabantu lusweleka ngaphambi kweminyaka yobudala engama-40. Ngesi sizathu, oogqirha bahlala becebisa ukuba umntu enze utyando ngaphambi kweminyaka eyi-10. Amaxesha amaninzi, utyando ukulungisa ukungqubana lwenziwa ngexesha lobusana.

Ukunciphisa okanye ukudibanisa umthambo ungabuya emva kotyando. Oku kunokwenzeka ngakumbi kubantu abaye batyandwa njengosana olusandul 'ukuzalwa.

Iingxaki ezinokuthi zenzeke ngaphambi, ngexesha, okanye kungekudala emva kotyando zibandakanya:

• Indawo ye-aorta iba nkulu kakhulu okanye iibhaluni ziphume
• Ukulila eludongeni lwe-aorta
• Ukuqhekeka kwe-aorta
• Ukopha kwingqondo
• Ukuphuhliswa kwangoko kwesifo se-coronary disease (CAD)
• I-Endocarditis (usulelo entliziyweni)
• Ukumelwa yintliziyo
• Ukurhabaxa
• Iingxaki zezintso
• Ukukhubazeka kwesiqingatha esezantsi somzimba (ingxaki enqabileyo yotyando ukulungisa ukubola)
• Uxinzelelo lwegazi olunamandla
• Ukubetha

Iingxaki zexesha elide zibandakanya:

• Iyaqhubeka okanye iphindaphindwe ukunciphisa i-aorta
• Endocarditis
• Igazi elonyukayo

Fowunela umnikezeli wakho ukuba:

• Wena okanye umntwana wakho uneempawu zokubambezeleka kwe-aorta
• Ukhula isiqaqa okanye iintlungu zesifuba (ezi inokuba ziimpawu zengxaki enkulu)

Akukho ndlela yaziwayo yokuthintela esi sifo. Nangona kunjalo, ukwazi umngcipheko wakho kunokukhokelela ekuchongeni kwangoko kunye nonyango.

Ukudibana kweAortic

• Ukuhlinzwa kwentliziyo yabantwana-ukukhutshwa

• Ukudibanisa i-aorta

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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 Saunders; I-2019: isahluko 75.