Ukuhlangana kwe-aorta

I-aorta ithwala igazi lisuke enhliziyweni liyise ezitsheni ezihambisa umzimba ngegazi. Uma ingxenye ye-aorta incishisiwe, kunzima ukuthi igazi lidlule emthanjeni. Lokhu kubizwa ngokuthi yi-coarctation ye-aorta. Luhlobo lokukhubazeka kokuzalwa.

Isizathu esiqondile sokuquqa kwe-aorta asikaziwa. Kubangelwa ukungajwayelekile ekukhuleni kwe-aorta ngaphambi kokuzalwa.

I-aortic coarctation ivame kakhulu kubantu abanezinkinga ezithile zofuzo, njenge-Turner syndrome.

I-aortic coarctation ingesinye sezimo zenhliziyo ezivame kakhulu ezikhona lapho kuzalwa (ukukhubazeka kwenhliziyo yokuzalwa). Lokhu okungajwayelekile kubanga cishe u-5% wakho konke ukukhubazeka kwenhliziyo okuzelwe. Kuvame ukutholakala ezinganeni noma kubantu abadala abangaphansi kweminyaka engama-40.

Abantu abanenkinga nge-aorta yabo bangaba nendawo ebuthakathaka odongeni lwemithambo yegazi ebuchosheni babo. Lobu buthakathaka budala ukuthi umthambo wegazi uqhume noma ubhalise. Lokhu kwaziwa njenge-aneurysm yamajikijolo. Kungakhuphula ubungozi bokushaywa unhlangothi.

Ukuhlangana kwe-aorta kungabonakala nokunye ukukhubazeka kwenhliziyo okuzalwa, njenge:

• I-bicuspid aortic valve
• I-aortic stenosis
• Isici se-septal se-Ventricular
• I-patent ductus arteriosus

Izimpawu zincike ekutheni lingakanani igazi elingagobhoza emthanjeni. Okunye ukukhubazeka kwenhliziyo nakho kungadlala indima.

Cishe uhhafu wezinsana ezisanda kuzalwa onale nkinga zizoba nezimpawu ezinsukwini ezimbalwa zokuqala zokuphila. Lokhu kungabandakanya ukuphefumula ngokushesha, izinkinga zokudla, ukucasula okwandayo, nokwanda kokulala noma ukungaphenduli kahle. Ezimweni ezimbi kakhulu, usana lungaqala ukuhluleka kwenhliziyo nokwethuka.

Ezimweni ezinzima, izimpawu zingase zingakhuli ingane ize ifinyelele ebusheni. Izimpawu zifaka:

• Ubuhlungu besifuba
• Izinyawo noma imilenze ebandayo
• Isizungu noma ukuquleka
• Ukwehla kwekhono lokuzivocavoca umzimba
• Ukwehluleka ukuchuma
• Amajaqamba omlenze ngokuzivocavoca umzimba
• Wakhala igazi
• Ukukhula okubi
• Ikhanda elibuhlungu
• Ukuphelelwa umoya

Kungase kungabikho zimpawu.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa ngokomzimba bese ehlola umfutho wegazi nokushaya kwenhliziyo ezingalweni nasemilenzeni.

• Ukushaya kwenhliziyo endaweni yezimbilapho (kwesifazane) noma ezinyaweni kuzoba buthakathaka kunokudonswa yizingalo noma kwentamo (carotid). Kwesinye isikhathi, ukushaya kwesibindi kungazwakala nhlobo.
• Umfutho wegazi emilenzeni uvame ukuba buthakathaka kunezingalo. Umfutho wegazi uvame ukuba phezulu ezingalweni ngemuva kobuntwana.

Umhlinzeki uzosebenzisa i-stethoscope ukulalela inhliziyo futhi ahlole ukububula. Abantu abane-coarctation ye-aortic bavame ukuba nokukhononda okunomsindo okungazwakala ngaphansi kwethambo lekhola langakwesobunxele noma ngemuva. Ezinye izinhlobo zokububula nazo zingaba khona.

I-coarctation ivame ukutholwa ngesikhathi sokuhlolwa kokuqala kosana olusanda kuzalwa noma ukuhlolwa kwengane enhle. Ukuthatha ishaya emntwaneni kuyingxenye ebalulekile yokuhlolwa, ngoba kungenzeka zingabi khona ezinye izimpawu kuze kube yilapho ingane isikhulile.

Ukuhlolwa kokuthola lesi simo kungafaka:

• I-catheterization yenhliziyo kanye ne-aortography
• I-x-ray yesifuba
• I-Echocardiography isivivinyo esivame kakhulu ukuthola ukuthi unalesi sifo, futhi singasetshenziswa ukuqapha umuntu ngemuva kokuhlinzwa
• I-Heart CT ingadingeka ezinganeni ezindala
• I-MRI noma i-MR angiography yesifuba ingadingeka ezinganeni ezindala

Kokubili i-Doppler ultrasound ne-catheterization yenhliziyo kungasetshenziswa ukubona ukuthi kukhona yini ukungafani kwengcindezi yegazi ezindaweni ezahlukahlukene ze-aorta.

Iningi lezinsana ezisanda kuzalwa ezinezimpawu zizohlinzwa ngemuva nje kokuzalwa noma ngemuva nje kwalokho. Bazothola kuqala imithi ezobazinzisa.

Izingane ezitholwa uma sezikhulile nazo zizodinga ukuhlinzwa. Ezimweni eziningi, izimpawu azinzima kangako, ngakho-ke isikhathi esiningi singathathwa ukuhlela ukuhlinzwa.

Ngesikhathi sokuhlinzwa, ingxenye encane ye-aorta izosuswa noma ivulwe.

• Uma indawo enenkinga incane, imingcele emibili yamahhala ye-aorta ingaxhunywa kabusha. Lokhu kubizwa ngokuthi i-anastomosis yokuphela kokuphela.
• Uma kususwa ingxenye enkulu ye-aorta, kungaxhunyelelwa noma ngeminye imithambo yesiguli ukuvala igebe. Ukuxhunyelelwa kungenziwa ngumuntu noma ku-cadaver.

Kwesinye isikhathi, odokotela bazozama ukwelula ingxenye enciphile ye-aorta ngokusebenzisa ibhaluni enwetshiwe ngaphakathi komthambo wegazi. Lolu hlobo lwenqubo lubizwa nge-balloon angioplasty. Kungenziwa esikhundleni sokuhlinzwa, kepha kunezinga eliphakeme lokwehluleka.

Izingane ezindala ngokuvamile zidinga imithi yokwelapha umfutho wegazi ophezulu ngemuva kokuhlinzwa. Abanye bazodinga ukwelashwa impilo yonke kule nkinga.

Ukubumbana kwe-aorta kungalapheka ngokuhlinzwa. Izimpawu ziba ngcono ngokushesha ngemuva kokuhlinzwa.

Kodwa-ke, kunengozi eyengeziwe yokufa ngenxa yezinkinga zenhliziyo phakathi kwalabo abalungiswe i-aorta yabo. Ukulandela impilo yonke nodokotela wenhliziyo kuyakhuthazwa.

Ngaphandle kokwelashwa, abantu abaningi bafa ngaphambi kweminyaka yobudala engama-40. Ngalesi sizathu, odokotela bavame ukuncoma ukuthi umuntu ahlinzwe ngaphambi kweminyaka yobudala eyi-10. Esikhathini esiningi, ukuhlinzekelwa ukulungisa ubumbano lwenziwa ngesikhathi sasebuntwaneni.

Ukunciphisa noma ukujiya komthambo kungabuya ngemuva kokuhlinzwa. Lokhu kungenzeka kakhulu kubantu abahlinzwa njengengane esanda kuzalwa.

Izinkinga ezingenzeka ngaphambi, ngesikhathi, noma ngokushesha ngemuva kokuhlinzwa zifaka:

• Indawo ye-aorta iba nkulu kakhulu noma ibhaluni iphume
• Izinyembezi odongeni lwe-aorta
• Ukudabuka kwe-aorta
• Ukopha ebuchosheni
• Ukuthuthukiswa kokuqala kwesifo se-coronary artery (CAD)
• I-Endocarditis (ukutheleleka enhliziyweni)
• Ukwehluleka kwenhliziyo
• Ukungahambi kahle
• Izinkinga zezinso
• Ukukhubazeka kwengxenye engezansi yomzimba (inkinga engajwayelekile yokuhlinzwa yokulungisa ukujiya komzimba)
• Umfutho wegazi ophezulu
• Unhlangothi

Izinkinga zesikhathi eside zifaka:

• Ukuqhubeka noma ukuphindaphindwa kwe-aorta
• I-Endocarditis
• Umfutho wegazi ophezulu

Shayela umhlinzeki wakho uma:

• Wena noma ingane yakho unezimpawu zokuhlangana kwe-aorta
• Uba nobuhlungu bokuquleka noma besifuba (lokhu kungaba yizimpawu zenkinga enkulu)

Ayikho indlela eyaziwayo yokuvimbela lesi sifo. Kodwa-ke, ukwazi ngengozi yakho kungaholela ekutholakaleni nokwelashwa kusenesikhathi.

Ukuthambekela kwe-aortic

• Ukuhlinzwa kwenhliziyo yezingane - ukukhishwa

• Ukuhlangana kwe-aorta

I-Fraser CD, uKane LC. Isifo senhliziyo esizalwa naso. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 58.

I-Webb GD, iSmallhorn JF, uTherrien J, uRedington AN. Isifo senhliziyo esizalwa naso esigulini esidala nesingane. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier Saunders; 2019: isahluko 75.