I-aneurysm ye-Thoracic aortic

I-aneurysm ukunwetshwa okungajwayelekile noma ukubhaliswa kwengxenye yomthambo ngenxa yobuthakathaka odongeni lomthambo wegazi.

I-thoracic aortic aneurysm yenzeka engxenyeni yomthambo omkhulu womzimba (i-aorta) odlula esifubeni.

Isizathu esivame kakhulu se-thoracic aortic aneurysm ukuqina kwemithambo. Lesi simo sivame kakhulu kubantu abane-cholesterol ephezulu, umfutho wegazi wesikhathi eside, noma ababhemayo.

Ezinye izinto eziyingozi ze-aneurysm ye-thoracic zifaka:

• Izinguquko ezidalwa yiminyaka
• Izinkinga zezicubu ezixhuma njengeMarfan noma i-Ehlers-Danlos syndrome
• Ukuvuvukala kwe-aorta
• Ukulimala ekuweni noma ezingozini zezimoto
• Ugcunsula

Ama-aneurysms akhula kancane eminyakeni eminingi. Iningi labantu alinazo izimpawu kuze kube yilapho i-aneurysm iqala ukuvuza noma ukunweba.

Izimpawu zivame ukuqala ngokungazelelwe lapho:

• I-aneurysm ikhula ngokushesha.
• Izinyembezi ze-aneurysm zivulekile (ezibizwa ngokuthi ukuqhekeka).
• Igazi liyavuza odongeni lwe-aorta (i-aortic dissection).

Uma i-aneurysm icindezela ezakhiweni eziseduze, izimpawu ezilandelayo zingavela:

• Ukungahambi kahle
• Izinkinga zokugwinya
• Ukuphefumula okuphezulu (stridor)
• Ukuvuvukala entanyeni

Ezinye izimpawu zingafaka:

• Ubuhlungu besifuba noma bengaphezulu emuva
• Isikhumba seClammy
• Isicanucanu nokuhlanza
• Ukushaya kwenhliziyo okusheshayo
• Umuzwa wenhlekelele ezayo

Ukuhlolwa komzimba kuvame ukujwayelekile ngaphandle kokuthi kuqhamuke ukuvuza noma ukuvuza.

Iningi lama-aneurysms we-thoracic aortic atholakala ekuhlolweni kwe-imaging okwenzelwe ezinye izizathu. Lezi zivivinyo zifaka i-x-ray yesifuba, i-echocardiogram, noma isifuba se-CT scan noma i-MRI.Isikena se-CT esifubeni sikhombisa ubukhulu be-aorta nendawo ngqo ye-aneurysm.

I-aortogram (isethi ekhethekile yezithombe ze-x-ray ezenziwe lapho idayi ijojowe ku-aorta) ingakhomba i-aneurysm nanoma yimaphi amagatsha e-aorta angabandakanyeka.

Kunobungozi bokuthi i-aneurysm ingavuleka (iqhume) uma ungenakho ukuhlinzwa ukuyilungisa.

Ukwelashwa kuya ngendawo ye-aneurysm. I-aorta yenziwe ngezingxenye ezintathu:

• Ingxenye yokuqala iya phezulu iye ngasekhanda. Ibizwa ngokuthi i-aorta ekhuphukayo.
• Ingxenye emaphakathi igobile. Ibizwa ngokuthi i-aortic arch.
• Ingxenye yokugcina iya phansi, ngasezinyaweni. Ibizwa ngokuthi i-aorta eyehlayo.

Kubantu abanama-aneurysms we-aorta ekhuphukayo noma i-aortic arch:

• Kuyanconywa ukuhlinza ukufaka i-aorta uma i-aneurysm inkulu kunamasentimitha ama-5 kuye kwayi-6.
• Kusikeka phakathi kwesifuba sesifuba.
• I-aorta ishintshwa ngeplastiki noma ngendwangu yokuxhunyelelwa.
• Lokhu ukuhlinzwa okukhulu okudinga umshini wenhliziyo namaphaphu.

Kubantu abane-aneurysms ye-aorta ye-thoracic eyehlayo:

• Ukuhlinzwa okukhulu kwenziwa ukukhipha i-aorta ngendwangu yokuxhunyelelwa uma i-aneurysm inkulu kunamasentimitha ayisithupha.
• Lokhu kuhlinzwa kwenziwa ngokusikeka ohlangothini lwesobunxele sesifuba, esingafinyelela esiswini.
• I-Endovascular stenting iyindlela engeyona eyonakalisayo. I-stent iyinsimbi encane noma ipulasitiki esetshenziselwa ukugcina umthambo uvulekile. Ama-stents angafakwa emzimbeni ngaphandle kokusika isifuba. Kodwa-ke, akubona bonke abantu abane-aneurysms ye-thoracic abakhethayo ukugcotshwa.

Umbono wesikhathi eside wabantu abane-thoracic aortic aneurysm uncike kwezinye izinkinga zezokwelapha, njengesifo senhliziyo, umfutho wegazi ophakeme nesifo sikashukela. Kungenzeka ukuthi lezi zinkinga zidale noma zaba nomthelela kulesi simo.

Izinkinga ezinkulu ngemuva kokuhlinzwa kwe-aortic zingafaka:

• Ukopha
• Ukutheleleka ngokuxhunyelelwa
• Isifo senhliziyo
• Ukushaya kwenhliziyo okungajwayelekile
• Ukulimala kwezinso
• Ukukhubazeka
• Unhlangothi

Ukufa ngemuva nje kokuhlinzwa kwenzeka kubantu abangu-5% kuya kwabangu-10%.

Izinkinga ngemuva kokunuka nge-aneurysm zibandakanya ukulimala emithanjeni yegazi ehambisa umlenze, okungadinga okunye ukuhlinzwa.

Tshela umhlinzeki wakho wezempilo uma une:

• Umlando womndeni wokuphazamiseka kwezicubu (njengeMarfan noma i-Ehlers-Danlos syndrome)
• Ukungaphatheki kahle kwesifuba noma emuva

Ukuvimbela isifo sokuqina kwemithambo yegazi:

• Lawula umfutho wegazi lakho namazinga wegazi lipid.
• UNGABHALI.
• Yidla ukudla okunempilo.
• Vocavoca umzimba njalo.

I-aortic aneurysm - i-thoracic; I-aneurysm ye-syphilitic; I-Aneurysm - i-thoracic aortic

• Ukulungiswa kwe-aortic aneurysm esiswini - ukuvula - ukukhipha
• Ukulungiswa kwe-aortic aneurysm - endovascular - discharge

• I-aortic aneurysm
• Ukuqhuma kwe-aorta - i-x-ray yesifuba

I-Acher CW, i-Wynn M. Thoracic ne-thoracoabdominal aneurysms: ukwelashwa okuvulekile okuhlinzekwayo. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 77.

IBraverman AC, iShermerhorn M. Izifo ze-aorta. 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; 2019: isahluko 63.

ILederle FA. Izifo ze-aorta. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 69.

USingh MJ, uMakaroun MS. Ama-aneurysms we-Thoracic ne-thoracoabdominal: ukwelashwa kwe-endovascular. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 78.