Inlet ephindwe kabili engakwesokunxele

Ukungena kabili kwesokunxele i-ventricle (i-DILV) kuyisici senhliziyo esivele kusukela ekuzalweni (kokuzalwa). Kuthinta ama-valve namagumbi enhliziyo. Izingane ezizalwe zinalesi simo zinekamelo elilodwa kuphela lokumpompa (i-ventricle) enhliziyweni yazo.

I-DILV ingenye yezinkinga zenhliziyo eziningi ezaziwa njengokukhubazeka okukodwa (noma okuvamile) kwe-ventricle. Abantu abane-DILV bane-ventricle enkulu yesobunxele ne-ventricle encane engakwesokudla. I-ventricle yangakwesobunxele ikamelo lokumpompa lenhliziyo elithumela igazi elicebile oksijini emzimbeni. I-ventricle efanele yigumbi lokumpompa elithumela igazi elingenayo i-oxygen emaphashini.

Enhliziyweni ejwayelekile, ama-ventricle angakwesokudla nangakwesobunxele athola igazi kusuka ku-atria yangakwesokudla nangakwesobunxele. Ama-atria amakamelo aphezulu enhliziyo.Igazi elimpofu le-oksijeni elibuya emzimbeni ligobhoza liye e-atrium elungile naku-ventricle engakwesokudla. I-ventricle efanele bese ipompa igazi emthanjeni wamaphaphu. Lesi yisitsha segazi esihambisa igazi liye emaphashini ukuyolanda umoya-mpilo.

Igazi elinomoya-mpilo omusha libuyela e-atrium yesobunxele naku-ventricle wesobunxele. I-aorta bese ihambisa igazi elicebile oksijini liye kulo lonke umzimba kusuka ku-ventricle yesobunxele. I-aorta ingumthambo omkhulu oholela enhliziyweni.

Kubantu abane-DILV, kuphela i-ventricle yesobunxele eyakhiwayo. Womabili la ma-atria aqukethe igazi kule ventricle. Lokhu kusho ukuthi igazi elicebile nge-oxygen lihlangana negazi elingenayo i-oxygen. Ingxube leyo bese ifakwa emzimbeni nasemaphashini.

I-DILV ingenzeka uma imithambo yegazi emikhulu evela enhliziyweni isendaweni engafanele. I-aorta ivela ku-ventricle encane yangakwesokudla futhi umthambo wamaphaphu uvela ku-ventricle wesobunxele. Kungenzeka futhi lapho imithambo yegazi isezikhundleni ezijwayelekile futhi ivela kuma-ventricles ajwayelekile. Kulokhu, igazi ligeleza lisuka kwesobunxele liye kwi-ventricle yangakwesokudla ngembobo ephakathi kwamagumbi abizwa nge-ventricular septal defect (VSD).

I-DILV ayivamile kakhulu. Imbangela ngqo ayikaziwa. Inkinga kungenzeka ukuthi yenzeke ekuqaleni kokukhulelwa, lapho inhliziyo yengane ikhula. Abantu abane-DILV bavame ukuba nezinye izinkinga zenhliziyo, njenge:

• Ukuhlangana kwe-aorta (ukuncipha kwe-aorta)
• I-pulmonary atresia (i-valve yamaphaphu yenhliziyo ayakhiwe kahle)
• I-pulmonary valve stenosis (ukunciphisa i-valve yamaphaphu)

Izimpawu ze-DILV zingafaka:

• Umbala oluhlaza okwesibhakabhaka esikhumbeni nasezindebeni (i-cyanosis) ngenxa yomoya-mpilo omncane egazini
• Ukwehluleka ukukhuluphala nokukhula
• Isikhumba esiphaphathekile (i-pallor)
• Ukudla okungafanele kusuka ekukhathaleni kalula
• Ukujuluka
• Imilenze evuvukile noma isisu
• Ukuphefumula kanzima

Izimpawu ze-DILV zingafaka:

• Isigqi senhliziyo esingajwayelekile, njengoba kubonakala ku-electrocardiogram
• Ukwakhiwa koketshezi oluzungeze amaphaphu
• Ukwehluleka kwenhliziyo
• Inhliziyo ibubula
• Ukushaya kwenhliziyo okusheshayo

Ukuhlolwa kokuthola i-DILV kungafaka:

• I-x-ray yesifuba
• Ukulinganiswa komsebenzi kagesi enhliziyweni (i-electrocardiogram, noma i-ECG)
• Ukuhlolwa kwe-Ultrasound kwenhliziyo (echocardiogram)
• Ukudlulisa ishubhu elincane, eliguquguqukayo liye enhliziyweni ukuhlola imithambo yegazi (i-catheterization yenhliziyo)
• Inhliziyo MRI

Ukuhlinzwa kuyadingeka ukwenza ngcono ukujikeleza kwegazi emzimbeni nasemaphashini. Ukuhlinzwa okuvamile ukwelapha i-DILV kunguchungechunge lwemisebenzi emibili kuya kwemithathu. Lokhu kuhlinzwa kufana nalokho okusetshenziselwa ukwelapha i-hypoplastic left heart syndrome kanye ne-tricuspid atresia.

Ukuhlinzwa kokuqala kungadingeka lapho ingane inezinsuku ezimbalwa nje izelwe. Ezimweni eziningi, ingane ingaya ekhaya ivela esibhedlela ngemuva kwalokho. Ingane izodinga kakhulu ukuphuza imithi nsuku zonke futhi ilandelwe eduze nodokotela wenhliziyo yezingane (i-cardiologist). Udokotela wengane uzonquma ukuthi isigaba sesibili sokuhlinzwa kufanele senziwe nini.

Ukuhlinzwa okulandelayo (noma ukuhlinzwa kokuqala, uma ingane ingadingi inqubo njengengane esanda kuzalwa) kubizwa ngokuthi yi-bidirectional Glenn shunt noma inqubo ye-Hemifontan. Lokhu kuhlinzwa kuvame ukwenziwa lapho ingane inezinyanga ezi-4 kuya kwezi-6 ubudala.

Ngisho nangemva kokuhlinzwa okungenhla, ingane isengabukeka iluhlaza okwesibhakabhaka (i-cyanotic). Isinyathelo sokugcina sibizwa ngokuthi inqubo ye-Fontan. Lokhu kuhlinzwa kuvame ukwenziwa lapho ingane inezinyanga eziyi-18 kuye eminyakeni emithathu. Ngemuva kwalesi sinyathelo sokugcina, umntwana akasekho okwesibhakabhaka.

Umsebenzi we-Fontan awudali ukujikeleza okujwayelekile emzimbeni. Kepha, kuthuthukisa ukugeleza kwegazi ngokwanele ukuze ingane iphile futhi ikhule.

Ingane ingadinga ukuhlinzwa okwengeziwe kokunye ukukhubazeka noma ukunweba ukusinda ngenkathi ilinde inqubo ye-Fontan.

Ingane yakho ingadinga ukuphuza imithi ngaphambi nangemva kokuhlinzwa. Lokhu kungafaka:

• Ama-anticoagulants ukuvimbela ukujiya kwegazi
• Ama-ACE inhibitors ukunciphisa umfutho wegazi
• I-Digoxin ukusiza inkontileka yenhliziyo
• Amaphilisi wamanzi (isisu) ukunciphisa ukuvuvukala emzimbeni

Ukufakelwa kwenhliziyo kunganconywa, uma izindlela ezingenhla zehluleka.

I-DILV yinkinga yenhliziyo eyinkimbinkimbi kakhulu okungelula ukuyelapha. Ukuthi ingane yenza kahle kangakanani kuya ngokuthi:

• Isimo jikelele sengane ngesikhathi sokuxilongwa nokwelashwa.
• Uma kukhona ezinye izinkinga zenhliziyo.
• Yeka ukuthi kukhubazeka kangakanani.

Ngemuva kokwelashwa, izingane eziningi ezine-DILV ziphila zibe ngabantu abadala. Kepha, zizodinga ukulandelwa impilo yonke. Bangase babhekane nezinkinga futhi kungadingeka ukuthi banciphise imisebenzi yabo yomzimba.

Izinkinga ze-DILV zifaka:

• Ukubhuqa (ukuqina kwemibhede yezipikili) ezinzwaneni naseminwe (uphawu olwedlule)
• Ukwehluleka kwenhliziyo
• I-pneumonia ejwayelekile
• Izinkinga zesigqi senhliziyo
• Ukufa

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma ingane yakho:

• Kubonakala ukukhathala kalula
• Unenkinga yokuphefumula
• Inesikhumba noma izindebe eziluhlaza okwesibhakabhaka

Futhi khuluma nomhlinzeki wakho uma ingane yakho ingakhuli noma izuza isisindo.

Akukho ukuvimbela okwaziwayo.

I-DILV; I-ventricle eyodwa; I-ventricle ejwayelekile; Inhliziyo engaguquguquki; Inhliziyo ye-univentricular yohlobo lwesokunxele lwe-ventricular; Isici senhliziyo esizelwe - i-DILV; Isici senhliziyo seCyanotic - i-DILV; Isici sokuzalwa - DILV

• Inlet ephindwe kabili engakwesokunxele

I-Kanter KR. Ukuphathwa kwe-ventricle eyodwa kanye nokuxhuma kwe-cavopulmonary. Ku: Sellke FW, del Nido PJ, Swanson SJ, ama-eds. Ukuhlinzwa kweSabiston neSpencer kwesifuba. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2016: isahluko 129.

IKliegman RM, iSt Geme JW, iBlum NJ. Shah SS, Tasker RC, Wilson KM. ISchor NF. Isifo senhliziyo esizalwa naso se-cyanotic: izilonda ezihambisana nokukhuphuka kwegazi le-pulmonary. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 458.

UWohlmuth C, uGardiner HM. Inhliziyo. Ku: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, ama-eds. Imithi ye-Fetal: Isayensi Eyisisekelo kanye Nokuzijwayeza Komtholampilo. 3rd ed. IPhiladelphia, PA: Elsevier; 2020: isahluko 29.