I-ventricle yesokudla ephindwe kabili

I-ventricle yangakwesokudla ephuma kabili (i-DORV) yisifo senhliziyo esivele kusukela ekuzalweni (kokuzalwa). I-aorta ixhuma ku-ventricle elungile (i-RV, ikamelo lenhliziyo elimpompa igazi elingenayo i-oxygen emaphashini), esikhundleni se-ventricle engakwesokunxele (i-LV, ikamelo elijwayele ukupompa igazi elicebile oksijini emzimbeni).

Kokubili umthambo wamaphaphu (othwala igazi elingenawo umoya-mpilo uye emaphashini) kanye ne-aorta (ethwala igazi elinomoya-mpilo osuka enhliziyweni uye emzimbeni) uvela egumbini elifanayo lokumpompa. Ayikho imithambo exhunywe kwi-ventricle engakwesobunxele (ikamelo ngokuvamile elimpompa igazi emzimbeni).

Ngokwesakhiwo senhliziyo esejwayelekile, i-aorta ixhuma kwi-LV. Umthambo wamaphaphu uvame ukuxhumeka kwi-RV. Ku-DORV, yomibili imithambo yegazi iphuma kwi-RV. Lokhu kuyinkinga ngoba i-RV ithwala igazi elingenayo i-oxygen. Leli gazi bese lisakazwa emzimbeni wonke.

Okunye ukukhubazeka okubizwa nge-ventricular septal defect (VSD) kwenzeka njalo nge-DORV.

Igazi elicebile nge-oksijeni emaphashini ligobhoza lisuka ohlangothini lwesobunxele lwenhliziyo, livule i-VSD futhi lingene kwi-RV. Lokhu kusiza usana olune-DORV ngokuvumela igazi elicebe nge-oxygen ukuthi lihlangane negazi elingenayo i-oxygen. Ngisho nale ngxube, umzimba kungenzeka ungatholi i-oxygen eyanele. Lokhu kwenza inhliziyo isebenze kanzima ukuhlangabezana nezidingo zomzimba. Kunezinhlobo eziningana ze-DORV.

Umehluko phakathi kwalezi zinhlobo indawo ye-VSD njengoba ihlobene nendawo yomthambo wamaphaphu kanye ne-aorta. Izimpawu nobukhulu benkinga kuzoya ngohlobo lwe-DORV. Ukuba khona kwe-valve stenosis yamaphaphu nakho kuthinta isimo.

Abantu abane-DORV bavame ukuba nezinye izinkinga zenhliziyo, njenge:

• Ukukhubazeka kwe-Endocardial cushion (izindonga ezihlukanisa wonke amakamelo amane enhliziyo azakhiwe kahle noma azikho)
• Ukuhlangana kwe-aorta (ukuncipha kwe-aorta)
• Izinkinga ze-Mitral valve
• I-pulmonary atresia (i-valve yamaphaphu ayakheki kahle)
• I-pulmonary valve stenosis (ukunciphisa i-valve yamaphaphu)
• I-aortic arch engakwesokudla (i-aortic arch ingakwesokudla esikhundleni sobunxele)
• Ukushintshwa kwemithambo emikhulu (i-aorta ne-pulmonary artery ishintshiwe)

Izimpawu ze-DORV zingafaka:

• Inhliziyo ekhulisiwe
• Inhliziyo ibubula
• Ukuphefumula ngokushesha
• Ukushaya kwenhliziyo okusheshayo

Izimpawu ze-DORV zingafaka:

• Ukudla okungafanele kusuka ekukhathaleni kalula
• Umbala we-Bluish wesikhumba nezindebe
• Ukubhuqa (ukuqina kwemibhede yezipikili) zezinzwane neminwe (uphawu lwakamuva)
• Ukwehluleka ukukhuluphala nokukhula
• Umbala ophaphathekile
• Ukujuluka
• Imilenze evuvukile noma isisu
• Ukuphefumula kanzima

Ukuhlolwa kokuthola i-DORV kufaka:

• Ama-x-ray esifubeni
• Ukuhlolwa kwe-Ultrasound kwenhliziyo (echocardiogram)
• Ukudlulisa ishubhu elincane, eliguquguqukayo lingene enhliziyweni ukukala umfutho wegazi nokujova udayi wezithombe ezikhethekile zenhliziyo nemithambo yegazi (i-catheterization yenhliziyo)
• Inhliziyo MRI

Ukwelashwa kudinga ukuhlinzwa ukuze kuvalwe imbobo enhliziyweni futhi kuqondiswe igazi kusuka ku-ventricle engakwesokunxele liye ku-aorta. Ukuhlinzwa kungadingeka futhi ukuhambisa umthambo we-pulmonary noma i-aorta.

Izici ezinquma uhlobo nenombolo yokusebenza okudingwa yingane zifaka:

• Uhlobo lwe-DORV
• Ubukhulu besici
• Ukuba khona kwezinye izinkinga enhliziyweni
• Isimo sonke sengane

Ukuthi ingane yenza kahle kangakanani kuya ngokuthi:

• Usayizi nendawo ye-VSD
• Usayizi wamakamelo okumpompa
• Indawo yomthambo i-aorta ne-pulmonary artery
• Ukuba khona kwezinye izinkinga (njengokuhlangana kwezinkinga ze-aorta ne-mitral valve)
• Impilo ephelele yengane ngesikhathi sokuxilongwa
• Ukuthi ukulimala kwamaphaphu kwenzeke yini egazini eliningi eligelezela emaphashini isikhathi eside

Izinkinga ezivela ku-DORV zingafaka:

• Ukwehluleka kwenhliziyo
• Umfutho wegazi ophezulu emaphashini, ongelashwa ungaholela ekulimaleni unomphela kwamaphaphu
• Ukufa

Izingane ezinalesi simo senhliziyo zingadinga ukuthatha ama-antibiotic ngaphambi kokwelapha amazinyo. Lokhu kuvimbela izifo ezizungeze inhliziyo. Ama-antibiotic nawo angadingeka ngemuva kokuhlinzwa.

Shayela umhlinzeki wakho wezokunakekelwa kwezempilo uma ingane yakho ibonakala ikhathala kalula, inenkinga yokuphefumula, noma inesikhumba noma izindebe eziluhlaza okwesibhakabhaka. Kufanele futhi uthintane nomhlinzeki wakho uma ingane yakho ingakhuli noma izuza isisindo.

DORV; Ukungalingani kweTaussig-Bing; I-DORV ene-VSD ezinikele kabili; I-DORV ene-VSD engazibophezeli; I-DORV ene-subaortic VSD; Ukukhubazeka kwenhliziyo okuzalwa - i-DORV; Isici senhliziyo seCyanotic - DORV; Isici sokuzalwa - DORV

• I-ventricle yesokudla ephindwe kabili

UBichell D. I-ventricle engakwesokudla ephuma kabili. Ku: Ungerleider RM, Meliones JN, McMillian KN, Cooper DS, Jacobs JP, eds. Isifo senhliziyo esibucayi ezinganeni nasezinganeni. 3rd ed. IPhiladelphia, PA: Elsevier; 2019: isahluko 58.

UHaller C, uVan Arsdell GS, uYoo SJ, uGeorge-Hyslop CST, uSpicer DE, noAnderson A. I-ventricle ephuma kabili. Ku: Wernovsky G, Anderson RH, Kumar K, et al. I-Anderson's Pediatric Cardiology. Umhla wesi-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 39.

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; 2019: isahluko 75.