Kwi-aortic ukubuyisela kwakhona i-aortic valve iyaba yinto ephosakeleyo. I-valor ye-aortic ephumayo ihlala ibangela iingxaki ezintle zenhliziyo.
Abagadi be-valor a valtic ukuvula phakathi kwe-ventricle ekhohlo kunye ne-aorta. Iveni ye-aortic ivula njengoko i-ventricle ekhohlo iqala ukupompoza, ivumela igazi ukuba likhuphe entliziyweni nase-aorta. Xa i-ventricle igqibile ukubetha, i-valor i-aortic igcina ukugcina igazi ekuhlambuleni kwi-ventricle ekhohlo.
Xa uhlakulela i-aortic kwakhona, i-valor yakho ye-aortic ihluleka ukuvala ngokupheleleyo, ngaloo ndlela uvumela igazi ukuba lihlele phambili ukusuka e-aorta ukuya kwi-ventricle ekhohlo. Le "ukuhlaziywa" kwegazi kubangela ukuba intliziyo isebenze nzima kakhulu, kwaye ukuxinezeleka ngakumbi entliziyweni kunokukhokelela ekuphelelweni kwentliziyo kunye nezinye iingxaki ezibalulekileyo.
Ziziphi izizathu zokubuyiswa kwe-Aortic?
Izifo ezininzi zezokwelapha zivelisa ukuvuselelwa kwe-aortic. Ezi ziquka:
- Endocarditis. I-Endocarditis (intsholongwane yeentsimbi zentliziyo) ingenza i-aortic valve ibonakale, ivelise ngokutsha.
- I-valorpid aortic valve. Ukuhlaziywa kwe-Aortic kungabangelwa yi-valve bicuspid, imeko yesisu apho i-valve ye-aortic inamalungu amabini "i-cusps" (okt, i-flaps) endaweni yesithathu eqhelekileyo. Iimvenge ze-aortic ezinamaqhinga zixhomekeke ngakumbi ekubunjweni kwe-calcium deposits, ezivame ukuvelisa i- aortic stenosis . Ngoko izigulane ezine-valve i-aortic valve zingakhula zombini i-stenosis kunye nokuhlaziywa.
- Isifo senhliziyo yesifo seRheumatic . Kwiminyaka engama-50 edlulileyo, isifo senhliziyo yesifo se-rheumatic sasiyimbangela ebangela ukubuyiswa kwe-aortic kwihlabathi eliphuhlisiweyo. Ngokuza kwee-antibiotiki, isifo senhliziyo yesifo se-rheumatic siye saqhelekanga.
- Ukuvuselela i-aortic. Zininzi iintlobo zesifo senhliziyo esiswini esingazalwayo zingenza ukuvuselelwa kwe-aortic, kuquka i-Turner syndrome, i-tetralogy ye Fallot, kunye ne-truncus arteriosus.
- Ukuxilwa kweengcambu ze-aortic. Iingcambu ze-aortic yinxalenye ye-aorta ngokukhawuleza ngaphaya kwe-valve ye-aortic. Iimeko ezininzi zingabangela ukuba ingcambu ye-aortic ihlaziye okanye ikhulise. Olu kuhlanjululwa lunokuphazamisa i-aortic valve ngokwayo, kubangela ukuphindaphinda. Ezinye zezinto ezibangela ukuhluthwa kweengcambu ze-aorti zibandakanya ingozi ephezulu yengozi , i-aortitis (ukuvuvukala kwe-aorta, engabangelwa zizifo ezinjenge-syphilis), ukulimala kwesifuba, ukusabalalisa i-aortic (ukugqabhuka ngokukhawuleza kodonga lwe-aorta, obangelwa sisifo se-vascular degenerative ), kunye ne-Marfan syndrome.
Ziziphi iingxaki ezibangelwa yi-Aortic Restoration?
Kwi-aortic yokubuyiswa kwakhona, i-ventricle ekhohlo kufuneka isebenze nzima kakhulu ukwenzela ukubonelela izicubu zomzimba ngexabiso elaneleyo legazi. Ngokukodwa, ngentliziyo nganye, i-ventricle kufuneka iphephe onke igazi elidinga umzimba, kunye nexabiso legazi elibuyisela emuva kwi-ventricle. Le ndoda eyongezelelekileyo yegazi ibangela ukuba imisipha yenhliziyo ikhuphe (okanye "i-hypertrophy") kwaye ibangela i-ventricle ekhohlo ukuba ihluthe.
Olu xinzelelo olongezelelweyo kwi-ventricle ekhohlo ekugqibeleni lunokukhokelela ekuphelelweni kwentliziyo, kunye ne-cardiac arrhythmias ezifana ne- frill fibrillation , i- tricycardia ye-ventric , kunye ne-fibrillation ye-ventricular.
Iifomu ezintle zokuvuselela i-aortic ngokuqhelekileyo azivelisi iimpawu. Nangona kunjalo, ukuba ukuhlaziywa kukugqithisileyo, i-ventricle iya kuba yongxininisa ngakumbi kwaye ukuhluleka kwentliziyo kuqala ukuphuhlisa. Kule nqanaba, umntu onokubuyiselwa kwe-aortic uya kuqala ukuqaphela i- dyspnea (ukuphefumula okufutshane) kunye nokukhathala kwangaphambili. Ezi zimpawu zibuhlungu xa ukuhlaziywa kubaluleke ngakumbi, kwaye ekugqibeleni kunokuba nzima kakhulu.
Nangona i-aortic yokuvuselela ngokuqhelekileyo ikhula ngokuthe ngcembe - ngaphezu kwexesha leminyaka - kwezinye iimeko iyakwenzeka ngokukhawuleza. Ukubuyiselwa kwakhona kwe-aortic ngokuqhelekileyo kubangelwa yi-endocarditis, i-aortic dissection, okanye i-traum trauma.
Ukuhlaziywa kwe-aortic ngokuqhelekileyo kudla ngokuvelisa ukuphazamiseka kwentliziyo ngokukhawuleza kwaye kunzima, kwaye iyakwazi ukuphathwa kuphela ngophakamiso lwengxowanxu yokutshintsha.
I-Aortic Yokubuyisela I-Argurgation Diagnosed?
Ukuxilongwa kwe-aortic ukubuyiswa kwakhona kulungele ngqo. Ukuhlaziywa kwe-Aortic kubangela ukuba intliziyo ibonakalise ukuba amaninzi oogqirha baya kuqonda ngokukhawuleza. Ukuxilongwa kukwazi ukuqinisekiswa okanye ukugwetywa ngaphandle kwe- echocardiogram .
Ukunyangwa kwe-Aortic
Ekugqibeleni, unyango lokubuyisela i-aortic ludinga ukutshintshwa ngokugqithisileyo kwiplavayi ewonakalisiweyo. Izidakamizwa ezithintela imithwalo yegazi (amaninzi, i- calcium channel blockers okanye i- ACE inhibitors ) inokunceda ukunciphisa inani legazi elibuyiselwa kwi-ventricle engasekhohlo kwaye lunokunceda ukulawula iimpawu. Kwaye, ngokuqinisekileyo, abanye abantu abane-aortic yokubuyisela kwakhona abazange bafune ukuhlinzwa. Kodwa ukuvuselelwa kwe-aortic yinkqubo yokuxininisa, kwaye ukujongana nento, ufuna isisombululo sombane.
Ixesha elifanelekileyo lotyando lubaluleke kakhulu. Njengomgaqo jikelele, utyando lwe-aortic kufuneka uyenze nje ngaphambi kokuba u-aortic ubuye uqale ukuvelisa iimpawu. Uvavanyo lweemviwo zemihla ngemihla kwaye i-echocardiograms ngokukhawuleza ngezihlandlo luncedo ekuphuculeni ixesha lokuhlinzwa.
Esinye isisombululo esibalulekileyo luhlobo lwentsimbi ye-valve eza kusetyenziswa. Iiprotheni ze-aortic zeprostythi ziquka zonke izinto ezenziwe ngumntu (iiplavines mechanical) okanye zenziwe kwi-valve yenhliziyo yesilwanyana, ngokuqhelekileyo ihagu (i-valve bioprosthetic). Ukugqiba ukuba yeyiphi uhlobo lwesiganeko sokusebenza esisetyenziswayo kuxhomekeke kwiminyaka yesigulane kwaye nokuba ukuthatha i-antiticoagulation engapheliyo ingxaki.
Zonke iipilisi zentliziyo zengqondo zandisa ukunyuka kwegazi. Nangona kunjalo, i-clotting yegazi ingaphantsi kwengxaki kunye ne-bioprosthetic kunamagatya e-mechanical, ngoko ke abantu abane-valve bioprosthetic abanakufuneka bathathe i-anticoagulant, ngelixa abo abanezigwityu ze-mechanical zihlala zenza. Ngakolunye uhlangothi, iiplavini zogcino zihlala ixesha elide kunezivenge ze-bioprosthetic.
Ukongezelela, uhlobo oluthile lokungena endaweni ye-aortic valve endaweni ngoku i-FDA ivunyiwe-i- transcatheter i-aortic valve implantation, okanye i-TAVI . Nangona utyando lwe-TAVI lugqithise kakhulu kunokuba kuguqulelwe i-valve, le nkqubo isenomngcipheko omkhulu. Ngokuqhelekileyo, namhlanje igcinelwe izigulane ezithathwa "zigula kakhulu" ekutshintsheni i-valves standard. Nangona kunjalo, njengamava kunye ne-TAVI iqokelelwe ngokuqinisekileyo kuya kufumaneka kwiindidi ezibanzi zezigulana ezifuna i-aortic valve esikhundleni.
Njalo: Ukuba ufuna i-valve esikhundleni sokubuyisela i-aortic, kwaye uneminyaka engaphantsi kweminyaka engama-65 okanye i-70 kwaye unokuthatha i-anticoagulant, ugqirha wakho uya kuncoma ukuba i-valve mechanical. Ukuba uneminyaka engaphezulu kwama-65 okanye 70, okanye awukwazi ukuthatha i-anticoagulant, i-valve ye-bioprosthetic iya kucetyiswa. Ukuba umngcipheko wakho wokugonywa uthathwa njengophakamileyo, i-TAVI kufuneka iqwalaselwe.
Umgca wecala kukuba kukho iziqhelo kunye neengxaki kuzo zonke iindidi zephinivesti zokutshintshwa. Ukugqiba uhlobo oluthile lwe-valve kufuneka libe yisigqibo esabelwe phakathi kwakho kunye nogqirha wakho.
Imithombo:
Nishimura RA, Otto CM, Bonow RO, et al. 2014 Isikhokelo se-AHA / ACC sokulawulwa kwezigulane ezine-valvular isifo senhliziyo: ingxelo ye-American College of Cardiology / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: e57.