I-aortic stenosis yintlobo yesifo se-valves senhliziyo esibangelwa ukuvinjelwa kwesahluko se-aortic valve. Nge-storosis ye-aortic, kuba nzima ukuba intliziyo ipheputhe igazi kumalungu omzimba. I-aortic stenosis ingaba nefuthe kakhulu ekusebenzeni kwenyama, ukuvelisa iimpawu ezibalulekileyo, kwaye ekugqibeleni iholele ekufeni ngaphandle kokuba iphathwa.
Yintoni i-Aortic Stenosis?
Abagadi be-valor a valtic ukuvula phakathi kwe-ventricle ekhohlo kunye ne-aorta. Njengokuba i-ventricle ekhohlo iqala ukuvumelwano, i-valor i-aortic ivuleka ukuze ivumele igazi kwi-ventricle engasekhohlo ukuba ikhuphe entliziyweni , kwi-aorta, nakwi-body. Ngokukhawuleza ukuba i-ventricle ekhohlo igqityiwe, i-aortic valve ivala ukugcina igazi ekuhlambuleni kwi-ventricle.
Xa umntu edala i-aortic stenosis, i-aortic valve yayo ihluleka ukuvula ngokupheleleyo xa i-ventricle iqala ukubetha, ngoko intliziyo kufuneka isebenze nzima ukwenzela ukuxosha igazi kwi-valves evaliweyo. Ukuxinezeleka ngakumbi entliziyweni kunokukhokelela ekuphelelweni kwentliziyo kunye nezinye iingxaki ezinzima zeengqondo.
Ziziphi Iingxaki ze-Aortic Stenosis?
Kukho iingxaki ezininzi ezinokuvelisa i-aortic stenosis, kuquka:
- Ukuhlaziywa kunye nokubalwa : Kubantu abangaphezu kweminyaka engama-70 ubudala, imbangela eqhelekileyo ye-aortic stenosis "yambatha kwaye ikhwebu." Ngethuba lexesha, i-valve ye-aortic ingaqala ukubola, idale i-calcium deposits ukuqokelela kwi-valve. Le calcium idibanise iphula umthetho wokuvula i-valvular, kubangele i-aortic stenosis.
- I-valorpid valve i-bicuspid : Iyona nto ibangela ukuba i-aortic stenosis ebantwini abancinci i-valve bicuspid valve. Kule meko umntu uzalwe nge-valve ye-aortic equkethe "iipoksi" ezimbini (oko kukuthi, iimbophu) endaweni yezinto eziqhelekileyo ezintathu. Iimpawu ze-aortic ezinamaqhinga ezincinci zixhomekeke ekubunjweni kwe-calcium deposits-kwaye ke, kwi-aortic stenosis. Abantu abanama-bicuspid aortic stenosis bavame ukuvelisa iimpawu kuma-40s no-50s.
- Isifo senhliziyo yesifo se-Rheumatic : Akunjalo ukuba amashumi eminyaka edlulileyo, isifo senhliziyo sisifo esiyimbangela ebangela i-aortic stenosis kwihlabathi eliphuhlisiweyo. Kodwa ngokuphuhliswa kwee-antibiotics ezichanekileyo kwi-bacteria ye-streptococcus , kwaye ukunciphisa okulandelayo kwiziganeko zentsholongwane ye- rheumatic , isifo senhliziyo sesifo se-rheumatic sesiqhelekanga.
- I-aortic stenosis ye-Congenital : Iingxaki ezincinci ze-congenital ngaphezu kwe-valve bicuspid zingavelisa i-aortic stenosis. Ezi ziquka ukuhlukumeza okungafaniyo kwe-valve ye-aorti ngokwayo, kunye neendlela ezingaqhelekanga zokuvimbela isifo senhliziyo ngaphezulu okanye ngaphantsi kwe-valve yangempela ye-aortic. Ezi ndlela ezingavamile ze-aortic stenosis zivame ukubonakala kubantwana.
Ziziphi iingxaki ezibangelwa yi-Aortic Stenosis?
Nge-storosis ye-aortic, ukuphuma kwegazi ukusuka kwi-ventricle engasekhohlo kupheliswa ngokukhawuleza, ngoko kuya kuba nzima kwinhliziyo ukuxosha igazi. Lo msebenzi wecala olungaphezulu ubeka uxinzelelo olubalulekileyo kwi-muscular ventularular muscle, nto leyo eyenza ukuba ikhuphe, okanye "i-hypertrophy."
Oku kushiya i-hypertrophy ye-ventricular ingakhokelela ekusebenziseni i- diastolic ukungasebenzi kunye nokuhluleka kwentliziyo ye-diastolic , apho imisipha ekhunileyo "iminyanisela" i-ventricle, kwaye yenza kube nzima ukuba iifricricle zizalise igazi phakathi kweentsimbi zenhliziyo.
Iimpawu ekugqibeleni ziphumo. Le miqondiso ibandakanya i- dyspnea (ukuphefumula okufutshane), ukukhathala okulula kunye nokunciphisa ukunyamezela kokunyamezela, kunye nokwanda komngcipheko wokuphucula i-fibrillation ye-antiretroviral .
Njengoko i-aortic stenosis ibuhlungu, i-angina inokuthi ivele, kunye neziqendu zokukhanya okulula kunye ne- syncope (ukulahlekelwa kwengqondo) ngexesha lokuzikhandla.
Nge-aortic stenosis enamandla kakhulu, i-muscle ye-ventricle engasekho iyakwazi ukuguqula ekubeni yomelele kwaye ibe nzima ukuba ibe buthathaka kwaye iyancipha-imeko ebizwa ngokuthi i-cardiomyopathy . Xa i-aortic stenosis ivelisa i-cardiomyopathy, i-heart failure isingenakwenzeka.
Ukufa ngokukhawuleza kuqhelekileyo kwi-aortic stenosis.
I-Aortic Stenosis ifunyaniswe njani?
Ngenxa yokuba i-aortic stenosis engaqhelekanga iyingozi kakhulu, ukwenza ukuba ukuxilongwa ngokuchanekileyo kubaluleke kakhulu. Ngethamsanqa, ukufumanisa i-aortic stenosis namhlanje akusoloko kunzima.
Oogqirha bayakrokraza i-aortic stenosis xa izigulane zabo zikhalaza "iimpawu eziqhelekileyo" (ukuphefumula okufutshane, ukunciphisa umzimba, ukunciphisa isifuba, isizungu okanye i syncope). Okukhethwa ngakumbi, ugqirha uya kukhankanya i-aortic stenosis ngaphambi kokuba iimpawu ziphuhlise xa ziva intliziyo igungqeleka efana nale meko. Ukuxilongwa kungaqinisekiswa okanye kugwetywe yi- echocardiogram .
Ukuphathwa kwe-Aortic Stenosis
Ukunyangwa kwe-aortic stenosis yindawo yokutshintshwa kwevaji. Ukusetyenziswa kweziyobisi kunokuphucula iimpawu zexeshana, kodwa ekugqibeleni akunakwenzeka kuba ingxaki yindlela yokukhusela i-aortic valve. Ngoko xa umntu ephethe i-aortic stenosis, umbuzo kaninzi awunjani ukuba wenze utyando, kodwa xa.
Njengomgaqo jikelele, ukutshintshwa kwe-valve ye-aorti kufuneka kwenziwe kwangoko emva kokuba i-aortic stenosis yomntu iqala ukuvelisa iimpawu-ukuphefumula, intlungu yesifuba, ukuxakeka, okanye i-syncope. Xa enye yale mpawu ibangelwa kwi-aortic stenosis, ukuhlala kwithuba lokuphila ngaphandle kwe-valve esikhundleni sayo kuyiminyaka emi-2 okanye emithathu. Ukutshintshwa kwe-valve ngokukhawuleza kuphucula kakhulu le nto. Xa umntu efunyaniswa ukuba ene-storosis ye-aortic, kubalulekile ukuba bajongwe ngokunyamekela naluphina uphawu lokuphuhlisa loo mpawu.
Ngenxa yokuba ukuhlinzwa ngokukhawuleza kunciphisa ukukhuseleka okukhulu kwimizi yokugula kwegazi, kwimeko ezininzi iimeko zentliziyo ziphucula ngokucacileyo emva kokutshintshwa kwevaji. Ngoko ke abantu abantu asebekhulile kwaye banempawu kakhulu banokwenza kakuhle emva kokuhlinzwa kwe-aortic stenosis.
Iiplavines ezisebenzisayo ukufaka indawo ye-aortic valve ezinokugula zinokuthi zibandakanye izinto ezenziwe ngabantu (iiplavines mechanical), okanye ziyakwenziwa kwi-valve yenhliziyo yesilwanyana, ngokuqhelekileyo ihagu (i-valve ye-bioprosthetic). Ukugqiba ukuba yiyiphi uhlobo le-valve yokufakelwa eliyisebenzisayo kuxhomekeke kwiminyaka yomntu, nokuba ngaba bangathatha igazi elincinci njengeCoumadin .
Zonke iipilisi zentliziyo zengqondo zandisa ukunyuka kwegazi. Nangona kunjalo, i-clotting yegazi ayinanto yenkinga nge-valve ye-bioprosthetic kunokuba i-valves mechanical, ngoko ke abantu abanezinye zangaphambili abanakuze bathathe unyango olungapheliyo lwe-Coumadin; abo banamagqoba engcingo. Ngakolunye uhlangothi, iiphini zogqirha zibonakala zihlala ixesha elide kunezivenge ze-bioprosthetic.
Ngoko kubantu abane-aortic stenosis abangaphantsi kweminyaka engama-65 abanokuthatha i-Coumadin, iivilves zentliziyo zivame ukucetyiswa. Kubantu abangaphezu kweminyaka engama-65, okanye abangakwazi ukuthatha i-Coumadin, i-valve ye-bioprosthetic ivame ukucetyiswa.
Izindlela ezingabonakaliyo ezincinci zokuphatha i-Aortic Stenosis
Unyango olungenasiphene kunokuba uphuhlise i-valve esikhundleni.
Kwi- aortic valvulotomy , i-catheter ibhaluni idluliselwa kwi-valve ye-aortiki kwaye ibhaluni ihlonyelwe ukwenzela ukuba ichithe ezinye i-calcium deposits kwi-valve. Oku kuvame ukuvumela i-valve ukuba ivule ngokugcwele ngokupheleleyo, kwaye ikhuphe ezinye ze-aortic stenosis. Ngelishwa, i-valvulotomy ayiyi kuvelisa iziphumo ezifanelekileyo, kwaye ingabangela iingxaki ezinzulu.
Enye inkqubo yokusekela i-cathterter stenosis yi- trans-catheter i-aortic valve implantation (TAVI) . Izixhobo ezininzi ze-TAVI ziphantsi kophuhliso olusebenzayo, kwaye ezimbalwa ziye zavunywa ukuba zisebenzise iikliniki kwizigulane ezisengozini enkulu yokuhlinzwa okwenzelwe i-valve. Nangona kunjalo, iingxaki kunye ne-TAVI kule ndawo ziyimfuneko. Zombili i-TAVI kunye ne-valvulotomy ngeli xesha zigcinwe kubantu abane-aortic stenosis abangenakwenzeka ukuba baphile endaweni yokuguqula i-valve.
ILizwi
I-aortic stenosis yintlobo yesifo senhliziyo se-valvular esithintela ukuhamba kwegazi entliziyweni. I-aortic stenosis ehamba phambili ibangela iimpawu ezibalulekileyo, kwaye iyanciphisa kakhulu ixesha lokuphila. Ngethamsanqa, xa unyango olusesikhatywayo lunexesha, abantu abane-aortic stenosis bangenza kakuhle.
> Imithombo:
> Inzala ka-GW, uSchirmer H, uHeggelund G, et al. I-Evolving Epidemiology yeValvular Aortic Stenosis. uphando lweTromsø. Intliziyo ka-2013; 99: 396.
> Leon MB, Smith CR, Mack M, et al. I-Transcatheter i-Aortic-valve Ukufakelwa kwe-Aortic sSenosis kwizigulane ezingenako ukuguqulwa. N Engl J Med 2010; 363: 1597.
> Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC Isikhokelo soLawulo lwezilwelisi ezine-Valvular Heart Disease: Ingxelo ye-American College of Cardiology / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: e57.