Ngokuphindaphindiwe kwe-aortic i-valve ye-aortic iba yiphutha. I-valve e-aortic ephukile ngokuvamile iholela ezinkingeni zenhliziyo ezibalulekile.
Abaqaphi be-aortic valve ukuvula phakathi kwe-ventricle kwesokunxele ne-aorta. I-valve ye-aortic ivulwa njengoba i-ventricle yesokunxele iqala ukupompa, ivumela igazi ukuba likhishwe enhliziyweni nase-aorta. Lapho i-ventricle iqede ukushaya, i-valve ye-aortic ivala ukugcina igazi ekubuyiseleni emuva kwe-ventricle kwesokunxele.
Uma uhlakulela ukuvuselelwa kwe-aortic, i-valve yakho ye-aortic ihluleka ukuvala ngokuphelele, ngaleyo ndlela ivumela igazi ukuba liphumele emuva kusukela e-aorta lingene ku-ventricle kwesokunxele. Lokhu "ukuvuselelwa" kwegazi kwenza inhliziyo isebenze kanzima kakhulu, futhi ukucindezeleka okungaphezu kwenhliziyo kungaholela ekuhlulekeni kwenhliziyo nezinye izinkinga ezibalulekile.
Yiziphi Izimbangela Zokuvuselelwa Kwe-Aortic?
Izifo eziningi zezokwelapha zingenza ukuvuselelwa kwe-aortic. Lokhu kufaka:
- Endocarditis. I-endocarditis (ukutheleleka kwe-valve yenhliziyo) ingabangela i-valve ye-aortic ukuba ihlasele, ikhiqize ukuphindaphinda.
- I-valve ye-aortic ye-bicuspid. Ukuvuselelwa kwe-Aortic kungabangelwa i-valve bicuspid, isimo sokubeletha lapho i-valve ye-aortic iqukethe "ama-cusps" amabili kuphela (okungukuthi, ama-flaps) esikhundleni sezintathu ezijwayelekile. Ama-valve ama-aortic ama-bicus ahloswe kakhulu ekwakhiweni kwe-calcium deposits, evame ukukhiqiza i- aortic stenosis . Ngakho iziguli ezine-valve e-bicuspid aortic zingase zenze kokubili isifo nokuvuselelwa.
- Isifo senhliziyo esiyinkimbinkimbi . Eminyakeni engamashumi ayisihlanu edlule, isifo senhliziyo esisodwa sasiyisifo esiyinhloko sokuvuselelwa kwe-aortic ezweni elithuthukile. Ngokufika kwama-antibiotics, isifo se-heart rheumatic sesiyinto engavamile.
- Ukuvuselelwa kwe-aortic ebusweni. Izinhlobo eziningana zesifo senhliziyo esingazalwa zingenza ukuvuselelwa kwe-aortic, kuhlanganise ne-Turner syndrome, i-tetralogy ye-Fallot, ne-truncus arteriosus.
- Ukuxuba kwempande ye-aortic. Umsuka we-aorti uyisabelo se-aorta ngokushesha ngaphezu kwe-valve ye-aortic. Izimo eziningana zingabangela izimpande ze-aortic ukuba zinciphise noma zande. Lokhu kuncibilikisa kungaphazamisa i-aortic valve ngokwayo, kubangele ukuphindaphinda. Ezinye zezimbangela ze-aortic root dilation zihlanganisa ukucindezeleka okungapheli, i-aortitis (ukuvuvukala kwe-aorta, okungabangelwa izifo ezinjenge-syphilis), ukulimala kwesifuba, ukusabalalisa kwe-aortic (ukudubula ngokuzumayo kodonga lwe-aorta, obangelwa isifo se-vascular degenerative ), ne-Marfan syndrome.
Iziphi Izinkinga Ezibangelwa Ukuvuselelwa Kwe-Aortic?
Ngokuphindaphindiwe kwe-aortic, i-ventricle yangakwesokunxele kufanele isebenze kanzima ukuze inikeze izicubu zomzimba ngesamba esanele segazi. Ngokuqondile, nge-heartbeat ngayinye, i-ventricle kumele ichithe lonke igazi elidinga umzimba, kanye nenani legazi elibuyisela emuva ngaphakathi kwe-ventricle. Leli gesi legazi elengeziwe lenza ukuba imisipha yezinhliziyo iqhube (noma "hypertrophy") futhi ibangele ukuba i-ventricle yesokunxele ihlise.
Lokhu ukucindezeleka okungeziwe kwi-ventricle yangakwesokunxele ekugcineni kungaholela ekuhlulekeni kwenhliziyo, futhi ku-arrhythmias ye-cardiac njenge -fibrillation ye-atrial , i- tricycardia ye-ventricular , ne-fibrication ye-ventricular.
Izinhlobo ezincane zokuvuselelwa kwe-aortic ngokuvamile azikhiqizi izimpawu. Kodwa-ke, uma ukuphindwa kabusha kuqhubeka, i-ventricle iba yinkimbinkimbi nokucindezeleka kwenhliziyo iqala ukuthuthukisa. Ngalesi sigaba, umuntu ozovuselela i-aortic uzoqala ukuqaphela i- dyspnea (ukuphefumula okuncane) ngokuzikhandla nokukhathala okuqala. Lezi zimpawu ziba nzima kakhulu njengoba ukuphindaphindiwe kubonakala kubaluleke kakhulu, futhi ekugcineni kungaba nzima kakhulu.
Nakuba ukuvuselelwa kwe-aortic kuvame ukukhula kancane kancane - esikhathini esithile seminyaka - kwezinye izimo kungenzeka ngokuzumayo. Ukuphindaphinda kwe-aortic okuvame kakhulu kubangelwa i-endocarditis, i-aortic dissection, noma i-traum trauma.
Ukuphindaphindiwe kwe-aortic okuvame ukukhiqiza ukuhluleka kwenhliziyo ngokuzumayo nangokweqile, futhi kungelashwa kuphela ngokuhlinzwa okuphuthumayo kwe-valve.
Ukubuyiselwa Kwama-Aortic Kutholakala Kanjani?
Ukuxilongwa kokuvuselelwa kwe-aortic kuhle kakhulu. Ukuvuselelwa kwe-Aortic kubangela ukuba inhliziyo yezinhlamvu ikhononde ngokuthi odokotela abaningi bayokwazi ngokushesha. Ukuxilongwa kungaqinisekiswa noma kugwetshwe nge- echocardiogram .
Ukwelapha ukuvuselelwa kwe-Aortic
Ekugcineni, ukwelashwa kabusha kwe-aortic kudinga ukuguqulwa kokuhlinzwa kwe-valve ewonakele. Izidakamizwa ezithwala imithwalo yegazi (ngokuvamile, izivimbela ze-calcium noma i- ACE inhibitors ) zingasiza ukunciphisa inani legazi elibuyela emuva ngaphakathi kwe-ventricle engakwesokunxele futhi lingasiza ukulawula izimpawu. Futhi ngokuqinisekile, abanye abantu abane-aortic abuyele ukuvuselelwa akudingeki bahlinzekwe nhlobo. Kodwa ukuvuselelwa kwe-aortic kuyinkinga yemishini, futhi ukubhekana nayo ngempela, udinga isisombululo semishini.
Ukusebenza kwesikhathi sokuhlinzwa kubaluleke kakhulu. Njengomthetho jikelele, ukuhlinzwa kwe-valor aortic kufanele kwenziwe ngaphambi nje kokuba ukuvuselelwa kwe-aortic kuqala ukuveza izimpawu. Izivivinyo zemizimba ngezikhathi ezithile kanye nama-echocardiograms ikakhulukazi ngezikhathi ezithile ziwusizo ekwandiseni isikhathi sokuhlinzwa.
Esinye isinqumo esibalulekile yilona uhlobo lwe-valve ezayo ezosetshenziswa. Ama-valve e-prothétique ahlanganiswe ngokuphelele ngezinto ezenziwe abantu (ama-valve mechanical) noma zenziwe kusukela ku-valve yenhliziyo yesilwane, ngokuvamile ingulube (i-valve ye-bioprosthetic). Ukunquma ukuthi yiluphi uhlobo lwe-valve yokufakelwa okufanele lusetshenziswe kuncike ekuguleni kwesiguli nokuthi ngabe ukuthatha i-antiticoagulation engavamile kuyinkinga.
Zonke izivinji zenhliziyo ezinamandla zinezikhukhula ezengeziwe zokwenza ama-clots egazi. Noma kunjalo, ukugaya igazi kungaphansi kwenkinga nge-bioprosthetic kunama-valve kagesi, ngakho-ke abantu abane-valve ye-bioprosthetic angeke bathathe i-anticoagulant, kuyilapho labo abaneziphazamisi zemishini bahlale bezenza. Ngakolunye uhlangothi, ama-valve kagesi ngokuvamile ahlala isikhathi eside kunama-valve e-bioprosthetic.
Ukwengeza, uhlobo oluthile olungavamile lwe-aortic valve esikhundleni manje luvunyelwe i-FDA - i- transcatheter aortic valve implantation, noma i-TAVI . Ngenkathi ukuhlinzekwa kwe-TAVI kungabonakali kakhulu kunokuba kusetshenziswe i-valve esikhundleni, le nqubo isengcupheni enkulu. Ngokuvamile, namuhla kulondolozwe iziguli ezithathwa njengokuthi "zigula kakhulu" esikhundleni se-valve ejwayelekile. Kodwa-ke, njengoba isipiliyoni se-TAVI sinqwabelana ngokuqinisekile ngeke sitholakale kwizigaba ezibanzi zeziguli ezidinga ukufakwa esikhundleni se-valve.
Ngakho-ke: Uma udinga i-valve esikhundleni sokuvuselela i-aorti, futhi uneminyaka engaphansi kweminyaka engu-65 noma engu-70 futhi ungathatha i-anticoagulant, udokotela wakho mhlawumbe uncoma i-valve mechanical. Uma usudala kuneminyaka engu-65 noma engu-70, noma awukwazi ukuthatha i-anticoagulant, i-valve ye-bioprosthetic cishe iyophakanyiswa. Uma ngabe ingozi yakho yokuhlinzeka ibonakala iphakeme kakhulu, i-TAVI kufanele icatshangelwe.
Okubalulekile ukuthi kunezinzuzo nezingozi kuwo wonke ama-valve wokufaka esikhundleni. Ukunquma uhlobo olufanele lwe-valve kufanele kube yisinqumo esabiwe phakathi kwakho nodokotela wakho.
Imithombo:
Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC isiqondiso sokuphathwa kweziguli ezine-valvular isifo senhliziyo: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2014; 63: e57.