Umutima Utatera ne Kuvura Umuhogo mu Mutima: Ibimenyetso, Intandaro, n’Uko Uvuzwa

Umutima utatera ne kuvura umuhogo mu mutima ni ikibazo gikomeye cy’umutima abana bavukana, aho umuvure w’umuhoro utubaka neza kandi hari umwobo hagati y’ibice by’ingenzi by’umutima bikubita. Ibi bivuze ko amaraso adafite ogisijeni adashobora kugenda neza ava mu mutima yerekeza mu mpyiko kugira ngo afate ogisijeni.

Tekereza ku mutima wawe nk’ufite ibyumba bine bifite imiryango hagati yabyo. Muri iki kibazo, kimwe muri ibyo byumba (umuvure w’umuhoro) gifunze rwose, kandi hari ubwambuzi ku rukuta hagati y’ibyumba bibiri bitagomba kubaho. Ibi bituma habaho ikibazo gikomeye aho umutima w’umwana wawe ugomba gukora cyane kugira ngo ubone ogisijeni umubiri.

Umutima Utatera ne Kuvura Umuhogo mu Mutima Ni iki?

Umutima utatera ne kuvura umuhogo mu mutima (PA-VSD) bibaho iyo ibibazo bibiri by’umutima bibaho hamwe kuva umwana avutse. Umuvure w’umuhoro, ugomba gufunguka kugira ngo amaraso ave mu mutima yerekeze mu mpyiko, uba ufunze cyangwa ubuze.

Muri icyo gihe, hari umwobo ku rukuta (septum) rutandukanya ibice bibiri byo hasi by’umutima (ventricles). Ubu buryo bwombi bituma bigoye cyane ko amaraso agera mu mpyiko kugira ngo afate ogisijeni.

Umubiri w’umwana wawe ugerageza kwishyura hakoreshejwe imitsi y’amaraso y’inyongera yitwa collateral circulation. Izi nzira zinyongera zifasha amaraso amwe kugera mu mpyiko, ariko ntabwo zikora neza nk’inzira isanzwe.

Iki kibazo kigira ingaruka ku bana bagera kuri 1 kuri buri 10.000 bavutse. Nubwo byumvikana nk’iby’akaga, iterambere mu kubaga umutima w’abana ryatumye kuvura kuba byoroshye kurusha mbere.

Ibimenyetso by’Umutima Utatera ne Kuvura Umuhogo mu Mutima Ni ibihe?

Ibimenyetso bya PA-VSD bigaragara mu minsi mike cyangwa mu byumweru bike by’ubuzima bw’umwana wawe. Ushobora kubona uruhu rw’umwana wawe, iminwa, cyangwa imisumari ihinduka y’ubururu, cyane cyane mu gihe arira cyangwa anywa.

Dore ibimenyetso by’ingenzi ugomba kwitondera:

• Ibara ry’ubururu ku ruhu, iminwa, cyangwa imisumari (cyanosis)
• Gukomeretsa guhumeka cyangwa guhumeka vuba
• Kunywesha nabi cyangwa kunanirwa vuba mu gihe cyo kunywa
• Kunanirirwa kwiyongera mu bunanire
• Kwiyongera kw’uburakari cyangwa guhora uhangayitse
• Imikono n’ibirenge by’umwana bikaba binini (imikono iba yoroshye kandi ikaba nini)
• Guta ubwenge cyangwa igihe umwana wawe aba adafite imbaraga

Bamwe mu bana bashobora kugira ingaruka zikomeye kurushaho nko kunanirwa kw’umutima, aho umutima uba udashobora kubumba amaraso neza. Mu bihe bitoroshye, abana bashobora kugira ibibazo by’ubwonko cyangwa stroke kubera amaraso akabumbira.

Ubukana bw’ibimenyetso bushobora gutandukana cyane bitewe n’amaraso menshi ashobora kugera mu mpyiko binyuze mu nzira zinyongera twavuze haruguru.

Ubwoko bw’Umutima Utatera ne Kuvura Umuhogo mu Mutima Ni ubuhe?

Abaganga basanzwe basobanura PA-VSD bashingiye ku buryo amaraso agera mu mpyiko n’imiterere yihariye y’umutima w’umwana buri wese. Itandukaniro nyamukuru ni uko umwana wawe afite amaraso ahagije yerekeza mu mpyiko cyangwa atayifite.

Ubwoko bwa 1 burimo abana bafite imitsi myiza y’amaraso y’inyongera yateye mu buryo bw’umwimerere kugira ngo itange amaraso mu mpyiko. Izi nzira zinyongera zishobora gutanga amaraso ahagije, nubwo atari menshi nk’uko umutima usanzwe watanga.

Ubwoko bwa 2 burimo abana bafite imitsi y’amaraso y’inyongera micye cyangwa idahagije. Aba bana bakeneye ubufasha bwihuse kuko impyiko zabo ziba zidafite amaraso ahagije.

Hari kandi isobanuro rishingiye ku kuba imitsi y’amaraso y’ingenzi (imitsi minini itwara amaraso yerekeza kuri buri mpyiko) iteye neza cyangwa ari mito. Abana bafite imitsi y’amaraso minini kandi iteye neza bagira umusaruro mwiza.

Umuganga w’umutima w’umwana wawe azamenya ubwoko bw’umwana wawe afite binyuze mu bushakashatsi bw’amashusho, ibi bifasha mu gutegura gahunda yo kuvura.

Intandaro z’Umutima Utatera ne Kuvura Umuhogo mu Mutima Ni izihe?

PA-VSD itera mu byumweru 8 bya mbere byo gutwita igihe umutima w’umwana wawe uba ukirimo gukura. Intandaro nyayo ntiyumvikana neza, ariko isa n’ihuriro ry’ibintu by’umurage n’ibidukikije.

Ibyinshi bibaho mu buryo butunguranye nta kintu cyabiteye. Imiterere y’umutima w’umwana wawe ntabwo itera neza muri ibyo byumweru by’ingenzi bya mbere igihe imyanya y’umubiri iba ikura.

Dore bimwe mu bintu bishobora kongera ibyago:

• Indwara z’umurage nka DiGeorge syndrome cyangwa CHARGE syndrome
• Amateka y’umuryango afite ibibazo by’umutima wavutse
• Diabete ya nyina mu gihe cyo gutwita
• Imiti imwe ifatwa mu gihe cyo gutwita
• Indwara za nyina nka rubella mu gihe cyo gutwita
• Itabi rya nyina mu gihe cyo gutwita
• Imyaka myinshi ya nyina (irenga 35)

Mu bihe bitoroshye, PA-VSD ishobora kuba igice cy’indwara y’umurage ikomeye igira ingaruka ku myanya myinshi y’umubiri. Ariko, abana benshi bafite iki kibazo baragifite nk’ikibazo cy’umutima gusa.

Ni ngombwa kumenya ko nta kintu wakoze cyangwa utarakora mu gihe cyo gutwita cyateye iki kibazo. Ibibazo by’umutima nka PA-VSD bibaho mu gihe cyo gutwita hakiri kare, mbere y’uko uzi ko utwite.

Ni ryari ukwiye kujya kwa muganga kubera Umutima Utatera ne Kuvura Umuhogo mu Mutima?

PA-VSD isanzwe imenyekana mu gihe cyo gutwita binyuze mu isuzuma rya ultrasound, busanzwe bukorwa mu byumweru 18-22. Niba bikekwa, muganga wawe azategeka ultrasound yihariye yitwa fetal echocardiogram kugira ngo abone amashusho y’umutima w’umwana wawe.

Nyuma yo kuvuka, ibizamini byinshi bigomba gukorwa kugira ngo tumenye imiterere y’umutima w’umwana wawe. Ibara ry’uruhu rw’umwana wawe, uburyo bwo guhumeka, n’ibibazo byo kunywa bikunze gutanga ibimenyetso bya mbere by’uko hari ikintu gikenewe kwitabwaho.

Uburyo bwo kuvura busanzwe burimo:

1. Isuzuma ry’umubiri no gutega amatwi umutima
2. X-ray y’ibituro kugira ngo turebe ingano y’umutima n’amaraso mu mpyiko
3. Echocardiogram (ultrasound y’umutima) kugira ngo turebe imiterere y’umutima
4. Electrocardiogram (EKG) kugira ngo turebe imiterere y’umutima
5. Pulse oximetry kugira ngo turebe urwego rw’ogisijeni
6. Cardiac catheterization kugira ngo turebe neza ibipimo
7. MRI cyangwa CT scan kugira ngo turebe amashusho

Cardiac catheterization ni ingenzi cyane kuko iha abaganga uburyo bwo kubona uko amaraso agenda mu mutima w’umwana wawe kandi bakapima umuvuduko mu byumba bitandukanye. Aya makuru ni ingenzi mu gutegura kuvura.

Umuganga w’umutima w’umwana wawe azareba kandi niba hari izindi ndwara z’umurage cyangwa izindi ndwara z’umutima zishobora kubaho. Iyi gahunda y’isuzuma irambuye ifasha mu gutegura gahunda yo kuvura ikwiranye n’umwana wawe.

Ibyago by’Umutima Utatera ne Kuvura Umuhogo mu Mutima Ni ibihe?

Hari ibintu byinshi bishobora kongera amahirwe yo kugira umwana ufite PA-VSD, nubwo abana benshi bafite iki kibazo bavuka ku babyeyi badafite ibyago bizwi. Gusobanukirwa ibi bintu bishobora gufasha mu gutegura umuryango no kwita ku gutwita.

Dore ibyago by’ingenzi abaganga bamenye:

• Kugira undi mwana ufite ikibazo cy’umutima wavutse
• Umubyeyi cyangwa umuvandimwe ufite ikibazo cy’umutima wavutse
• Indwara zimwe z’umurage mu muryango
• Diabete ya nyina (ubwoko bwa 1 cyangwa ubwoko bwa 2)
• Imyaka myinshi ya nyina irenga imyaka 35
• Kunywa imiti imwe mu gihe cyo gutwita
• Indwara za nyina mu gihe cyo gutwita
• Itabi cyangwa inzoga mu gihe cyo gutwita

Mu bihe bitoroshye, PA-VSD iba igice cy’indwara z’umurage nka DiGeorge syndrome, igira ingaruka ku myanya myinshi y’umubiri. Imiryango imwe ishobora kugira ibyago byinshi kubera ibintu by’umurage, ariko ibi ni bike.

Niba ufite ibyago, muganga wawe ashobora kugutegeka gukurikirana byinshi mu gihe cyo gutwita, harimo ultrasound yihariye y’umutima (fetal echocardiograms) kugira ngo arebe uko umutima w’umwana wawe ukura.

Ingaruka zishoboka z’Umutima Utatera ne Kuvura Umuhogo mu Mutima Ni izihe?

Utabonye ubuvuzi, PA-VSD ishobora gutera ingaruka zikomeye zigira ingaruka ku mikurire y’umwana wawe, iterambere, n’imibereho myiza. Inkuru nziza ni uko ubuvuzi bugezweho bushobora gukumira cyangwa gucunga neza izi ngaruka.

Ingaruka zisanzwe zirimo:

• Gutinda gukura no kunanirwa gukura
• Ibyago byiyongereye byo kwandura mu mpyiko
• Ibibazo by’umutima (arrhythmias)
• Kunanirwa kw’umutima
• Stroke kubera amaraso akabumbira
• Ubwonko bw’ubwonko kubera kwandura
• Ibibazo by’impyiko kubera amaraso adatembera neza
• Gutinda gukura

Bamwe mu bana bashobora kugira ingaruka zikomeye ariko zidafite akaga nko kwandura kw’imbere y’umutima (endocarditis). Abandi bashobora kugira ibibazo byo kuva amaraso kubera amaraso adakabumbira neza.

Ingaruka z’igihe kirekire zishobora kuba umuvuduko w’amaraso muri impyiko (pulmonary hypertension) no kunanirwa kw’umutima niba iki kibazo kidacungwa neza. Ariko, hamwe no kuvura bikwiye no gukurikirana, izi ngaruka nyinshi zishobora gukumirwa cyangwa kuvurwa neza.

Itsinda ry’abaganga b’umwana wawe rizahora rikurikirana izi ngaruka binyuze mu bugenzuzi n’ibizamini bisanzwe, bigatuma habaho ubufasha bwihuse igihe bibaye ngombwa.

Uko Umutima Utatera ne Kuvura Umuhogo mu Mutima Umenyekanishwa?

PA-VSD ikunze kumenyekana mu gihe cyo gutwita binyuze mu isuzuma rya ultrasound, busanzwe bukorwa mu byumweru 18-22. Niba bikekwa, muganga wawe azategeka ultrasound yihariye yitwa fetal echocardiogram kugira ngo abone amashusho y’umutima w’umwana wawe.

Nyuma yo kuvuka, ibizamini byinshi bigomba gukorwa kugira ngo tumenye imiterere y’umutima w’umwana wawe. Ibara ry’uruhu rw’umwana wawe, uburyo bwo guhumeka, n’ibibazo byo kunywa bikunze gutanga ibimenyetso bya mbere by’uko hari ikintu gikenewe kwitabwaho.

Uburyo bwo kuvura busanzwe burimo:

1. Isuzuma ry’umubiri no gutega amatwi umutima
2. X-ray y’ibituro kugira ngo turebe ingano y’umutima n’amaraso mu mpyiko
3. Echocardiogram (ultrasound y’umutima) kugira ngo turebe imiterere y’umutima
4. Electrocardiogram (EKG) kugira ngo turebe imiterere y’umutima
5. Pulse oximetry kugira ngo turebe urwego rw’ogisijeni
6. Cardiac catheterization kugira ngo turebe neza ibipimo
7. MRI cyangwa CT scan kugira ngo turebe amashusho

Cardiac catheterization ni ingenzi cyane kuko iha abaganga uburyo bwo kubona uko amaraso agenda mu mutima w’umwana wawe kandi bakapima umuvuduko mu byumba bitandukanye. Aya makuru ni ingenzi mu gutegura kuvura.

Umuganga w’umutima w’umwana wawe azareba kandi niba hari izindi ndwara z’umurage cyangwa izindi ndwara z’umutima zishobora kubaho. Iyi gahunda y’isuzuma irambuye ifasha mu gutegura gahunda yo kuvura ikwiranye n’umwana wawe.

Uko Umutima Utatera ne Kuvura Umuhogo mu Mutima Uvuzwa?

Kuvura PA-VSD hafi ya hose bisaba kubagwa, ariko igihe n’uburyo biterwa n’umwana wawe n’ibimenyetso. Intego ni ugufasha amaraso menshi kugera mu mpyiko no kugabanya umutwaro ku mutima w’umwana wawe.

Abana benshi bakeneye kubagwa bwa mbere mu mezi make ya mbere y’ubuzima bwabo. Iki gikorwa cya mbere, cyitwa Blalock-Taussig shunt, gikora inzira nshya y’amaraso kugera mu mpyiko hakoreshejwe umuyoboro muto.

Gahunda yuzuye yo kuvura isanzwe irimo kubagwa kenshi mu myaka myinshi:

1. Kubagwa bwa mbere (busanzwe mu mezi ya mbere y’ubuzima)
2. Kubagwa hagati kugira ngo amaraso agere mu mpyiko (mu mezi 4-6)
3. Kubagwa gukemura burundu (busanzwe hagati y’amezi 6 na 2)
4. Kubagwa bishoboka byinyongera uko umwana wawe akura

Hagati y’ubuganga, umwana wawe azakenera imiti ifasha umutima gukora neza no gukumira ingaruka. Ibi bishobora kuba imiti igabanya amazi no gufasha umutima gukubita neza.

Bamwe mu bana bashobora gukenera ibindi bikorwa nko gukoresha ballon angioplasty kugira ngo bafungure imitsi y’amaraso mito cyangwa gushyira ibikoresho kugira ngo dufungure ubwambuzi hagati y’imitsi y’amaraso.

Itsinda ry’abaganga bazakorana nawe kugira ngo bagene igihe cyiza cyo kubaga, hakurikijwe imikurire y’umwana wawe, ibimenyetso, n’ubuzima bwa rusange. Kubaga umutima w’abana bigezweho bifite umusaruro mwiza mu kuvura PA-VSD.

Uko Witwara mu Rugo mu Gihe cy’Umutima Utatera ne Kuvura Umuhogo mu Mutima?

Kwita ku mwana ufite PA-VSD mu rugo bisaba kwitondera byihariye, ariko imiryango myinshi irakwirangira neza hamwe n’amabwiriza akwiye. Igikorwa cyawe nyamukuru kizaba ari ukureba ibimenyetso by’umwana wawe no guhamya ko abona indyo yuzuye n’ikiruhuko gihagije.

Kunywesha bishobora kuba bigoye kuko abana bafite PA-VSD bakunze kunanirwa vuba. Bahe ibiryo bike, byinshi, kandi utekereze ku maforomula afite amavuta menshi niba muganga wawe abisabye kugira ngo afashe mu kwiyongera mu bunanire.

Dore ibintu by’ingenzi byo kwitaho mu rugo:

• Kureba ibara ry’uruhu, cyane cyane ku minwa n’imisumari
• Kureba impinduka mu buryo bwo guhumeka
• Gukurikirana kwiyongera mu bunanire n’uburyo bwo kunywa
• Guha imiti nk’uko yategetswe
• Gukumira indwara hamwe n’isuku nziza
• Kugabanya uburyo bwo guhura n’abarwayi
• Kugira gahunda yo kuryama
• Gukurikiza amabwiriza yo gukora imyitozo nk’uko byategetswe

Andika ibyabaye buri munsi by’ibimenyetso by’umwana wawe, ibiryo, n’impinduka zose ziteye impungenge. Aya makuru afasha itsinda ry’abaganga bawe gufata ibyemezo byuzuye ku gihe cyo kuvura no guhindura.

Shyiraho ahantu hatuje, hafasha mu rugo. Abana bafite ibibazo by’umutima bakunze gukora neza bafite gahunda zihoraho n’umunaniro muke. Ntugatinye gusaba umuryango n’inshuti gufasha mu mirimo ya buri munsi kugira ngo ushobore kwibanda ku kwita ku mwana wawe.

Uko Wakitegura Kugenda kwa Muganga?

Kwitoza kujya kwa muganga bifasha mu kugira ngo ubone ibyiza byinshi muri buri gikorwa kandi utibagiwe ibibazo cyangwa impungenge z’ingenzi. Komeza urutonde rw’ibintu byabaye ku mwana wawe hagati y’ibikorwa.

Zana dosiye yuzuye y’ubuvuzi bw’umwana wawe, harimo ibizamini cyangwa ibindi bikorwa byakozwe n’abandi baganga. Niba wari ufite ibyabaye buri munsi, bizane kuko bitanga amakuru y’ingenzi ku mibanire n’impinduka.

Dore ibyo ugomba kwitegura mbere y’ibikorwa buri gihe:

• Urukuta rw’imiti iriho n’ibipimo
• Ibibazo ku kibazo cy’umwana wawe no kuvura
• Impungenge ku bimenyetso cyangwa impinduka mu myitwarire
• Amakuru ku kunywa, gukura, n’iterambere
• Amakuru y’ubwisungane n’impapuro zikenewe
• Amakuru y’abantu bakwitaho mu gihe cy’akaga
• Ibintu byo guhumuriza umwana wawe

Andika ibibazo by’ingenzi mbere, nko kubaza ibyerekeye amabwiriza yo gukora imyitozo, igihe kubagwa bishobora kuba ngombwa, cyangwa ibibazo by’ingenzi bigomba kwitabwaho. Ntugatinye kubaza ibibazo byinshi - itsinda ry’abaganga bawe rishaka ko uba uzi neza.

Tekereza kuzana umuntu wo mu muryango cyangwa inshuti kugira ngo aguhe inkunga, cyane cyane mu gihe cy’ibikorwa aho ibyemezo by’ingenzi bizafatwa. Kugira undi muntu uri aho bishobora kugufasha kwibuka amakuru y’ingenzi no guha inkunga.

Icyemezo cy’ingenzi ku Mutima Utatera ne Kuvura Umuhogo mu Mutima Ni iki?

PA-VSD ni ikibazo gikomeye cy’umutima ariko kivurwa gisaba ubuvuzi bwihariye no kubagwa kenshi mu gihe. Nubwo ibyo kumenya bishobora kuba by’akaga, iterambere mu kubaga umutima w’abana ryatumye umusaruro wiyongera cyane ku bana bafite iki kibazo.

Abana benshi bafite PA-VSD bashobora kubaho ubuzima buzuye, bukorwa neza nyuma yo kuvurwa neza no gukurikirana. Ikintu nyamukuru ni ugukorana n’itsinda ry’abaganga b’umutima w’abana no gukurikiza amabwiriza yabo yo kubaga no gukurikirana.

Urugendo rw’umwana wawe ruzaba rwihariye, kandi gahunda yo kuvura ikozwe ku buryo buri wese. Bamwe mu bana bashobora gukenera ibindi bikorwa kurusha abandi, ariko intego ihora ari ugufasha umwana wawe kugira imibereho myiza.

Wibuke ko nturi wenyine muri uru rugendo. Itsinda ry’abaganga bawe, umuryango, n’amatsinda y’inkunga bashobora gutanga ubufasha n’inkunga by’agaciro. Imiryango myinshi isanga ari ingirakamaro guhura n’abandi bamaze kunyura muri uru rugendo.

Ibibazo Bikunze Kubahwa ku Mutima Utatera ne Kuvura Umuhogo mu Mutima

Umutima wanjye ufite PA-VSD ushobora kubaho ubuzima busanzwe?

Abana benshi bafite PA-VSD bashobora kubaho ubuzima buzuye, bukorwa neza nyuma yo kuvurwa neza. Nubwo bazakenera gukurikiranwa n’abaganga b’umutima ubuzima bwabo bwose kandi bashobora kugira bimwe mu byo gukora, abenshi bashobora kwitabira ishuri, siporo, n’ibindi bikorwa by’abana. Ikintu nyamukuru ni ugukorana n’itsinda ry’abaganga bawe kugira ngo ubu burwayi bucungwe neza kandi ubugenzuzi bukorwe igihe cyose.

Ingano y’ubuganga umwana wanjye azakenera ni iyihe?

Abana benshi bafite PA-VSD bakeneye kubagwa inshuro 2-3 mu myaka mike ya mbere y’ubuzima bwabo, bafite uburyo bwo kubagwa byinyongera uko bakura. Umubare nyakuri uterwa n’imiterere y’umwana wawe n’uko asubiza neza kuvura. Umuganga wawe azakubwira uburyo bwo kubaga uteganijwe kandi akugire inama y’ibyo witegura muri buri cyiciro.

Ingaruka z’igihe kirekire za PA-VSD ni izihe?

Hamwe no kuvurwa neza, abana benshi bafite PA-VSD bashobora kwitega umusaruro mwiza w’igihe kirekire. Ariko, bazakenera gukurikiranwa n’abaganga b’umutima ubuzima bwabo bwose kugira ngo bakurikirane imikorere y’umutima kandi barebe ingaruka zishoboka. Bamwe bashobora kugira ibibazo byo gukora imyitozo cyangwa gukenera ibindi bikorwa mu myaka yabo y’ubukure, ariko abenshi babaho ubuzima busanzwe bafite ubuvuzi bukwiye.

PA-VSD ishobora gukumirwa?

Ubu, nta buryo bwo gukumira PA-VSD kuko itera mu gihe cyo gutwita hakiri kare kubera ibintu byinshi bitagenzurwa. Ariko, kugira ubuvuzi bwiza bwo gutwita, gucunga diabete niba iriho, kwirinda inzoga n’itabi mu gihe cyo gutwita, no gufata imiti ya folic acid bishobora gufasha mu iterambere ry’umwana muzima.

PA-VSD izagira ikihe kigero ku mikurire n’iterambere ry’umwana wanjye?

Mbere yo kubagwa, abana bafite PA-VSD bakunze kugira ibibazo byo kwiyongera mu bunanire kandi bashobora kugera ku ntambwe z’iterambere nyuma y’igihe. Nyuma yo kuvurwa neza, abana benshi barasubira inyuma cyane mu mikurire n’iterambere. Itsinda ry’abaganga bawe rizahora rikurikirana ibi bintu kandi rizatanga ubufasha niba bibaye ngombwa kugira ngo umwana wawe agere ku bushobozi bwe bwuzuye.