Kubagwa umutsi wa Aorta ni iki? Impamvu, Uburyo & Gukira

Kubagwa umutsi wa Aorta ni uburyo bwo kubaga umutima busana cyangwa bugasimbura urufatiro rwa aorta yawe, umutsi munini utwara amaraso ava mu mutima wawe ukajya mu bindi bice by'umubiri wawe. Urufatiro rwa aorta rumeze nk'ishingiro ry'irembo rikuru ry'umutima wawe, kandi iyo ryangiritse cyangwa rikabyimba, kubagwa birashobora gusubiza imikorere myiza y'amaraso no kurengera imikorere y'umutima wawe.

Ubu buryo bushobora kumvikana nk'ubworoheje, ariko ibihumbi by'abantu babagwa umutsi wa aorta buri mwaka. Kumva icyo bikubiyemo birashobora kugufasha kumva witeguye kandi ufite icyizere ku bijyanye n'inzira.

Kubagwa umutsi wa aorta ni iki?

Kubagwa umutsi wa aorta bikubiyemo gusana cyangwa gusimbuza urufatiro rwa aorta, ari rwo gice aho aorta yawe ihurira n'umutima wawe. Iri shyirahamwe rikubiyemo valve ya aorta n'igice cya mbere cya aorta ubwayo.

Tekereza urufatiro rwa aorta nk'aho amaraso ava mu cyumba gikuru cy'umutima wawe. Iyo aka gace karwaye, kakabyimba, cyangwa kangiritse, bishobora kugira ingaruka ku buryo umutima wawe utera amaraso mu mubiri wawe.

Hariho ubwoko butandukanye bwo kubagwa umutsi wa aorta. Umuganga wawe ushinzwe kubaga ashobora gusana igice cyawe gisanzwe, agasimbura valve gusa, cyangwa agasimbura igice cyose cy'urufatiro bitewe n'uburwayi bwawe bwihariye.

Kuki kubagwa umutsi wa aorta bikorwa?

Muganga wawe agushishikariza kubagwa umutsi wa aorta iyo urufatiro rwa aorta rwagize ubunini burenze, rwangiritse, cyangwa rwarwaye ku buryo rutagikora neza. Ibi bishobora kubaho bitewe n'uburwayi butandukanye bugira ingaruka ku bushobozi bw'umutima wawe bwo gutera amaraso neza.

Impamvu isanzwe ni aneurysme y'urufatiro rwa aorta, aho inkuta za aorta zicogora zigasa nk'izibyimba hanze nk'agahururu. Hatabayeho kuvurwa, uku kubyimba bishobora kuba ibyago kandi bishobora gushyira ubuzima mu kaga.

Dore indwara zikomeye zishobora gusaba kubagwa umutsi wa aorta:

• Aneurisme y'imizi ya aorota (kwaguka kw'imizi ya aorota)
• Indwara ya valve ya aorota igira ingaruka ku muzi uyikikije
• Aortic dissection (gucika kw'urukuta rwa aorota)
• Syndrome ya Marfan cyangwa izindi ndwara zifitanye isano n'imitsi ihujwe
• Valve ya aorota ya bicuspid hamwe no kwaguka kw'imizi
• Udukoko tw'imizi ya aorota (endocarditis)
• Ubumuga bwo mu mutima bwo kuva bavutse bugira ingaruka ku muzi wa aorota

Ibintu bike bidasanzwe nka syndrome ya Loeys-Dietz cyangwa syndrome ya Ehlers-Danlos nabyo bishobora kunaniza imizi ya aorota uko igihe kigenda. Muganga wawe azasuzuma neza uko ubuzima bwawe buhagaze kugira ngo amenye niba kubagwa ari ryo hitamo ryiza kuri wowe.

Ni iki gikorerwa kubagwa kw'imizi ya aorota?

Kubagwa imizi ya aorota bikorerwa munsi ya anesthesia rusange mu cyumba cy'ibagiro cyo mu bitaro na muganga w'umutima. Ubusanzwe iki gikorwa gifata amasaha 3 kugeza kuri 6, bitewe n'uburyo ikibazo cyawe kimeze.

Umuganga wawe azakora urukonda mu gituza cyawe akoreshe imashini y'umutima n'ibihaha kugira ngo ifate akazi ko gutera k'umutima wawe mu gihe gito cy'ibikorwa. Ibi bituma umuganga wawe akora ku mutima wawe mu gihe utagikora.

Intambwe zihariye ziterwa n'ubwoko bw'ubuvuzi ukeneye:

1. Gusimbuza imizi ya aorota: Umuganga wawe akuraho imizi yangiritse akayisimbuza urukiramende, akenshi rukozwe mu bintu bya sintetike cyangwa imitsi y'inyamaswa
2. Gusimbuza imizi itarimo valve: Valve ya aorota nzima irarindwa mugihe hasimburwa gusa igice cyagutse cy'imizi
3. Gusimbuza urukiramende ruhuriweho: Valve ya aorota n'imizi byombi byasimburwa n'igice kimwe kirimo ibice byombi
4. Uburyo bwa Ross: Valve yawe bwite ya pulmonary yimurwa kugira ngo isimbure valve ya aorota n'imizi

Mugihe cyo kubagwa, umuganga wawe ashobora kandi gukenera gusubiza imitsi ya koronari kugira ngo yemeze imikorere myiza y'amaraso mu mikaya y'umutima wawe. Iki ni igice cyoroshye ariko gisanzwe cy'iki gikorwa.

Uburyo bwo kwitegura kubagwa imizi ya aorota yawe?

Kwitegura kubagwa umutsi w'umutima bikubiyemo intambwe z'ingenzi zigufasha kugira ngo ibisubizo bibe byiza. Itsinda ry'abaganga bazagufasha mu gihe cyo kwitegura mu byumweru bizaba biri imbere y'uko ubagwa.

Mbere na mbere, uzakorerwa ibizamini byinshi kugira ngo bagenzure imikorere y'umutima wawe n'ubuzima bwawe muri rusange. Ibi bikubiyemo ibizamini by'amaraso, imirasire ya X yo mu gituza, echocardiograms, rimwe na rimwe catheterization y'umutima cyangwa CT scans.

Ibi nibyo ushobora kwitega mu gihe cyo kwitegura:

• Reka kunywa itabi byibuze mbere y'ibyumweru 2 mbere yo kubagwa kugira ngo wongere ubuzima
• Hindura cyangwa uhagarike imiti imwe n'imwe nk'uko byategetswe na muganga wawe
• Gira isuku nziza y'amenyo kandi uvure ibibazo byose by'amenyo
• Kurikiza amabwiriza y'imirire mbere yo kubagwa, akenshi kwiyiriza kuva saa sita z'ijoro mbere yo kubagwa
• Tegura umuntu uzagutwara akagusubiza mu rugo kandi agufashe mu gihe cyo koroherwa
• Tegura urugo rwawe kugira ngo ukore neza hamwe n'intebe nziza n'ibintu byoroshye kugera kuri byo

Muganga wawe ashobora kandi kugusaba gukora imyitozo ngororamubiri mbere yo kubagwa niba ufite umwanya. Ibi birashobora gufasha gukomeza umutima wawe no kunoza imibereho yawe muri rusange kuri ubu buryo.

Ni gute usoma ibipimo byawe by'umutsi w'umutima?

Ibipimo by'umutsi w'umutima bikoreshwa cyane na echocardiography cyangwa CT scans kandi bipimwa muri milimetero. Muganga wawe azagereranya ibipimo byawe n'ibipimo bisanzwe bishingiye ku bunini bw'umubiri wawe n'imyaka yawe.

Ku bantu bakuru benshi, umutsi w'umutima usanzwe upima hagati ya milimetero 20-37 ku gice cyayo kirekire. Ariko, muganga wawe azabara ibintu bisanzwe ku bunini bw'umubiri wawe ukoresheje uburebure bwawe, uburemere bwawe, n'ubuso bw'umubiri wawe.

Uku niko abaganga basobanura ibipimo by'umutsi w'umutima:

• Bisanzwe: Muri gahunda yitezwe ku bunini bw'umubiri wawe
• Byagutse gato: 40-45 mm (bishobora gusaba gukurikiranwa)
• Byagutse mu rugero rwo hagati: 45-50 mm (gukurikiranwa hafi birakenewe)
• Byagutse cyane: Hejuru ya 50 mm (kubagwa bikunze gushyirwaho)

Muganga wawe azanareba uko umuzi wawe wa aortique ugenda wiyongera mu gihe. N'ubwo byaba bipima bito, bishobora gusaba kubagwa niba bigenda byihuta cyangwa niba ufite indwara zimwe na zimwe zishingiye ku bisekerezo.

Ni gute wakwitwara nyuma yo kubagwa umuzi wa aortique?

Kuvurwa nyuma yo kubagwa umuzi wa aortique ni inzira itinda, isanzwe ifata amezi menshi. Abantu benshi bamara iminsi 5-7 mu bitaro nyuma yo kubagwa, iminsi 1-2 ya mbere bakayimara muri serivisi y'abarwayi barembye kugira ngo babakurikirane hafi.

Mugihe uri mu bitaro, itsinda ry'abaganga rizagufasha gutangira kugenda, gukora imyitozo yo guhumeka, no kongera buhoro buhoro urwego rw'ibikorwa byawe. Uzatangira kandi gufata imiti yo kurengera umutima wawe no gukumira ingorane.

Ingengabihe yawe yo kuvurwa muri rusange ikurikiza iyi shusho:

• Ibyumweru 2 bya mbere: Kuruhuka mu rugo, kugenda intera ngufi, ntukazamure ibirenze ibiro 10
• Ibyumweru 2-6: Kongera buhoro buhoro intera yo kugenda, ibikorwa byoroheje byo mu rugo
• Ibyumweru 6-12: Gusubira mu bikorwa bisanzwe, ushobora gusubira ku kazi
• Amezi 3-6: Kuvurwa neza, gusubira mu bikorwa byose harimo imyitozo ngororamubiri

Uzakeneye gufata imiti ituma amaraso atiyongera niba warahawe valve ya mekaniki, kandi uzagira gahunda yo gukurikiranwa buri gihe kugira ngo ukurikirane iterambere ryawe. Abantu benshi bumva barushijeho kuba beza mu mezi make kandi bashobora gusubira mu buzima busanzwe.

Ni iki cyiza cyo kubagwa umuzi wa aortique?

Ibyiza byo kubagwa umuzi wa aortique ni igihe icyo gikorwa cyagenze neza gikumira ingorane ziteje akaga mugihe kigufasha gusubira mu bikorwa byawe bisanzwe hamwe n'imikorere y'umutima yarushijeho kuba myiza. Urwego rw'ubushobozi bwo kubagwa umuzi wa aortique birashishikariza cyane, abantu benshi bagira ibisubizo byiza by'igihe kirekire.

Kubaga umuzi wa awo utunganya imitsi y'umutima ya none bifite intsinzi nyinshi cyane, aho abantu barenga 95% barokoka nyuma yo kubagwa bakabaho ubuzima busanzwe, bufite imbaraga. Kubaga bikuraho neza ibyago byo guturika kwa awo kandi akenshi bigatuma ibimenyetso wenda wari ufite bigabanuka.

Ibyiza by'igihe kirekire akenshi birimo:

• Gukuraho burundu ibyago byo guturika kwa aneurysm
• Kongera ubushobozi bwo gukora imyitozo no kugira imbaraga
• Kuvurwa ibimenyetso nk'ububabare mu gituza cyangwa guhumeka nabi
• Kugaruka mu bikorwa bya buri munsi bisanzwe mu mezi 3-6
• Ubwiza bwo kurama mu myaka 10 (birenze 90%)

Ibyavuye mu kubagwa kwawe biterwa n'ibintu nk'imyaka yawe, ubuzima bwawe muri rusange, n'ubwoko bwihariye bwo kubagwa ukeneye. Abantu benshi batungurwa n'uko barushaho kumva bameze neza nyuma yo gukira kubagwa.

Ni ibihe bintu byongera ibyago byo gukenera kubagwa umuzi wa awo?

Ibintu byinshi byongera ibyago byo kugira ibibazo by'imizi ya awo bishobora gusaba kubagwa. Kumva ibi bintu birashobora gufasha wowe na muganga wawe gukurikirana ubuzima bw'umutima wawe neza.

Ikintu cy'ingenzi cyongera ibyago ni ukugira indwara ya genetique igira ingaruka ku gice cyawe cy'umubiri gihuza, nka Marfan syndrome cyangwa bicuspid aortic valve. Izi ndwara akenshi zirandurwa kandi zishobora gutuma umuzi wa awo waguka uko igihe kigenda.

Dore ibintu by'ingenzi byongera ibyago byo kwitondera:

• Amateka y'umuryango ya aortic aneurysms cyangwa urupfu rutunguranye rwo mu mutima
• Marfan syndrome cyangwa izindi ndwara zihuza imitsi
• Bicuspid aortic valve (kuvuka ufite ibice bibiri bya valve aho kuba bitatu)
• Umubyimba mwinshi w'amaraso, cyane cyane niba utagenzurwa neza
• Indwara zabanje z'imitsi y'umutima (endocarditis)
• Urugero mu gituza cyangwa kubagwa umutima kwabanje
• Indwara zimwe na zimwe z'ubwirinzi bw'umubiri

Ubukure n'igitsina

Imyaka n'igitsina nabyo bigira uruhare, ibibazo by'imizi ya awoota bikunda kugaragara cyane ku bagabo n'abantu barengeje imyaka 60. Ariko, indwara zishingiye ku mikorere y'uturemangingo dushobora gutera kwaguka kw'imizi ya awoota ku myaka iyo ari yo yose, ni yo mpamvu amateka y'umuryango ari ingenzi cyane.

Ese ni byiza kubagwa imizi ya awoota hakiri kare cyangwa nyuma y'igihe?

Igihe cyo kubagwa imizi ya awoota giterwa no gupima ibyago byo gutegereza n'ibyago byo kubagwa ubwabyo. Mu bihe byinshi, kubagwa hakiri kare birasabwa iyo ibipimo cyangwa ibimenyetso bigeze ku rugero runaka, aho gutegereza igihe cy'ikiza.

Kubagwa hakiri kare muri rusange ni byiza iyo imizi ya awoota yawe igeze ku bipimo runaka cyangwa niba ufite ibimenyetso. Gutinda cyane birashobora kongera ibyago byo guhura n'ibibazo bikomeye byateza akaga nk'ukuranga cyangwa gutandukana kwa awoota.

Muganga wawe azagusaba kubagwa vuba niba ufite:

• Imizi ya awoota nini irenze mm 50 mu rugero rwayo
• Ukwaguka vuba (kurenza mm 5 ku mwaka)
• Ibimenyetso nk'ububabare mu gituza cyangwa guhumeka bigoranye
• Amateka y'umuryango y'ukuranga kwa awoota
• Indwara zishingiye ku mikorere y'uturemangingo nk'indwara ya Marfan
• Imigambi yo gutwita (abagore bafite imizi ya awoota yagutse)

Kubagwa gukorwa mbere y'uko ibihe by'ikiza bigera muri rusange bifite ibisubizo byiza kandi bifite ibyago bike ugereranije n'uburyo bwo kubaga bwihutirwa. Itsinda ry'abaganga bashobora gutegura neza kandi ushobora kwitegura mu buryo bw'umubiri no mu byiyumvo.

Ni izihe ngaruka zishobora guterwa no kutavura kwaguka kw'imizi ya awoota?

Kutavura kwaguka kw'imizi ya awoota bishobora gutera ingaruka zikomeye, zishobora gutera akaga. Ibyago bikomeye ni ukuranga cyangwa guturika kwa awoota, bishobora kubaho mu buryo butunguranye kandi bisaba ubuvuzi bwihutirwa.

Iyo imizi ya awoota ikomeje kwaguka, inkuta ziroroshya kandi zigacika intege, bituma bishoboka cyane ko zishwanyuka. Ibi bitera ikiza gishobora kwica niba kitavuwe ako kanya.

Ingaruka zikomeye cyane zirimo:

• Uburwayi bwo mu mutsi w'umutima (gucika mu rukuta rw'umutsi w'umutima)
• Umutsi w'umutima uraturika (gucika burundu kw'urukuta rw'umutsi w'umutima)
• Uburwayi bukomeye bwo gusubira inyuma kw'umuvuduko w'amaraso (amaraso ava mu mutsi)
• Kunanirwa k'umutima biturutse ku mikorere mibi y'umuvuduko w'amaraso
• Amashyiga y'amaraso akorera ahantu hanini
• Guhagarika ibice by'umutima byegereye

Ibice bike bikomera birimo guhagarika imitsi y'amaraso ikora umutima, itanga amaraso mu mikaya y'umutima, cyangwa guhagarika ibice byegereye nka vena cava y'imbere. Ibi bintu bisaba ubufasha bwihuse bw'abaganga.

Inkuru nziza ni uko ibi bibazo byirindwa no kubagwa ku gihe. Kugenzura buri gihe no gukurikiza inama z'abaganga bawe bishobora gufasha kumenya ibibazo mbere yuko biba bibi.

Ni ibihe bibazo bishobora kuvuka nyuma yo kubagwa umutsi w'umutima?

Nk'uko bigenda ku kubagwa gukomeye, kubagwa umutsi w'umutima bifite ibibazo bimwe na bimwe, nubwo ibibazo bikomeye bidakunze kubaho hamwe n'amakipe abagwa afite ubunararibonye. Kumva ibi bibazo bishobora kugufasha gufata icyemezo gifitiye akamaro no kwitegura gukira kwawe.

Ibibazo bisanzwe ni iby'igihe gito kandi bikemuka mu gihe cyo gukira kwawe. Ibi bishobora kuba birimo imikorere idasanzwe y'umutima y'igihe gito, kubika amazi, cyangwa indwara nto zikira neza iyo zivuwe.

Ibibazo bishobora kuvuka birimo:

• Kuva amaraso bishobora gusaba ko wongerwa amaraso
• Indwara ahantu habagiwe cyangwa mu maraso
• Imikorere idasanzwe y'umutima (arrhythmias)
• Umutsi wo mu bwonko cyangwa ibibazo byo mu bwonko
• Ibibazo by'impyiko biturutse ku mashini ikoreshwa mu mutima no mu bihaha
• Ibibazo byo kuvugurura kubagwa bisaba kubagwa kongera

Ibibazo bike ariko bikomeye birimo guturika k'umutima, kuva amaraso menshi, cyangwa ibibazo by'umuvuduko mushya cyangwa igice cyashyizweho. Ikipe yawe ibaga izagukurikiranira hafi kugirango irinde kandi ivure vuba ibibazo byose bishobora kuvuka.

Ubwoko bw'indwara zikunda kubaho ni buto, kandi abantu benshi barakira neza nta ngaruka zihoraho. Umuganga wawe azaganira nawe ku bintu byose bigushobokeraho kandi asubize ibibazo byose waba ufite.

Ni ryari nkwiriye kubona umuganga ku bijyanye n'ibibazo by'urwungano rw'amaraso?

Ukwiye kubona umuganga niba ubona ibimenyetso bishobora kwerekana ibibazo by'urwungano rw'amaraso, cyane cyane niba ufite ibintu bigushobokeraho nk'amateka y'umuryango cyangwa indwara ziterwa n'imiterere y'umubiri. Kumenya no gukurikirana hakiri kare birinda ingaruka zikomeye.

Ntuzinduke niba wumva ububabare mu gituza, cyane cyane niba bukomeye, butunguranye, cyangwa bukagera mu mugongo wawe. Ibi bishobora kuba ibimenyetso byo guturika kw'urwungano rw'amaraso, bisaba ubuvuzi bwihutirwa.

Gena gahunda yo kubonana n'umuganga wawe niba ufite:

• Ububabare mu gituza cyangwa kutumva neza, cyane cyane iyo ukora imirimo
• Kugufiwa umwuka mu gihe ukora imirimo isanzwe
• Kunanirwa cyangwa kunanuka bikomeza
• Kugwa igihumure cyangwa kwegera kugwa igihumure
• Umutima utera cyane cyangwa umutima utera nabi
• Amateka y'umuryango y'ibibazo by'urwungano rw'amaraso cyangwa urupfu rutunguranye ruterwa n'umutima

Niba ufite indwara izwi iterwa n'imiterere y'umubiri nka Marfan syndrome cyangwa bicuspid aortic valve, ukwiye kugira ibizamini by'umutima buri gihe kabone n'ubwo wumva umeze neza. Gukurikirana hakiri kare bishobora gufata ibibazo mbere yuko bikomera.

Hamagara 911 ako kanya niba wumva ububabare butunguranye, bukomeye mu gituza bumeze nk'uburira, cyane cyane niba bujya mu mugongo wawe. Ibi bishobora kwerekana guturika kw'urwungano rw'amaraso, bikaba ari ibibazo by'ubuvuzi byihutirwa.

Ibice by'ibibazo bikunze kubazwa ku bijyanye n'ubuganga bw'urwungano rw'amaraso

Q.1 Ese kubagwa urwungano rw'amaraso bifitiye akamaro abafite bicuspid aortic valve?

Yego, kubagwa urwungano rw'amaraso bishobora kugira akamaro kanini ku bantu bafite bicuspid aortic valve iyo urwungano rw'amaraso rwagutse. Bicuspid aortic valve ni indwara isanzwe ivukana aho uvukana n'udushumi tubiri tw'umutima aho kuba dutatu.

Abantu bafite umutsi w'umutima wa aortic ufite impande ebyiri akenshi bagira umutima wa aortic ugenda wiyongera uko igihe gishira. Kubagwa bishobora gukemura ikibazo cy'umutsi w'umutima ndetse no kwiyongera kw'umutima, bitewe n'uko ubuzima bwawe bwifashe. Rimwe na rimwe umutima gusa niwo ugomba gusimburwa mugihe umutsi wawe ukingiwe.

Q.2 Ese kwiyongera k'umutima wa aortic bitera kubabara mu gituza?

Kwiyongera k'umutima wa aortic bishobora gutera kubabara mu gituza, nubwo abantu benshi batagira ibimenyetso kugeza igihe icyo kibazo kigeze imbere. Uburibwe bushobora kumvikana nk'umuvuduko, ukwigunga, cyangwa kutumva neza mu gituza cyawe.

Uburibwe bwo mu gituza akenshi bubaho kuko umutima wiyongereye ugira ingaruka ku buryo umutima wawe utera amaraso neza cyangwa kuko umutsi wa aortic udakora neza. Abantu bamwe kandi bagira guhumeka bigoranye cyangwa umunaniro hamwe no kutumva neza mu gituza.

Q.3 Nshobora gukora imyitozo nyuma yo kubagwa umutima wa aortic?

Abantu benshi bashobora gusubira mu myitozo isanzwe nyuma yo gukira neza kubagwa umutima wa aortic, akenshi mu mezi 3-6. Muganga wawe azatanga amabwiriza yihariye ashingiye ku bwoko bw'ubuvuzi bwawe n'imikurire yo gukira.

Uzatangira no kugenda buhoro buhoro hanyuma ukazamura urwego rwawe rw'ibikorwa. Abantu benshi bashobora gukora imyitozo yo hagati nko koga, gukoresha igare, cyangwa gusimbuka. Muganga wawe ashobora kugusaba kwirinda ibikorwa bikomeye cyane cyangwa imikino ikoranwa.

Q.4 Ese imikorere yo gukora umutima wa aortic imara igihe kingana iki?

Imikorere yo gukora umutima wa aortic akenshi imara imyaka myinshi, akenshi imyaka mirongo, cyane cyane hamwe n'uburyo bwa none bwo kubaga n'ibikoresho. Ubuzima burambye buterwa n'ibintu nk'imyaka yawe, ubwoko bwo gukora, n'uburyo ukurikiza gahunda yawe yo kwitabwaho nyuma yo kubagwa.

Imitsi y'imashini irashobora kumara imyaka 20-30 cyangwa irenga, mugihe imitsi y'umubiri akenshi imara imyaka 15-20. Umuganga wawe uzahitamo uburyo bwiza bushingiye ku myaka yawe, imibereho yawe, n'ibyo ukunda bijyanye no gufata imiti igabanya amaraso.

Q.5 Ese nzakenera imiti y'ubuzima bwose nyuma yo kubagwa umutima wa aortic?

Imiti ukeneye nyuma yo kubagwa iterwa n'ubwoko bw'ubuvuzi wakiriye. Niba wakiriye valve ya mekaniki, uzakenera imiti igabanya amaraso ubuzima bwawe bwose kugira ngo wirinde ko ibyuma byo ku valve byakwiyongera.

Niba wakiriye valve y'igitambaro cyangwa ubuvuzi bwo gukiza valve, ushobora gukenera imiti by'agateganyo mugihe cyo koroherwa. Abantu benshi bafata imiti y'ibanze ifasha umutima nk'iyo ikoreshwa mu kugenzura umuvuduko w'amaraso cyangwa cholesterol.