Tetralogy Of Fallot

Tetralogy of Fallot inosanganiswa yekushanduka kwezvikamu zvina zvemoyo zviripo kubva pakuberekwa. Pane gomba mumoto rinonzi ventricular septal defect. Panewo kuomarara kwe pulmonary valve kana imwe nzvimbo iri munzira iri pakati pemoyo nemapapu. Kuomarara kwe pulmonary valve kunonzi pulmonary stenosis. Arterial huru yemuviri, inonzi aorta, yakashata nzvimbo. Madziro ekamuri yekurudyi yemoyo akasimba, mamiriro ezvinhu anonzi right ventricular hypertrophy. Tetralogy of Fallot inochinja maitiro eropa rinoyerera mumoto nekumwe muviri.

Tetralogy of Fallot (teh-TRAL-uh-jee of fuh-LOW) chirwere chisingawanzoitika chemoyo chiripo kubva pakuberekwa. Izvo zvinoreva kuti ndicho chirwere chemoyo chinoberekwa nacho. Mwana anoberekwa aine chirwere ichi ane matambudziko mana akasiyana emoyo.

Matambudziko aya emoyo anokanganisa chimiro chemoyo. Mamiriro ezvinhu anokonzera kuyerera kweropa kwakachinja mumoto nekumwe muviri. Vacheche vane tetralogy of Fallot kazhinji vane ganda rebhuruu kana grey nekuda kwekushomeka kweokisijeni.

Tetralogy of Fallot kazhinji inoonekwa panguva yekuzvitakura kana mushure mekunge mwana aberekwa. Kana shanduko dzemoyo nezviratidzo zvichinyoro, tetralogy of Fallot ingasawanikwa kana kuonekwa kusvika pakuva mukuru.

Vanhu vanoonekwa vane tetralogy of Fallot vanoda kuvhiyiwa kuti vagadzirise moyo. Vachange vachida kuongororwa kwehutano nguva dzose kweupenyu hwavo hwose.

Nzira yakanakisa yekurapa inoramba ichikakavara, asi kazhinji, kugadzirisa kwakakwana kunorayirwa mumasvondo matatu kusvika matanhatu ekutanga ehupenyu. Zvinokosha, kushandiswa kwe modified Blalock–Taussig shunt sechirongwa chekupora kunoitirwa zvishoma zvikuru munguva ino. Chinangwa chekuvhiya kugadzirisa kwakakwana, kunosanganisira kuvharwa kwe ventricular septal defect uye kubvisa kukanganisa kwe right ventricular outflow tract, izvo zvinofanira kuitwa nekuchengetedza basa re pulmonary valve. Kuita kwakajairika kwemoyo kunoitwa pakuva mukuru ndiko kutsiva kwe pulmonary valve mushure mekugadzirisa tetralogy of Fallot muucheche kana muhudiki.

Kune nzira mbiri dzakajairika dzekugadzirisa kwakakwana. Yekutanga ndeyenzira ye transatrial-transpulmonary uye yechipiri ndeyenzira ye transventricular. Nzira ye transatrial-transpulmonary ine mukana wakajeka wekuchengetedza basa re pulmonary valve asi inogona kuve nani, uye iri nyore zvishoma, kupfuura mwedzi mina. Kushandiswa kwakasarudzwa kwe incision duku ye infundibular kunogona kubatsira kubvisa zvachose kukanganisa kwe right ventricular outflow tract uye/kana kuvandudza kuona kwe ventricular septal defect mumamiriro ezvinhu akati. Kuedza kwakabatana kunoitirwa kuramba uri pasi pe pulmonary annulus, uye kuchengetedza pulmonary valve kana izvi zvichiitwa, kunyanya kana saizi ye pulmonary valve annulus ichigamuchirwa, saka inoda pulmonary valvotomy chete. Nzira ye transventricular inogona kushandiswa pazera ripi zvaro. Kunyangwe yakamira bvunzo yenguva, takadzidza kuti varwere vazhinji pakupedzisira vanoda kutsiva kwe pulmonary valve gare gare muhupenyu nekuda kwe pulmonary regurgitation. Saka, kana nzira ye transventricular iri kushandiswa, kupatsanura kwakakura kwe transannular kunodziviswa kuti kuderedze kuwedzera kwe right ventricular gare gare uye kusashanda kwe right ventricular, pulmonary regurgitation yakakomba, uye kudzivisa ventricular arrhythmias. Kunyangwe zvakakosha kubvisa zvakakwana kukanganisa kwe right ventricular outflow tract, kusiya kukanganisa kwakasiyana shure kwakafungwa kuti kunogamuchirwa, kunyanya kana kuchengetedzwa nebasa re pulmonary valve zvichigona kuchengetedzwa. Kazhinji, gradient yakasara ye 20 kusvika ku 30 millimeters ye mercury pamusoro pe pulmonary valve kazhinji inoshivirira uye inobvumirwa.

Kuvepo kwe anomalous left anterior descending coronary artery kazhinji hakusi chinhu chinorambidza kugadzirisa kwakakwana munguva ino. Incision pfupi ye transannular inogona kuitwa inodzivisa anomalous left anterior descending coronary artery uye inogona kushandiswa kuti iwedzere kubvisa kukanganisa kwe right ventricular outflow tract, kana zvichidiwa. Sarudzo yekuvhara patent foramen ovale inonyanya kuenderana nezera remurwere uye kana kugadzirisa kwe transannular kwakashandiswa. Kazhinji, patent foramen ovale inorasirwa yakavhurika kana kugadzirisa kwakakwana kuchiitwa mumwana kana kugadzirisa kwe transannular kwakaitwa uye pulmonary regurgitation yakakomba iripo. Kushandiswa kwe kugadzirisa kwe monocusp kuvandudza kukwanisa kwe pulmonary valve kunogona kubatsira munzvimbo iyi uye kunogona kuita kuti nguva yekutanga mushure mekuvhiya ive nyore.

Munguva ino, kugadzirisa kwe tetrology of Fallot kunogona kuitwa nekufa kwakaderera kwazvo, pedyo ne 1%, uye hupenyu hwakareba uye mhando yehupenyu zvakanaka kwazvo kune vakawanda varwere. Kazhinji, vana vanopinda chikoro uye vanogona kubatanidzwa mumabasa mazhinji emwana pasina miganho. Kugadzirisa kwekukurumidza mumasvondo matanhatu ekutanga ehupenyu ndiyo mutemo, uye kuchengetedza kwe pulmonary valve uye kuderedza pulmonary regurgitation ndicho chinangwa. Zvinodikanwa kutarisa kwenguva refu hakugone kusimbiswa zvakanyanya, kuitira kuti nguva yakakodzera yekubata chero zviito zvinotevera zvigone kuvandudzwa.

Zviratidzo zveTetralogy of Fallot zvinoenderana nekuti ropa rakawanda sei rinodziviswa kubva pakubuda pamoyo kuenda kumapapu. Zviratidzo zvinogona kusanganisira: Ruvara rweganda rebhuruu kana grey. Kushaya mweya nekukurumidza kufema, kunyanya panguva yekudyisa kana kurovedza muviri. Kusakwanisa kuwedzera uremu. Kuneta nyore panguva yekutamba kana kurovedza muviri. Kusagutsikana. Kuvhunduka kwenguva yakareba. Kuenda pasi. Vamwe vacheche vane tetralogy of Fallot vanotanga kuve neruvara rweganda, misumari, nemiromo ye bhuruu kana grey. Izvi zvinowanzoitika kana mwana achichema, achidyisa kana asina kufara. Aya mamiriro anozivikanwa se tet spells. Tet spells zvinokonzerwa nekudonhedzwa kukurumidza kwe oxygen muropa. Zvinowanzoitika kuvana vaduku, vanenge vane makore maviri kusvika mana. Tet spells zvinogona kusawanikwa zvakajeka muvana vaduku nevakuru. Izvozvo ndizvo nekuti vanowanzoita squat kana vasina mweya. Squatting inotumira ropa rakawanda ku mapapu. Zvirwere zvakakomba zvemoyo zvinowanzonzwisiswa usati kana mushure mekunge mwana wako aberekwa. Tsvaka rubatsiro rwekurapa kana ukaona kuti mwana wako ane aya zviratidzo: Kushaya mweya. Ruvara rwebhuruu rweganda. Kushayikwa kwekunzwisisa. Kuita seizures. Kushaya simba. Kusagutsikana kupfuura kazhinji. Kana mwana wako akaita bhuruu kana grey, isa mwana wako parutivi wobva wabata magaro emwana wako kuenda pachipfuva. Izvi zvinobatsira kuwedzera ropa kuenda ku mapapu. Dana 911 kana nhamba yako yekukurumidza rubatsiro.

Zvirwere zvakakomba zvemoyo zvinoonekwa kazhinji usati kana pashure panguva pfupi mwana wako aberekwa. Tsvaka rubatsiro rwekurapa kana ukaona kuti mwana wako ane zviratidzo izvi:

• Kunetseka kufema.
• Ruvara rwebhuruu reganda.
• Kushayikwa kwehungwaru.
• Kuita marwadzo.
• Kushaya simba.
• Kushatirwa kupfuura zvakajairwa.

Kana mwana wako akaita bhuruu kana grey, isa mwana wako parutivi wobva waburitsa magaro emwana wako kuenda pachipfuva. Izvi zvinobatsira kuwedzera kuyerera kweropa kumapfupa. Dana 911 kana nhamba yako yekukurumidzira munzvimbo yako nekukasira.

Tetralogy of Fallot inoitika sezvinokura mwoyo wemwana panguva yekuzvitakura. Kazhinji, chikonzero hachizivikanwi.

Tetralogy of Fallot inosanganisira matambudziko mana ane chimiro chemwoyo:

• Kuomarara kwevavhu pakati pemwoyo nemapapu, kunonzi pulmonary valve stenosis. Iyi mamiriro anoita kuti ropa riyeruke kubva pamwoyo kuenda kumapapu. Kuomarara kungangove kuri pavavhu chete. Kana kungangoitika panzvimbo dzakawanda munzira iri pakati pemwoyo nemapapu. Dzimwe nguva vavhu harigadzirwe. Panzvimbo iyoyo, pepa rakasimba rinodzivirira ropa kubva kurutivi rwerudyi rwemwoyo. Izvi zvinonzi pulmonary atresia.
• Huro iri pakati pekamuri dzepasi pemwoyo, rinonzi ventricular septal defect. Ventricular septal defect inochinja maitiro ekufamba kweropa kuburikidza nemwoyo nemapapu. Ropa risina oksijeni mukamuri yepasi kurudyi rinopindirana neropa rine oksijeni mukamuri yepasi kuruboshwe. Mwoyo unofanirwa kushanda nesimba kuti apumpe ropa mumuviri. Dambudziko rinogona kuita kuti mwoyo ushome simba nekufamba kwenguva.
• Kuchinjika kwe artery huru yemuviri. Artery huru yemuviri inonzi aorta. Kazhinji inobatanidzwa nekamuri yepasi kuruboshwe remwoyo. Mu tetralogy of Fallot, aorta iri panzvimbo isiriyo. Yakachinjirwa kurudyi uye iri pamusoro pehuro riri padziro yemwoyo. Izvi zvinochinja maitiro ekufamba kweropa kubva ku aorta kuenda ku mapapu.
• Kuwedzera kwekamuri yepasi kurudyi yemwoyo, kunonzi right ventricular hypertrophy. Kana mwoyo uchifanira kushanda zvakanyanya, madziro ekamuri yepasi kurudyi yemwoyo anoita gobvu. Nekufamba kwenguva, izvi zvinogona kuita kuti mwoyo ushome simba uye pakupedzisira utadze.

Vanhu vamwe vane tetralogy of Fallot vane mamwe matambudziko anokanganisa aorta kana arteries dzemwoyo. Zvingavewo nehuro pakati pekamuri dzepamusoro dzemwoyo, rinonzi atrial septal defect.

Chikonzero chaicho chetetralogy of Fallot hachizivikanwi. Zvimwe zvinhu zvinogona kuwedzera njodzi yemwana kuzvarwa ane tetralogy of Fallot. Zvinhu zvinokonzera njodzi zvinosanganisira:

• Nhoroondo yemhuri.
• Kuva nehutachiona panguva yekuzvitakura. Izvi zvinosanganisira rubella, inozivikanwawo seGerman measles.
• Kunwa doro panguva yekuzvitakura.
• Kudya zvisina kunaka panguva yekuzvitakura.
• Kusvuta panguva yekuzvitakura.
• Zera raamai rakapfuura makore 35.
• Down syndrome kana DiGeorge syndrome mwana.

Tetralogy of Fallot isingasina kazhinji inotungamira kumatambudziko anotyisa hupenyu. Matambudziko aya angakonzera kutadza kana rufu nekukura kwechipo.

Imwe nyaya inogona kuitika yetetralogy of Fallot ndeye hutachiona hwekunyunguduka kwemukati kwemoyo kana mavaire emoyo. Izvi zvinonzi infective endocarditis. Dzimwe nguva mishonga inorwisa mabhakitiriya inopiwa usati waita basa rezino kudzivirira rudzi urwu rwehutachiona. Bvunza timu yako yekuchengetedza utano kana mishonga inodzivirira inokodzera iwe kana mwana wako.

Matambudziko anogonawo kuitika mushure mekuvhiya kwekugadzirisa tetralogy of Fallot. Asi vanhu vakawanda vanoita zvakanaka mushure mekuvhiya kwakadaro. Kana matambudziko achiitika, anogona kusanganisira:

• Kuyerera kwepashure kweropa kuburikidza nevaire yemoyo.
• Kurova kwemoyo kusina kururama.
• Buri mumoto risingaperi mushure mekuvhiya.
• Kushanduka kukuru kwekamuri dzemoyo.
• Kuwedzera kwechikamu cheaorta, kunonzi aortic root dilation.
• Kufa kwemoyo kamwe kamwe.

Imwe nzira kana kuvhiya kunogona kudikanwa kugadzirisa matambudziko aya.

Vanhu vakaberekwa nechirwere chakaoma chemwoyo chinogona kunge vari pangozi yematambudziko panguva yekuzvitakura. Taura nechikwata chako chekuchengetedza utano nezve njodzi uye matambudziko anogona kuitika ekusununguka. Pamwe chete munogona kukurukura uye kuronga chero hanya chaiyo inodiwa.

Chikonzero chaicho chekukuvara kwemoyo kunoberekwa nacho hachizivikanwi, saka zvinogona kunge zvisingaite kudzivirira mamiriro aya. Kana uine njodzi yakakwira yekubereka mwana ane kukuvara kwemoyo kunoberekwa nacho, bvunzo dzemajini nekuongororwa zvinogona kuitwa panguva yekuzvitakura. Kune matanho aunogona kutora kuti ubatsire kuderedza njodzi yemwana wako yekukuvara kunoberekwa nacho, akadai se:

• Tora hanya yekuzvitakura zvakanaka. Kuongororwa nguva dzose nechikwata chehutano panguva yekuzvitakura kunogona kubatsira kuchengetedza amai nemwana vakagwinya.
• Tora multivitamin ine folic acid. Kutora 400 micrograms ye folic acid zuva nezuva kwakaratidzwa kuderedza kukuvara kunoberekwa nacho mubongo nemutadzi wemutsipa. Zvinogona kubatsira kuderedza njodzi yekukuvara kwemoyo zvakare.
• Usanwe kana kusvuta. Aya mararamiro anogona kukuvadza hutano hwemwana. Dzivisawo utsi hwechipiri.
• Tora jekiseni re rubella (German measles). Hutachiona hwe rubella panguva yekuzvitakura hunogona kukanganisa kukura kwemoyo wemwana. Tora jekiseni usati watanga kuedza kuita pamuviri.
• Dzora shuga yeropa. Kana uine chirwere cheshuga, kudzora zvakanaka shuga yeropa kunogona kuderedza njodzi yekukuvara kwemoyo kunoberekwa nacho.
• Tarisa mamiriro ehutano asingaperi. Kana uine mamwe mamiriro ehutano, kusanganisira phenylketonuria, taura nechikwata chehutano chako nezve nzira yakanakisa yekurapa nekutarisira.
• Dzivisa zvinhu zvinokuvadza. Panguva yekuzvitakura, ita kuti mumwe munhu aite kupenda nekutsvaira nezvinhu zvine kunhuhwirira kwakasimba.
• Tarisa nechikwata chehutano chako usati watora mishonga ipi neipi. Mishonga mimwe inogona kukonzera kukuvara kunoberekwa nacho. Udza chikwata chehutano chako nezve mishonga yose yaunotora, kusanganisira iyo inotenga pasina chinyorwa.

Tetralogy of Fallot kazowanzoonekwa nekukurumidza mushure mekuberekwa. Ganda remwana wako rinogona kutaridzika riine ruvara rwebhuruu kana grey. Inzwi rekuchema rinogona kunzwika pakuteerera mwoyo wemwana ne stethoscope. Izvi zvinonzi heart murmur.

Kuongorora kwetetralogy of Fallot kunosanganisira:

• Kuyerwa kwemazinga okisijeni. Sensor duku inoiswa pazvigunwe zvechigunwe kana chitsitsinho inoyerwa nekukurumidza huwandu hweoksijeni iri muropa. Izvi zvinonzi pulse oximetry test.
• Echocardiogram. Kuongorora uku kunoshandisa mafungu ekuita mifananidzo yemwoyo uchifamba. Inoratidza mwoyo nemavharuvhu emwoyo uye kuti ari kushanda zvakanaka sei.
• Electrocardiogram, inonziwo ECG kana EKG. Kuongorora uku kunotora basa remagetsi remwoyo. Inoratidza kuti mwoyo uri kurova sei. Mapachi anobatanidzwa anonzi electrodes anoiswa pachipfuva uye dzimwe nguva pazviruwo kana makumbo. Matambo anobatanidza mapachi ku komputa. Komputa inodhinda kana kuratidza mhinduro. Electrocardiogram inogona kubatsira kuona kurova kwemwoyo kwasinganzwisisiki. Kushanduka mumagetsi emwoyo kunogonawo kuitika nekuda kwemwoyo wakakura.
• X-ray yechipfuva. X-ray yechipfuva inoratidza chimiro nemirimo yemwoyo nemapapu. Chiratidzo chakajairika chetetralogy of Fallot pa X-ray ndemwoyo une chimiro chebhuti. Izvo zvinoreva kuti kamuri yepasi kurudyi yakakura zvakanyanya.
• Cardiac catheterization. Kuongorora uku kunobatsira kuona kana kurapa mamiriro emwoyo. Inogona kuitwa kuronga kuvhiya. Chiremba anopinda chubhu imwe kana dzakawanda diki, dzakasununguka mudziya ropa, kazhinji muhudyu. Machubhu anonzi catheters. Chiremba anotungamira machubhu kumwoyo. Panguva yekuongorora, vanachiremba vanogona kuita bvunzo dzakasiyana dzemwoyo kana kurapwa.