I-Atresia Ye-Tricuspid

I-tricuspid atresia yisifo senhliziyo esikhona kusukela ekuzalweni, esaziwa njengesifo senhliziyo esizalwa naso. I-valve ayenziwa phakathi kwamakhamera amabili enhliziyo yasekunene. Esikhundleni salokho, iphepha eliqinile lezicubu livimba ukugeleza kwegazi phakathi kwamakhamera enhliziyo yasekunene. Leli simo lilinganiselwe ukugeleza kwegazi ngenhliziyo. I-tricuspid atresia ibangela ukuba ingxenye engezansi yasekunene yenhliziyo ingathuthuki kahle.

Izimpawu ze-tricuspid atresia zivame ukubonakala ngokushesha ngemva kokuzalwa. Izimpawu ze-tricuspid atresia zingafaka:

• Ukuba oluhlaza okwesibhakabhaka noma olugrey isikhumba namazinyo ngenxa yezinga eliphansi loketshezi le-oksijini
• Ukuphefumula kanzima
• Ukukhathala kalula, ikakhulukazi ngesikhathi sokudla
• Ukukhula kancane nokungaqabi kahle isisindo

Abanye abantu abane-tricuspid atresia baphuthuma futhi izimpawu zokwehluleka kwenhliziyo. Izimpawu zokwehluleka kwenhliziyo zifaka:

• Ukukhathala nobuthakathaka
• Ukuphefumula kanzima
• Ukukhuluphala ezinyaweni, ezinzwini nasezinyaweni
• Ukukhuluphala kwesifunda sesisu, isimo esibizwa ngokuthi i-ascites
• Ukuqabuka ngokushesha kwesisindo ngenxa yokwakheka koketshezi

Ukukhubazeka okukhulu kwenhliziyo okuvela ngokuzalwa kuqaphelwa ngaphambi noma ngokushesha ngemva kokuzalwa kwengane yakho. Uma ubona ukuthi ingane yakho inesimo esihlukile sesikhumba, inkinga yokuphefumula, ukukhula okuhamba kancane noma ukwanda okuncane kwenani, xhumana nodokotela wakho.

Izingozi eziningi zokubeletha ezinzima zenhliziyo, kuhlanganise nokushoda kwe-tricuspid, zivela ezinqumeni ezenzeka ekuqaleni njengoba inhliziyo yengane isathuthuka ngaphambi kokuzalwa. Imbangela eqondile ngokuvamile ayaziwa.

Akuqondakali ngokupheleleyo ukuthi kungani kukhiqizwa iingxaki zentliziyo ezelwe nazo ezinjengotricuspid atresia. Kodwa kukhona ezinye izinto eziyizimbangela ezikhonjisiwe. Abantwana abaningi abazalwa benesifo sokuzalwa esibizwa ngokuthi yi-Down syndrome bane-tricuspid atresia.

Ezinye izinto ezingandisa ingozi yomntwana wakho yokuba ne-tricuspid atresia zihlanganisa:

• Ukuba ne-German measles (rubella) noma olunye ubuhlungu obubangelwa yi-viral ekuqaleni kokukhulelwa
• Umlando womndeni wesifo sentliziyo esizalwa naso
• Ukusebenzisa utshwala ngesikhathi sokukhulelwa
• Ukubhema ngaphambi noma ngesikhathi sokukhulelwa
• Ukugula okungalawuleki kahle kweswekile ngesikhathi sokukhulelwa
• Ukusebenzisa imithi ethile ngesikhathi sokukhulelwa, kuhlanganise nezinye ezisetshenziswa ekwelapheni isifo se-acne, isifo se-bipolar kanye nezehlakalo

Ukuvalela kwe-tricuspid kuvimba ukugeleza kwegazi othandweni oluya emaphashini. Igumbi eliphansi lasekunene lenhliziyo lincinyane futhi alithuthukisiwe kahle. Ukuhlupheka okubulalayo kokungasebenzi kahle kwe-tricuspid ukungabi khona koksijini kumaseli omzimba. Lesi simo sibizwa ngokuthi i-hypoxemia.

Ukuphathwa ngokushesha kuthuthukisa kakhulu umphumela kubantwana abanesifo se-tricuspid atresia. Kepha izinhlungu zingase zivele kamuva ekuphileni. Izinhlungu ze-tricuspid atresia zingafaka:

• Ukukhathala kalula ngesikhathi somsebenzi
• Ukungazinzi komjikelezo wenhliziyo
• Ukugula kwesibindi noma isibindi
• Ukwehluleka kwenhliziyo

Ngenxa yokuthi imbangela eqondile yeningi leziphene zenhliziyo ezelwe nazo ayaziwa, kungenzeka ukuthi akunakwenzeka ukuvimbela i-tricuspid atresia. Uma unomlando womndeni weziphene zenhliziyo ezelwe nazo noma unesikhathi esikhulu sokubeletha ingane enenkinga, ukuhlolwa kwe-genetic kungase kunconywe ngaphambi noma ngesikhathi sokukhulelwa. Cabanga ukukhuluma nodokotela we-genetic kanye nodokotela wezingane wenhliziyo ngengozi yakho ethile. Ezinye zezindlela ongasiza ngazo ukuvimbela ingozi yonke yengane yakho yeziphene zenhliziyo ezelwe nazo yilezi:

• Thola ukunakekelwa okuhle kokukhulelwa. Ukuhlolwa okuvamile kunodokotela wezempilo ngesikhathi sokukhulelwa kungasiza ekuqondeni wena nengane yakho.
• Thatha i-multivitamin ene-folic acid. Ukuthatha ama-micrograms angu-400 we-folic acid nsuku zonke kuye kwabonakala kunciphisa izinkinga ezingqondweni nasemgogodleni ngesikhathi sokuzalwa. Kungasiza ekuphisiseni ingozi yeziphene zenhliziyo ezelwe nazo.
• Thola isithombe se-rubella (i-German measles). Ukutheleleka kwe-rubella ngesikhathi sokukhulelwa kungathinta ukuthuthukiswa kwenhliziyo yengane. Thatha isithombe ngaphambi kokuzimisela ukukhulelwa.
• Hlola nodokotela wakho ngaphambi kokuthatha noma yimiphi imithi. Eminye imithi ethathwe ngesikhathi sokukhulelwa ingabangela izinkinga zempilo engwaneni. Tshela umhlinzeki wakho wezempilo ngayo yonke imithi oyithathayo, kufaka phakathi leyo oyithengayo ngaphandle kwesikripthi.
• Ungabhemi utshaba noma uphuze utshwala ngesikhathi sokukhulelwa. Noma yikuphi okungandisa ingozi yeziphene zenhliziyo ezelwe nazo.
• Gwema ukukhishwa kwezinto ezikhemikhali noma kunini lapho kungenzeka. Ngesikhathi ukhulelwe, kungcono ukuhlala kude nezinto ezikhemikhali, kufaka phakathi imikhiqizo yokuhlanza nokupeyinta, ngangokunokwenzeka.
• Phatha ezinye izimo zempilo. Uma unezinye izimo zempilo, khuluma nodokotela wakho wezempilo ngendlela engcono kakhulu yokwelapha nokuphatha zona.

I-Tricuspid atresia ingase ihlonishwe ngesikhathi sokwenza i-ultrasound yokukhulelwa evamile ngaphambi kokuzalwa komntwana. Kubalulekile ukuthola ukunakekelwa okuhle kokukhulelwa ngesikhathi sokukhulelwa.

Ngemva kokuzalwa, umhlinzeki wezinsizakalo zezempilo uhlola umntwana ngokushesha futhi ulalele inhliziyo nomphefumulo womntwana. Umhlinzeki wokunakekelwa angase athambekele ekubeni nenkinga yenhliziyo efana ne-tricuspid atresia uma umntwana enesikhumba esiluhlaza okwesibhakabhaka noma esimnyama, unesinkinga sokuphefumula, noma unelizwi elingavamile lenhliziyo elibizwa ngokuthi yi-heart murmur. Ukushintsha kokugeleza kwegazi kuya nenhliziyo kungabangela i-heart murmur.

Amathethhu okuhlonishwa kwe-tricuspid atresia angafaka:

• I-Echocardiogram. Amaza omsindo adala izithombe ezihamba phambili zokugeleza kwegazi ngenhliziyo nezivali zenhliziyo. Kumntwana one-tricuspid atresia, i-echocardiogram ibonisa i-tricuspid valve engapheli nokugeleza kwegazi okungavamile. Uvivinyo lungase lubekezelele ezinye izinkinga zenhliziyo.
• I-Electrocardiogram. Ebizwa nangokuthi yi-ECG noma i-EKG, lo mvivinyo osheshayo futhi ongenaphimbo uqopha umsebenzi wamagetsi wenhliziyo. Ungabonisa ukuthi inhliziyo ishaya ngokushesha kangakanani noma kancane kangakanani. I-ECG ingathola izindlela ezingavamile zokubetha kwenhliziyo.
• I-Pulse oximetry. Isinye esincane esinamathele esandleni noma onyakeni silinganisa inani lokufinyelela komoya egazini. I-Pulse oximetry ilula futhi ayibuhlungu.
• I-X-ray yesifuba. I-X-ray yesifuba ibonisa isimo senhliziyo nemiphunga. Ingasiza ekuqondeni usayizi wenhliziyo namakhamera ayo. I-X-ray yesifuba ingabonisa ukwakheka kwamanzi emiphungeni.
• I-Cardiac catheterization. Umphako omncane, onobuningi, obizwa ngokuthi yi-catheter ufakwa emithanjeni yegazi, ngokuvamile endaweni yesisu, futhi uqondiswe enhliziyweni. Umenzi ugeleza nge-catheter emakhamera enhliziyo. Umenzi uqeda ukubona amakhamera ezithombeni ze-X-ray. I-catheter ingasetshenziswa futhi ekuqondeni ukucindezela emakhamera enhliziyo. I-Cardiac catheterization ayisetshenziswa ngokuvamile ekuhlonishweni kwe-tricuspid atresia, kodwa ingase yenziwe ekuhlolweni kwenhliziyo ngaphambi kokuthi kwenziwe ukuhlinzwa kwe-tricuspid atresia.

Akuka indlela yokufaka i-valve ye-tricuspid ku-tricuspid atresia. Uma ingane yakho inenkinga ye-tricuspid atresia, izinqubo eziningi zokuthunga zivame ukwenziwa ukuthuthukisa ukugeleza kwegazi ehartini nasemaphaphwini. Imithi isebenza ekulawuleni izimpawu. Uma ingane yakho inesifo se-tricuspid atresia, cabanga ukuthola ukunakekelwa esibhedlela esinabachwepheshe bokuhlinzwa nabanye abahlinzeki bezempilo abanawo okuhlangenwe nakho ekwelapheni izifo ezihlukahlukene zezinhliziyo. Imithi ye-tricuspid atresia inganikezwa ukuze: Umoya ongeziwe unganikezwa ukusiza ingane ukuba ipheme kangcono. Ngaphambi kokuthunga kwenhliziyo, ingane enesifo se-tricuspid atresia inganikezwa i-prostaglandin ye-hormone ukuze isize ukwandisa nokugcina ivulekile i-ductus arteriosus. Ingane enesifo se-tricuspid atresia ivame ukudinga ukuhlinzwa kwenhliziyo okuningi noma izinqubo. Ezinye zazo ziyizixazululo zesikhashana zokuthuthukisa ngokushesha ukugeleza kwegazi ngaphambi kokuba kwenziwe inqubo eqinile. Ukuhlinzwa noma izinqubo ze-tricuspid atresia kufaka phakathi ukuhlinzwa kwenhliziyo evulekile nokuhlinzwa kwenhliziyo okungenayo ukuhlinzwa okukhulu. Uhlobo lokuhlinzwa kwenhliziyo kuncike ekusonkaleni okukhethekile kwenhliziyo. Ukuhlanganisa. Le nqubo idala indlela entsha (i-shunt) yokugeleza kwegazi. Ku-tricuspid atresia, i-shunt iphinda ihambise igazi esiseleni esikhulu legazi eliphuma ehartini liye emaphaphwini. Ukuhlanganisa kukhuphula inani lokugeleza kwegazi emaphaphwini. Kusiza ukuthuthukisa amazinga oksijini. Odokotela abenza ukuhlinzwa ngokuvamile bafake i-shunt phakathi kwamasonto amabili okuqala okuphila. Noma kunjalo, izingane ngokuvamile zikhula i-shunt. Zingadinga enye inqubo yokuyifaka. Inqubo ye-Glenn. Enqubweni ye-Glenn, udokotela ohlinzayo ususa i-shunt yokuqala. Khona-ke omunye wemithambo emikhulu evame ukubuyisela igazi ehartini uxhunyaniswe ngqo emthambo wephaphu esikhundleni salokho. Inqubo ye-Glenn incipha ukucindezela ekamelweni elingaphansi kwesobunxele lenhliziyo, kunciphisa ingozi yokulimaza. Le nqubo ingenziwa lapho ukucindezela emaphaphwini omntwana kunciphile, okuvela njengoba ingane ikhulile. Inqubo ye-Glenn ibeka isikhundla sokuhlinzwa okulungisayo okuhlala njalo okuthiwa yi-Fontan procedure. Inqubo ye-Fontan. Lolu hlobo lokuhlinzwa kwenhliziyo ngokuvamile lwenziwa lapho ingane eneminyaka engu-2 kuya kwengu-5. Yakha indlela ukuze iningi, uma kungenjalo konke, igazi eliya ehartini lasekunene lingagalele ngqo emthambo wephaphu. Ukubukeka kwesikhathi esifushane nesiphakathi kwizingane ezine-Fontan procedure ngokuvamile kuyathembisa. Kodwa ukuhlolwa okuvamile kuyadingeka ukuqapha izinkinga, kufaka phakathi ukwehluleka kwenhliziyo. Ngemva kokwelashwa, izingane ezine-tricuspid atresia zidinga ukuhlolwa okuvamile kwezempilo, ngokukhethekile nodokotela wezingane oqeqeshwe ezimweni zezinhliziyo ezingazalwa. Lo mhlinzeki wokunakekelwa ubizwa ngokuthi i-pediatric congenital cardiologist. Izingane eziningi ezinezifo zezinhliziyo ezingazalwa, njenge-tricuspid atresia, zikhula zibe nokuphila okugcwele. Abadala abaphathwe nge-tricuspid atresia badinga ukuhlolwa okuqhubekayo kokuphila, ngokukhethekile nodokotela oqeqeshwe ezimweni zezinhliziyo zabantu abadala abazalwa nazo. Lo mhlinzeki wokunakekelwa ubizwa ngokuthi i-adult congenital cardiologist. * Qinisisa umuscle wenhliziyo * Ncipha ukucindezela kwegazi * Susa amanzi engeziwe emzimbeni * Ukuhlanganisa. Le nqubo idala indlela entsha (i-shunt) yokugeleza kwegazi. Ku-tricuspid atresia, i-shunt iphinda ihambise igazi esiseleni esikhulu legazi eliphuma ehartini liye emaphaphwini. Ukuhlanganisa kukhuphula inani lokugeleza kwegazi emaphaphwini. Kusiza ukuthuthukisa amazinga oksijini. Odokotela abenza ukuhlinzwa ngokuvamile bafake i-shunt phakathi kwamasonto amabili okuqala okuphila. Noma kunjalo, izingane ngokuvamile zikhula i-shunt. Zingadinga enye inqubo yokuyifaka. * Inqubo ye-Glenn. Enqubweni ye-Glenn, udokotela ohlinzayo ususa i-shunt yokuqala. Khona-ke omunye wemithambo emikhulu evame ukubuyisela igazi ehartini uxhunyaniswe ngqo emthambo wephaphu esikhundleni salokho. Inqubo ye-Glenn incipha ukucindezela ekamelweni elingaphansi kwesobunxele lenhliziyo, kunciphisa ingozi yokulimaza. Le nqubo ingenziwa lapho ukucindezela emaphaphwini omntwana kunciphile, okuvela njengoba ingane ikhulile. Inqubo ye-Glenn ibeka isikhundla sokuhlinzwa okulungisayo okuhlala njalo okuthiwa yi-Fontan procedure. * Inqubo ye-Fontan. Lolu hlobo lokuhlinzwa kwenhliziyo ngokuvamile lwenziwa lapho ingane eneminyaka engu-2 kuya kwengu-5. Yakha indlela ukuze iningi, uma kungenjalo konke, igazi eliya ehartini lasekunene lingagalele ngqo emthambo wephaphu. Ukubukeka kwesikhathi esifushane nesiphakathi kwizingane ezine-Fontan procedure ngokuvamile kuyathembisa. Kodwa ukuhlolwa okuvamile kuyadingeka ukuqapha izinkinga, kufaka phakathi ukwehluleka kwenhliziyo. * Ukubekwa kwe-pulmonary artery band. Le nqubo ingenziwa uma ingane enesifo se-tricuspid atresia inenkinga ye-ventricular septal defect. Udokotela ohlinzayo ubeka ibhendi emthambo wephaphu omkhulu ukuze anciphise inani legazi elihamba ehartini liye emaphaphwini. * I-Atrial septostomy. Ngokungavamile, ibhaluni isebenza ukudala noma ukwandisa ukuvula phakathi kwamakamelo aphezulu enhliziyo. Lokhu kuvumela igazi eliningi ukuba ligeleze ekamelweni eliphezulu lasekunene liye ekamelweni eliphezulu lasehlangothini lobunxele.