Mu aortic kubwezeretsanso a valtic valve imakhala yovuta. Mphutsi yothamanga ya aortic nthawi zambiri imabweretsa mavuto amtima.
Vuvu ya aortic imayang'anira kutsegula pakati pa ventricle lakumanzere ndi aorta. Vuvu ya aortic imatsegula monga zotsalira zazing'amba zimayamba kupopera, zomwe zimalola kuti magazi achoke pamtima ndi mu aorta. Pamene ventricle yatha kugunda, valavu ya aortic imatseka kuti magazi asamatsuke kumbuyo kwa ventricle lakumanzere.
Mukamayambitsa kupuma kwa aortic, valve yanu ya aortic imatha kutseka kwathunthu, motero magazi amatha kuthamangira kuchokera ku aorta kupita ku ventricle kumanzere. Izi "kubwezeretsedwa" kwa magazi zimapangitsa mtima kugwira ntchito molimbika kwambiri, ndipo kupanikizika kwina pamtima kungayambitse kukhumudwa mtima ndi mavuto ena akuluakulu.
Kodi N'chiyani Chimachititsa Aortic Kubwezeretsanso?
Matenda angapo a zachipatala akhoza kubweretsanso aortic. Izi zikuphatikizapo:
- Endocarditis. Endocarditis (matenda a valves pamtima) angayambitse valavu ya aortic kuti iwonongeke, kubwezeretsanso.
- Mphutsi yotchedwa aortic valve. Aortic regurgitation ikhoza kuyambitsidwa ndi valve ya bicuspid, yomwe imakhala yobadwa m'mimba imene valve ya aortic imakhala ndi "ziphuphu" ziwiri (ie, ziphuphu) m'malo mwa zitatu zowonongeka. Ma valve amadzimadzi amathandiza kwambiri kupanga mapulogalamu a calcium, omwe nthawi zambiri amapanga aortic stenosis . Choncho odwala ndi valvepid aortic valve angakhale ndi stenosis komanso kubwezeretsedwa.
- Matenda a mtima wa rheumatic . Zaka makumi asanu zapitazo, matenda a mtima wa rheumatic ndiwo omwe amachititsa kuti aortic ayambirenso m'mayiko otukuka. Pakubwera kwa maantibayotiki, matenda a mtima wodwala matenda a rheumatic asanduka achilendo.
- Aortic Congenital regurgitation. Mitundu yosiyanasiyana ya matenda a mtima obadwa nawo amatha kubwezeretsa aortic, kuphatikizapo Turner syndrome, tetralogy ya Fallot, ndi truncus arteriosus.
- Kutaya kwa mizu ya aortic. Mzu wa aortic ndi gawo la aorta nthawi yomweyo pamwamba pa valve ya aortic. Zambiri zingayambitse muzu wa aortic kuti uchepetse kapena uwonjezere. Kusungunuka kumeneku kungasokoneze valavu ya aortic yokha, kuchititsa kubwezeretsa. Zina mwa zifukwa zomwe zimayambitsa mizu ya aortic zimaphatikizapo matenda aakulu, aortitis (kutupa kwa aorta, komwe kungayambitsidwe ndi matenda monga syphilis), chifuwa choyipa, aortic dissection ( kutuluka mwadzidzidzi kwa khoma la aorta, chifukwa cha matenda osokoneza maganizo ), ndi matenda a Marfan.
Kodi Ndizovuta Ziti Zimayambitsa Aortic?
Mu aortic kubwezeretsanso, ventricle kumanzere amayenera kugwira ntchito molimbika kwambiri kuti apereke matupi a thupi ndi kuchuluka kwa magazi okwanira. Mwachindunji, ndi kugunda kwa mtima kulikonse, mpweyawu umayenera kutulutsa magazi onse omwe thupi limasowa, kuphatikizapo kuchuluka kwa magazi omwe amabwerera m'mbuyo mu ventricle. Magazi ochulukirapowa amachititsa kuti minofu ya mtima iwonongeke (kapena "hypertrophy") ndipo imachititsa kuti ventricle ya kumanzere iwonjezere.
Mavuto ena omwe ali kumapeto kwa ventricle kumapeto amatha kukhumudwitsa mtima, komanso kugonana kwa mtima monga matenda a atrial fibrillation , ventricular tachycardia , ndi fibrication ya ventricular.
Mitundu yochepa ya aortic yowonongeka nthawi zambiri imabweretsa zizindikiro. Komabe, ngati kubwezeretsa kumawonongeka, mpweyawu umakhala wopanikizika kwambiri ndipo mtima ukulephera kuyamba. Panthawi imeneyi, munthu yemwe akuyambiranso aortic adzayamba kuona dyspnea (kupuma pang'ono) ndi kuyesayesa komanso kutopa. Zizindikirozi zimawonjezereka pamene kubwezeretsedwa kumakhala kofunika kwambiri, ndipo pamapeto pake kumakhala kovuta kwambiri.
Ngakhale kuti aortic kubwezeretsa nthawi zambiri imayamba pang'onopang'ono - kwazaka zambiri - nthawi zina zingatheke mwadzidzidzi. Kuchuluka kwa aortic kubwezeretsa kaŵirikaŵiri kumachitika ndi endocarditis, aortic dissection, kapena chifuwa chachikulu.
Kawirikawiri aortic kubwezeretsa nthawi zambiri imatulutsa mtima mwadzidzidzi, ndipo imatha kuchiritsidwa ndi opaleshoni yowonjezereka.
Kodi Aortic Ikubweranso Bwanji?
Kutulukira kwa aortic kubwereranso kumakhala kosavuta. Aortic kubwezeretsa kumapangitsa mtima wodandaula umene madokotala ambiri amadziwa nthawi yomweyo. Matendawa akhoza kutsimikiziridwa mosavuta kapena kulamulidwa ndi echocardiogram .
Kuchiza Aortic Kubwezera
Potsirizira pake, kuchiza kubwezeretsa aortic kumafuna kupatsidwa opaleshoni ya valve yowonongeka. Mankhwala omwe amachepetsa mitsempha yamagazi (nthawi zambiri, kansalu ya calcium kapena ACE inhibitors ) angathandize kuchepetsa kuchuluka kwa magazi kubwerera kumbuyo kwa ventricle ndipo zingathandize kuchepetsa zizindikiro. Ndipo ndithudi, anthu ena okhala ndi aortic wobwezeretsedwa mwachizoloŵezi safuna konse opaleshoni konse. Koma aortic kubwezeretsa ndi vuto lamagetsi, ndipo kuti muchite nawo, mukufunikira njira yothetsera.
Kuchita opaleshoni nthawi yoyenera n'kofunika kwambiri. Monga lamulo, opaleshoni ya valve ya aortic iyenera kuchitidwa kokha kuti aortic isayambe kubwezeretsa zizindikiro. Kuyezetsa magazi nthawi ndi nthawi komanso mapepala apakompyuta amawathandiza kuthetsa nthawi yopaleshoni.
Chisankho china chofunika ndi mtundu wa valve wotsatiridwa womwe uti ukhale wogwiritsidwa ntchito. Mavitamini otchedwa aortic valves mwina amakhala opangidwa ndi zipangizo zopangidwa ndi anthu (magetsi) kapena amapangidwa kuchokera ku mtima wa valve wa nyama, makamaka nkhumba (bioprosthetic valve). Kusankha mtundu wa valavu yogwiritsira ntchito kumadalira msinkhu wa wodwalayo ndipo ngati kutenga mankhwala osokoneza bongo aakulu ndi vuto.
Magetsi onse opangira mtima amakula kwambiri kuti apange magazi. Komabe, kutseka magazi sikungakhale kovuta ndi bioprosthetic kusiyana ndi magetsi, kotero anthu omwe ali ndi valves bioprosthetic sayenera kutenga anticoagulant, pamene iwo omwe ali ndi valve zamagetsi nthawizonse amachita. Komabe, ma valve opangidwa ndi mawotchi amatha nthawi yaitali kusiyana ndi ma valve a bioprosthetic.
Kuonjezera apo, mtundu wotsutsa wa aortic wosasintha kwenikweni ndiwotchedwa FDA ovomerezeka - transcatheter aortic valve implantation, kapena TAVI . Ngakhale kuti opaleshoni ya TAVI ndi yovuta kwambiri kuposa yowonjezeredwa ndi valve, njirayi imakhalabe yoopsa kwambiri. Kawirikawiri, lero izo zasungidwa kwa odwala amene amawoneka "akudwala kwambiri" m'malo olowera ma valve. Komabe, monga momwe chidziwitso cha TAVI chinapezera, mosakayika chidzakhalapo kwa magulu ambiri a odwala omwe amafunikira malo a valve m'malo mwake.
Momwemo: Ngati mukufuna mpata wothandizidwa ndi aortic, ndiye kuti muli ndi zaka 65 kapena 70 ndipo mutha kutenga anticoagulant, dokotala wanu angakulimbikitseni makina opanga. Ngati ndinu wamkulu kuposa 65 kapena 70, kapena simungathe kutenga anticoagulant, valve ya bioprosthetic iyenera kutonthozedwa. Ngati chiopsezo chanu chochita opaleshoni chimawoneka ngati chapamwamba kwambiri, a TAVI ayenera kuganiziridwa.
Mfundo yaikulu ndi yakuti pali zowonjezera ndi zowonongeka ku mitundu yonse ya ma valve m'malo. Kusankha mtundu wa valve woyenera kuyenera kukhala chisankho pakati pa inu ndi dokotala wanu.
Zotsatira:
Nishimura RA, Otto CM, Bonow RO, ndi al. 2014 AHA / ACC chitsogozo cha odwala odwala matenda a valvular: lipoti la American College of Cardiology / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2014; 63: e57.