Tricuspid atresia

Tricuspid atresia rudzi rwechirwere chemwoyo icho chiripo pakuzvarwa (congenital heart disease), umo tricuspid moyo vharuvhu isipo kana zvisina kujairika kugadzirwa. Urema hwacho hunodzivirira kuyerera kweropa kubva paatrium yekurudyi kuenda kurudyi ventricle. Zvimwe zvinokanganisa moyo kana mudziyo zvinowanzovapo panguva imwe chete.

Tricuspid atresia chimiro chisina kujairika chechirwere chepfungwa yemoyo. Iyo inokanganisa vangangoita mashanu mune ese zviuru zana ekuberekwa kuzvarwa. Mumwe muvanhu vashanu vane chirwere ichi vanozovewo nemamwe matambudziko emoyo.

Kazhinji, ropa rinoyerera kubva mumuviri kuenda kurudyi atrium, uyezve kuburikidza neiyo tricuspid vharuvhu kuenda kurudyi ventricle uye kuenda kumapapu. Kana iyo tricuspid vharafu ikasavhura, ropa harigone kuyerera kubva kurudyi atrium kuenda kurudyi ventricle. Nekuda kwedambudziko neiyo tricuspid vharafu, ropa pakupedzisira harigone kupinda mumapapu. Apa ndipo painofanirwa kuenda kunotora oxygen (inova oxygenated).

Asi, iro ropa rinopfuura nepaburi pakati penzvimbo yekurudyi neyekuruboshwe. Mune atrium yekuruboshwe, inosangana neropa-rakazara ropa rinodzoka kubva mumapapu. Iko kusanganiswa kweoksijeni-yakapfuma uye oksijeni-isina ropa reropa inozoputirwa kunze mumuviri kubva kuruboshwe ventricle. Izvi zvinokonzera kuti okisijeni iri muropa ive yakaderera pane zvakajairwa.

Mune vanhu vane tricuspid atresia, mapapu anogamuchira ropa kuburikidza nepakati pegomba pakati pechivhenekeri kurudyi uye kuruboshwe (zvinotsanangurwa pamusoro), kana kuburikidza nekuchengetedza mudziyo wechi fetus unonzi ductus arteriosus. Iyo ductus arteriosus inobatanidza iyo pulmonary artery (arteri kumapapu) kune aorta (main artery kumuviri). Iyo iripo kana mwana achinge azvarwa, asi kazhinji inovhara yega pachayo nguva pfupi mushure mekuzvarwa.

Zviratidzo zvinosanganisira:

• Ruvara rweBluish kune ganda (cyanosis) nekuda kweiyo yakaderera oxygen mwero muropa
• Kukurumidza kufema
• Kuneta
• Kukura kwakashata
• Kufema kwekufema

Aya mamiriro anogona kuwanikwa panguva yenguva dzose prenatal ultrasound imaging kana kana mwana achiongororwa mushure mekuzvarwa. Bluish ganda riripo pakuzvarwa. Kugunun'una kwemoyo kunowanzo kuvepo pakuzvarwa uye kunogona kuwedzera mukudaidzira pamusoro pemwedzi yakati wandei.

Miedzo inogona kusanganisira zvinotevera:

• ECG
• Echocardiogram
• Chest x-ray
• Catheterization yemwoyo
• MRI yemoyo
• CT scan yemoyo

Kamwe kuongororwa kwacho kwaitwa, mwana anowanzo gamuchirwa kuchipatara chekubereka kwakanyanya (NICU). Mushonga unonzi prostaglandin E1 unogona kushandiswa kuchengetedza iyo ductus arteriosis yakavhurika kuitira kuti ropa rigotenderera kumapapu.

Kazhinji, varwere vane chirwere ichi vanoda kuvhiyiwa. Kana moyo usingakwanise kupomba ropa rakakwana kuenda kumapapu uye nemuviri wese, kuvhiya kwekutanga kazhinji kunoitika mukati memazuva mashoma ekutanga ehupenyu. Mune maitiro aya, shunt yekuisira inoiswa kuti irambe ichiyerera ichienda kumapapu. Mune zvimwe zviitiko, kuvhiya kwekutanga uku hakudiwe.

Mushure meizvozvo, mwana anoenda kumba kazhinji. Mwana anozofanirwa kutora imwe kana yakawanda yemishonga yemazuva ese uye achiteverwa zvakanyanya nachiremba wevana. Uyu chiremba achasarudza kuti chikamu chechipiri chekuvhiya chinofanira kuitwa riini.

Chikamu chinotevera chekuvhiya chinonzi iyo Glenn shunt kana hemi-Fontan maitiro. Maitiro aya anobatanidza hafu yetsinga dzinotakura oxygen isina muropa kubva kuhafu yekumusoro yemuviri yakananga kune tsinga yemapapu. Kuvhiyiwa kunowanzoitwa kana mwana ari pakati pemwedzi mina kusvika kumatanhatu ekuberekwa.

Pakati pechikamu I ne II, mwana anogona kunge achiri kutarisa bhuruu (cyanotic).

Stage III, yekupedzisira nhanho, inonzi maitiro ePontan. Iyo yakasara tsinga inotakura oxygen-isina ropa ropa kubva mumuviri yakabatana yakanangana kune pulmonary arteri inotungamira kumapapu. Iyo yekuruboshwe ventricle ikozvino inongofanirwa kupomba kumuviri, kwete mapapu. Kuvhiya uku kunowanzoitwa kana mwana aine mwedzi gumi nemasere kusvika pamakore matatu ekuberekwa. Mushure meiyi nhanho yekupedzisira, ganda remwana harisisiri rebhuruu.

Muzviitiko zvakawanda, kuvhiyiwa kunovandudza mamiriro acho.

Zvinetso zvinogona kusanganisira:

• Zvisina kujairika, zvinomhanya pamoyo mutinhimira (arrhythmias)
• Chirwere chisingaperi (kubva kuchirwere chinonzi protein-kurasikirwa enteropathy)
• Kutadza kwemoyo
• Fluid mudumbu (ascites) uye mumapapu (pleural effusion)
• Kuvharirwa kweiyo shunt yekugadzira
• Kurohwa uye kumwe kushushikana kweshungu
• Kufa kamwe kamwe

Bata wako mupi wezvehutano ipapo kana mwana wako ane:

• Shanduko nyowani mukufema maitiro
• Matambudziko kudya
• Ganda riri kushanduka bhuruu

Iko hakuna inozivikanwa nzira yekudzivirira tricuspid atresia.

Tri atresia; Valve kusagadzikana - tricuspid atresia; Mwoyo unoberekwa - tricuspid atresia; Cyanotic chirwere chemoyo - tricuspid atresia

• Mwoyo - chikamu kuburikidza nepakati
• Tricuspid atresia

Fraser CD, Kane LC. Congenital chirwere chemoyo. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya. 20th ed. Philadelphia, PA: Elsevier; 2017: chitsiko 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital chirwere chemoyo mune mukuru uye wevarwere murwere. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chits. 75.