Yakapinda kaviri kaburi ventricle

Double inlet kuruboshwe ventricle (DILV) hurema hwemwoyo huripo kubva pakuberekwa (kuberekwa). Iyo inokanganisa mavhavha uye makamuri emoyo. Vacheche vanozvarwa vaine chirwere ichi vanongova nekamuri imwe chete yekupomba (ventricle) mumoyo yavo.

DILV ndeimwe yemaperembudzi emoyo anozivikanwa seasina kuroora (kana zvakajairika) ventricle kuremara. Vanhu vane DILV vane hombe kuruboshwe ventricle uye diki kurudyi ventricle. Iyo yekuruboshwe ventricle ndiyo yekupomba kamuri yemoyo iyo inotumira oxygen-yakazara ropa kumuviri. Iyo chaiyo ventricle ndiyo yekupomba kamuri iyo inotumira oxygen-isina ropa mapapu.

Mumwoyo chaiwo, kurudyi uye kuruboshwe ma ventricles anogamuchira ropa kubva kurudyi uye kuruboshwe atria. Iwo maatria ndiwo makamuri epamusoro emoyo.Oxygen-isina ropa rinodzoka kubva mumuviri inoyerera ichienda kurudyi atrium uye kurudyi ventricle. Icho ventricle chaicho chinobva chapomba ropa kune pulmonary arteri. Uyu ndiwo mudziyo weropa unotakura ropa kuenda kumapapu kunotora oxygen.

Ropa rine oxygen nyowani rinodzokera kuruboshwe atrium uye kuruboshwe ventricle. Iyo aorta inozotakura ropa-rakapfuma reropajeni kune iyo yese yemuviri kubva kuruboshwe ventricle. Iyo aorta ndiyo huru arteri inotungamira kunze kwemoyo.

Mune vanhu vane DILV, chete kuruboshwe ventricle ndiyo inogadzirwa. Ose maviri atria haana ropa mukati meiyi ventricle. Izvi zvinoreva kuti oxygen-yakazara ropa inosangana ne oxygen-muropa ropa. Iko kusanganiswa kunozoputirwa kune ese muviri nemapapu.

DILV inogona kuitika kana iyo hombe midziyo yeropa ichibuda kubva pamoyo iri munzvimbo dzisina kunaka. Iyo aorta inomuka kubva kune diki kurudyi ventricle uye pulmonary arteri inomuka kubva kuruboshwe ventricle. Izvo zvinogona zvakare kuitika apo arteri ari munzvimbo dzakajairika uye anomuka kubva kune zvakajairwa ma ventricles. Muchiitiko ichi, ropa rinoyerera kubva kuruboshwe kuenda kurudyi ventricle kuburikidza neburi pakati pemakamuri anonzi ventricular septal defect (VSD).

DILV ishoma kwazvo. Chikonzero chaicho hachizivikanwi. Dambudziko rinowanzoitika pakutanga kwepamuviri, apo moyo wemwana unokura. Vanhu vane DILV kazhinji vanewo mamwe matambudziko emoyo, akadai se:

• Kubatana kweaorta (kuderera kweaorta)
• Pulmonary atresia (pulmonary vharafu yemoyo haina kuumbwa nemazvo)
• Pulmonary vharafu stenosis (kudzikira kwepulmonary valve)

Zviratidzo zveDILV zvinogona kusanganisira:

• Ruvara rweBluish kune ganda nemiromo (cyanosis) nekuda kweakaderera oxygen muropa
• Kukundikana kuwedzera uremu uye kukura
• Ganda rakachenuruka (pallor)
• Kudya zvakashata kubva mukuneta nyore
• Kudikitira
• Makumbo akazvimba kana dumbu
• Kunetseka kufema

Zviratidzo zveDILV zvinogona kusanganisira:

• Abnormal moyo mutinhimira, sezvinoonekwa pane electrocardiogram
• Kuvaka kwemvura yakatenderedza mapapu
• Kutadza kwemoyo
• Moyo kugunun'una
• Kukurumidza kurova kwemoyo

Kuyedza kuongorora DILV kunogona kusanganisira:

• Chest x-ray
• Kuyerwa kwechiitiko chemagetsi mumoyo (electrocardiogram, kana ECG)
• Ultrasound bvunzo yemoyo (echocardiogram)
• Kupfuudza mutete, wakapfava chubhu mukati memwoyo kuti utarise arteri (moyo catheterization)
• Mwoyo MRI

Kuvhiya kunodiwa kunatsiridza kutenderera kweropa kuburikidza nemuviri uye mumapapu. Kuvhiya kwakajairika kurapa DILV akateedzana maviri kana matatu mashandiro. Aya kuvhiya akafanana neaya anoshandiswa kurapa hypoplastic rakasara moyo chirwere uye tricuspid atresia.

Kuvhiya kwekutanga kunogona kudikanwa kana mwana achingova nemazuva mashoma akura. Muzviitiko zvakawanda, mwana anogona kuenda kumba kubva kuchipatara mushure. Mwana anowanzoda kutora mishonga zuva rega rega uye kunyatsoteverwa nachiremba wechiremba wemwoyo (cardiologist). Chiremba wemwana anoona kuti chikamu chechipiri chekuvhiya chinofanira kuitwa riini.

Kuvhiya kunotevera (kana kuvhiya kwekutanga, kana mwana aisada maitiro semwana achangozvarwa) kunonzi bidirectional Glenn shunt kana Hemifontan maitiro. Kuvhiya uku kunowanzoitwa kana mwana aine mwedzi mina kusvika kumwedzi mitanhatu yekuberekwa.

Kunyangwe mushure mekuvhiyiwa pamusoro, mwana anogona achiri kutaridzika bhuruu (cyanotic). Nhanho yekupedzisira inonzi iyo Fontan maitiro. Kuvhiya uku kunowanzoitwa kana mwana aine mwedzi gumi nemasere kusvika pamakore matatu ekuberekwa. Mushure meiyi nhanho yekupedzisira, mwana haasisiri bhuruu.

Iko kushanda kwePontan hakugadzi kutenderera kwakanaka mumuviri. Asi, zvinovandudza kuyerera kweropa zvakakwana kuti mwana ararame uye akure.

Mwana anogona kuda kuvhiiwa kwakawanda kwehumwe hurema kana kuwedzera kupona akamirira maitiro ePontan.

Mwana wako angangoda kutora mishonga usati uye mushure mekuvhiyiwa. Izvi zvinogona kusanganisira:

• Anticoagulants kudzivirira kuvhara kweropa
• ACE inhibitors kudzikisa BP
• Digoxin kubatsira chibvumirano chemoyo
• Mapiritsi emvura (diuretics) ekuderedza kuzvimba mumuviri

Kuiswa kwemoyo kunogona kukurudzirwa, kana nzira dziri pamusoro dzikundikana.

DILV irema rakaomarara remoyo iro risiri nyore kurapa. Kunyatsoita mwana zvinoenderana ne:

• Mamiriro ezvinhu emucheche panguva yekuongororwa uye kurapwa.
• Kana paine mamwe matambudziko emoyo.
• Iko kuremara kwakakomba sei.

Mushure mekurapwa, vacheche vazhinji vane DILV vanorarama kuva vanhu vakuru. Asi, izvo zvinoda kutevedzera kweupenyu hwese. Ivo vanogona zvakare kusangana nezvinetso uye vangatofanira kudzikisira zviitwa zvemuviri.

Zvinetso zveDILV zvinosanganisira:

• Kirabhu (kuomarara kwemabhedha ezvipikiri) pazvigunwe neminwe (chiratidzo chekupedzisira)
• Kutadza kwemoyo
• Kakawanda pneumonia
• Matambudziko emoyo mutinhimira
• Rufu

Fonera wako mupi wezvehutano kana mwana wako:

• Zvinoratidzika kuneta nyore
• Anonetseka kufema
• Ine ganda rebhuruu kana miromo

Uyezve taura nemupi wako kana mwana wako asiri kukura kana kuwedzera uremu.

Iko hakuna kunozivikanwa kudzivirira.

DILV; Imwe ventricle; Kazhinji ventricle; Univentricular moyo; Univentricular moyo weruboshwe ventricular mhando; Kuberekwa kwemoyo kukanganisa - DILV; Cyanotic moyo hurema - DILV; Kuremara kwekuzvarwa - DILV

• Yakapinda kaviri kaburi ventricle

Kanter KR. Management of chete ventricle uye cavopulmonary kubatana. Mune: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston uye Spencer Kuvhiya kweChipfuva. 9th ed. Philadelphia, PA: Elsevier; 2016: chits. 129.

Kliegman RM, St. Geme JW, Blum NJ. Shah SS, Tasker RC, Wilson KM. Schor NF. Cyanotic congenital moyo chirwere: maronda ane hukama nekuwedzera kwemapurmoni kuyerera kweropa. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 458.

Wohlmuth C, Gardiner HM. Mwoyo. Mune: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, eds. Fetal Mushonga: Basic Science uye Clinical Practice. 3rd ed. Philadelphia, PA: Elsevier; 2020: chitsiko 29.