Kutaya kwa valavu wamapapo

Valavu yamapapu yosapezeka ndimavuto osowa omwe mavavu am'mapapo samasowa kapena sanapangidwe bwino. Magazi opanda oxygen amapita kudzera mu valavuyi kuchokera pamtima kupita m'mapapu, komwe amatenga mpweya wabwino. Vutoli limakhalapo pakubadwa (kobadwa nako).

Valavu yam'mapapo yomwe imakhalapo imachitika pamene valavu yam'mapapo simapanga kapena kukula bwino mwana ali m'mimba mwa mayi. Zikakhalapo, nthawi zambiri zimachitika ngati gawo lamatenda amtima otchedwa tetralogy of Fallot. Amapezeka pafupifupi 3% mpaka 6% ya anthu omwe ali ndi tetralogy of Fallot.

Valavu yamapapo ikasowa kapena sikugwira ntchito bwino, magazi samayenda bwino m'mapapu kuti akapeze mpweya wokwanira.

Nthawi zambiri, pamakhalanso bowo pakati pamitsempha yamanzere yakumanzere ndi kwamanja (chotengera chamagetsi cham'mimba). Vutoli limathandizanso kuti magazi omwe ali ndi mpweya wocheperako aponyedwe mthupi.

Khungu lidzakhala ndi mawonekedwe a buluu (cyanosis), chifukwa magazi amthupi amakhala ndi mpweya wochepa.

Valavu ya m'mapapo yomwe imakhalapo imapangitsanso mitsempha yotulutsa magazi (mitsempha yomwe imanyamula magazi kupita nawo m'mapapu kukatenga mpweya). Amatha kukulitsidwa kotero kuti amathinikiza pamachubu omwe amabweretsa mpweya m'mapapu (bronchi). Izi zimayambitsa kupuma.

Zolakwika zina zamtima zomwe zimatha kupezeka ndi ma valavu osapezekanso ndi awa:

• Valavu yachilendo ya tricuspid
• Matenda osokoneza bongo
• Kawiri kubwereketsa ventricle kumanja
• Ductus arteriosis
• Endocardial khushoni chilema
• Matenda a Marfan
• Tricuspid atresia
• Mitsempha yam'mapapo yamanzere

Mavuto amtima omwe amapezeka ndimavuto am'mapapo osakhalapo amatha kukhala chifukwa cha zolakwika zamtundu winawake.

Zizindikiro zimatha kusiyanasiyana kutengera zolakwika zomwe khanda limakhala nazo, koma zingaphatikizepo:

• Mtundu wa buluu pakhungu (cyanosis)
• Kutsokomola
• Kulephera kukula bwino
• Kulakalaka kudya
• Kupuma mofulumira
• Kulephera kupuma
• Kutentha

Mavala am'mapapo osapezeka amatha kupezeka mwanayo asanabadwe ndi mayeso omwe amagwiritsa ntchito mafunde akumveka kuti apange chithunzi cha mtima (echocardiogram).

Pakati pa mayeso, wothandizira zaumoyo amatha kumva kudandaula m'chifuwa cha khanda.

Kuyesedwa kwa valavu yamapapu yomwe kulibe ndi monga:

• Kuyesa kuyeza zochitika zamagetsi pamtima (electrocardiogram)
• Kujambula mtima kwa CT
• X-ray pachifuwa
• Zojambulajambula
• Kujambula kwamaginito (MRI) kwamtima

Makanda omwe ali ndi zizindikiro za kupuma amafunika kuchitidwa opaleshoni nthawi yomweyo. Makanda omwe alibe zizindikilo zowopsa nthawi zambiri amachitidwa opaleshoni m'miyezi itatu kapena isanu ndi umodzi yoyambirira.

Kutengera mtundu wamatenda amtima omwe khanda limakhala nawo, kuchitidwa opaleshoni kumatha:

• Kutseka bowo pakhoma pakati pamitsempha yamanzere yakumanzere ndi yamanja (chotengera chamagetsi chosalowerera)
• Kutseka chotengera chamagazi chomwe chimalumikiza aorta ndi mtsempha wamagazi (ductus arteriosis)
• Kukulitsa kutuluka kuchokera ku ventricle kumanja kupita kumapapu

Mitundu ya maopareshoni a valavu yamapapo omwe mulibe ndi monga:

• Kusuntha mtsempha wamagazi m'mapapo kupita kutsogolo kwa aorta ndikutali ndi mlengalenga
• Kumanganso khoma lamitsempha m'mapapu kuti muchepetse kuthamanga kwa ma airways (pulmonary plication ndi kuchepetsa arterioplasty)
• Kumanganso mphepo yamachubu ndi machubu opumira m'mapapu
• Kusintha valavu yamapapo yosagwira ndi imodzi yotengedwa munthupi la munthu kapena nyama

Makanda omwe ali ndi zizizindikiro zopumira kwambiri angafunike kulandira mpweya kapena kuyikidwa pamakina opumira (asanapite opaleshoni kapena pambuyo pake).

Popanda kuchitidwa opaleshoni, makanda ambiri omwe ali ndi vuto lalikulu m'mapapo amafa.

Nthawi zambiri, opareshoni imatha kuthana ndi vutoli ndikuchepetsa zizindikilo. Zotsatira nthawi zambiri zimakhala zabwino kwambiri.

Zovuta zingaphatikizepo:

• Matenda a ubongo (abscess)
• Kugwa kwa mapapo (atelectasis)
• Chibayo
• Kulephera kwa mtima kumanja
• Sitiroko

Itanani omwe akukuthandizani ngati khanda lanu lili ndi zizindikilo za ma valve osapezekanso. Ngati muli ndi banja lofooka pamtima, lankhulani ndi omwe amakupatsani chithandizo musanakhale kapena panthawi yapakati.

Ngakhale palibe njira yopewa vutoli, mabanja atha kuyesedwa kuti adziwe chiwopsezo chawo chobadwa nako.

Matenda a valve osagwira; Kobadwa nako valavu m'mapapo mwanga; Agenesis wamapapu; Cyanotic matenda amtima - valavu yamapapo; Kobadwa nako matenda a mtima - valavu m'mapapo mwanga; Mtima wobadwa wopanda vuto - valavu yamapapo

• Kutaya kwa valavu wamapapo
• Chisokonezo 'Tet spell'
• Zolemba Zachinyengo

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Matenda a mtima obadwa ndi Acyanotic: zotupa za regurgitant. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 455.

Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Zilonda zam'mimba zotsekemera: zotupa zomwe zimakhudzana ndi kuchepa kwa magazi m'mapapo. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 457.

Scholz T, Kuganizira BE. Matenda amtima obadwa nawo. Mu: Gleason CA, Juul SE, olemba. Matenda a Avery a Mwana Wongobadwa kumene. 10th ed. Philadelphia, PA: Elsevier; 2018: chap 55.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Matenda obadwa nawo mumtima mwa wamkulu komanso wodwala. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 75.