Bicuspid aortic valve

Bicuspid aortic valve (BAV) ndi valavu ya aortic yomwe imangokhala ndi timapepala tiwiri, m'malo mwa atatu.

Valavu ya aortic imayendetsa magazi kuchokera mumtima kupita ku aorta. Aorta ndiye chotengera chachikulu chamagazi chomwe chimabweretsa magazi olemera okosijeni m'thupi.

Valavu ya aortic imalola magazi olemera okosijeni kuyenda kuchokera mumtima kupita ku aorta. Zimalepheretsa magazi kuti abwerere kuchokera ku aorta kulowa mumtima pomwe chipinda chopopera chimatsitsimuka.

BAV imakhalapo pobadwa (kobadwa nayo). Valavu yachilendo ya aortic imayamba m'masabata oyambira apakati, pomwe mtima wa mwana ukukula. Zomwe zimayambitsa vutoli sizikudziwika, koma ndiye vuto lobadwa nalo la mtima. BAV nthawi zambiri imayenda m'mabanja.

BAV ikhoza kukhala yothandiza kwambiri pakuletsa magazi kuti abwererenso mumtima. Kutayikira uku kumatchedwa kuti aortic regurgitation. Valavu ya aortic imakhalanso yolimba osatseguka. Izi zimatchedwa aortic stenosis, zomwe zimapangitsa mtima kupopa movutikira kuposa masiku onse kuti utenge magazi kudzera mu valavu. The aorta itha kukulitsidwa ndi vuto ili.

BAV imakonda kufala pakati pa amuna kuposa akazi.

BAV nthawi zambiri imakhalapo mwa makanda okhala ndi coarctation ya aorta (kuchepa kwa aorta). BAV imawonekeranso m'matenda momwe muli kutsekeka kwa magazi kumanzere kwa mtima.

Nthawi zambiri, BAV imapezeka mwa makanda kapena ana chifukwa siyimayambitsa zisonyezo. Komabe, valavu yachilendo imatha kutuluka kapena kupapatiza pakapita nthawi.

Zizindikiro za zovuta ngati izi zingaphatikizepo:

• Matayala a mwana kapena mwana mosavuta
• Kupweteka pachifuwa
• Kuvuta kupuma
• Kuthamanga kwanthawi yomweyo komanso kosasinthasintha (kugunda)
• Kutaya chidziwitso (kukomoka)
• Khungu lotumbululuka

Ngati mwana ali ndi mavuto ena obadwa nawo amtima, amatha kuyambitsa zizindikilo zomwe zimapangitsa kuti apeze BAV.

Pakati pa mayeso, wothandizira zaumoyo atha kupeza zizindikilo za BAV kuphatikiza:

• Kukulitsidwa mtima
• Kung'ung'uza mtima
• Kugunda kofooka m'manja ndi akakolo

Mayeso omwe atha kulamulidwa ndi awa:

• MRI, yomwe imapereka chithunzi chatsatanetsatane cha mtima
• Echocardiogram, yomwe ndi ultrasound yomwe imawona momwe mtima umakhalira komanso magazi amayenda mkati mwa mtima

Ngati wothandizirayo akukayikira zovuta kapena zolakwika zina pamtima, mayeso ena atha kukhala:

• X-ray pachifuwa
• Electrocardiogram (ECG), yomwe imayesa zochitika zamagetsi pamtima
• Catheterization yamtima, njira yomwe chubu yocheperako (catheter) imayikidwa mumtima kuti muwone kuthamanga kwa magazi ndikutenga mulingo woyenera wa kuthamanga kwa magazi ndi kuchuluka kwa mpweya
• MRA, MRI yomwe imagwiritsa ntchito utoto kuti iwone mitsempha yamagazi yamtima

Khanda kapena mwana angafunike kuchitidwa opaleshoni kuti akonze kapena kusinthitsa valavu yodontha kapena yocheperako, ngati zovuta zili zazikulu.

Valavu yocheperako imatha kutsegulidwanso kudzera mu catheterization yamtima. Chubu chabwino (catheter) chimayendetsedwa pamtima ndikutseguka kochepa kwa valavu ya aortic. Buluni yolumikizidwa kumapeto kwa chubu imakhudzidwa kuti pakhale kutsegula kwa valavu.

Kwa akuluakulu, valavu ya bicuspid ikakhala yocheperako kapena yocheperako, imafunika kusintha ina.

Nthawi zina minyewa imafunikiranso kukonza ngati yakula kwambiri kapena ili yopapatiza.

Mankhwala angafunike kuti athetse zizindikiro kapena kupewa zovuta. Mankhwala atha kuphatikizira:

• Mankhwala osokoneza bongo omwe amachepetsa ntchito pamtima (beta-blockers, ACE inhibitors)
• Mankhwala osokoneza bongo omwe amachititsa kuti minofu ya mtima igwire kwambiri (inotropic agents)
• Mapiritsi amadzi (okodzetsa)

Zomwe mwana amachita bwino zimadalira kupezeka kwa zovuta za BAV.

Kupezeka kwa zovuta zina zakuthupi pobadwa kungakhudzenso momwe mwana amakhalira bwino.

Ana ambiri omwe ali ndi vutoli alibe zizindikilo, ndipo vutoli silipezeka mpaka atakula. Anthu ena sazindikira kuti ali ndi vutoli.

Mavuto a BAV ndi awa:

• Mtima kulephera
• Kutulutsa magazi kudzera mu valavu kubwerera mumtima
• Kupapatiza kutsegula kwa valavu
• Kutenga kwa minofu yamtima kapena valavu ya aortic

Itanani yemwe amakupatsani mwana wanu ngati mwana wanu:

• Alibe njala
• Ili ndi khungu lotumbululuka kapena labuluu modabwitsa
• Zikuwoneka kuti zatopa mosavuta

BAV imayenda m'mabanja. Ngati mukudziwa za vutoli m'banja mwanu, lankhulani ndi omwe amakupatsani mwayi musanakhale ndi pakati. Palibe njira yodziwika yopewera vutoli.

Bicommissural valale aortic; Matenda a Valvular - bicuspid aortic valve; BAV

• Opaleshoni ya valve yamtima - kutulutsa

• Bicuspid aortic valve

Borger MA, Fedak PWM, Stephens EH, ndi al. Malangizo a AATS pamavuto okhudzana ndi bicuspid aortic aortopathy: mawonekedwe athunthu pa intaneti. J Thorac Cardiovasc Opaleshoni. 2018; 156 (2): e41-74 (Pamasamba) onetsani: 10.1016 / j.jtcvs.2018.02.115. PMID: 30011777 pubed.ncbi.nlm.nih.gov/30011777/.

Braverman AC, Cheng A. Bicuspid aortic valve ndi matenda opatsirana aortic. Mu: Otto CM, Bonow RO, eds. Matenda a Mtima wa Valvular: Wothandizana ndi Matenda a Mtima a Braunwald. 5th ed. Philadelphia, PA: Elsevier; 2021: mutu 11.

CD ya Fraser, Cameron DE, McMillan KN, Vricella LA. Matenda a mtima ndi zovuta zamagulu. Mu: Ungerleider RM, Meliones JN, McMillian KN, Cooper DS, Jacobs JP, olemba. Matenda Oopsa a Mtima kwa Makanda ndi Ana. Wachitatu ed. Philadelphia, PA: Elsevier; 2019: mutu 53.

Lindman BR, Bonow RO, Otto CM. Matenda a valve aortic. 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 68.