Mu aortic regurgitation the aortic valve inova yakashata. Rimwe rakaputika aortic valve rinowanzokonzera zvinetso zvemoyo.
Vadhigiri vemavhendi e-aortic mukova pakati pevhirikiriri rekupedzisira ne-aorta. The valor valve inovhurwa sezvo sverricle yakasara inotanga kuputira, zvichibvumira ropa kuti ribvise mukati memwoyo uye mu-aorta. Apo ganda rinopedza kurova, vhuti re aortic rinovhara kuchengetedza ropa kubva pakushambidza zvakare kuruboshwe.
Paunokura aortic kudzokera shure, yako aortic valve inokundikana kuvhara zvachose, nokudaro rega ropa riyerere kumashure kubva paaorta kusvika kuruboshwe rweserikiri. Iyi "kudzorerwa" kweropa inokonzera mwoyo kushanda zvakaoma zvikuru, uye kuwedzera kudzvinyirira pamwoyo kunogona kutungamirira kukundikana kwemoyo uye zvimwe zvinetso zvakakosha.
Chii Chinokonzera Aortic Kudzorerazve?
Matambudziko akawanda ezvoutano anogona kuita kuti aortic idzoke zvakare. Izvi zvinosanganisira:
- Endocarditis. Endocarditis (hutachiona hwemwoyo yemagetsi) inogona kuita kuti aortic valve iwedzere, zvichiita kuti chigadziriswe.
- Bicuspid aortic valve. Aortic regurgitation inogona kukonzerwa nevicuspid valve, chirwere chekuberekwa iyo iyo aortic valve ine maviri chete "cusps" (kureva, mavhiri) panzvimbo yevaya vatatu. Bicuspid aortic valves inonyanya kugadziriswa pakuumbwa kwe calcium deposits, iyo inowanzobudisa aortic stenosis . Saka varwere vane bicuspid aortic valve vanogona kukura zvose stenosis uye kudzokerazve.
- Rheumatic heart disease . Makore makumi mashanu akapfuura, chirwere cherheumatic moyo chaive chikonzero chikuru chekudzorera aortic munyika yakabudirira. Nekuuya kwemishonga inorwisa mabhakitiriya, chirwere chinonzi rheumatic heart chave chisingawanzoitiki.
- Congenital aortic regurgitation. Mhando dzinoverengeka dzehutano hwepfungwa dzinogona kuunza aortic kudzokerazve, kusanganisira Turner syndrome, tetralogy ye Fallot, uye truncus arteriosus.
- Kushungurudzwa kwemuti we aortic. Muti we aortic ndiwo mugove weaorta pakarepo pamusoro pevhiriji ye aortic. Mamiriro ezvinhu mazhinji anogona kuita kuti aortic midzi iwedzere kana kuwedzera. Izvi zvinogona kukanganisa aortic valve pachayo, zvichikonzera kudzokerazve. Zvimwe zvezvikonzero zvinokonzera aortic root dilation zvinosanganisira chronic hypertension , aortitis (kuputika kweaorta, iyo inogona kukonzerwa nezvirwere zvakadai sechiphilis), chifuva kukuvadza, aortic dissection (kamwe-kamwe kuputika kworusvingo rweaorta, kunokonzerwa nehutachiona hwechirwere chetachiona ), uye Marfan syndrome.
Ndeapi Matambudziko Anokonzerwa neAortic Kudzorerazve?
Muchidimbu chechirongwa chekare chinonzi reorgia chinoda kushanda zvakaoma zvikuru kuitira kupa mishonga yemuviri neropa rakawanda. Kunyanya, nemoyo mumwe nomumwe, chirwere chinokonzera mhepo chinofanira kuputira ropa rose iro muviri unoda, pamwe nekuwanda kweropa iro rinodzokera kumashure. Izwi iri rinowedzera ropa rinokonzera mushumo wemwoyo kuti uite (kana kuti "hypertrophy") uye inokonzera kuti ventricle yakasara iwedzere.
Izvi zvinowedzera kushungurudzika kumhepo inobhururuka zvishoma zvinogona kutungamirira kukundikana kwemoyo, uye kumagayidi emitambo yakadai seyereyria fibrillation , ventricular tachycardia , uye ventricular fibrillation.
Maitiro mashoma ekudzorera aortic kazhinji haatauri zviratidzo. Zvisinei, kana kudzoka kunotyisa, mhepo inowedzera inosimbiswa uye mwoyo kukanganisa kunotanga kukura. Panguva ino, munhu ane aortic kudzokerazve achatanga kuona dyspnea (kupfupika kwefemhepo) nekushingaira uye kuneta kwokutanga. Zviratidzo izvi zvinowedzera sezvo kudzokerazve kunowedzera kukosha, uye pakupedzisira kunogona kuva kwakanyanya.
Kunyange zvazvo aortic kudzoka zvakare inowedzera zvishoma nezvishoma - pamusoro pemakore emakore - mune dzimwe nguva inogona kuitika kamwe kamwe. Kubata aortic kudzoka kunowanzokonzerwa ne endocarditis, aortic dissection, kana chest trauma.
Kubudirira kwakaitwa aortic kunowanzotadza kukurumidza kusuruvara uye kukanganisa mwoyo, uye kunogona kungobatwa nechisimba chinoshandiswa pakuvhiya kushandiswa.
Aortic Kudzokorora Kunowanikwa Sei?
Kuongororwa kweaortic kudzoka kwakanaka chaizvo. Aortic regurgitation inokonzera mwoyo unhu hunogunun'una kuti vanachiremba vakawanda vanoziva nokukurumidza. Kuongororwa kunogona kugadziriswa nyore nyore kana kutongwa kunze ne echocardiogram .
Kubata Aortic Kudzorera
Pakupedzisira, kubata chirwere chinonzi aortic chinoda kushandiswa kwekugadziriswa kwevhavha yakakonzerwa. Zvinodhaka zvinowedzera mishonga yeropa (kazhinji kacho, calcium channel blockers kana ACE inhibitors ) inogona kubatsira kuderedza kuwanda kweropa kunodonha kupinda kuruboshwe uye kungabatsira kudzora zviratidzo. Uye zvechokwadi, vamwe vanhu vane runyararo rwekuvandudza aortic havambodi kuvhiyiwa zvachose. Asi aortic kudzokera zvakare chinetso chemagetsi, uye kunyatsoshanda nayo, iwe unoda mechanical solution.
Nguva yakakodzera yekuvhiya inokosha zvikuru. Sezvo mutemo wehurumende, chirwere chinonzi aortic valve chinofanira kuitika nguva pfupi kuti aortic isadzokezve inotanga kubudisa zviratidzo. Kuongorora kwenguva nenguva uye kunyanya periodic echocardiograms kunobatsira mukugadzirisa nguva yekuvhiyiwa.
Chimwe chisarudzo chinokosha ndechekushandura valve inoshandiswa. Zvirwere zvinonzi aortic valves zvinogona kushandiswa zvachose zvakagadzirwa nemunhu (magetsi emagetsi) kana kuti zvinogadzirwa kubva pamwoyo valve yemhuka, kazhinji yenguruve (bioprosthetic valve). Kusarudza mhando yevhavha yekushandisa inoshandiswa kunoenderana nezera remurwere uye kuti kunyora anticoagulation isingaperi dambudziko.
Zvose zvipfeko zvemwoyo zvinoshandiswa zvinowedzera kuwedzera ropa. Zvisinei, kuvhara ropa hakusi kwechinetso ne bioprosthetic pane magetsi, saka vanhu vane bioprosthetic valve havafaniri kutora anticoagulant, neavo vane magetsi vanowanzoita. Kune rimwe divi, magetsi emagetsi anowanzopedza nguva yakareba kudarika bioprosthetic valves.
Pamusoro pezvo, rudzi rwemhando yeaortic inoshandiswa inoshandiswa ikozvino yava FDA inogamuchirwa - transcatheter aortic valve, kana TAVI . Nepo kuvhiyiwa kweTATVI kunonyanya kuderera kupfuura kuchinja kwechivharo chevhavha, nzira iyi ichiri kutakura ngozi yakawanda. Kazhinji, nhasi yakachengeterwa varwere vanoonekwa se "vanorwara zvikuru" pakugadziriswa kwevhavha. Zvisinei, sechiitiko neTATVI chakawedzerwa pasina mubvunzo chichava chinowanikwa kune zvikamu zvakakura zvevarwere vanoda aortic valve kutsiva.
Saka: Kana uchida kugadziriswa kwevhavha yeaortic regurgitation, uye iwe uri pasi pemakore makumi matanhatu kana makumi manomwe uye unogona kutora anticoagulant, chiremba wako angangokurudzira ma mechanical valve. Kana iwe mukuru kudarika 65 kana 70, kana iwe haugone kutora anticoagulant, valve ye bioprosthetic inogona kukurudzirwa. Kana kukanganisa kwako kunofunga kuve kwakakwirira kwazvo, a TAVI anofanira kuonekwa.
Chinokosha ndechekuti kune zvakagadzikana uye zvinonamatira kumarudzi ose emagetsi ekutsiva. Kugadzirisa zvakanakisisa rudzi rwevhavha rinofanira kuva sarudzo inobatanidzwa pakati pako nachiremba wako.
Sources:
Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC mutungamiri wehutano hwevarwere vane chirwere chepfungwa chevurvular: mushumo weAmerican College of Cardiology / American Heart Association Task Force pamusoro pekushandisa mazano. J Am Coll Cardiol 2014; 63: e57.