Aortic stenosis chirwere chemwoyo valve chirwere chinokonzerwa nekudziviswa kusinganzwisisiki kwevhenji ye aortic. Ne aortic stenosis, inova yakaoma mwoyo kuti inoputira ropa kunze kune nhengo dzemuviri. Aortic stenosis inogona kukanganisa kushanda kwemoyo, zvichiita zviratidzo zvinoshamisa, uye zvingaguma zvichitungamirira kurufu kunze kwokunge zvichibatwa.
Chii Chinonzi Aortic Stenosis?
Vadhigiri vemavhendi e-aortic mukova pakati pevhirikiriri rekupedzisira ne-aorta. Sezvo kuruboshwe rworuboshwe rwunotanga kubvumirana, vhuti re aortic rinotanga kuitira kuti ropa rive mubhokisi riri kuruboshwe ribvise mukati memwoyo , mukati meaorasi, uye kune imwe yose yomuviri. Pangopera simba rekusiya rakapedza kubvumirana, vheti ye aortic inovhara kuchengetedza ropa kubva pakushambidza zvakare kusvika muvhu.
Apo munhu anoudza aortic stenosis, awo aortic valve inokundikana kuzarura zvachose apo dutu rinotanga kurova, saka mwoyo unofanirwa kushanda zvakaoma zvikuru kuti udzivise ropa nevhavhavha yakavharwa. Izvi zvinowedzera kushungurudzika pamwoyo zvinogona kutungamirira kukundikana kwemoyo uye mamwe matambudziko anokosha emwoyo.
Chii Chinokonzera Aortic Stenosis?
Pane zvinetso zvakasiyana-siyana zvinogona kubudisa aortic stenosis, kusanganisira:
- Degeneration uye calcification : Muvanhu vanopfuura makore makumi manomwe, chikonzero chinonyanya kukosha che aortic stenosis "kupfeka uye kubvarura." Nekufamba kwemazuva, the valve aortic inogona kutanga kuipa, zvichiita kuti calcium deposits iunganidzwe pavhavha. Izvozvo zvinokonzerwa ne calcium inoputsa pamusana wevhirivular, zvichikonzera aortic stenosis.
- Bicuspid aortic valve : Chikonzero chinonyanya kukonzerwa ne aortic stenosis kuvanhu vaduku ndeye congenital bicuspid valve. Mumamiriro ezvinhu aya munhu anoberekwa ane aortic valve ine ma "cusps" maviri (kureva, mavhiri) panzvimbo yevaya vatatu. Bicuspid aortic valves inonyanya kukonzerwa nekuumbwa kwe calcium deposits-uye saizvozvo, kune aortic stenosis. Vanhu vane bicuspid aortic stenosis vanowanzova zviratidzo mumakore avo makumi mana nemakumi mashanu.
- Rheumatic heart heart : Kwete kuti makumi emakore akapfuura, chirwere chemwoyo chinonzi rheumatic chinokonzera chikonzero cheaortic stenosis munyika yakagadzirwa. Asi nekuvandudzwa kwemishonga inorwisa mabhakitiriya inobudirira kurwisa mabhakitiriya e streptococcus , uye kuderedza kunotevera mumatambudziko e rheumatic fever , chirwere chemwoyo chinonzi rheumatic chinenge chisingawanzoitiki.
- Congenital aortic stenosis : Matambudziko akawanda emukanda pamwe nevhavhavha inogona kubudisa aortic stenosis. Izvi zvinosanganisira maitiro akasiyana-siyana e-aortic valve pachayo, uyewo maitiro asina kukodzera ekuvhara musimba wemwoyo kumusoro kana pasi peiyo chaiyo aortic valve. Iyi dzimwe nzira dzisina kujairika dzekuberekwa aortic stenosis dzinowanzoonekwa muvana.
Ndeapi Matambudziko Anokonzerwa neAortic Stenosis?
Ne aortic stenosis, kuputika kweropa kubva kuruboshwe kuruboshwe kunowanzobvhiringidzwa, saka zvinova zvakaoma mwoyo kuti ibvise ropa. Iri rimwe basa remwoyo rinonyanya kunetseka mupfungwa pamusana wemhepo yakasara, izvo zvinokonzera kuti zvive, kana "hypertrophy."
Izvi zvakasiya ventricular hypertrophy zvinogona kutungamirira ku diastolic kudzvinyirira uye diastolic mwoyo kusakundikana , umo musimba wakaoma "unomesa" mhepo, uye inoita kuti zvive zvakaoma kuti mhepo dzemaodzanyemba dzizadze neropa pakati pemoyo.
Zviratidzo zvinozoguma. Zviratidzo izvi zvinowanzobatanidza dyspnea (kukurumidza kufema), nyore kuneta uye kuderedza kushivirira kwekurovedza muviri, uye kuwedzerwa kungozi yekukurumidza kupera friction .
Sezvo aortic stenosis inowedzera, angina inogona kuitika, pamwe nezvikamu zvekuchena uye kunyange syncope (kurasikirwa kwekuziva) panguva yekuedza.
Nesimba rakanyanya aortic stenosis, mutsara wekupedzisira we ventricle unogona kutendeuka kubva kuva wakaoma uye wakasimba kuti uve usina simba uye uwedzere-chirwere chinonzi dilated cardiomyopathy . Pane imwe nguva aortic stenosis inounza kuora mwoyo kwepfungwa, kukanganisa kwemwoyo kunogona kusinganzwisisike.
Kungoerekana kwafa kufa kunowanzosangana nehair aortic stenosis.
Aortic Stenosis Inowanikwa Sei?
Nemhaka yokuti isina kubatwa aortic stenosis inowanzouraya, kuita kuti chirwere chinonyatsozivikanwa chakakosha. Nenzira yakanaka, kuongororwa kweaortic stenosis nhasi hakuwanzooma.
Vanachiremba vanopokana neaortic stenosis apo varwere vavo vanonyunyuta nezve "zviratidzo" zvinoratidza (kukurumidza kufema, kuperevedzwa kwekudzivirira muviri, kurwadziwa kwepfupa, chizivo, kana syncope). Zvimwe zvinonzwisisika, chiremba achange achishushikana ne aortic stenosis zviratidzo zvisati zvaitika apo vanonzwa mwoyo kugunun'una izvo zvinowanzoitika mumamiriro aya. Kuongororwa kunogona kugadziriswa nyore nyore kana kutongwa kunze kwechirevo chekodzero .
Kubata Aortic Stenosis
Kurapa kweaortic stenosis ndiko kushandiswa kwevhavhavha yekugadzirisa. Kushandisa zvinodhaka kunogona kuvandudza zviratidzo zvekanguva, asi pakupedzisira hazvibatsiri nokuti dambudziko ndiro kushandiswa kwemagetsi evharovha. Saka kana munhu ane aortic stenosis, mubvunzo hawanzoiti kana kuita chirwere, asi apo.
Sezvo mutemo wehuwandu, kushandiswa kwevheti ye-aortic inofanira kuitwa nguva pfupi mushure mekunge munhu aortic stenosis inotanga kubudisa zviratidzo-kupfupika kwemhepo, kurwadziwa kwepfupa, chizivo, kana syncope. Kana imwe yechiratidzo ichi ichibva pane aortic stenosis, chiyero chekurarama kweupenyu pasina kusvitsa mavhariji nderamakore maviri kana matatu. Kushandurwa kwemagetsi panguva yakakodzera kunowedzera zvakanyanya izvi. Kamwe kana munhu aonekwa kuti ane aortic stenosis, zvinokosha kuti vaongororwe zvakanakira chero chiratidzo chekuwedzera zviratidzo izvozvo.
Nokuti kuvhiyiwa kunobvisa kamwe kunopisa kwakanyanya kumwoyo wekuyerera kweropa, mune dzakawanda mamiriro ekushanda kwemoyo unovandudza zvakajeka zvinoshamisa mushure mekushandurwa kwemagetsi. Saka kunyange vanhu vakwegura uye vane zviratidzo zvikuru vanogona kuita zvakanaka mushure mokuvhiya aortic stenosis.
Mavhavha echipfeti anoshandiswa kutora chinonzi aortic valve ane chirwere chinogona kunge chinoshandiswa zvachose nezvinhu zvakagadzirwa nevanhu (magetsi emagetsi), kana zvinogona kugadzirwa kubva pamwoyo valve yemhuka, kazhinji yenguruve (bioprosthetic valve). Kusarudza kuti rudzi rwechivharo chekushandisa rinoshandiswa runoenderana nezera remunhu, uye kana vanogona kutora ropa rakapfa se Coumadin .
Zvose zvipfeko zvemwoyo zvinoshandiswa zvinowedzera kuwedzera ropa. Zvisinei, kuvhara ropa hakusi kwechinetso nevhioprosthetic valves kupfuura iyo ine magetsi yemagetsi, saka vanhu vane chekare vangasafanira kutora nguva refu Coumadin therapy; avo vane magetsi emagetsi vanoita. Kune rumwe rutivi, magetsi emagetsi kakawanda anoita seanogara kwenguva yakareba kupfuura bioprosthetic valves.
Saka kune vanhu vane aortic stenosis pasi pezera remakore makumi matanhatu nemashanu vanogona kutora Coumadin, ma mechanical moyo valves anowanzokurudzirwa. Mune vanhu vanopfuura 65, kana kuti ndiani asingagoni kutora Coumadin, bhavheji ye bioprosthetic inowanzorudzirwa.
Nzira Dzakashata Dzinopindirana Yokurapa Aortic Stenosis
Mishonga isingasvikiki pane kupfurikidza kushandiswa kwevhavha inoshandiswa.
Mune aortic valvulotomy , bhatiri catheter inopfuudzwa nepamusoro pevheti ye-aortic uye ibhaluni inogamuchirwa kuitira kuti iparadze mamwe emashicium akaisa pavhavha. Izvi zvinowanzoita kuti valve izarure zvakakwana, uye inoderedza zvimwe zve aortic stenosis. Zvinosuruvarisa, valvulotomy haibvumiri mhinduro dzinobatsira zvakafanana, uye zvinogona kukonzera zvinetso zvakakomba.
Imwe catheter-based procedure yekurapa aortic stenosis inotenderera-catheter aortic valve implantation (TAVI) . Zvimwe zvinhu zvakawanda zveTVI zviri pasi pekushanda kwekushanda, uye vashoma vakagamuchirwa kushandisa kliniki kune varwere avo vari pangozi yakanyanya yekuita chirwere chinoshandiswa pakugadzirisa magetsi. Zvisinei, zvinetso neTATVI panguva ino ndezvimwe zvinokonzera. Zvose TAVI uye valvulotomy panguva ino zvakachengeterwa vanhu vane chirwere chakanyanya kuoma aortic stenosis vasingakwanisi kupona kugadziriswa kwevhavha yekuvhiya.
Shoko Rinobva
Aortic stenosis chirwere chepfungwa chinonzi valvular chinokanganisa kubuda kweropa kubva mumoyo. Yakagadziriswa aortic stenosis inokonzera zviratidzo zvikuru, uye inoderedza zvikuru kutarisira upenyu. Nenzira yakanaka, nekurapwa kwakanyatsogadzirwa nguva, vanhu vane aortic stenosis vanogona kuita zvakanaka.
> Sources:
> Eveborn GW, Schirmer H, Heggelund G, et al. The Evolving Epidemiology of Valvular Aortic Stenosis. Tromsø kudzidza. Moyo 2013; 99: 396.
> Leon MB, Smith CR, Mack M, et al. Transcatheter Aortic-valve Kugadzirwa kweAortic sSenosis kune Varwere Vasingagoni Kuvhiyiwa. N Engl J Med 2010; 363: 1597.
> Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA / ACC Nhungamiro yekutarisira varwere neValvular Heart Disease: Nyaya yeAmerican College yeCardiology / American Heart Association Task Force pamusoro pekushandisa mazano. J Am Coll Cardiol 2014; 63: e57.