Chirwere Chetachiona Mwoyo Wemagetsi
Chinangwa chemakumbo mana emwoyo (the tricuspid, pulmonary, mitral, uye aortic valves) ndechekuti ave nechokwadi chokuti kana mwoyo uchirova, ropa rinotenderera zvakasununguka nenzira yakakodzera. Kana imwe kana yakawanda yemapapiro emwoyo inova nekurwara, kana kusununguka kweropa kusununguka kuburikidza nemwoyo kunodzima (stenosis), kana ropa rinogona kubvumira shure kumativi akavharizwa evhavha (kudzorerwa) -uye zvose. Chero chero rudzi rwechinetso, kana rusingaongororwi nguva dzose uye ruchibatwa zvakanaka, runogona kutungamirira kukundikana kwemoyo , pamwe nemamwe matambudziko emwoyo.
Migumisiro yehutachiona hwemwoyo inotenderera kune mavhavha ayo anobatanidzwa, pasinei dambudziko guru nderekuti stenosis kana kudzokazve, uye kuwanda kwekuvhiringidza kwevhirivular. Kana uine chirwere chemwoyo chinonzi valvular, unoda kushanda pamwe chete nemudzidzisi wako wehutachiona kuti uone kuti mamiriro ako epirvular chirwere, uye chidimbu chekurapa, inodzokororwa nguva dzose.
Mwoyo Mavheti mana uye Zvavanoita
> Ona mavheti mana emwoyo.
Mwoyo unemakamuri mana-kurudyi uye kuruboshwe inria, uye kuruboshwe uye kuruboshwe. Burivha yegavha iri mukati mekamuri pakati pemakamuri maviri uye yakaiswa pamusuo neketini yakagadzirwa, inonzi annulus. Zvakasungirirwa kumutsarudzo mabhii maviri kana matatu (dzimwe nguva anonzi cusps) anoshanda se "flaps." The mitral valve ine mapepa maviri; mamwe magetsi ane mapepa matatu.
Apo mwoyo unorova, mapepa anozaruka uye akavhara. Apo mapepa acho akazaruka, ropa rinogona kuyambuka napamusoro pevhavha. Apo mapepa acho akavharwa, ropa rinoputika kumativi evhavha.
Mhepo yakarurama yakachengetedzwa nemagetsi eti tricuspid uye mapapumine . Ivhavhavha inoputika iri pakati peatrium yakarurama uye ventricle yakarurama. Pano paine zvibvumirano zvakakodzera, valve inonzi tricuspid inotanga uye inobvumira ropa kupinda mu ventricle yakarurama. Zvadaro, kana bvumirano yakarurama yevashandi ichivhara (inodzivirira ropa kuti irege kudzokera kune inrium yakarurama), uye vhuvha yemapurmoni inotanga kubvumira ropa richiputirwa nekodzero yekutenderera ichienda mumapirmita arteri uye kune mapapu.
Iko kuruboshwe kuruboshwe runochengetedzwa ne mitral valve uye aortic valves . Iyo mitral valve, iyo iri pakati pekupedzisira ye-atrium uye yakasiyira ventricle, inotanga apo magumisiro echibvumirano atrium kubvumira ropa richiyerera kuruboshwe rwevhu. Apo kuruboshwe kwemhepo inobhururuka, mitral valve inovhara uye vhuti re aortic rinotanga kurongedza ropa rakaputirwa muaorta uye kunze kumatumbu emuviri.
Ndeapi Mhando Yezvinetso Ingaita Kuti Mwoyo Ive Mavheti?
Kudzokorora, mavhiri emwoyo anoita zvinhu zviviri zvinokosha: Vanovimbisa kuti kana mwoyo unorova, ropa rinotenderera mukati memwoyo zvakasununguka uye rinongotarisana chete nenzira yakarurama.
Saka zvinonzwisisika kuti kana mwoyo yemagetsi ichiva chirwere, marudzi maviri ehutano anokonzera.
Chokutanga, zvinetso zvemagetsi zvepfungwa zvinogona kuita kuti valve iite zvishoma nezvishoma, kuitira kuti ropa rirege kuramba ruchiyerera pachena. Izvi zvinonzi valvular stenosis . Apo gumbo remwoyo rinova stenotic, kamuri remwoyo inofanira kukonzera ropa mhiri kwevhavha rakanyanyisa rinofanira kushanda zvakaoma zvikuru kuti ibudise ropa kunze. Izvi zvinokonzera kushungurudzika mukamuri iyoyo kuwedzera, izvo zvinozoita kuti mwoyo wemisvo kuve (kuti ive "hypertrophic"), uye pakupedzisira inogona kukonzera kuti misiyo itadze.
Chechipiri, chirwere chepfungwa chemwoyo chinogona kuita kuti valve isakwanisa; ndiko kuti, valve inokundikana kupfigira zvachose uye ropa rinokwanisa kutenderera kumashure kumativi evhavha apo inofanirwa kuvharwa. Izvi zvinonzi " valvular regurgitation" . Kudzorera kunokonzera hutachiona hunovhiringidza kuputira ropa rakawanda kudarika rinowanzoitika, izvo zvinogona kutungamirira kuputika kwemakamuri emwoyo, kuora mwoyo kwemitsipa yemwoyo, uye pakupedzisira, mwoyo kusagadzikana.
Saka, zvose valvular stenosis uye kugadziriswa kwevhuvularini zvinogona kutungamirira kumoyo kukanganisa. Mukuwedzera, chirwere chepachivha chepachiviri chakanyatsobatanidzwa nehuwandu hwehutachiona hwemwoyo , kunyanya kushaya firati .
Zvose zvevhirivha yemoyo inogona kuva stenotic kana regurgitant, uye mamwe mavheti emwoyo anokwanisa kuratidza zvose zvezvinetso izvi panguva imwe chete. Kuoma kwehutachiona hwemwoyo kunobva pauwandu hwe stenosis kana kudzoka zvakare kuri kuitwa. Nemhando dzakawanda dzechirwere chepfungwa chepurvular, kuoma kwemamiriro acho ezvinhu-uye kukanganisa kwayo pamwoyo-kunogona kufambira mberi zvakanyanya sezvo nguva inopera. Kunyange "mwoyo munyoro" chirwere chevhavha chinofanira kutorwa zvakanyanya uye chinoteverwa nguva nenguva nechiremba ane unyanzvi.
Ndezvipi Zvimwe Zvinokonzera Mwoyo Wemagetsi Evhavha?
Valvular chirwere chemwoyo chinogona kuguma nekuwanda kwemamiriro ekurapa akasiyana. Zvikonzero zvinowanzovhiringidza zvehutano hwepfungwa dzemwoyo zvinosanganisira:
- Valvular Calcification: Dhipatimendi yeCalcium inogona kuumba pamwoyo yemagetsi, pasina chikonzero chakajeka, mukubatana nekwegura. Valvular calcification inowanzove yakanyanya kunyanya ine mitral valve uye, kusvika zvishoma, neaortic valve. Mune zviitiko zvakawanda, valvular calcification haitombogadziri kuchinja kwakanyanya mubasa revhavha. Asi inogona kubereka kana stenosis kana kudzokerazve, saka ani naani ane valvular calcification inofanira kuteverwa nguva dzose kuti adzokere zvakare mamiriro acho ezvinhu.
- Cardiac Dilation: Kana kamuri yemukati inowedzera, inogona kukonzera kuti gore rinosangana nemagetsi emwoyo rive rakanyanyisa, iro iro rinogona kudzivirira mapepa emagetsi kubva pakuvhara zvachose. Valvular kudzorerwa kunogona kuguma. Kushushikana kwemuviri kunogona kuitika nemarudzi mazhinji ehutano hwemwoyo. Kazhinji, kuputika kunogona kuitika mushure mekurwadziwa kwepfungwa , kana kuine chirwere chinokonzera chirwere chemoyo , chinosangana nekuderedza mitral valve kana tricuspid valve, zvichiita kuti mitral kana tricuspid kudzokere zvakare.
- Congenital Heart Disease: Mhando dzakawanda dzehutano hwepfungwa dzomukomana dzinobatanidzwa nemagetsi anokonzerwa nemagetsi anokwanisa kubudisa stenosis kana kudzoka zvakare. Mhando dzakawanda dzedambudziko revhavha dzinoonekwa nehutano hwemamiriro ezvinhu ndeye pulmonary stenosis, bicuspid aortic valve chirwere (umo inonzi aortic valve ine mhando mbiri chete pane zvinotatu, izvo zvinogona kutungamirira kune aortic stenosis), uye mitral valve prolapse.
- Kutapukisa Endocarditis: Kutapukisa endocarditis , utachiona hwemukati wemoyo uye kunyanya yemapapiro emwoyo, zvinogona kutungamirira kukuvadza kwevheti yemwoyo, kazhinji kuchinjazve. Mavhiringirwo emagavvular anokonzerwa nehutachiona endocarditis anogona kufambira mberi zvishoma, asi iyi ndiyo imwe mamiriro ezvinhu angawanzobereka zvakanyanya, uye zvichida zvinokonzera, moyo wemagetsi kuchinja zvakare.
- Rheumatic Heart Disease: Chirwere chepfungwa chinonzi Rheumatic heart chirwere chekuvhiringidza kwemwoyo chinowanzoonekwa kana munhu aine rheumatic fever . Kunyange zvazvo chirwere chemwoyo chinonzi rheumatic isingazivikanwi zvikuru munyika dzekuMadokero kuti yaiva makore makumi mashanu apfuura, ichiri chinonyanya kunetseka munzvimbo dzakawanda dzenyika. Kudzivirira rheumatic fever nekubata nechisimba muromo wehuro kunoramba kuchikosha zvikuru.
- Mamwe Mamiriro Ezvokurapa: Chirwere chepfungwa chepfungwa chinogona kuguma kubva kune dzimwe nzira dzakawanda dzoutano, kusanganisira sarufu , zvirwere zvinokonzerwa nemaputi (zvakadai se lupus ), zvakasiyana-siyana mumaronda, aortic aneurysm , carcinoid , uye remishonga inonzi radiation kuchipfuva.
Zviratidzo zveMwoyo Wemagetsi Emwoyo
Muzviitiko zvakawanda, chirwere chemwoyo chinokonzera mhepo hachina zviratidzo zvachose kusvikira mushumo wemwoyo uchingopararira zvakakwana kutanga kutadza. Kana zviratidzo zvikaitika, zvinowanzova zvakafanana nezviratidzo zvekushaya mwoyo . Izvi zvinosanganisira dyspnea (kukurumidza kufema); generalized weak; bhudziro ; kana edema (kuzvimba) mumakumbo, patsoka kana mudumbu.
Arrhythmias inogonawo kuguma kubva pamwoyo yemagetsi; sezvakataurwa, mungozi yehutachiona hwehutano inowedzera. Zviratidzo zvepfungwa dzomukati dzinogona kusanganisira zvikamu zvekumbera , kuchena, kushaya simba, kana kushaya muviri kushivirira.
Muvanhu vazhinji, zviratidzo zvehutano hwemwoyo yevhirivu inowanzotanga kuratidzwa kwechirwere. Zvakanaka, munhu ane chirwere chemwoyo chinonzi valve achange aongororwa zvakanaka zvisati zvaitika zviratidzo, kuitira kuti kurapwa kunogona kugadziriswa kusati kwave kusinganzwisisi mwoyo musungo waro wakaitika.
Dzimwe nguva, kunyange zvakadaro, moyo wevheti inorwara inogona kuva dambudziko rakaoma uye kwete chiitiko chinoramba chiripo. Iro valvelar chirwere chemwoyo chinogona kuitika, somuenzaniso, sechikonzero chemoyo wemusana unokonzerwa nekurwadziwa kwepfungwa, kana kubva pakukuvadza kwakanyanya kumwoyo yemagetsi kubva kune utachiona endocarditis kana rheumatic heart disease.
Asi kazhinji kacho, chirwere chemwoyo chinonzi valve chirwere chisingaperi, chinopfuurira chinogona kuongororwa zvakanaka zvisati zvaitika zviratidzo. Kunyanya kuongororwa, chokwadi, ndicho chinhu chinokosha.
Kuongororwa Valvular Heart Disease
Kutanga kufungidzirwa kwepfungwa yevhirivha yemwoyo kunokosha zvikuru kune yakakosha yekugadzirisa. Zvakakodzera, kurapwa kunotangwa musati mutezo wemwoyo unotanga kukanganisa uye kusakanganiswa kwemwoyo kunokonzerwa. Asi kuti zviite kudaro, zvinowanzokosha kuti uzive kuti chirwere chevhavha chiripo zvakanaka zvisati zvaitika zviratidzo zvikavapo.
Chirwere chepfungwa chepachivha chepakutanga ndechimwe chezvinetso zvekurapa zvisingaoneki izvo zvinowanzowanikwa kare nekugadzirisa kurapwa kwechiremba-uye chimwe chezvikonzero zvese tinokurudzirwa kuti tive nechekuongorora.
Chiratidzo chekutanga chechinetso chevhavha yemwoyo kakawanda kuonekwa kwe mwoyo kun'un'una panguva yekuongorora. Zvichida valvular stenosis kana kudzoka kwevhuvuri inobereka humwe huwandu hwemhirizhonga wehupenyu mukati memwoyo. Izvi zvinokonzera ruzha urwo chiremba anokwanisa kunzwa ne stethoscope (mwoyo unogunun'una). Hazvisi zvose kugunun'una kwemoyo kunoratidza dambudziko remoyo, zvakadaro; vazhinji vanonzi "vasina mhosva" kugunun'una, kureva kuti, vanokonzerwa nechinguva chiduku chinogona kuvapo mumoyo wose.
Kana chiremba wako akacherechedza mhere inogona kuratidza chirwere chemwoyo valvular, echocardiogram yakanaka kwazvo kusiyanisa pakati penharo yemwoyo yevhavha uye kusunungura kusina mhosva. Ne echocardiogram, tsanangudzo yekujekesa inogona kuitwa inenge inenge chero ipi zvayo yenharo yemagetsi yemwoyo.
Kana chirwere chinonzi valvular chiripo, echocardiogram inogonawo kuenzanisa zvakakwana dambudziko racho. Zvimwe zviyero zvakananga zvinogona kuitwa neropa rekuyerera nemaitiro uye chimiro chemakamuri emwoyo, uye izvi zviyero zvinogona kuenzaniswa neavo kubva kune dzimwe nzira dzinoongorora echo kuitira kuti vaone kuti nokukurumidza dambudziko revhavha rinowedzera sei (kana zvachose).
Dambudziko Rinokosha reMagetsi Nemishonga Yavo
Mitral Stenosis: Mu mitral stenosis , kuvhiringidzwa kwemaster valve kunoderedza kubuda kweropa kubva kuruboshwe kuruboshwe kusvika kuruboshwe rwe ventricle. Nokufamba kwenguva, kushamiswa kunowedzera muatrium yakasara, pakupedzisira zvichiita kuti mishonga inokonzerwa nehutachiona uye kushaya mwoyo kunokanganisa kunyanya rutivi rworudyi rwemoyo. Mishonga inoshandiswa pakugadzira kana kushandiswa kwemagetsi emitral, uye nguva yekuvhiya inokosha. Kana imwe nguva chirongwa chekuvhiyiwa chichigadzirwa, chirongwa chakakwana chetraral stenosis chirwere chinoda kutsanangurwa kune mumwe nomumwe.
Mitral Kudzorera: Mitral kudzorera , iyo inoita kuti kubuda kwechiropa kubva kuruboshwe kuruboshwe kuruboshwe, ndiyo inonyanya kuwanda yemwoyo yevhavhavha yehosha nokuti ine zvikonzero zvakawanda. Semuenzaniso, kukosha kukuru kwemitral valve prolapse (MVP) ndeyokuti dzimwe nguva inogona kubudisa mitral yakawanda zvakare. Mitral kudzokera kunogona kukonzera kuwedzera kwekukuvadza kune zvose zviri kuruboshwe uye kuruboshwe, uye kunze kwokunge ichibatwa kunogona kutungamirira kusakanganisika kwemoyo kusakundikana. Nguva yakanakisisa yekurapa kushandiswa inobva pachigarire chekudzoka zvakare . Nzira dzakasiyana-siyana dzokuvhiya dzinowanika mukurapa mitral kudzoka.
Aortic Stenosis: In aortic stenosis , the aortic valve inobviswa zvishoma, zvichiita kuti zvive zvakaoma kuruboshwe rweseri kurwisa ropa kumatumbu emuviri. Inotungamirira ku hypertrophy yemutsipa wekupedzisira we ventricle, uye pakupedzisira kumwoyo kusakundikana. Mukuwedzera, kana chiyero cheropa iyo mwoyo inogona kupopera yakaderera zvikuru nekuda kwekudziviswa, syncope kana kunyange rufu rwe kamwe kamwe runogona kuitika. Ichokwadi, syncope inokonzerwa ne aortic stenosis inofanira kurapwa sechirwere chekukurumidzira, sezvo inoratidza kuti aortic valve yakanyanyisa kuderedzwa. Sezvinorudzi chero ipi zvayo yeropa remwoyo, valiti aortic stenosis inofanira kuonekwa zvakanyanyisa kupfuura nguva. Kana iyo yakava yakakosha zvakakwana, chirwere chinonzi aortic chirwere chichadiwa.
Aortic Kudzokorora: Ne aortic kudzokerazve , the valor aortic inosvibisa kuitira kuti ropa richenese kumashure kubva pane aorta kusvika kuruboshwe rwemhepo. Kuyerera kweropa kunowedzera basa reruboshwe rworuboshwe. Kana kudzoka kunokosha, chirwere chinopedzisira chinoputika zvikuru uye kushaya mwoyo kunosvika. Kurapa kwekukosha kwekuvandudza aortic kunoda kushandiswa kwechirwere che aortic valve.
Tricuspid Stenosis: Tricuspid stenosis, kushandiswa kwechikamu chechivharo chinonzi tricuspid, ndicho chinonyanya kufanana chezvirwere zvikuru zvevhirivular. Inowanzowanzoonekwa kuvanhu vane chirwere chepfungwa chepachirwere uye, mumatambudziko mazhinji, inoperekedzwa nehosha mune mamwe mavhavha emwoyo. Kana zvakakosha, tricuspid stenosis inokonzera nyore kuneta uye kuderedzwa kushivirira kushivirira. Zvisinei, zviratidzo zvinokonzerwa nechirwere mune imwe yemamwe magetsi zvinowanzoitika zvakanaka pamberi pekuti tricuspid stenosis inotanga kubudisa zviratidzo. Nekudaro, kurapwa kwechirwere chetricuspid stenosis (iyo inosanganisira kugadziridza valvular panzvimbo yekugadzirisa) nguva dzose inowanzoitika senzira ye "add-on", apo kuvhiyiwa kunofanirwa kuporesa yakaoma mwoyo yevhavhavha.
Kunyanya Kudzokororazve: Mukutengesa kusununguka , ropa rinodonha mumhepo inonzi tricuspid valve kubva kurudyi ye ventricle kusvika ku right atrium. Kunyanya kudzoka zvakare kunowanzokonzerwa nekuwedzera kwe tricuspid annulus inowanikwa semugumisiro wemapirmita arteri hypertension, moyo kusagadzikana, kana mapurmonary embolus . Iko kushandiswa kwekuzvidzorera pachako kunowanzoita zvinyoro uye kazhinji hakudi kurapa kurapwa. Kuongorora kwakanyatsonaka kutsvaga chinetso chepachirwere chepakakosha kunokosha, sezvo kurapa dambudziko redu rinowanzokonzera kukura kwakanyanya mukugadziriswa kwekare.
Pulmonary Stenosis: Pulmonary stenosis, kuvhiringidzika kwemapapu emapurmonary, kazhinji kacho chirwere chepenemen anowanzobatanidzwa ne tetralogy ye Fallot, Noonan syndrome (a genetic disorder ine kusagadzikana kwepfungwa, nguva shoma, chifu chekuora, uye zvinetso zvekudzidza), kana kuberekwa rubella. Pulmonary stenosis inowanzoongororwa pakuberekwa kana nguva pfupi pashure payo. Kana zvakanyanya, zvinogona kukonzera kukanganisa kwekakarurama kwemoyo. Zvinyoro zvepermysten stenosis zvinogona kunge zvakakwana zvachose izvo zvisingatori kurapa. Kana chirwere ichi chiri chakakomba, chinogona kutarisirwa nebharuon valvuloplasty, chirongwa checatheterization shoma.
Kudzokorora Kudengenyeka: Mumapurmonary regurgitation, ropa rinoputika pamhepo yakavharwa yemapurmonary valve kubva pamapirmita arteri kuenda mu ventricle yakarurama. Chikonzero chinonyanya kukosha chemapurmonary regurgitation is pulmonary arteri hypertension, iyo inogona kubudisa kuwedzera kwepermonary valvular annulus kusvika pakuti valve yemapapanhau haigoni kuswedera zvachose. Kana zvakanyanya, kupora kwemapurmari kunogona kukonzera mwoyo wakarurama kuti uwedzere, uye kusagadzikana kwemoyo kunogona kuita. Kazhinji, kurapwa kwemapurmonary kudzokerazve kutora matanho ekuderedza mapirmita arteri kudzvinyirira . Kuvhiya hakuwanzodiwa.
Pane Pane Zvisina Kuvhiyiwa Kuchengetedza Zvirwere zveMagetsi Here?
Chirwere chepachivha chepfungwa chinongova chinetso chemagetsi. Kuti atarise zvinokonzera, chirwere chinowanzosarudzwa chete.
Zvisinei, muzviitiko zvakawanda chirwere chekurapa chinogona kuwanika chinogona kubatsira. Dzimwe nguva, mishonga inogona kubatsira kugadzirisa mwoyo uye kunonoka kufambira mberi kwechirwere chevhavha. Izvi zvinonyanya kuitika nemhando dzakawanda dzekurwazve kwevhirivular, umo dambudziko revhavha rinokonzerwa nekuwedzera kwekamuri remwoyo. Kurapa kwechisimba kunotungamirirwa pakuchengetedza chirwere chepfungwa chepamusoro kana kuwedzera chirwere chemwoyo , kana kudzivirira ventricular kugadzirisa mushure mekurwadziwa kwepfungwa, kana kuti kunyange kutarisa kushaya kwemwoyo muhutachiona hwehutachiona , somuenzaniso, kunogona kuderedza zvikuru mikana yekudzikisa mitral yakakura kana kuti kugadzirisa zvakare.
Nokuda kwechikonzero ichi, kazhinji chikonzero chakanaka chevanhu vane chirwere chemwoyo chevhirivular chinoonekwa nguva dzose nechechi yezvemapurisa, uyo anogona nyore nyore kutarisana nehupi hupi hunoita matambudziko emwoyo.
Kurarama Nemwoyo Wemagetsi Mwoyo
Kana uine chirwere chepfungwa chepfungwa, kune zvimwe zvinhu zvaunoda kuita kuti uwedzere mikana yako yekurarama hupenyu hwakareba uye hune utano. Unofanirwa kudzidza zvose zvaunogona maererano nehutano hwevhuvularlar dambudziko raunazvo, uye zvakakwana dambudziko rako revhavha. Kana iwe uri mishonga yekubatsira mwoyo wako kushanda zvakajeka, unofanirwa kuvaendesa nguva dzose uye ugozivisa chero dambudziko navo kune chiremba wako.
Nokuda kwechinhu ichocho, unofanirwa kuchengeta nguva yako yekugadza newachiremba wako. Kunyange zvazvo izvi zvichikosha kune ani zvake, zvinonyanya kukosha kune munhu ane dambudziko remwoyo wevhavha, sezvo chirwere chemwoyo chinonzi valvular chinowanzofambira mberi kwenguva. Iwe unofanirwa kutaura nachiremba wako nezvekuti iwe unoda kutora antibiotic prophylaxis ye endocarditis .
Pakupedzisira, sezvo iwe uine dambudziko remwoyo, iwe unofanira kuita zvose zvaunogona kuti uderedze maitiro ako ekuvandudza mamwe marudzi ehutano hwehutano: Usasvuta; kuchengeta kudya kwakanaka uye uremu hwakanaka; kuwana muviri wakawanda; uye, kana iwe une hypertension kana chirwere cheshuga , iva nechokwadi chekuti une mamiriro aya pasi pesimba rakakwana.
Shoko Rinobva
Valvular chirwere chemoyo chinogona kuva dambudziko rakakomba. Asi nekutarisa kwokutanga, kuongororwa kwechiremba nguva dzose, uye kuwanika kwekuchengetedzwa kwemazuva ano uye kurapwa, nhasi vanhu vazhinji vane chirwere chepfungwa chemoyo vanogona kutarisira kurarama hupenyu hurefu uye hune hutano.
Sources:
> Joint Task Force pamutungamiri weValvular Heart Disease yeEuropean Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, et al. Nhungamiro pamusoro pekutungamirirwa kwechirwere chepfungwa chevhirivular (version 2012). Eur Heart J 2012; 33: 2451.
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.