Aortic stenosis

Aorta ke mothapo o moholo o ntšang mali ka pelong ho a isa 'meleng kaofela. Mali a phalla ho tsoa pelong le ho aorta ka valve ea aortic. Ho aortic stenosis, valve ea aortic ha e bulehe ka botlalo. Sena se fokotsa phallo ea mali ho tsoa pelong.

Ha valve ea aortic e ntse e fokotseha, ventricle e letšehali e tlameha ho sebetsa ka thata ho pompa mali ka hara valve. Ho etsa mosebetsi ona o eketsehileng, mesifa e maboteng a ventricle e ba tenya. Sena se ka lebisa ho bohloko ba sefuba.

Ha khatello e ntse e phahama, mali a ka khutlela matšoafong. Aortic stenosis e matla e ka fokotsa palo ea mali a fihlang bokong le 'meleng oohle.

Aortic stenosis e kanna ea ba teng ho tloha tsoalong (congenital), empa hangata e hlaha hamorao bophelong. Bana ba nang le aortic stenosis ba ka ba le maemo a mang ho tloha tsoalong.

Aortic stenosis e hlaha haholoholo ka lebaka la pokello ea likhalsiamo tse fokotsang belofo. Sena se bitsoa calcific aortic stenosis. Bothata bo ama haholo batho ba baholo.

Khalase ea khalsiamo e etsahala kapele ho batho ba tsoetsoeng ba e-na le li-valve tse sa tloaelehang tsa aortic kapa bicuspid. Maemong a sa tloaelehang, calcium buildup e ka hlaha kapele haholo ha motho a fumane mahlaseli a sefuba (joalo ka kalafo ea mofets'e).

Lebaka le leng ke rheumatic fever. Boemo bona bo ka hlaha kamora 'metso oa strep kapa fever e sekareleta. Mathata a li-valve ha a hlahise lilemo tse 5 ho isa ho tse 10 kapa ho feta ka mor'a hore rheumatic fever e hlahe. Rheumatic fever e se e fumaneha ka bongata United States.

Aortic stenosis e hlaha ho batho ba ka bang 2% ho feta lilemo tse 65. E etsahala hangata ho banna ho feta basali.

Batho ba bangata ba nang le aortic stenosis ha ba hlahise matšoao ho fihlela lefu lena le tsoela pele. Ho ka etsahala hore ebe o fumanoe ha mofani oa tlhokomelo ea bophelo a utloa ho honotha ha pelo mme a etsa liteko.

Matšoao a aortic stenosis a kenyelletsa:

• Ho se utloe bohloko sefubeng: Bohloko ba sefuba bo ka mpefala le ts'ebetso mme ea fihla letsohong, molaleng kapa mohlahareng. Sefuba le sona se ka utloa se le thata kapa se petelitsoe.
• Khohlela, mohlomong e nang le mali.
• Mathata a ho hema ha u ikoetlisa.
• Ho khathala habonolo.
• Ho utloa ho otloa ha pelo (palpitations).
• Ho felloa ke matla, ho fokola kapa ho ba le botsoa ka ho etsa lintho.

Ho masea le bana, matšoao a kenyelletsa:

• Ho khathala habonolo ka boikitlaetso (maemong a bonolo)
• Ho hloleha ho nona
• Ho fepa hampe
• Mathata a tebileng a ho hema a hlahang matsatsing kapa libeke tsa tsoalo (maemong a boima)

Bana ba nang le aortic stenosis e bonolo kapa e itekanetseng ba ka mpefala ha ba ntse ba tsofala. Ba boetse ba kotsing ea tšoaetso ea pelo e bitsoang bacterial endocarditis.

Ho honotha ha pelo, ho tobetsa kapa molumo o mong o sa tloaelehang hangata ho utloahala ka stethoscope. Mofani oa thepa a ka khona ho utloa ho thothomela kapa ho sisinyeha ha a beha letsoho holim'a pelo. Ho kanna ha ba le pulse e fokolang kapa liphetoho boleng ba pulse molaleng.

Khatello ea mali e ka ba tlase.

Aortic stenosis hangata e fumanoa ebe e lateloa ka ho sebelisa tlhahlobo e bitsoang transthoracic echocardiogram (TTE).

Liteko tse latelang le tsona li ka etsoa:

• ECG
• Koetlisa khatello ea maikutlo
• Catheterization ea pelo e letšehali
• MRI ea pelo
• Transesophageal echocardiogram (TEE)

Ho hlahlojoa khafetsa ke mofani e ka ba sohle se hlokahalang haeba matšoao a hau a se matla. Mofani oa thepa o lokela ho botsa ka nalane ea hau ea bophelo bo botle, ho etsa tlhahlobo ea 'mele le ho etsa echocardiogram.

Batho ba nang le aortic stenosis e matla ba ka bolelloa hore ba se bapale lipapali tsa tlholisano, leha ba se na matšoao. Haeba matšoao a hlaha, ts'ebetso e boima e tlameha ho fokotsoa hangata.

Meriana e sebelisetsoa ho alafa matšoao a ho hloleha ha pelo kapa lipina tse sa tloaelehang tsa pelo (hangata atrrillation ea atrial). Tsena li kenyelletsa diuretics (lipilisi tsa metsi), nitrate le beta-blockers. Khatello ea mali e phahameng le eona e lokela ho phekoloa. Haeba aortic stenosis e le matla, kalafo ena e tlameha ho etsoa ka hloko hore khatello ea mali e se theohe haholo.

Nakong e fetileng, batho ba bangata ba nang le mathata a li-valve pelo ba ne ba fuoa lithibela-mafu pele ho mosebetsi oa meno kapa ts'ebetso e joalo ka colonoscopy. Lithibela-mafu li fanoe ho thibela tšoaetso ea pelo e senyehileng. Leha ho le joalo, lithibela-mafu ha li sa sebelisoa hangata pele ho mosebetsi oa meno le lits'ebetso tse ling. Botsa mofani oa hao oa tlhokomelo ea bophelo ho fumana hore na o hloka lithibela-mafu.

Batho ba nang le sena le maemo a mang a pelo ba lokela ho emisa ho tsuba mme ba etsetsoe liteko tsa cholesterol e phahameng.

Ho buoa ho lokisa kapa ho nkela valve sebaka hangata ho etsetsoa batho ba baholo kapa bana ba hlahisang matšoao. Le ha matšoao a se mabe haholo, ngaka e ka khothaletsa ho buuoa ho ipapisitsoe le liphetho tsa liteko.

Mokhoa o fokolang o bitsoang balloon valvuloplasty o ka etsoa ho fapana le pele kapa pele o etsoa opereishene.

• Balune e kenngoa ka mothapong o ka mpeng, e fasellelitsoe pelong, e beoe ka nqane ho phunyang, ebe e tšeloa moea. Leha ho le joalo, ho fokotsa hangata ho hlaha hape kamora ts'ebetso ena.
• Tsamaiso e ncha e etsoang ka nako e ts'oanang le valvuloplasty e ka kenya valve ea maiketsetso (transcatheter aortic valve replacement kapa TAVR). Tsamaiso ena hangata e etsoa ho bakuli ba sa khoneng ho etsoa opereishene, empa e se e atile haholo.

Bana ba bang ba ka hloka ho lokisoa ha li-aortic valve kapa ho nkeloa sebaka. Bana ba nang le aortic stenosis e bonolo ba ka khona ho nka karolo mesebetsing e mengata.

Phello e fapana. Boloetse bona bo kanna ba ba bobebe mme ha bo hlahise matšoao. Ha nako e ntse e feta, valve ea aortic e ka fokotseha. Sena se ka baka mathata a maholo a pelo joalo ka:

• Matšoao a atrial le flutter ea atrial
• Mali a koahela bokong (stroke), mala, liphio kapa libaka tse ling
• Ho nyahama (syncope)
• Ho hloleha ha pelo
• Khatello ea mali e phahameng methapong ea matšoafo (pulmonary hypertension)

Liphetho tsa phetisetso ea aortic valve hangata li ntle haholo. Ho fumana kalafo e ntle ka ho fetesisa, ea setsing se etsang opereishene ea mofuta ona khafetsa.

Bitsa mofani oa hau haeba uena kapa ngoana oa hau u na le matšoao a aortic stenosis.

Ikopanye le ngaka ea hau hanghang haeba o fumanoe o na le boemo bona mme matšoao a hau a mpefala kapa matšoao a macha a hlaha.

Stenosis ea valve ea aortic; Rheumatic aortic stenosis; Calcific aortic stenosis; Lefu la pelo aortic stenosis; Valvular aortic stenosis; Congenital pelo - aortic stenosis; Rheumatic fever - aortic stenosis

• Aortic stenosis
• Li-valve tsa pelo

Carabello BA. Boloetse ba pelo ba Valvular. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 66.

MOSEBETSI OA MOLIMO: Hermann HC, Mack MJ. Phekolo ea Transcatheter ea lefu la pelo la valvular. Ka: Zipes DP, Libby P, Bonow RO, Mann, DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 72.

Lindman BR, Bonow RO, Otto CM. Lefu la aortic valve. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 68.

Nishimura RA, Otto CM, Bonow RO, le al. Ntlafatso ea AHA / ACC ea 2017 ea tataiso ea AHA / ACC ea 2014 bakeng sa taolo ea bakuli ba nang le lefu la pelo ea valvular: tlaleho ea American College of Cardiology / American Heart Association Task Force mabapi le Litataiso tsa Tloaelo ea Bongaka. Tsamaiso. 2017; 135 (25): e1159-e1195. PMID: 28298458 e fetotsoe.ncbi.nlm.nih.gov/28298458/.