Cutar cututtukan zuciya na hagu

Ciwon cututtukan zuciya na hagu mai haɗari yana faruwa lokacin da sassan ɓangaren hagu na zuciya (mitral valve, ventricle na hagu, bawul aortic, da aorta) ba su ci gaba gaba ɗaya. Yanayin yana nan lokacin haihuwa (na haihuwa).

Hypoplastic hagu zuciya ce ta musamman nau'in cututtukan zuciya da ke haifar mutum. Ya fi faruwa ga maza fiye da mata.

Kamar yadda yake da yawancin lalatattun cututtukan zuciya, babu wani sanannen sanadi. Kimanin kashi 10% na jariran da ke fama da cututtukan zuciya na hagu suna da sauran lahani na haihuwa. Hakanan yana haɗuwa da wasu cututtukan ƙwayoyin cuta irin su Turner syndrome, Jacobsen syndrome, trisomy 13 da 18.

Matsalar tana tasowa kafin haifuwa lokacin da sashen hagu da sauran sifofin basa girma yadda yakamata, gami da:

• Aorta (jijiyoyin jini da ke ɗauke da wadataccen jini daga hagu zuwa ga dukkan jiki)
• Ofar shiga da fita daga cikin ƙasan
• Bayanai na mitral da aortic

Wannan yana haifar da rashin haɓakar ventricle da aorta, ko hypoplastic. A mafi yawancin lokuta, ƙananan hagu da aorta sun fi ƙanƙanta da na al'ada.

A jarirai masu wannan yanayin, gefen hagu na zuciya ba zai iya aika isasshen jini zuwa jiki ba. A sakamakon haka, gefen dama na zuciya dole ne ya kula da zagawar huhu da jiki. Ventarfin dama zai iya tallafawa zagayawa zuwa huhu da jiki na ɗan lokaci, amma wannan ƙarin aikin daga ƙarshe yana haifar da gefen dama na zuciya ya gaza.

Yiwuwar yuwuwar rayuwa ita ce haɗi tsakanin dama da hagu na zuciya, ko tsakanin jijiyoyi da jijiyoyin huhu (jijiyoyin da ke ɗaukar jini zuwa huhu). Ana haihuwar jarirai da ɗayan waɗannan haɗin:

• Oram (kwata tsakanin dama da hagu atrium)
• Ductus arteriosus (karamin jiji ne wanda yake hada aorta da jijiyar huhu)

Duk waɗannan haɗin suna yawanci rufe da kansu 'yan kwanaki bayan haihuwa.

A cikin jarirai masu cutar cututtukan zuciya na hagu, jinin da ke barin gefen dama na zuciya ta jijiyar huhu yana bi ta cikin bututun jini zuwa cikin aorta. Wannan ita ce kadai hanyar da jini zai shiga jiki. Idan an bar ductus arteriosus ya rufe a cikin jaririn da ke fama da cutar ciwon zuciya ta hagu, jaririn na iya mutuwa da sauri saboda ba za a sami jini a jiki ba. Yara kanana da sananniyar cututtukan zuciya na hagu yawanci ana farawa akan magani don kiyaye buɗewar ductus arteriosus.

Saboda kadan ko babu kwarara daga zuciya ta hagu, jinin da ke dawowa zuwa zuciya daga huhu yana bukatar wucewa ta cikin oram ko kuma nakasar atrial (ramin da ke haɗa ɗakunan tarawa a hagu da dama na zuciya) koma zuwa gefen dama na zuciya. Idan babu babban ovale, ko kuma idan yayi karami, jaririn na iya mutuwa. Yaran da ke da wannan matsalar suna da rami tsakanin atria, ko dai ta hanyar tiyata ko kuma amfani da siririn bututu mai sassauƙa (catheterization na zuciya).

Da farko, jariri da zuciyar hagu mai hypoplastic na iya zama al'ada. Kwayar cutar na iya faruwa a cikin hoursan awannin farko na rayuwa, kodayake yana iya ɗaukar aan kwanaki kaɗan don ci gaba da alamomin. Wadannan alamun na iya haɗawa da:

• Bluish (cyanosis) ko launin fata mara kyau
• Cold hannuwanku da ƙafafu (iyakar)
• Rashin nutsuwa
• Matsayi mara kyau
• Rashin shan nono da ciyarwa
• Pounding zuciya
• Saurin numfashi
• Rashin numfashi

A cikin lafiyayyun jarirai, launi mai laushi a hannu da ƙafafu martani ne ga sanyi (wannan aikin ana kiran shi cyanosis na gefe).

Launi mai laushi a kirji ko ciki, lebe, da harshe ba al'ada bane (ana kiransa cyanosis na tsakiya). Alama ce cewa babu wadataccen iskar oxygen a cikin jini. Cyanosis na tsakiya sau da yawa yana ƙaruwa da kuka.

Gwajin jiki na iya nuna alamun gazawar zuciya:

• Da sauri fiye da yadda aka saba da zuciya
• Rashin nutsuwa
• Fadada Hanta
• Saurin numfashi

Hakanan, bugun jini a wurare daban-daban (wuyan hannu, makwancin gwaiwa, da sauransu) na iya zama mai rauni sosai. Akwai lokuta da yawa (amma ba koyaushe ba) sautin zuciya mara kyau yayin sauraron kirji.

Gwaje-gwaje na iya haɗawa da:

• Cardiac catheterization
• ECG (lantarki)
• Echocardiogram
• X-ray na kirji

Da zarar an gano asalin zuciyar hypoplastic na hagu, za a shigar da jaririn ɗakin kulawa mai kulawa da jarirai. Ana iya buƙatar na'urar numfashi (mai amfani da iska) don taimakawa jaririn numfashi. Ana amfani da wani magani mai suna prostaglandin E1 don kiyaye jini yana zagayawa cikin jiki ta hanyar bude bututun durin.

Wadannan matakan basu magance matsalar ba. Yanayin koyaushe yana buƙatar tiyata.

Yin aikin farko, wanda ake kira aikin Norwood, yana faruwa ne a cikin withinan kwanakin farko na rayuwar jariri. Tsarin Norwood ya kunshi gina sabuwar hanya ta:

• Amfani da huhun huhu da jijiya
• Haɗa tsohuwar aorta da jijiyoyin jini zuwa sabuwar aorta
• Cire bango tsakanin atria (atrial septum)
• Yin haɗi na wucin gadi daga kogin hagu na dama ko jijiyoyin jiki zuwa jijiyar huhu don kiyaye jinin jini zuwa huhu (wanda ake kira shunt)

Za'a iya amfani da bambancin tsarin Norwood, wanda ake kira tsarin Sano. Wannan aikin yana haifar da madaidaicin ventricle zuwa haɗin jijiya na huhu.

Bayan haka, jariri yakan tafi gida a mafi yawan lokuta. Yaron zai buƙaci shan magungunan yau da kullun kuma likitan zuciya na yara ya bi shi, wanda zai ƙayyade lokacin da ya kamata a yi mataki na biyu na tiyata.

Mataki na II na aikin ana kiran sa hanyar Glenn shunt ko tsarin hemi-Fontan. Hakanan ana kiranta azaman shunt na cavopulmonary. Wannan aikin yana haɗa manyan jijiyoyin da ke ɗauke da shuɗi daga saman rabin jiki (babban vena cava) kai tsaye zuwa jijiyoyin jini zuwa huhu (jijiyoyin huhu) don samun iskar oxygen. A mafi yawan lokuta ana yin aikin tiyatar lokacin da yaro ya kai watanni 4 zuwa 6.

A lokacin matakai Na da na II, yaro na iya bayyana da ɗan shuɗi (cyanotic).

Mataki na III, mataki na ƙarshe, ana kiran sa aikin Fontan. Sauran jijiyoyin dake ɗauke da shuɗi daga jiki (ƙarancin vena cava) suna haɗuwa kai tsaye zuwa jijiyoyin jini zuwa huhu. Hannun dama na yanzu yana aiki ne kawai a matsayin ɗakin famfo na jiki (ba huhu da jiki ba). Wannan tiyatar galibi ana yin sa ne yayin da jariri ya kai watanni 18 zuwa 4. Bayan wannan matakin na ƙarshe, yaron baya cikin cyanotic kuma yana da matakin oxygen a cikin jini.

Wasu mutane na iya buƙatar ƙarin tiyata a cikin 20s ko 30s idan sun ci gaba da wuya don sarrafa arrhythmias ko wasu rikitarwa na aikin Fontan.

Wasu likitocin sunyi la’akari da dasawa zuciya madadin zuwa tiyata ta 3. Amma akwai 'yan zukatan da aka bayar don kananan yara.

Idan ba a kula da shi ba, cututtukan zuciya na hagu masu haɗari na mutuwa. Matsayin rayuwa don gyaran da aka shirya yana ci gaba da tashi kamar yadda dabarun tiyata da kulawa bayan tiyata suka inganta. Tsira bayan matakin farko ya fi kashi 75%. Yaran da suka tsira daga shekarar farko suna da kyakkyawar dama don rayuwa ta dogon lokaci.

Sakamakon yaron bayan tiyata ya dogara da girman da aikin ƙirar dama.

Matsalolin sun hada da:

• Toshewar shuntin roba
• Cloullar jini wanda zai iya haifar da bugun jini ko huhu na huhu
• Gudawa (na kullum) gudawa (daga cutar da ake kira enteropathy mai asara)
• Ruwa a cikin ciki (ascites) da kuma cikin huhu (pleural effusion)
• Ajiyar zuciya
• Ba daidai ba, saurin zuciya (arrhythmias)
• Shanyewar jiki da sauran rikice-rikicen tsarin
• Rashin lafiyar jijiyoyin jiki
• Mutuwa kwatsam

Tuntuɓi mai ba da sabis na kiwon lafiya kai tsaye idan jaririnka:

• Ya rage ƙasa (rage abinci)
• Yana da fata mai launin shuɗi (cyanotic)
• Yana da sababbin canje-canje a tsarin numfashi

Babu wata sananniyar rigakafin cutar cututtukan zuciya ta hagu. Kamar yadda yake tare da yawancin cututtukan da ake haifarwa, sababin cutar rashin lafiyar zuciya ta hagu ba shi da tabbas kuma ba a haɗa shi da cuta ko halayyar uwa ba.

HLHS; Zuciyar ciki - zuciyar hagu ta hypoplastic; Cyanotic zuciya cuta - hypoplastic hagu zuciya

• Zuciya - sashi ta tsakiya
• Zuciya - gaban gani
• Cutar cututtukan zuciya na hagu

Fraser CD, Kane LC. Cutar cututtukan zuciya. A cikin: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Littafin Sabiston na Tiyata: Tushen Halittu na Ayyukan Tiyata na Zamani. 20th ed. Philadelphia, PA: Elsevier; 2017: babi na 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN.Cutar cututtukan ciki a cikin baligi da haƙuri na yara. A cikin: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald na Ciwon Zuciya: Littafin rubutu na Magungunan zuciya da jijiyoyin jini. 11th ed. Philadelphia, PA: Elsevier; 2019: babi na 75.