Hanyar shiga hagu ta hanyar shiga biyu

Bugun shiga na hagu mai shiga biyu (DILV) nakasa ce ta zuciya da take kasancewa tun daga haihuwa (haifuwa). Yana shafar bawuloli da ɗakunan zuciya. Yaran da aka haifa da wannan yanayin suna da ɗakin yin famfo guda ɗaya kawai (zuciya) a cikin zuciyarsu.

DILV ɗayan lahani ne na zuciya da aka sani da lahani na (ko na kowa). Mutanen da ke tare da DILV suna da babban hagu da ƙananan hancin dama. Hagu na hagu shine bangaren yin famfo na zuciya wanda ke aika jini mai wadataccen oxygen zuwa jiki. Hannun dama na dama shine ɗakin famfo wanda ke aikawa da jinin mara ƙaran oxygen zuwa huhu.

A cikin zuciya ta yau da kullun, hanyoyin dama da hagu suna karɓar jini daga atria ta dama da hagu. Atria sune manyan ɗakunan zuciya. Jini mai talauci wanda yake dawowa daga jiki yana gudana zuwa dama da kuma dama. Hannun dama na dama yana harba jini zuwa jijiyar huhu. Wannan shi ne jijiyoyin jini da ke ɗaukar jini zuwa huhu don karɓar iskar oxygen.

Jini tare da sabon oxygen yana dawowa zuwa atrium na hagu da na hagu. Sannan aorta yana ɗaukar jini mai wadataccen oxygen zuwa sauran jiki daga ɓangaren hagu. Aorta ita ce babbar jijiya wacce take fita daga zuciya.

A cikin mutanen da ke tare da DILV, kawai hagu ne ake haɓaka. Dukansu suna zubar da jini a cikin wannan ventricle. Wannan yana nufin cewa jinin mai wadataccen oxygen yana haɗuwa da oxygen mai ƙarancin oxygen. Ana cakuda hadin ga jiki da huhu.

DILV na iya faruwa idan manyan jijiyoyin jini da suka taso daga zuciya suna cikin matsayi mara kyau. Aorta yana fitowa ne daga ƙaramin ƙugu na dama kuma jijiyar huhu na tashi daga hagu. Hakanan yana iya faruwa yayin jijiyoyin suna cikin yanayin al'ada kuma suna tashi daga abubuwan da aka saba. A wannan halin, jini yana gudana daga hagu zuwa dama ta ramin da ke tsakanin ɗakunan da ake kira lalataccen septal aibin (VSD).

DILV yana da wuya. Ba a san takamaiman dalilin ba. Matsalar na iya faruwa a farkon lokacin ɗaukar ciki, lokacin da zuciyar jariri ta haɓaka. Mutanen da ke tare da DILV galibi kuma suna da wasu matsalolin zuciya, kamar:

• Coarctation na aorta (takaita aorta)
• Ciwon ciki na huhu (huhun huhu na zuciya ba a kafa shi da kyau)
• Ciwon bawul na huhu (taƙaitaccen bawul na huhu)

Kwayar cutar DILV na iya haɗawa da:

• Launin Bluish zuwa fata da lebe (cyanosis) saboda ƙarancin oxygen a cikin jini
• Rashin samun nauyi da girma
• Fata mai haske (mai launi)
• Rashin ciyarwa daga gajiya cikin sauki
• Gumi
• Legsafafun kumbura ko ciki
• Matsalar numfashi

Alamomin DILV na iya haɗawa da:

• Heartwayar zuciya mara kyau, kamar yadda aka gani akan na'urar lantarki
• Ruwan ruwa a kusa da huhu
• Ajiyar zuciya
• Zuciyar zuciya
• Saurin bugun zuciya

Gwaje-gwajen don gano DILV na iya haɗawa da:

• Kirjin x-ray
• Gwajin aikin lantarki a cikin zuciya (electrocardiogram, ko ECG)
• Duban dan tayi na zuciya (echocardiogram)
• Wuce sirara, sassauƙan bututu zuwa cikin zuciya don bincika jijiyoyin jini (catheterization na zuciya)
• Zuciya MRI

Ana buƙatar tiyata don inganta yanayin jini ta cikin jiki da cikin huhu. Yin aikin tiyata da aka fi so don yin aikin DILV jerin ayyuka ne guda biyu zuwa uku. Waɗannan tiyatar suna kama da waɗanda aka yi amfani da su don magance cututtukan zuciya na hagu da kuma tresuspid atresia.

Za'a iya buƙatar yin tiyata na farko lokacin da jaririn yan kwanaki kaɗan. A mafi yawan lokuta, jaririn na iya komawa gida daga asibiti daga baya. Yaron sau da yawa yana buƙatar shan magunguna kowace rana kuma likitan zuciya na yara (masanin zuciya) ya bi shi a hankali. Likitan yaron zai tantance lokacin da ya kamata a yi mataki na biyu na tiyata.

Tiyata ta gaba (ko tiyata ta farko, idan jaririn bai buƙaci hanya ba a matsayin jariri) ana kiransa bidirectional Glenn shunt ko Hemifontan hanya. Wannan tiyatar galibi ana yin sa ne idan yaro ya kai wata 4 zuwa 6.

Koda bayan ayyukan da aka sama, yaro na iya zama shuɗi (cyanotic). Mataki na ƙarshe ana kiran sa aikin Fontan. Wannan tiyatar galibi ana yin sa ne lokacin da yaro ya kai watanni 18 zuwa 3. Bayan wannan matakin na ƙarshe, jaririn ya daina shuɗi.

Aikin Fontan baya haifar da yaduwar al'ada cikin jiki. Amma, yana inganta haɓakar jini sosai don yaro ya rayu ya girma.

Yaro na iya buƙatar ƙarin tiyata don wasu lahani ko don faɗaɗa rayuwa yayin jiran aikin Fontan.

Yaronku na iya buƙatar shan magunguna kafin da bayan tiyata. Waɗannan na iya haɗawa da:

• Anticoagulants don hana yaduwar jini
• ACE masu hanawa don rage karfin jini
• Digoxin don taimakawa bugun zuciya
• Magungunan ruwa (diuretics) don rage kumburi a jiki

Ana iya ba da shawarar dashen zuciya, idan hanyoyin da ke sama sun gaza.

DILV cuta ce mai rikitarwa ta zuciya wacce ba saukin magani. Ta yaya jariri yayi kyau ya dogara da:

• Babban yanayin jaririn a lokacin ganewar asali da magani.
• Idan akwai wasu matsalolin zuciya.
• Yaya mummunan lahani yake.

Bayan magani, jarirai da yawa tare da DILV suna rayuwa don zama manya. Amma, za su buƙaci bin-tsawan rayuwa. Hakanan suna iya fuskantar rikitarwa kuma suna iya iyakance ayyukansu na zahiri.

Matsalolin DILV sun hada da:

• Sanya kumburi (kafewar gadaje na ƙusa) a yatsun kafa da yatsu (alamar ƙarshe)
• Ajiyar zuciya
• Ciwon huhu akai-akai
• Matsalar bugun zuciya
• Mutuwa

Kira mai ba da sabis na kiwon lafiya idan ɗanka:

• Ga alama gajiya da sauƙi
• Yana da matsalar numfashi
• Yana da fata mai laushi ko lebe

Har ila yau, yi magana da mai ba ku idan jaririnku ba ya girma ko yana da nauyi.

Babu sanannun rigakafin.

DILV; Ricwararru ɗaya; Kasuwancin gama gari; Zuciyar mara nauyi; Zuciyar mara nauyi na nau'in hagu na hagu; Cutar rashin haihuwa - DILV; Ciwon zuciya na Cyanotic - DILV; Lalacewar haihuwa - DILV

• Hanyar shiga hagu ta hanyar shiga biyu

Kanter KR. Gudanar da ventricle guda ɗaya da haɗin cavopulmonary. A cikin: Sellke FW, del Nido PJ, Swanson SJ, eds. Sabiston da Spencer Tiyata na Kirji. 9th ed. Philadelphia, PA: Elsevier; 2016: babi 129.

Kliegman RM, St. Geme JW, Blum NJ. Shah SS, Tasker RC, Wilson KM. Schor NF. Cyanotic congenital cututtukan zuciya: raunuka da ke haɗuwa da haɓakar jinin huhu. A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi na 458.

Wohlmuth C, Gardiner HM. Zuciya. A cikin: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, eds. Maganin Fetal: Kimiyyar Asali da Aiki. 3rd ed. Philadelphia, PA: Elsevier; 2020: babi na 29.