| Japanese |
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| Title | 臓器提供待機中に7回のLVAD Device交換を施行した重症DCMの一例 |
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| Subtitle | 症例 |
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| Authors | 近澤元太*, 川合明彦**, 木原信一郎**, 中島雅人**, 山崎健二**, 遠藤真弘**, 小柳仁** |
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| Authors(kana) | |
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| Organization | *東京医科大学霞ヶ浦病院心臓血管外科, **東京女子医科大学附属日本心臓血圧研究所循環器外科 |
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| Journal | 循環制御 |
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| Volume | 23 |
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| Number | 2 |
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| Page | 180-184 |
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| Year/Month | 2002/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 緒言 臓器移植法に基づく脳死臓器移植が再開され, 心移植までのbridge useとしての補助人工心臓の果たす役割が本邦においても益々重要になってきた. しかし, 現在保険承認されている体外設置型補助人工心臓は, 長期循環補助に伴う感染や血栓塞栓症の併発が問題であり, 臓器提供待機患者へのbridge useとして使用するには限界がある. 今回著者らは待機期間中にLVAD pump sac内の血栓形成に対して, 計7回のdevice交換を施行した拡張型心筋症（DCM）の一例を経験した. 本症例の臨床経過を通じて補助人工心臓装着が必要な臓器提供待機患者に対する治療戦略および管理上の問題点を中心に考察する. 症例 症例：症例は拡張型心筋症（DCM）の38歳, 男性で, 2000年2月19日末期重症心不全の状態に対して他施設で体外設置型Left Ventricular Assist Device（LVAD）（日本ゼオン社製東大型）の植込み手術（心尖脱血及び上行大動脈送血）を施行した. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | End stage Heart Failure, Heart Transplantation, LVAD Exchange, Thromboembolism, Infection |
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| English |
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| Title | End Stage Heart Failure with Multiple Left Ventricular Assist Device Exchange during the Awaiting of Heart Transplantation:A case report |
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| Subtitle | |
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| Authors | Genta Chikazawa*, Akihiko Kawai*, Shinichiro Kihara**, Masato Nakajima**, Kenji Yamazaki**, Masahiro Endo**, Hitoshi Koyanagi** |
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| Authors(kana) | |
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| Organization | *Department of Cardiovascular Surgery, Kasumigaura Hospital, Tokyo Medical University, **Department of Cardiovascular Surgery, Heart institute of Japan, Tokyo Women's Medical University |
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| Journal | Circulation Control |
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| Volume | 23 |
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| Number | 2 |
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| Page | 180-184 |
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| Year/Month | 2002/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We experienced a case of end stage heart failure awaiting heart transplantation, in which a multiple left ventricular assist device （LVAD） exchange had to be used because of thrombus formation in the pump sac. Two types, of extracorporeal pneumatic LVAD presently available under the health insurance are not suitable for a long-term support as a bridge to heart transplantation because of complications such as thromboembolism and infection. Therefore, it is desirable to use of an implanted （wearable type） LVAD approved under the health insurance for the candidate of heart transplantation as soon as possible . Under the present circumstances in Japan, taking the problem of donor shortage into consideration, it is essential to investigate a new type LVAD which can be used permanently so as to improve the prognosis and quality of life of the patients with severe end stage heart failure. |
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| Practice | Basic medicine |
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| Keywords | End stage Heart Failure, Heart Transplantation, LVAD Exchange, Thromboembolism, Infection |
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