| Japanese |
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| Title | 修正大血管転位症に対するダブルスイッチ手術を目的とした肺動脈絞扼術による左室トレーニングの検討 |
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| Subtitle | 原著 |
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| Authors | 村田明, 坂本貴彦, 黒澤博身 |
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| Organization | 東京女子医科大学心臓血管外科 |
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| Journal | 循環制御 |
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| Volume | 29 |
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| Number | 3 |
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| Page | 241-247 |
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| Year/Month | 2008/12 |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」解剖学的根治が望める修正大血管転位症に対しては, ダブルスイッチ手術(DSO)を行うことができるが, 解剖学的左心室の機能が体循環を担うに十分でない症例ではDSOの前に肺動脈絞扼術(PAB)による左心室トレーニングが必要である. 我々はDSO前にPABを施行した13症例を対象とし, PABによる心機能の変化を検討し, 更にDSO到達例(7例)と非到達例(6例)の予後や患者因子を比較検討した. 年齢は1歳から16歳, 全例に三尖弁閉鎖不全を認めた. 13例中5例が1回のPABで左室トレーニングが成功しDSOを施行した. 5例に対し2回のPABを施行し, うち2例に対しその後DSOを施行した. DSO到達7症例の経過は生存6例, 遠隔死1例であり, 遠隔成績は良好であった. DSO非到達6症例のうち3例が早期に死亡した. DSO非到達群において年齢が高い傾向があり, 高度房室ブロックが有意に多かった. 本疾患群ではPABを経由してDSOに到達した症例の成績は良好であるが, DSO適応に到達しない症例の予後は悪い. したがって本疾患群で心不全や三尖弁逆流の兆候を認めた場合, 危険因子の少ない早期にDSO施行についての方針を決めるべきである. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Left Ventricular Training by Pulmonary Artery Banding for Double Switch Operation in Patients with Congenitally Corrected Transposition of the Great Arteries |
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| Subtitle | |
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| Authors | Akira Murata, Takahiko Sakamoto, Hiromi Kurosawa |
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| Organization | Department of Cardiovascular Surgery, Tokyo Women's Medical University |
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| Journal | Circulation Control |
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| Volume | 29 |
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| Number | 3 |
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| Page | 241-247 |
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| Year/Month | 2008/12 |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Some patients with corrected transposition of the great arteries(CCTGA) may be eligible for double switch operation(DSO). However, the candidates for DSO with small VSD or without VSD usually require pulmonary artery banding(PAB) as left ventricular training prior to DSO due to decreased LV pressure. The aim of this study is to compare the outcome and hemodynamic parameters in patients who could attain DSO and those in patients who could not attain DSO after PAB. Thirteen patients underwent PAB for LV training between 1989 and 2006. Seven patients attained DSO after initial or second PAB, whereas six could not attain DSO. Six of seven who underwent DSO had good results. In six patients who could not attain DSO after PAB, one patient had hospital death and two had late deaths. Age and advanced A-V block might be the risk factors in these patients. In conclusion, the outcome of DSO subsequent to PAB is satisfactory. However, some patients whose LV function was not improved by initial PAB and could not attain DSO showed poor prognosis. |
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| Practice | Basic medicine |
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| Keywords | corrected transposition of the great arteries, pulmonary artery banding, left ventricular training |
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