日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
〒162-0801東京都新宿区山吹町358-5アカデミーセンター Japanese Society of Pediatric Cardiology and Cardiac Surgery Academy Center, 358-5 Yamabuki-cho, Shinju-ku, Tokyo 162-0801, Japan
Pediatric Cardiology and Cardiac Surgery 36(3): 256-262 (2020)
doi:10.9794/jspccs.36.256

症例報告Case Report

特発性拡張型心筋症に対し肺動脈絞扼術を施行した1乳児例Pulmonary Artery Banding in an Infant with Idiopathic Dilated Cardiomyopathy

1国立成育医療研究センター循環器科Division of Cardiology, National Center for Child Health and Development ◇ Tokyo, Japan

2国立成育医療研究センター心臓血管外科Division of Cardiovascular surgery, National Center for Child Health and Development ◇ Tokyo, Japan

受付日:2019年12月12日Received: December 12, 2019
受理日:2020年3月29日Accepted: March 29, 2020
発行日:2020年10月1日Published: October 1, 2020
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特発性拡張型心筋症の診断で,心不全症状が内科的治療に不応で進行性であった7か月乳児に対し,在宅管理を目標に,過去に有効性が報告されている肺動脈絞扼術を施行した.心不全症状の進行は緩徐になったが,回復するまでには至らず入院は継続され,術後1年2か月後にExcor®を装着し,心臓移植待機中である.肺動脈絞扼術後に右室機能が低下したことが,回復しなかった一因であると推測される.適切な患者背景や絞扼条件が確立できれば,肺動脈絞扼術は乳児拡張型心筋症に対する心不全治療の一つの選択肢になり,患者家族の負担軽減,医療費の低減,医療の均てん化に貢献できる可能性がある.

A 7-month-old male infant with a diagnosis of idiopathic dilated cardiomyopathy exhibited poor response to anti-heart failure medication. Following diagnosis, the infant underwent pulmonary artery banding, which has been reported to be effective in restoring heart function. Although we initially aimed to transition the patient to home care, we observed a slow deterioration of his heart. As a result, the infant remained hospitalized for 14 months thereafter, and underwent Excor® implantation. At the time of writing, he is waiting for heart transplantation. In this case, the ineffectiveness of pulmonary artery banding may be partially attributable to the development of right ventricular dysfunction following pulmonary artery banding. Provided that the criteria for patient selection and optimal tightness of the band are established, pulmonary artery banding can be a treatment option for infants with severe heart failure. Thus, pulmonary artery banding can help to alleviate the caregivers’ burden, mitigate health care costs, and equalize medical care nationwide.

Key words: idiopathic dilated cardiomyopathy; pulmonary artery banding; infant; heart transplantation; ventricular assist device

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This page was last modified on 2020-10-19T12:05:49.000+09:00


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