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
Pediatric Cardiology and Cardiac Surgery 38(4): 229-233 (2022)


成人期の心房中隔欠損の特徴と治療戦略を知るTackling Atrial Septal Defects in Adults

岡山大学循環器内科Department of Cardiovascular Medicine, Okayama University Hospital ◇ Okayama, Japan

発行日:2022年12月1日Published: December 1, 2022

心房中隔欠損(Atrial septal defect, ASD)は頻度の高い先天性心疾患であり,チアノーゼなどの症状が出ないことも多く,小児期に診断されることなく成人に到達する症例も少なくない.成人期まで到達したASDでは長年の右心系の負荷と肺血流の増加に伴い,心不全,心房細動,肺高血圧,などの合併症を伴い病態が複雑となることがある.従来の外科手術に加えて,近年の経カテーテルASD閉鎖術,心房細動に対するカテーテルアブレーション,肺高血圧治療薬の進歩に伴い治療成績は向上している.

Atrial septal defects (ASDs) are common congenital heart defects that can remain undiagnosed until adulthood among asymptomatic patients. However, due to the prolonged volume overload of the right heart and increased pulmonary arterial blood flow, ASDs in adult patients are often complicated by heart failure, atrial fibrillation, and/or pulmonary hypertension. Recent advancements in transcatheter ASD closure, catheter ablation of atrial fibrillation, and the intravenous and oral treatment of pulmonary hypertension have provided opportunities for the treatment of patients with complex ASD regardless of their age.

Key words: adult congenital heart disease; atrial septal defect; heart failure; atrial fibrillation; pulmonary hypertension

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