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

Early neonatal open-heart surgery for total anomalous pulmonary venous return (TAPVR) often results in unfavorable outcomes. However, recent reports suggest that placing a ductus venosus stent in low-birth-weight infants with infracardiac type TAPVR could lead to better outcomes by avoiding the need for early neonatal open-heart surgery. Because stent stenosis caused by intimal thickening frequently occurs after stenting, an objective method to evaluate restenosis needs to be developed. This study presents a case with infracardiac type TAPVR, born at 34 weeks of gestation with a body weight of 1,556 g, who underwent ductus venosus stenting on day 7 of life. The stent was repeatedly expanded when needed after evaluating the narrowing within the stent, which included measuring the highest pulse Doppler velocity of the hepatic vein over a period of time. After weight gain, the patient successfully underwent TAPVR repair. This study shows that sequential measurements of the pulse Doppler velocity of the hepatic vein can be used to effectively evaluate stent stenosis.