第60回日本小児循環器学会総会・学術集会

講演情報

JCK-AP

Fontan

JCK-AP session 4 (II-JCKAP4)
Fontan

2024年7月12日(金) 14:05 〜 15:20 第8会場・JCK-AP Forum (5F 502+503)

Chair:Ryo Inuzuka(Department of Pediatrics, University of Tokyo)
Chair:Tae Gook Jun(Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University School of Medicine, Samsung Seoul Hospital)

[II-JCKAP4-3] Incidence and current clinical practice for all-cause morbidity in patients with Fontan circulation (Japan Fontan Registry: JFR)

Hideo Ohuchi1, Kota Takei2, Jun Muneuchi3, Shingo Kasahara4, Yuichi Ishikawa5, Masanori Tsukada6, Masaki Nii7, Shin Ono8, Hirofumi Saiki9 (1.Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, 2.Pediatric Cardiology, Nagano Children's Hospital, Nagano, 3.Department of Pediatrics, Kyushu Hospital Community Healthcare Organization, Fukuoka, 4.Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital, Okayama, 5.Department of Pediatric Cardiology, Fukuoka Children's Hospital, Fukuoka, 6.Department of Pediatrics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, 7.Department of Pediatric Cardiology, Shizuoka Children's Hospital, Shizuoka, 8.Department of Pediatric Cardiology, Kanagawa Children's Medical Center, Kanagawa, 9.Department of Pediatrics, Iwate Medical University, Iwate)

キーワード:Fontan circulation, morbidity, hospitalization

Objective: To clarify the incidence and clinical practice of unscheduled hospitalization (USH) in patients with Fontan circulation (FC). Method: We conducted a multi-center prospective study with 3-year registration of USH FC patients.Results: We followed 3225 FC patients in 20 institutions and 243 (7.5%) patients encountered USH. The most common cause was heart failure (HF, 19.3%), followed by infection (18.9%) and protein losing enteropathy (PLE, 16.5%), hemorrhage (13.2%), arrhythmia (9.5%), thromboembolism (TE, 2.5%), plastic bronchitis (1.6%), and others (17.7%). O2 inhalation was the most common non-pharmacological managements (38%), followed by surgery (12%), and catheter intervention (10%), while diuretics (iv) was the most common pharmacological managements (28%), followed by antibiotics (iv) (28%), and heparin (iv) (11%). Overall median USH-stay (days) was 9 and the longest stay was due to PLE (20), followed by TE (17) and HF (13). After discharge, 76 (31%) patients re-hospitalized with the highest cause of PLE (34%), followed by HF (16%) and hemorrhage and infection (13% for each). Leukopenia and hypoproteinemia at discharge were independently associated with a high risk of re-USH (p<0.05). Conclusions: We clarified current practices in FC patients in Japan. Further analyses of each USH are necessary for establishing management strategy.