第52回日本小児循環器学会総会・学術集会

講演情報

シンポジウム

シンポジウム2(II-S02)
Current Advance in Pediatric Interventional Cardiology; from Bench to Cath lab

2016年7月7日(木) 09:25 〜 11:15 第A会場 (天空 A)

座長:
馬場 健児(岡山大学病院小児科 IVRセンター)
富田 英(昭和大学横浜市北部病院 循環器センター)

II-S02-01~II-S02-05

09:25 〜 11:15

[II-S02-02] Hybrid Strategies to treat Heart failure

Dietmar Schranz (Consultant Fetal Cardiology, Fetal Cardiology Unit Evelina London Children’s Hospital St Thomas’ Hospital)

Heart failure (HF) in children ranges from an obvious isolated left ventricular (LV) systolic dysfunction to a discrete right ventricular (RV) diastolic dysfunction; HF might be associated with left or right ventricular failure or both but even with congenital heart defects, arrhythmias or secondary to pulmonary or systemic circulatory diseases. The severity of ventricular failure is still defined best by the clinical functional status. Indicating morphological, functional and molecular parameters an advanced ventricular failure, despite improvements in medical therapy the overall prognosis of patients with severe heart failure remains poor. Orthotopic heart transplantation (HTX) is the final pathway but if, only the final chance for a minority.
Presented are novel interventional - surgical strategies from diastolic device in out-of-proportion left atrial pressure to reversible pulmonary artery banding (rPAB) in left ventricular dilative cardiomyopathy (LV-DCM) with preserved right ventricular function, to Hybrid procedure combining atrio-septostomy and reversed Potts-shunt physiology (back to the fetal circulation) by transcatheter or surgical interventions in patients with morphological and/or functional LV as well as RV failure. In addition, the option is discussed to change a “VSD”-Eisenmenger to a PDA-Eisenmenger by surgical correction combined with reverse Potts-Shunt.
It is hypothesized that these novel Interventional-Surgical and Hybrid techniques might be able to bridge patients longer with severe heart failure to transplantation or might be even an alternative for HTX or heart-lung transplantation, respectively.