ポスターセッション34（P34）
カテーテル治療 2

[P34-03] 動脈管開存症の経皮的閉鎖術：患者特異的中空立体模型を用いたシミュレーションの有用性

^○松原 大輔¹, 片岡 功一¹, 岡 健介¹, 安済 達也¹, 古井 貞浩¹, 鈴木 峻¹, 横溝 亜希子¹, 南 孝臣¹, 河田 政明², 山形 崇倫¹ (1.自治医科大学 小児科, 2.自治医科大学とちぎ子ども医療センター 小児・先天性心臓血管外科)

Keywords:動脈管開存症, 経皮的閉鎖術, 3Dシミュレーション

【Introduction】 Percutaneous catheter closure of patent ductus arteriosus (PDA) is difficult when the ductus is large and long or accompanies calcification. We created a patient-specific three-dimensional (3D) model for PDA, with which we simulated device deployment, thereby selecting the device/size in a patient-by-patient manner. 【Purpose】 We assessed whether this 3D model is effective for catheter PDA closure. 【Material and Method】 The 3D model was created in this institute. After its introduction, 7 consecutive patients (the study group) with severe PDA underwent closure with the aid of the 3D model. The control group consisted of 8 patients before 3D-model introduction, with all having severe PDA: the requirement of computed tomography was a criterion. 【Result】 Patients of the study group had significantly poorer heart conditions (advanced NYHA stage and a higher cardiothoracic ratio) with significantly longer PDA, and were more likely to have calcifications. These patients required significantly less contrast medium for angiography to determine device deployment. In all study group patients, the devices/sizes could be pre-selected based on the simulation, whereas devices were changed during the procedure in 2 of 8 in the control group. Although the study group consisted of patients with severer PDA or more difficult-procedure-requiring PDA, the total procedural/fluoroscopic times did not differ between the 2 groups.【Conclusion】 This 3D model may be effective for percutaneous catheter closure of PDA.