[OR08-3] 喀血に対してミシガン小児病院で施行された心臓カテーテル検査・治療
Keywords:hemoptysis , aortopulmonary collaterals, embolization
Background: Hemoptysis arises from various etiologies. Cardiac catheterization may play a role on finding the cause of hemoptysis with potential transcatheter interventions.Objective: To evaluate the diagnostic utility of cardiac catheterization and the efficacy of transcatheter interventions in patients with hemoptysis.Method: This was a retrospective study of all the patients who were brought to the pediatric cardiac catheterization for the indication of hemoptysis over 15 years (2006 - 2020). Result: There were 28 cardiac catheterizations in 21 patients. One patient had four catheterizations. Three patients had two catheterizations. Median age was 17.4 years. Primary cardiac diagnosis of 21 patients included normal heart (n=3), pulmonary hypertension (n=1), heart transplant (n=1), diffuse pulmonary AVM (n=1), pulmonary vein occlusion/atresia (n=3), other biventricular CHD (n=5) and single ventricles (n=7). The diagnostic utility of catheterization was 81% (17/21). At two-third (18/28) of catheterizations, transcatheter interventions were performed in 14/21 (67%) patients: AP collateral embolization 14, AP and VV collateral embolization 1, and pulmonary AVM embolization 3. Although recurrent hemoptysis was observed post-intervention frequently (50%), the final effectiveness of transcatheter interventions was 79% (11/14 patients). Overall mortality was 19% (4/21).Conclusion: Cardiac catheterization was shown to have a good diagnostic utility for hemoptysis. Despite the high mortality and recurrent hemoptysis rate, transcatheter interventions was effective.