[I-LL-1] 小児心臓外科手術への努力
Keywords:homograft ホモグラフト, heart transplantation 心臓移植, pediatric coronary artery bypass surgery 小児冠動脈バイパス手術
I appreciate President Takaaki Suzuki, MD, PhD for the opportunity to talk some of my contributions in pediatric cardiac surgery (PCS)at the 59th Annual Meeting of the Japanese Society of Pediatric Cardiology and Cardiac Surgery. My talk will include the followings; 1) homograft use in PCS, most importantly benefits of pulmonary homograft for the aortic arch or RVOT reconstruction and the Ross operation. 2)modified bicaval anastomosis technique for pediatric cardiac transplantation and 3) pediatric coronary artery bypass surgery (PCABS) for Kawasaki disease (KD) and congenital heart disease (CHD), particularly for coronary insufficiency following the arterial switch operation for transposition of great arteries. PCABS has expanded its indications for obstructive complications following coronary transfer procedures for CHD since utilization of the internal thoracic artery (ITA) graft in children has started in 1985. The ITA can be used even in the newborns and small children. The growth potential and the long-term patency of the graft have been confirmed over 40 years with no graft disease. The ITA is the best conduit for infants and children and the fact is cited in “Guidelines” in many countries. Bilateral use of the ITA is also common for KD children with excellent results. I believe that PCABS-ITA is a new arena in PCS, and I hope pediatric cardiac surgeons be expertised for this procedure.