サイトウ　サトシ   Saitou Satoshi   齋藤　聡    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
論文種別	その他
言語種別	英語
査読の有無	査読なし
表題	Ventricular assist device for end-stage adult congenital heart disease patients: Current status.
掲載誌名	正式名：Journal of cardiology 略　 称：J Cardiol ISSNコード：18764738/09145087
掲載区分	国外
巻・号・頁	81(4),pp.378-384
著者・共著者	Shinkawa Takeshi†, Ichihara Yuki, Saito Satoshi, Ishido Mikiko, Inai Kei, Niinami Hiroshi
発行年月	2023/04
概要	As long-term surgical outcome of congenital heart disease has continued to improve, most pediatric patients with congenital heart disease are able to reach adulthood. However, adult congenital heart disease (ACHD) patients have increased risk of arrhythmia, valvular diseases, infectious endocarditis, and heart failure. The end-stage ACHD patients with advanced heart failure may require mechanical circulatory support to improve the heart failure symptoms or to recover from circulatory collapse, and may eventually aim to heart transplant or destination therapy. In general, long-term mechanical support for dilated cardiomyopathy or ischemic cardiomyopathy has been achieved with left ventricular assist device with excellent survival outcomes and improved quality of life. However, the ventricular assist device for end-stage ACHD patients can be challenging due to patient-specific anatomical feature, multiple histories of surgical and catheter-based interventions and possible multiple end-organ dysfunctions, and offered less frequently compared to non-ACHD patients. The Interagency Registry for Mechanically Assisted Circulatory Support data published recently showed that ACHD patients receiving long-term mechanical circulatory support consisted <1 % of all registrants and had higher mortality after mechanical support than non-ACHD patients. However, the ACHD patients supported with left ventricular assist device had similar survival with non-ACHD patients and a large proportion of the mortality difference between ACHD and non-ACHD patients seemed to result from operative and perioperative factors. Therefore, the ventricular assist device therapy can be an excellent treatment for selected ACHD patients. In this paper, we describe the current status of ventricular assist device support for end-stage ACHD patients and consideration to the future.
DOI	10.1016/j.jjcc.2022.09.007
PMID	36152979