イナイ　ケイ   Inai Kei   稲井　慶    所属   医学部 医学科（東京女子医科大学病院）    職種   准教授
言語種別	日本語
発表タイトル	Can Hemodynamics Parameter after First Palliative Operation Predict Hemodynamics after Fontan Procedure?
会議名	第81回日本循環器学会学術集会
主催者	日本循環器学会
学会区分	全国規模の学会
発表形式	ポスター掲示
講演区分	一般
発表者・共同発表者	◎朝貝省史, 杉山央, 稲井慶, 朴仁三
発表年月日	2017/03/19
開催地 （都市, 国名）	金沢市
学会抄録	第81回日本循環器学会学術集会　プログラム集 403
概要	Background: We hypothesis hemodynamics parameter at the first palliation (PA banding and BT shunt) could predict high central venous pressure (CVP) after the Fontan. Methods: Between 2003 and 2015, 85 patients with Fontan were retrospectively reviewed. The patients who didn't undergo first palliation in our institution were excluded. The relationship between the hemodynamics at first palliation and CVP after the Fontan procedure was evaluated. High CVP was defined as ≥ 13mmHg. Results:First palliation was PA banding in 22, BT shunt in 42, PA banding+BT shunt in 7 and no operation in 14. Age at the Fontan ranged from 1.2 to 13.6(median 2.6 years old). At the first palliation, mean PAP, pulmonary vascular resistance (PVR) and total pulmonary resistance (TPR) in high‒CVP group were significantly higher (p<0.05) than those in low‒CVP group (16.7±4.4 vs 14.7±3.8mmHg, 2.4±0.9 vs 1.9±0.7 unit∙m2 and 4.8±1.6 vs 3.9±1.4 unit∙m2, respectively). Furthermore, pulmonary artery index (PAI) and pulmonary vascular compliance (PVC) in high‒CVP group were significantly lower (p<0.005) than those in low‒CVP group (267±104 vs 347±139 mm2/m2 and 16.9±7.3 vs 25.2±10.6 mm2/mmHg/m2, respectively). In multivariate analysis, PVR in high‒CVP group was significantly higher than that in low‒CVP group (p=0.01) and PVC in high‒CVP group was significantly lower than that in low‒CVP group (p=0.001). Conclusions:Low PVR and high PVC after first palliation is likely to lower CVP after Fontan.