所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||Outcome of Transvenous Cardiac Implantable Electronic Devices Implantation for Adults with Complex Congenital Heart Disease|
|会議名||The 81st Annual Scientific Meeting of the Japanese Circulation Society (JCS2017)|
|主催者||Japanese Circulation Society|
|発表者・共同発表者||◎TAKEUCHI Daiji, HENMI Ryuta, IWANAMI Yuji, TOYOHARA Keiko, SHODA Morio, HAGIWARA Nobuhisa|
|学会抄録||PROGRAM JCS 2017 310|
|概要||Background: Bradycardia, malignant ventricular tachyarrhythmia, cardiac dysfunction are important late complications after repair in adult congenital heart disease (CHD). Although the number of cardiac implantable electronic device (CIED) implantation for adults CHD is increasing, transvenous CIED implantation for complex CHD is still challenging because of its unique anatomy and physiology.
Aim: To investigate the outcome of CIED implantation for complex CHD in a single center.
Results: We studied retrospectively total 117 adult patients with moderate to complex CHD after cardiac operation, who underwent transvenous CIED implantation: 60 pacemaker (PM), 44 implantable cardioverter defibrillator (ICD) and 13 cardiac resynchronized therapy (CRT). We performed catheter intervention for 3 patients before CIED implantation (stent dilatation for superior vena cava (SVC) stenosis after Mustard operation in 1 and atrial septal occlusion in 2). We used 3D mapping system (NavX) in 10 patients during CIED implantation to delineate low voltage lesions. Although all PM and ICD were successfully implanted, CRT implantation was failed in 3 out of 13 patients due to coronary vein anomaly. Acute and chronic complications associated with CIED occurred in 13% (n=16): 5 hematomas, 11 lead failures (2 recalled ICD leads), 1 SVC occlusion and 1 device infection. Lead extraction was performed in 2 patients. 61 patients (52%) were monitored remotely for early detection of CIED-based problems. There was no device related mortality.
Conclusion: The clinical outcome of transvenous CIED in complex adult CHD after intracardiac repair was considered acceptable in spite of relatively high incidence of implantation failure and complications.