イシド　ミキコ   SHIMIZU MIKIKO   石戸　美妃子    所属   医学部 医学科（東京女子医科大学病院）    職種   講師
言語種別	日本語
発表タイトル	Predictors of Neo Aortic Valve Regurgitation After Arterial Switch Operation in Long- Term
会議名	第83回 日本循環器学会学術集会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎髙田卓磨, 朝貝省史, 佐藤正規, 原田元, 島田衣里子, 石戸美妃子, 篠原徳子, 富松宏文, 稲井慶, 萩原誠久, 杉山央
発表年月日	2019/03/31
開催地 （都市, 国名）	横浜
概要	Objective: The aim of our study is to investigate the relationship between the hemodynamics or the anatomical status of the aortic root and degree of aortic valve regurgitation (AR) after arterial switch operation (ASO) for the adult patients.Methods: From February 2005 to September 2018, a total of 41 patients who diagnosed as d-transposition of the great arteries (d-TGA) or TGA type of double outlet right ventricular were received the catheterization in our institution. The median age were 21 years (interquartile range: 18-25 years). The median years after ASO were 21 years (interquartile range: 17-24 years). We compared 12 patients with AR more than grade 2 (AR+) which was assessed by Sellers classification after ASO to 29 patients with AR less than grade 2 (AR-) after that.Results: There were no statistically significant differences in age, smoking, previous pulmonary artery banding, renal function, cholesterol and hemoglobin A1c level between 2 groups. The data from Swan-Ganz catheter were similar, but aortic valve dimension (AR+ vs. AR-: 31 vs. 23 mm), the distance of Valsalva sinus (47 vs. 38 mm) and sinotubular junction (30 vs 23 mm) were larger in AR+ group compared with AR- group (respectively, p< 0.05). Multivariate analysis demonstrated that aortic valve dimension was most related factor for AR (p< 0.05). Receiver operating characteristic curve for the end point of AR using aortic valve dimension showed that the cut-off value was 29.7 mm (sensitivity: 93.1 %, specificity: 66.7 %, AUC: 0.846).Conclusions: Patients with AR after ASO had the more enlarged aortic valve dimension than patients without AR in adulthood.