循環器ジャーナル69巻3号

2021年07月発行

特集 成人先天性心疾患 エキスパートコンセンサス Ⅱ．成人先天性心疾患特有の問題点に対するアプローチ

Fontan型手術あれこれ，および成人期再手術

著者： 上村秀樹¹

所属機関： ¹奈良県立医科大学先天性心疾患センター

ページ範囲：P.378 - P.386

Point
・多岐にわたる右心バイパス手術の創意工夫について，歴史的要素を加えながら簡便に解説する．
・Fontan循環達成後の成人期に留意すべき再手術要因を体系的に考察する．
・用語により概念的混乱を引き起こしかねない事項について注意喚起する．

参考文献

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17) Bridges ND, Lock JE, Castaneda AR:Baffle fenestration with subsequent transcatheter closure:Modification of the Fontan operation for patients at increased risk. Circulation 82:1681-1689, 1990

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20) Deshaies C, Hamilton RM, Shohoudi A, et al:Thromboembolic risk after atriopulmonary, lateral tunnel, and extracardiac conduit Fontan surgery. J Am Coll Cardiol 74:1071-1081, 2019

21) Masters JC, Ketner M, Bleiweis MS, et al:The effect of incorporating vessel compliance in a computational model of blood flow in a total cavopulmonary connection（TCPC）with caval centerline offset. J Biomech Eng 126:709-713, 2004

22) Carberry T, Murthy R, Hsiao A, et al:Fontan revision:presurgical planning using four-dimensional（4D）flow and three-dimensional（3D）printing. World J Pediatr Congenit Heart Surg 10:245-249, 2019

23) Mavroudis C, Backer CL, Deal BJ, et al:Total cavopulmonary conversion and maze procedure for patients with failure of the Fontan operation. J Thorac Cardiovasc Surg 122:863-871, 2001

24) 松田　暉：成人先天性心疾患に対する心臓移植：Failed Fontanからみた海外の現状と我が国の課題．日本成人先天性心疾患学会雑誌6:6-15, 2017