循環器ジャーナル72巻3号

2024年07月発行

特集 心房細動—予防・早期発見・治療の進化 Ⅵ.特殊な病態

医原性心房中隔欠損症（iASD）の問題は？

著者： 高谷陽一¹

所属機関： ¹岡山大学循環器内科

ページ範囲：P.499 - P.503

POINT
●カテーテルアブレーションのiASDは，頻度は少ないが，心不全増悪する場合がある．
●左心耳閉鎖術などカテーテルインターベンションでは，iASD併発率が高い．
●iASDは低心拍出量症候群や低酸素血症を呈する場合，閉鎖術が必要である．

参考文献

1）Rillig A, Meyerfeldt U, Birkemeyer R, et al. Persistent iatrogenic atrial septal defect after pulmonary vein isolation : incidence and clinical implications. J Interv Card Electrophysiol 2008 ; 22 : 177-81.

2）Chan NY, Choy CC, Lau CL, et al. Persistent iatrogenic atrial septal defect after pulmonary vein isolation by cryoballoon : an underrecognized complication. Europace 2011 ; 13 : 1406-10.

3）Hammerstingl C, Lickfett L, Jeong KM, et al. Persistence of iatrogenic atrial septal defect after pulmonary vein isolation-an underestimated risk? Am Heart J 2006 ; 152 : 362.e1-5.

4）Yamagishi Y, Oginosawa Y, Kikuchi K, et al. Heart failure caused by iatrogenic atrial septal defect after cryoballoon ablation for atrial fibrillation. J Cardiol Cases 2021 ; 24 : 303-6.

5）Narui R, Yamashita S, Yoshitaka M, et al. Right-to-left shunt via iatrogenic atrial septal defect requiring emergency surgical repair following cryoballoon atrial fibrillation ablation in a patient with arrhythmogenic right ventricular cardiomyopathy. J Cardiol Cases 2022 ; 27 : 16-8.

6）Alkhouli M, Sarraf M, Zack CJ, et al. Iatrogenic atrial septal defect following transseptal cardiac interventions. Int J Cardiol 2016 ; 209 : 142-8.

7）Kadado AJ, Islam A. Iatrogenic atrial septal defect following the MitraClip procedure : A state-of-the-art review. Catheter Cardiovasc Interv 2021 ; 97 : E1043-52.

8）Takaya Y, Akagi T, Hara H, et al. Iatrogenic atrial septal defect requiring transcatheter closure following transcatheter mitral valve repair. Circ J 2022 ; 86 : 1740-4.