大動脈の転位
1Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. warnes.carole@mayo.edu
Circulation
|December 13, 2006
まとめ
大動脈の転移を含む複雑な先天性心疾患を持つ大人は,心不全や不律症などの長期的なリスクに直面します. 専門のケアセンターは,これらの生涯にわたる状態の管理に不可欠です.
科学分野:
- 心臓病学 心臓病学
- 大人の先天性心疾患
- 心臓外科手術について
背景:
- 複雑な心臓の欠陥である心室動脈不協和症を持つ多くの成人は,成人期まで生存します.
- 大動脈の完全な転移のためのマスタードまたはセニング手術のような一般的な外科的修復は,右心室 (RV) を全身循環に配置します.
- 長期的な合併症は頻繁であり,初期欠陥と手術による修復によって変化します.
研究 の 目的:
- ベントリキュロ動脈不協和症の成人の患者の長期的なアウトカムと管理上の課題をレビューする.
- RV不全,不律,弁機能不全などの一般的な合併症を強調する.
- 専門家センターにおける専門的で生涯にわたる介護の必要性を強調する.
主な方法:
- 大人の先天性心疾患患者の臨床結果と管理戦略のレビュー.
- 心房スイッチおよび動脈スイッチの手続き後の合併症の分析.
- 生まれながらに修正された転置における課題の議論.
主要な成果:
- 右心室機能不全と三体吐は,心房のスイッチの手続きの後によく見られます.
- 動脈スイッチの手続きは,冠動脈狭窄症と大動脈根の膨張につながる可能性があります.
- 生まれながらにして修正された転置は,進行的な三管吐およびRV機能不全と関連しており,早期の外科的検討を必要とします.
結論:
- 腹腔動脈不協和症の成人は,進行する合併症に対する生涯のモニタリングを必要とします.
- RV機能不全と三体吐の早期発見と介入は極めて重要です.
- 管理は,成人先天性心疾患の専門知識を有する専門センターで行うべきである.
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