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日本先天性心脏病的支架植入术——来自日本先天性介入心脏病学会注册研究的综合分析

Stent Implantation for Congenital Heart Diseases in Japan - Comprehensive Analysis From the Japanese Society of Congenital Interventional Cardiology Registry.

作者信息

Tomita Hideshi, Kim Sung-Hae, Inuzuka Ryo, Matsui Hikoro, Tachimori Hisateru, Kobayashi Tohru, Kato Atsuko, Fujii Takanari, Haishima Yuji, Okamoto Yoshihiro, Sakoda Hideyuki

机构信息

Pediatric Heart Disease and Adult Congenital Heart Disease Center, Showa University Hospital.

Department of Cardiology, Shizuoka Children's Hospital.

出版信息

Circ J. 2021 Aug 25;85(9):1517-1524. doi: 10.1253/circj.CJ-20-0915. Epub 2021 Mar 11.

Abstract

BACKGROUND

Stent implantation for vascular stenosis associated with congenital heart diseases is commonly performed as an off-label procedure in Japan because there is no officially approved stent for any congenital heart disease.

METHODS AND RESULTS

We analyzed data from the Japanese Society of Congenital Interventional Cardiology Registry collected from January 2016 to December 2018. Patients who underwent stent implantation were enrolled in the present analysis. During the study period, there were 470 procedures, 443 sessions, and 391 cases. Of 443 sessions, 427 (96.4%) succeeded procedurally. There were no differences in the procedural success rates among age groups. In all, 416 sessions (367 patients; 94%) resulted in survival to 30 days after catheter intervention. Of 392 admissions, 357 patients (91%) survived to discharge. Only 4 deaths were directly related to stent implantation. Some in-hospital complications were observed during 55 of 443 sessions. Both hospital deaths and serious complications were significantly more frequent in the group with various preoperative risk factors.

CONCLUSIONS

Although not officially approved for congenital heart diseases in Japan, stent implantation in congenital heart diseases has been widely and routinely performed for many years with safety and efficacy. The aim of stenting was variable and broad because of many different applications and morphological variations. These data may facilitate approval of such an important device in Japan.

摘要

背景

在日本,由于尚无针对任何先天性心脏病的官方批准支架,因此用于先天性心脏病相关血管狭窄的支架植入通常作为一种未获批准的操作进行。

方法与结果

我们分析了日本先天性介入心脏病学会注册中心于2016年1月至2018年12月收集的数据。接受支架植入的患者纳入本分析。在研究期间,共进行了470例手术、443次操作和391例病例。在443次操作中,427次(96.4%)手术成功。各年龄组的手术成功率无差异。总体而言,416次操作(367例患者;94%)在导管介入后存活至30天。在392例入院患者中,357例(91%)存活至出院。只有4例死亡与支架植入直接相关。在443次操作中的55次观察到一些院内并发症。在有各种术前危险因素的组中,医院死亡和严重并发症的发生率明显更高。

结论

尽管在日本先天性心脏病支架植入未获官方批准,但多年来一直在广泛且常规地进行,具有安全性和有效性。由于应用多样且形态各异,支架植入的目的各不相同且范围广泛。这些数据可能有助于该重要器械在日本获得批准。

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