Heart Transplantation and the Batista Operation for Children With Refractory Heart Failure

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概要

• 論文の詳細を見る

• Medically refactory heart failure may be present in children with cardiomyopathy (CMP) or complex congenital heart disease (CHD). In adults, the surgical management of this condition is either heart transplantation or the Batista operation. From March 1995 to January 2000, a total of 6 children, aged from 1 to 16 years, with medically refractory heart failure associated with CMP or complex CHD underwent cardiac transplantation and one of them also had the Batista operation as a bridge to transplantation. One of the 6 patients died of intractable sepsis 17 days after the operation, but the other 5 were discharged with satisfactory hemodynamics. Immunosuppressive agents, including azathioprine, cyclosporin or FK-506, were given. One patient experinced moderate acute rejection, but it was controlled by FK-506, OKT-3 and solumedrol. However, another suffered from lymphoproliferative disease 8 months after transplant, but it was controlled by intravenous immunoglubulin, α-interferon and acyclovir. Cardiac function during serial follow-up (range, 1 month to 5 years) revealed normal systolic and diastolic function and none received any anticongestive medications. Almost all patients received an oversized donor heart. The left ventricle (LV) mass was remodeled, initially as an decrease and later as an increase. The patient who underwent the Batista operation was discharged 1 month after the operation with an increased LV ejection fraction (from 10% to 22%). She was successfully bridged to heart transplantation 7 months after the Batista opration. The results of cardiac transplantation in growing children are satisfactory and remain the mainstay of surgical treatment for medically refractory heart failure in these patients. However, with a shortage of donor hearts, the Batista operation may be adopted as a bridge to heart transplant with a fair response.

• 社団法人日本循環器学会の論文
• 2001-03-20

著者

• Chiu Shuenn-nan

  Department Of Pediatrics National Taiwan University Hospital College Of Medicine National Taiwan Uni

• Lin Jiuan-huey

  Department Of Pediatrics And Medicine National Taiwan University Hospital

• Wang Jou-kou

  Department Of Pediatrics National Taiwan University Hospital College Of Medicine National Taiwan Uni

• Wu Mei-hwan

  Department Of Pediatrics National Taiwan University Hospital College Of Medicine National Taiwan Uni

• Wang Jou-kou

  Department Of Pediatrics National Taiwan University Hospital

• Hsu Ron-bin

  Surgery National Taiwan University Hospital

• Lue Hung-chi

  Department Of Pediatrics

• Chen Yih-Shyang

  Surgery, National Taiwan University Hospital

• Jou Nae-Kuan

  Department of Pediatrics

• Chu Shu-Hsun

  Surgery, National Taiwan University Hospital

• Wu Mei-hwan

  Department Of Pediatrics National Taiwan University Hospital

• Chen Yih-shyang

  Surgery National Taiwan University Hospital

• Lin Jiuan-huey

  Department Of Pediatrics

• WU Mei-Hwan

  Department of Pediatrics and Medicine, National Taiwan University Hospital

• WANG Jou-Kou

  Department of Pediatrics and Medicine, National Taiwan University Hospital

• CHIU Shuenn-Nan

  Department of Pediatrics and Medicine, National Taiwan University Hospital

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