Construction of diagnostic algorism for transcatheter pulmonary valve implantation in patients with postoperative tetralogy of Fallot

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K08116
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Showa University
• Principal Investigator: Fujii Takanari 昭和大学, 医学部, 教授 (60384450)
• Co-Investigator(Kenkyū-buntansha): 富田 英 昭和大学, 医学部, 特任教授 (60180171)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 経皮的肺動脈弁留置術 / 先天性心疾患 / ファロー四徴症 / カテーテル治療

Outline of Final Research Achievements

Pulmonary artery regurgitation was evaluated by echocardiography and cardiac MRI in postoperative patients with tetralogy of Fallot who had pulmonary valve regurgitation. We screened patients who needed re-intervention according to the criteria for pulmonary valve replacement. Cardiac CT was performed on the patients who were judged to be indicated, a 3D stereoscopic model was created based on the image data, and the morphology of the right ventricular outflow tract and pulmonary artery was evaluated. Evaluation of the right ventricular outflow tract was possible by this method, and there were some cases that could be applied to the simulation of stent implantation. This year, transcatheter pulmonary valve implantation was actually approved in Japan. For cases considered to be indicated for this treatment, our diagnostic imaging strategy may be useful for preoperative planning.

Free Research Field

小児循環器学

Academic Significance and Societal Importance of the Research Achievements

経皮的肺動脈弁留置術の早期導入は患者の予後を大きく改善し、医療費の抑制にもつながり社会的にも有用であると考える。しかし、潜在的に存在する本治療の適応患者に関する国内のデータは皆無で，従来の画像診断のみでは評価することは困難である． 3Dプリント技術は本邦においては耳鼻科、整形外科、脳神経外科領域では既に実用化されているが、先天性心疾患診療分野では未開拓であり、かつ本研究の分野への応用は特に有用性が高い。本研究は本邦への経皮的肺動脈弁留置術早期導入に向けた基礎データの作成，医学研究を行う上での重要なデータとなる。