講演情報
[I-OR12-01]米国多施設Pulmonary Flow Restrictorレジストリにおける実臨床データに基づく早期治療成績
○小林 大介 (ワシントン大学 セントルイス小児病院)
キーワード：
Pulmonary flow restrictor、Congenital heart disease、Transcatheter palliation
Background: Transcatheter pulmonary flow restrictor (PFR) implantation using modified microvascular plugs is a palliative option for neonates and infants with complex congenital heart disease who are poor surgical candidates, but real-world outcome data are limited.Objectives: To report early U.S. multicenter experience from the Pulmonary Flow Restrictor (PFR) Registry, focusing on patient characteristics, procedural outcomes, and 1-year survival.Methods: The PFR Registry is an ongoing multicenter real-world registry organized by the Congenital Cardiac Interventional Study Consortium (CCISC). This analysis included patients undergoing branch pulmonary artery PFR implantation.Results: A total of 148 patients from 16 U.S. centers were enrolled, with 132 included in the study cohort. Median age and weight at implantation were 13 days and 3.0 kg; 27% weighed ＜2.5 kg. Prematurity (35%), genetic syndromes (39%), significant comorbidities (52%), and single-ventricle physiology (42%) were common. Procedural success was 92%. Oxygen saturation decreased modestly after implantation (88% to 84%, p=0.004). Adverse events occurred in 13%, including 2 catastrophic events. Among patients with follow-up (n=77), 1-year survival was 57%, lower in single-ventricle (43%) than biventricular physiology (68%). Excluding palliative and bridge-to-transplant cases, 1-year survival was 60%.Conclusions: Transcatheter PFR implantation is feasible with high procedural success in a high-risk neonatal population. Larger cohorts and longer follow-up are needed to refine patient selection and outcomes.