補助人工心臓装着後，心臓移植に至った幼児重症心不全患者の発達推移

抄録

【Objective】 We report the developmental trend of infants who received heart transplantation after using the ventricular assist device (VAD).

【Design】 To evaluate the infants development, the KIDS Infant Development Scale was conducted on parents of four infants who received heart transplantation after implanting the VAD, the term of VAD usage being August 2012 to December 2016.

【Methods】 The age of infants at VAD implantation and the age of infants at the time of heart transplantation in months were: Cases A to D: 15/25, 11/20, 10/22, and 21/30. Developmental evaluations were performed at 3 time points: before transplantation, 1 year after transplantation, and later at the time of postal mail inquiry (Case A to D: 5 years 5 months, 2 years 4 months, 2 years, and 2 years 5 months).

【Results】 In all cases, overall developmental was slower than the chronological age at the pre-transplant evaluation, and the overall developmental index (DQ) was around 50 (Cases A to D: 36.0, 60.0, 45.5, and 53.3). Development showed a catch up trend at one year after transplantation (Cases A to D: 48.6, 62.5, 14.7, and 107.1). Development was further promoted at the time of postal mail evaluation which was more than 2 years after transplantation, wherein 2 patients reached DQ100 (Cases A to D: 93.3, 106.3, 21.7, and 175.0).

【Conclusion】 The development of patients with severe heart failure seeking transplantation was delayed. After transplantation, development showed a trend of catching up.