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Wesselowski S, Saunders AB. Transesophageal echocardiography using a microprobe for determination of transcatheter procedural candidacy, device selection, and procedural monitoring in small dogs with patent ductus arteriosus. J Vet Cardiol 2024; 52:35-42. [PMID: 38422726 DOI: 10.1016/j.jvc.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Small dogs with patent ductus arteriosus (PDA) may be unable to undergo transesophageal echocardiography (TEE) with traditional probes. OBJECTIVES To report the utility of TEE using a microprobe in dogs weighing less than 4 kg diagnosed with PDA for determination of transcatheter procedural candidacy, device selection, and intraoperative procedural guidance. ANIMALS Eight dogs weighing less than 4 kg diagnosed with PDA. MATERIALS AND METHODS All dogs had standard transthoracic echocardiography and microprobe TEE imaging. The quality of TEE images was graded as optimal, adequate, or poor. The ability of TEE to assess PDA anatomy, determine procedural candidacy, provide procedural guidance, detect deployed devices, and assess residual flow was recorded. RESULTS The median age of included dogs was 6.4 months (range: 3.2-15.7 months) and the median body weight was 2.2 kg (range: 1.4-3.8 kg). Microprobe TEE images were adequate or optimal in all dogs and were integral for guiding procedural candidacy decisions. Transcatheter procedures were not pursued in two dogs based on TEE images. In the other six dogs, TEE procedural guidance was useful during transvenous (n = 5) and transarterial (n = 1) PDA occlusion attempts. Each deployed device (n = 4) was easily detected with the TEE microprobe. Real-time confirmation of adequate device sizing and placement was possible prior to release and residual flow could be monitored after release. CONCLUSIONS Transesophageal echocardiography using a microprobe in dogs weighing less than 4 kg diagnosed with PDA allowed for characterization of PDA anatomy and determination of transcatheter procedural candidacy. Microprobe TEE images were integral for PDA device selection and offered valuable intraoperative procedural guidance.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA.
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX 77843-4474, USA
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Craciun I, Silva J, Dutton LC, Loureiro J, Novo Matos J. Two- and three-dimensional transesophageal echocardiographic assessment and successful occlusion of a window-like patent ductus arteriosus in two dogs. J Vet Cardiol 2023; 51:214-219. [PMID: 38232623 DOI: 10.1016/j.jvc.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024]
Abstract
A 16-month-old Labrador-poodle cross (case 1) and a 3-month-old German shorthaired pointer (case 2) were referred for patent ductus arteriosus (PDA) occlusion. Two-dimensional transthoracic and two- and three-dimensional transesophageal echocardiography revealed a window-like PDA characterized by a wide and short ductus. Due to the atypical PDA morphology with no ampulla in case 1, ductal occlusion was attempted with non-canine-specific Amplatzer occluder devices. However, these were too small and failed to remain stable. Amplatz Canine Duct Occluder (ACDO) devices were used with success in both cases. Due to the defects' morphology, the proximal ACDO disc protruded into the aorta but there were no signs of obstruction to aortic blood flow 16 months (case 1) and 1 month (case 2) post-occlusion. We describe two cases of a window-like type PDA that were successfully occluded with an ACDO.
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Affiliation(s)
- I Craciun
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, CB3 0ES, Cambridge, UK; Department of Clinical Sciences, University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Calea Manastur 3-5, Cluj-Napoca 400372, Romania
| | - J Silva
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, CB3 0ES, Cambridge, UK; North Downs Specialist Referrals, The Friesian Buildings 3 & 4, Brewer Street, RH1 4QP, Bletchingley, Surrey, UK
| | - L C Dutton
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, CB3 0ES, Cambridge, UK
| | - J Loureiro
- North Downs Specialist Referrals, The Friesian Buildings 3 & 4, Brewer Street, RH1 4QP, Bletchingley, Surrey, UK
| | - J Novo Matos
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, CB3 0ES, Cambridge, UK.
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Ostenkamp S, Bell S, Hogan D. Transvenous correction of patent ductus arteriosus in two toy-breed dogs with the Amplatzer™ Vascular Plug 4. J Vet Cardiol 2022; 44:13-17. [DOI: 10.1016/j.jvc.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/18/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
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Transjugular Patent Ductus Arteriosus Occlusion in Seven Dogs Using the Amplatzer Vascular Plug II. Vet Sci 2022; 9:vetsci9080431. [PMID: 36006346 PMCID: PMC9415090 DOI: 10.3390/vetsci9080431] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/25/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary This study outlines the authors’ experience using the Amplatzer Vascular Plug II device for occlusion of patent ductus arteriosus (PDA) in dogs through a right transjugular approach, never before described in veterinary medicine for this purpose. The obtained results demonstrate that the use of the Amplatzer Vascular Plug II via a transvenous right jugular approach is a feasible and effective method, even in small-sized patients. The authors’ experience is that the transvenous approach is a safe and effective method for PDA occlusion in dogs. Furthermore, the right jugular approach provides easier and faster vascular access than the femoral one. The authors affirm that this approach, together with the properties of the Amplatzer Vascular Plug II and its wide size selection, potentially provide a novel method that can complement the current available methods for transcatheter PDA occlusion. Abstract Although vascular plugs for the closure of patent ductus arteriosus (PDA) have been validated in dogs, studies are lacking on its use as a first-choice device with a transjugular approach. The present case series describes the transvenous right jugular embolization of PDA using an Amplatzer Vascular Plug II in seven dogs of different ages, breeds, and body weights. Complete closure of the PDA was demonstrated in all cases. All dogs showed significant hemodynamic reduction of pulmonary overcirculation and left heart size after the procedure and at following echocardiographic check-ups. Transjugular PDA occlusion using an Amplatzer Vascular Plug II can thus be considered as a safe alternative to the arterial or venous femoral approach using an Amplatzer canine ductal occluder (ACDO), particularly in puppies with small femoral vessels.
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Martin M, Pedro B, Dickson D, Neves J, Harris J, Martinez Pereira Y, Oliveira MI, Willesen JL, Vatne L, Culshaw G, Linney C. Outcome clinical audit: analyses of interventional closure of patent ductus arteriosus in dogs. J Vet Cardiol 2022; 43:27-40. [DOI: 10.1016/j.jvc.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 11/29/2022]
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Transvenous detachable coiling of patent ductus arteriosus in small dogs. J Vet Cardiol 2022; 42:65-73. [DOI: 10.1016/j.jvc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/26/2022] [Accepted: 06/06/2022] [Indexed: 11/20/2022]
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Vernemmen I, Paulussen E, Dauvillier J, Decloedt A, van Loon G. Three‐dimensional and catheter‐based intracardiac echocardiographic characterization of the interatrial septum in 2 horses with suspicion of a patent foramen ovale. J Vet Intern Med 2022; 36:1535-1542. [PMID: 35635303 PMCID: PMC9308446 DOI: 10.1111/jvim.16451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
This case report describes the 2‐dimensional transthoracic (2D‐TTE), 3‐dimensional transthoracic (3D‐TTE) and intracardiac echocardiographic (ICE) characterization of the fossa ovalis region in 2 horses. The first case was presented for poor performance and showed an anechoic zone in the interatrial septum on 2D‐TTE. Based on 3D‐TTE a deepened fossa ovalis could be identified and using ICE the presence of an interatrial shunt could be excluded. The second case was referred for a cardiac murmur and the presence of turbulent flow in and around the interatrial septum on 2D‐TTE color flow Doppler. The complementary use of 2D‐TTE, 3D‐TTE, and ICE allowed detailed characterization of a patent foramen ovale, with evidence of a left‐to‐right shunt in a dorsocranial to ventrocaudal direction with limited hemodynamic implications. These 2 cases underline the feasibility of 3D‐TTE and ICE in horses and especially show the added value of ICE in a clinical setting.
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Affiliation(s)
- Ingrid Vernemmen
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Ghent Belgium
| | - Ellen Paulussen
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Ghent Belgium
| | - Julie Dauvillier
- Vet Inside, Equine Internal and Sports Medicine Referral Practice Sainte‐Terre France
| | - Annelies Decloedt
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Ghent Belgium
| | - Gunther van Loon
- Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine Ghent University Ghent Belgium
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Gomart S, MacFarlane P, Payne JR, Hezzell MJ, Borgeat K. Effect of preoperative administration of atenolol to dogs with pulmonic stenosis undergoing interventional procedures. J Vet Intern Med 2022; 36:877-885. [PMID: 35302255 PMCID: PMC9151475 DOI: 10.1111/jvim.16403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background Beta‐blockade is sometimes used in dogs with pulmonic stenosis with the intent of reducing frequency of ventricular arrhythmias during right heart catheterization. Objectives To evaluate if pretreatment with atenolol reduces frequency of ventricular arrhythmias, anesthetist interventions, or shortens procedure time. Animals Thirty dogs with pulmonic stenosis scheduled for interventional procedures. Methods Single center, prospective, randomized, open‐label study. Dogs were randomized to treatment with atenolol or no treatment preoperatively for a minimum of 10 days. Variables recorded included heart rate, arrhythmias and complexity, total procedure time and administration of antiarrhythmic treatment, vasopressors, positive chronotropes, or fluid boluses. Results Fifteen dogs were enrolled in each group. Dogs receiving atenolol had lower mean heart rates during the procedure (atenolol 100 ± 11 bpm vs untreated 115 ± 19 bpm, P = .01). There were no significant differences between the atenolol and untreated groups in the frequency of ventricular ectopic complexes (535 [6‐5296] vs 553 [79‐2863], P = .9), ventricular couplets (46 [0‐481] vs 29 [3‐121], P = .59), ventricular triplets (20 [0‐265] vs 16 [1‐82], P = .67), ventricular tachycardia (8 [0‐224] vs 8 [1‐118], P = .99), proportion exhibiting R‐on‐T phenomenon (11/15 vs 14/15, P = .33), proportion receiving intraoperative lidocaine (1/15 vs 3/15, P = .6), vasopressors/positive chronotropes (11/15 vs 5/15, P = .06), or fluid boluses (12/15 vs 7/15, P = .13). The procedure time was similar (atenolol 41 [23‐68] min vs untreated 35 [18‐98] min, P = .91). Conclusions and Clinical Importance No benefit of preoperative atenolol treatment was identified in this small group of dogs.
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Affiliation(s)
- Samantha Gomart
- Highcroft Veterinary Referrals, CVS Group, Bristol, United Kingdom
| | - Paul MacFarlane
- Langford Vets, University of Bristol, Bristol, United Kingdom
| | | | | | - Kieran Borgeat
- Langford Vets, University of Bristol, Bristol, United Kingdom
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Ro WB, Park HM, Song DW, Kim HS, Lee GW, Kang JH, Jo CH, Kang MH. Case Report: Aortic Regurgitation of Postocclusion and Long-Term Outcome Following PDA Correction in an Adult Dog. Front Vet Sci 2022; 9:848313. [PMID: 35359672 PMCID: PMC8963992 DOI: 10.3389/fvets.2022.848313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
A 9-year-old intact female Maltese dog was admitted for further evaluation of previously diagnosed patent ductus arteriosus (PDA). The dog showed severe coughing and exercise intolerance. On physical examination, a grade VI/VI continuous heart murmur was auscultated. Thoracic radiography demonstrated cardiomegaly, pulmonary overcirculation, and moderate bronchointerstitial pattern. Echocardiography revealed severe dilation of the left ventricle and atrium, decreased left ventricular contractility, and left-to-right PDA. On electrocardiography (ECG), R amplitude was increased. Computed tomographic angiography revealed type IIA PDA. The serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration was >10,000 pmol/L. Transarterial occlusion was performed and the Amplatz® Canine Duct Occluder was successfully deployed. On echocardiography 48 h after the procedure, aortic regurgitation (AR) and residual ductal flow were noted. Long-term follow-up on clinical signs, physical examination, radiography, echocardiography, ECG, and serum NT-proBNP were evaluated until 30 months after correction of PDA. The clinical indices of physical examination, thoracic radiography, echocardiography, ECG, and serum NT-proBNP concentration were improved, although the postocclusion AR and residual ductal flow persisted. The dog followed up without clinical signs for 41 months following the correction. To our knowledge, this is the first case report to demonstrate quite a long time of follow-up (41 months) in an older dog with transarterial occlusion of PDA with postocclusion AR and residual flow.
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Affiliation(s)
- Woong-Bin Ro
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea
| | - Hee-Myung Park
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea
| | - Doo-Won Song
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea
| | - Heyong-Seok Kim
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea
| | - Ga-Won Lee
- Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea
| | - Jin-Ho Kang
- Royal Dog and Cat Medical Center, Seoul, South Korea
| | - Chan-Ho Jo
- Royal Dog and Cat Medical Center, Seoul, South Korea
| | - Min-Hee Kang
- Department of Bio-Animal Care, Jangan University, Hwaseong, South Korea
- *Correspondence: Min-Hee Kang
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Hildebrandt N, Stosic A, Henrich E, Wiedemann N, Wurtinger G, Schneider M. Transvenous embolization of moderate to large patent ductus arteriosus in dogs using the Amplatzer vascular plug II. J Vet Intern Med 2022; 36:20-28. [PMID: 34914141 PMCID: PMC8783350 DOI: 10.1111/jvim.16342] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Catheter-based occlusion of patent ductus arteriosus (PDA) can be performed using different devices. Transvenous embolization using the Amplatzer vascular plug II (AVP-II) has been studied in humans, but it has not been described in dogs. OBJECTIVE Evaluate the feasibility and success of transvenous embolization of PDA using the AVP-II in dogs. ANIMALS Nineteen client-owned dogs with left-to-right shunting PDA, with minimal ductal diameter >2.5 mm. METHODS Prospective observational study using AVP-II with transvenous access for PDA closure in dogs. RESULTS Angiography showed a conical ductus with a long (n = 17) or short (n = 2) ampulla. The minimal diameter of the duct was 4.34 ± 1.11 mm, and the maximal diameter of the ampulla was 13.18 ± 3.47 mm. Technical success was achieved in 18 of the 19 (94.7%) patients after the first intervention and in all 19 (100%) patients after the second intervention. Postrelease angiography documented complete occlusion of the PDA in 10 of 19 (52.6%) dogs. Mild flow acceleration or stenosis of the left pulmonary artery was found in 6 and 1 of the 17 analyzed cases, respectively, by Doppler examination. The closure rate 24 hours after intervention was 94.7% (18/19). The remaining dog had a moderate residual shunt, and delayed complete closure after 3 months led to a 100% closure rate. CONCLUSION AND CLINICAL IMPORTANCE The AVP-II is a safe and effective device for transvenous embolization in dogs with moderate to large PDA.
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Affiliation(s)
- Nicolai Hildebrandt
- Small Animal Clinic (Internal Medicine)Justus‐Liebig Universität GiessenGiessenGermany
| | - Andreas Stosic
- Small Animal Clinic (Internal Medicine)Justus‐Liebig Universität GiessenGiessenGermany
| | - Estelle Henrich
- Small Animal Clinic (Internal Medicine)Justus‐Liebig Universität GiessenGiessenGermany
| | - Nicola Wiedemann
- Small Animal Clinic (Internal Medicine)Justus‐Liebig Universität GiessenGiessenGermany
| | - Gabriel Wurtinger
- Small Animal Clinic (Internal Medicine)Justus‐Liebig Universität GiessenGiessenGermany
| | - Matthias Schneider
- Small Animal Clinic (Internal Medicine)Justus‐Liebig Universität GiessenGiessenGermany
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Passavin P, Chetboul V, Poissonnier C, Saponaro V, Trehiou-Sechi E, Alvarado MP, Tissier R, Lagrange I, Deshuillers P. Red blood cell abnormalities occur in dogs with congenital ventricular outflow tract obstruction. Am J Vet Res 2021; 83:198-204. [PMID: 34936577 DOI: 10.2460/ajvr.21.11.0188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To document RBC abnormalities in dogs with congenital ventricular outflow tract obstruction. ANIMALS 62 dogs with pulmonic stenosis (PS) or aortic stenosis (AS) and 20 control dogs were recruited. PROCEDURES The proportions of RBCs that were schistocytes, acanthocytes, and keratocytes were assessed. Complete blood cell counts were performed. Tested variables included hemoglobin concentration, hematocrit, and erythrocyte count. RESULTS Median (interquartile range [IQR]) peak systolic Doppler-derived trans-stenotic pressure gradient (∆P) values were 161 mm Hg (108 to 215 mm Hg) and 134 mm Hg (125 to 165 mm Hg) for dogs with PS and AS, respectively. Hematologic abnormalities were detected in most dogs with AS or PS (54/62 [87%]) versus 8/20 [40%] in control dogs, with schistocytes found in 40 of 62 (65%; median, 0.1% RBCs; IQR, 0% to 0.3%), acanthocytes in 29 of 62 (47%; median, 0.3% RBCs; IQR, 0% to 0.9%), keratocytes in 39 of 62 (63%; median, 0% RBCs; IQR, 0% to 0.2%), and hemolytic anemia in 4 dogs with PS. No significant association was identified between these abnormalities and ∆P. However, 3 of 4 dogs with anemia had a ∆P > 200 mm Hg (range, 242 to 340 mm Hg). The dog with the highest ∆P value also had the most severe anemia and schistocytosis, and both resolved after balloon valvuloplasty. CLINICAL RELEVANCE Poikilocytosis is common in dogs with congenital ventricular outflow tract obstruction, with anemia only observed in few dogs with high ∆P values.
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Affiliation(s)
- Peggy Passavin
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Valérie Chetboul
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,Institut Mondor de Recherche Biomédicale, U955 Inserm, École Nationale Vétérinaire d'Alfort, UPEC, Maisons-Alfort, France
| | - Camille Poissonnier
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Vittorio Saponaro
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Emilie Trehiou-Sechi
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Maria-Paz Alvarado
- Unité de Cardiologie d'Alfort, Centre Hospitalier Universitaire Vétérinaire d'Alfort (CHUVA), École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Renaud Tissier
- Institut Mondor de Recherche Biomédicale, U955 Inserm, École Nationale Vétérinaire d'Alfort, UPEC, Maisons-Alfort, France.,Unité de Pharmacie-Toxicologie, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Isabelle Lagrange
- Unité de Biochimie et Biologie Clinique/Laboratoire BioPôle, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
| | - Pierre Deshuillers
- Unité de Biochimie et Biologie Clinique/Laboratoire BioPôle, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France.,UMR Biologie Moléculaire et Immunologie Parasitaires, École Nationale Vétérinaire d'Alfort, Université Paris-Est, Maisons-Alfort, France
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12
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Wesselowski S, Cusack K, Saunders AB, Jeffery N. Pre-procedural femoral vessel ultrasound in dogs with patent ductus arteriosus: diameter, image quality and relationship with arterial catheterization. J Vet Cardiol 2021; 39:69-78. [PMID: 34996021 DOI: 10.1016/j.jvc.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION /Objectives: Patent ductus arteriosus (PDA) in dogs is often treated via minimally invasive transvascular occlusion using femoral artery access. This study compared ultrasound-derived diameter and image quality of the right femoral artery (RFA) and vein (RFV) in dogs with PDA using a linear ultrasound probe (L-P) and phased-array transthoracic echocardiography probe (TTE-P). The case outcome was assessed. ANIMALS, MATERIALS & METHODS Forty-five client-owned dogs with PDA were prospectively enrolled. Ultrasound-measured RFA and RFV diameters were obtained on images acquired with both probes pre-operatively and compared using Bland-Altman plots. The image quality of RFA and RFV was scored on L-P and TTE-P images. RESULTS Comparison of RFA and RFV diameter from L-P versus TTE-P images revealed: [Mean difference (limits of agreement): RFA = 0.009 mm (-0.78-0.79 mm), RFV = 0.523 mm (-1.75-2.79 mm)]. Image quality scores were significantly higher for L-P than TTE-P (P < 0.0001). In six small dogs, measurable images were unattainable with TTE-P. Dogs of similar body weight had variable RFA diameters. Twenty-seven dogs had RFA catheterization. In 21/27 dogs, RFA diameter exceeded the external diameter of the introducer used for catheterization, and in 6/27, it was smaller. CONCLUSIONS Pre-procedural ultrasound of the RFA in dogs with PDA is useful given variable RFA diameter relative to body weight. Despite poorer image quality, RFA diameters from TTE-P images were very similar to L-P images on average, suggesting TTE-Ps are suitable for pre-procedural planning in most dogs. Vasospasm, hypotension or differences in the location of ultrasound measurement versus catheterization might produce variation in pre-procedural versus intraoperative RFA size.
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Affiliation(s)
- S Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA.
| | - K Cusack
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
| | - N Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, 4474 TAMU, College Station, TX, 77843-4474, USA
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13
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Rovroy LB, Szatmári V. Age of puppies at referral to veterinary cardiology specialists for murmur investigation. Acta Vet Scand 2021; 63:37. [PMID: 34556139 PMCID: PMC8461946 DOI: 10.1186/s13028-021-00603-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 09/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Cardiac auscultation is an important screening test at the first health examination of puppies because most clinically relevant congenital cardiac anomalies cause a loud murmur from birth. This retrospective study aimed to investigate the age at which dogs with suspected congenital cardiac anomalies were referred to a veterinary cardiology specialist for murmur investigation. A secondary aim was to establish the time interval between the visit to the cardiologist and the first available murmur documentation. The digital archive of a veterinary teaching hospital was searched for dogs with congenital cardiac anomalies and puppies with innocent murmurs during a 5-year period. Dogs had to be referred because of a murmur, and they had to undergo physical examination and echocardiography by a veterinary cardiology specialist. The health certificate section of the pet passport, and the medical records from the referring veterinarian, were reviewed to identify the date when the murmur was first documented. Results Of the 271 included dogs, 94% had a congenital cardiac anomaly and 6% had an innocent murmur. The dogs’ median age was 190 days when they were examined by the cardiologist. Only 10% of the dogs were referred by the breeder’s veterinarian, while 90% of the dogs were referred by the new owner’s veterinarian. The median age of the first available murmur documentation by a first opinion veterinary practitioner was 95 days. Conclusions Only 10% of the puppies in the present study were referred to a veterinary cardiology specialist for murmur investigation before they were sold to a new owner. Referral prior to re-homing would have been feasible if the murmur had been detected and documented by the breeder’s veterinarian, if referral was offered by the breeder’s veterinarian and the referral was accepted by the breeder.
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14
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Kochi M, Sugimoto K, Inoue M, Aoki T. Late recanalization after complete occlusion of patent ductus arteriosus in a Pembroke Welsh Corgi with von Willebrand disease. Vet Med Sci 2021; 8:26-30. [PMID: 34538019 PMCID: PMC8788971 DOI: 10.1002/vms3.634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A 36‐month‐old female Pembroke Welsh Corgi with a cardiac murmur weighing 12.6 kg was referred to the Matsubara Animal Hospital cardiology service. Echocardiography revealed a patent ductus arteriosus. The dog underwent ductus arteriosus closure using an Amplatz Canine Duct Occluder. After the operation, we suspected coagulation and a platelet disorder because of the slightly increased haemorrhage during the operation, postoperative purpura around the surgical wound inside of the thigh, and dog breed, which is known to be commonly affected with von Willebrand disease (vWD). Subsequently, type 1 vWD was confirmed. Complete occlusion was achieved 1 month after the operation; however, 2 months after the operation, recanalization appeared. Recanalization progressed gradually; cardiac redilation was not detected 6 years after the operation. The late recanalization was most likely associated with vWD. In canine breeds pre‐disposed to developing vWD, pre‐operative testing may be indicated prior to patent ductus arteriosus occlusion, though the prevalence of vWD is rare.
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Affiliation(s)
- Masaki Kochi
- Division of Cardiology, Matsubara Animal Hospital, Matsubara, Japan
| | - Keisuke Sugimoto
- Department of Internal Medicine 2, Faculty of Veterinary Medicine, Okayama University of Science, Imabari, Japan
| | - Michito Inoue
- Division of Cardiology, Matsubara Animal Hospital, Matsubara, Japan
| | - Takuma Aoki
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Azabu University, Sagamihara, Japan
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15
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Saunders AB. Key considerations in the approach to congenital heart disease in dogs and cats. J Small Anim Pract 2021; 62:613-623. [PMID: 34180062 DOI: 10.1111/jsap.13360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/12/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022]
Abstract
Congenital heart disease is an important subset of all cardiovascular disease in dogs and cats that is present at birth and most often detected in young animals but can be diagnosed in adulthood. The range of abnormalities that can occur during development of the heart is vast incorporating simple and complex defects, varying degrees of severity and clinical presentations that include heart failure and cyanosis. While some defects do not result in morbidity in an individual animal, others cause severe clinical signs and death at a young age. Advances in imaging and expanding treatment options offer increasingly more possibilities in the diagnosis and management of congenital heart disease which is the focus of this review. The objective is to provide a broad overview of current practice and highlight key aspects to guide practitioners in their approach to congenital heart disease diagnosis and knowledge of available treatment options.
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Affiliation(s)
- A B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
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16
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The use of Amplatzer vascular plug II in 32 consecutive dogs for transvenous occlusion of patent ductus arteriosus. J Vet Cardiol 2021; 41:88-98. [DOI: 10.1016/j.jvc.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/16/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022]
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17
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Angelou V, Chatzimisios K, Koutinas C, Papazoglou LG. Jackson-Henderson technique for the revision surgery following PDA rupture in a dog. Top Companion Anim Med 2021; 44:100533. [PMID: 33762187 DOI: 10.1016/j.tcam.2021.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
A 3-month-old female intact Maltese dog, was referred for further investigation and management of a patent ductus arteriosus (PDA), which was diagnosed with a grade V murmur during thoracic auscultation and a palpable thrill in the left third intercostal space during routine vaccination. Echocardiographic findings included left ventricle dilatation, high velocity continuous ductal flow in the pulmonary valve and a patent ductus arteriosus. Hematological and biochemical abnormalities were not detected. A left forth intercostal thoracotomy was performed and during dissection, the medial wall of the duct was perforated resulting in hemorrhage. Digital pressure was applied over the ductus and bleeding ceased. An attempt for further dissection aggravated bleeding so it was decided to abandon surgery and to reoperate the dog using a different technique. Three months after surgery a second procedure was scheduled. A Jackson-Henderson technique was chosen for the ductus ligation, which was completed through a left fourth intercostal thoracotomy and the dog was discharged 2 days postoperatively. The dog was reexamined at 2 and 8 months after surgery and found with no clinical evidence of heart disease. In conclusion the Jackson-Henderson technique was used in the second surgery for closure of the ductus in order to avoid dissection of the medial aspect of the ductus, where adhesions were formed and the dog was free of clinical signs of heart disease 2 and 8 months postoperatively.
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Affiliation(s)
- Vasileia Angelou
- Department of Clinical Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Kiriakos Chatzimisios
- Department of Clinical Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Koutinas
- Department of Clinical Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lysimachos G Papazoglou
- Department of Clinical Sciences, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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18
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Hogan DF, Goldfeder GT. Transarterial correction of patent ductus arteriosus in small dogs with the Amplatz™ Vascular Plug 4: A pilot study. J Vet Cardiol 2021; 35:48-54. [PMID: 33813218 DOI: 10.1016/j.jvc.2021.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/11/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Determine if the Amplatz™ Vascular Plug 4 (AVP4) can be used to occlude left-to-right shunting patent ductus arteriosus (PDA) in dogs with inadequate arterial vascular access for the Amplatz Canine Duct Occluder (ACDO). ANIMALS Six adolescent dogs with PDA whose femoral artery was too small for insertion of a 4 Fr vascular access sheath. MATERIALS AND METHODS Standard femoral arterial vascular access and a 4 Fr diagnostic catheter were used to deploy an appropriately sized AVP4 into the PDA of each dog. Successful occlusion was defined as no residual ductal flow and determined by color Doppler echocardiography and angiography. RESULTS The AVP4 was successfully deployed, and complete occlusion of the PDA was achieved in all dogs. There were no complications encountered in any of the dogs. CONCLUSIONS The AVP4 is a viable option for the correction of PDA in dogs with inadequate arterial vascular access for the ACDO and should be considered as one of the options available for PDA correction in this challenging animal population.
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Affiliation(s)
- D F Hogan
- Professor of Cardiology, Purdue University, College of Veterinary Medicine, Department of Veterinary Clinical Sciences-Lynn Hall, 625 Harrison Street, West Lafayette, IN, 47907-2026, USA.
| | - G T Goldfeder
- Clinical Director, Goldfeder & Dos Santos Cardiologia Veterinária, 121 Quitanduba Street, São Paulo, SP, 05516-030, Brazil
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Kharbush R, Trafny D. Transvenous patent ductus arteriosus occlusion via Canine Duct Occluder in a cat. J Vet Cardiol 2021; 33:6-12. [DOI: 10.1016/j.jvc.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
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20
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Hulsman AH, Breur JMPJ, Szatmári V. Low profile vascular plug for transarterial occlusion of patent ductus arteriosus in small dogs. J Vet Intern Med 2020; 35:98-106. [PMID: 33242371 PMCID: PMC7848328 DOI: 10.1111/jvim.15966] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 01/04/2023] Open
Abstract
Background Minimally invasive transcatheter occlusion using Amplatz canine duct occluder (ACDO) is the treatment of choice for dogs with left‐to‐right shunting patent ductus arteriosus (PDA). However, in small dogs the femoral artery diameter is often too small to accommodate the guiding catheter required for ACDO deployment. Objective Describe the effectiveness of transarterial implantation of Amplatzer Vascular Plug 4 (AVP‐4), the only self‐expandable nitinol mesh occlusion device which can be implanted through a 4 French diagnostic catheter, in small dogs with left‐to‐right shunting PDA. Animals Seven client‐owned dogs. Methods Descriptive case series. Dogs with hemodynamically relevant left‐to‐right shunting PDA and a femoral artery diameter less than 2.0 mm measured preoperatively with ultrasonography were prospectively enrolled. Results Angiography after releasing the device showed complete immediate PDA closure in 5 dogs, where the manufacturers' recommendation were strictly followed (30%‐50% device oversizing of the ductal ampulla's diameter). Trivial residual flow on angiography in the 6th dog, whose device was slightly undersized, had resolved on echocardiography within 2 hours after placement. Marked device undersizing in the 7th dog resulted in severe residual shunting, which necessitated the addition of a coil. In this dog, the AVP‐4 embolized into the pulmonary artery within 2 weeks after placement. Conclusions and Clinical Importance Transarterial implantation of AVP‐4 is a safe, effective and technically easy procedure for PDA occlusion in small dogs and offers a valuable alternative to coil implantation. Accurate PDA measurement and device sizing is essential to prevent residual shunting, inadvertent device embolization, and protrusion of the device into the aorta.
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Affiliation(s)
- Alma H Hulsman
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Johannes M P J Breur
- Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Centre, Utrecht, The Netherlands
| | - Viktor Szatmári
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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21
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Stern DJ, Gunasekaran T, Sanders RA. Periprocedural vascular access complications associated with percutaneous femoral arterial access using the modified Seldinger's technique in dogs during cardiac catheterization: a single-center experience. J Vet Cardiol 2020; 32:28-32. [PMID: 33080490 DOI: 10.1016/j.jvc.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The primary objective of this study is to evaluate the peri-procedural major and minor complications associated with percutaneous femoral arterial access using modified Seldinger's technique in dogs that underwent cardiac catheterization. METHODS Medical records of 62 client owned dogs that underwent percutaneous femoral arterial access for interventional cardiac procedures were retrospectively evaluated. Post-procedural manual compression was used for hemostasis. Peri-procedural vascular access complications (that occurred from procedure time to discharge) were evaluated. Vascular access complications were divided into two groups: minor complications that did not require specific therapy and major complications that did require an intervention to address the complication associated with vascular access. RESULTS The minor complication rate was 30.6% (19/62) with most dogs experiencing minor bruising and small hematomas. The major complication rate was 3.2% (2/62). Both major complications were associated with bleeding with one dog requiring blood transfusion and the other dog requiring fluid therapy. No peri-procedural mortality associated with vascular access was noted. CONCLUSION This retrospective study suggests that percutaneous femoral arterial access using the modified Seldinger's technique with post-procedural manual compression for hemostasis is viable option for vascular access during cardiac catheterization and associated with no peri-procedural mortality in dogs. The lower rate of complications noted in this study may be related to operator experiences and as such complication rate at a single center may not reflect the experience at other centers.
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Affiliation(s)
- D J Stern
- College of Veterinary Medicine, Michigan State University, 784 Wilson Rd, East Lansing, MI, 48824, USA
| | - T Gunasekaran
- College of Veterinary Medicine, Michigan State University, 784 Wilson Rd, East Lansing, MI, 48824, USA
| | - R A Sanders
- College of Veterinary Medicine, Michigan State University, 784 Wilson Rd, East Lansing, MI, 48824, USA.
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22
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Patata V, Scalise F, Sorropago G, Marchesotti F, Nicoli S, Auriemma E, Rondelli V, Pesaresi M, Glaus TM, Baron Toaldo M, Vezzosi T, Domenech O. Closure of an unusual morphology patent ductus arteriosus with a covered stent in a dog. J Vet Cardiol 2020; 32:7-15. [PMID: 33039928 DOI: 10.1016/j.jvc.2020.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 07/01/2020] [Accepted: 09/02/2020] [Indexed: 02/02/2023]
Abstract
Patent ductus arteriosus (PDA) with unusual morphology was diagnosed in a 3-year-old German shepherd presented for exercise intolerance. Two interventional PDA closure procedures with various Amplatzer devices and one surgical ligation were attempted to close the PDA. However, PDA closure failed with both methods due to the unusual morphology and the severe enlarged ductus ampulla. Therefore, the patient underwent an aortic covered stent placement, and successful closure of the PDA was achieved. Eight months after the procedure, the dog was free of clinical signs and no residual flow was identified through the PDA on transthoracic echocardiography. Moreover, computed tomography angiography demonstrated correct stent positioning, with no evidence of thrombus formation, damage to the stent, nor any aortic wall abnormalities. Aortic covered stent placement is a viable option in dogs with unusual PDA morphology.
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Affiliation(s)
- V Patata
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy.
| | - F Scalise
- Department of Interventional Cardiology, Policlinico di Monza, via Carlo Amati, 111, 20900, Monza, Italy
| | - G Sorropago
- Department of Interventional Cardiology, Policlinico di Monza, via Carlo Amati, 111, 20900, Monza, Italy
| | - F Marchesotti
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - S Nicoli
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - E Auriemma
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - V Rondelli
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - M Pesaresi
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
| | - T M Glaus
- Division of Cardiology, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty University of Zürich, Winterthurerstrasse 260, CH-8057, Zürich, Switzerland
| | - M Baron Toaldo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Via Tolara di Sopra 50, 40064, Ozzano Emilia, Italy
| | - T Vezzosi
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy; Department of Veterinary Medicine, University of Pisa, Viale delle Piagge, 1, 56124, Pisa, Italy
| | - O Domenech
- Istituto Veterinario di Novara, strada provinciale, 9, 28060, Granozzo con Monticello, Novara, Italy
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Winter RL, Remaks JD, Newhard DK. Development of Spontaneous Echocardiographic Contrast After Transarterial Occlusion of a Patent Ductus Arteriosus in an Adult Dog With Concurrent Pulmonary Hypertension. Front Vet Sci 2020; 7:103. [PMID: 32175342 PMCID: PMC7054289 DOI: 10.3389/fvets.2020.00103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/11/2020] [Indexed: 11/23/2022] Open
Abstract
An 8-year-old intact female Chihuahua was presented for evaluation and possible occlusion of a previously diagnosed patent ductus arteriosus (PDA). Transthoracic echocardiography revealed left ventricular and left atrial enlargement, enlargement of the main pulmonary artery, and a PDA with bidirectional shunting. Tricuspid regurgitant velocities suggested moderate pulmonary hypertension. The PDA was occluded with an Amplatz® Canine Duct Occluder using a transarterial approach on the following day. No immediate complications were observed other than an acute decrease in left ventricular systolic function. One day after the PDA occlusion transthoracic echocardiography revealed no residual ductal flow, but there was spontaneous echocardiographic contrast in the left ventricle. The patient was discharged with sildenafil, pimobendan, and clopidogrel. Five weeks later when the patient was presented for a recheck examination, the previously documented spontaneous echocardiographic contrast was no longer present. Finding spontaneous echocardiographic contrast in the dog has not previously been reported in association with PDA occlusion.
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Affiliation(s)
- Randolph L Winter
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Julia D Remaks
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Auburn University, Auburn, AL, United States
| | - Daniel K Newhard
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Auburn University, Auburn, AL, United States
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Love BA, Thierry F, Schwarz T, Martinez-Pereira Y, Culshaw GJ. Aortic sinus aneurysm communicating with the main pulmonary artery, and a concurrent patent ductus arteriosus, in a dog. J Small Anim Pract 2020; 62:300-304. [PMID: 31943231 DOI: 10.1111/jsap.13103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/22/2018] [Accepted: 11/20/2018] [Indexed: 11/29/2022]
Abstract
This is the first report of an aortic sinus aneurysm with a communication to the main pulmonary artery, resulting in left-to-right shunting, diagnosed in vivo in a dog. There was also a second left-to-right shunt through a patent ductus arteriosus. Computed tomography (CT) angiography was used to confirm both congenital anomalies and assess the relative contributions of the two left-to-right shunts to left-sided volume overload.
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Affiliation(s)
- B A Love
- Wear Referrals, Veterinary Hospital, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - F Thierry
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - T Schwarz
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - Y Martinez-Pereira
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
| | - G J Culshaw
- Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, EH25 9RG, UK
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Claretti M, Lopez BS, Boz E, Martelli F, Pradelli D, Bussadori CM. Complications during catheter-mediated patent ductus arteriosus closure and pulmonary balloon valvuloplasty. J Small Anim Pract 2019; 60:607-615. [PMID: 31280488 DOI: 10.1111/jsap.13046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/29/2019] [Accepted: 05/30/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate and illustrate complications of cardiac catheterisation and the associated risk factors of the most common cardiac intervention procedures. MATERIALS AND METHODS Retrospective study of clinical records of client-owned dogs presented to a cardiology referral centre between January 2006 and December 2017. RESULTS Five hundred and twenty-four dogs were included, 62 of which had complications. Complications were divided into technical complications and those due to unexpected additional anatomical abnormalities. Seven procedures (1.33%) were interrupted; five dogs (0.95%) subsequently underwent surgery, and four dogs died during the interventional procedure, indicating a mortality rate of 0.76% CLINICAL SIGNIFICANCE: There is a low risk of complications following closure of patent ductus arteriosus or pulmonary balloon valvuloplasty when carried out by a trained team using standardised procedures in a referral centre.
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Affiliation(s)
- M Claretti
- Department of Cardiology, Clinica Veterinaria Gran Sasso, 20131, Milan, Italy
| | - B S Lopez
- Department of Cardiology, Clinica Veterinaria Gran Sasso, 20131, Milan, Italy
| | - E Boz
- Department of Cardiology, Clinica Veterinaria Gran Sasso, 20131, Milan, Italy
| | - F Martelli
- Department of Cardiology, Clinica Veterinaria Gran Sasso, 20131, Milan, Italy
| | - D Pradelli
- Department of Cardiology, Clinica Veterinaria Gran Sasso, 20131, Milan, Italy
| | - C M Bussadori
- Department of Cardiology, Clinica Veterinaria Gran Sasso, 20131, Milan, Italy
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LeBlanc NL, Agarwal D, Menzen E, Nomi K, Sisson DD, Scollan KF. Prevalence of major complications and procedural mortality in 336 dogs undergoing interventional cardiology procedures in a single academic center. J Vet Cardiol 2019; 23:45-57. [PMID: 31174729 DOI: 10.1016/j.jvc.2019.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 01/17/2019] [Accepted: 01/17/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Overall complication rates associated with a wide range of diagnostic and therapeutic interventional cardiac procedures in a contemporary academic setting have not been reported. ANIMALS, MATERIALS AND METHODS Consecutive interventional procedures performed for client-owned dogs were retrospectively analyzed to characterize procedural complications and mortality. RESULTS Three hundred sixty-four procedures were performed on 336 dogs. Interventions included attempted or completed transvenous pacemaker (PM) implantation (n = 134) with subsequent pacing system revision (n = 8), pulmonic balloon valvuloplasty (BVP) (n = 117) with a subset of patients undergoing an additional BVP (n = 14), transarterial closure of left-to-right shunting patent ductus arteriosus (PDA) (n = 66), diagnostic angiography and/or cardiovascular pressure measurement (n = 9), transvenous temporary pacing (n = 7), septal defect occlusion (n = 5), heartworm extraction (n = 3), and BVP catheter fragment retrieval (n = 1). The prevalence of major perioperative and postoperative complications for all procedures was 5% and 6%, respectively, and the procedural mortality rate was 2%. The overall rate of major complications was 12% for the PM group, 11% for the BVP group, and 2% for the PDA occlusion group. Both PM implantation and BVP have higher rates of major complications overall compared with PDA occlusion (p=0.0151). CONCLUSIONS The results of this study indicate that the prevalence of major complications and mortality associated with interventional cardiac procedures is low; however, significant differences exist in complication rates between procedures.
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Affiliation(s)
- N L LeBlanc
- Oregon State University, Department of Clinical Sciences, College of Veterinary Medicine, 105 Magruder Hall, 700 SW 30(th) Street, Corvallis, Oregon 97331, USA.
| | - D Agarwal
- MedVet Medical and Cancer Center for Pets, Cardiology Department, 3964 Red Bank Road, Cincinnati, Ohio 45227, USA
| | - E Menzen
- Oregon State University, Department of Clinical Sciences, College of Veterinary Medicine, 105 Magruder Hall, 700 SW 30(th) Street, Corvallis, Oregon 97331, USA
| | - K Nomi
- Oregon State University, Department of Clinical Sciences, College of Veterinary Medicine, 105 Magruder Hall, 700 SW 30(th) Street, Corvallis, Oregon 97331, USA
| | - D D Sisson
- Oregon State University, Department of Clinical Sciences, College of Veterinary Medicine, 105 Magruder Hall, 700 SW 30(th) Street, Corvallis, Oregon 97331, USA
| | - K F Scollan
- Oregon State University, Department of Clinical Sciences, College of Veterinary Medicine, 105 Magruder Hall, 700 SW 30(th) Street, Corvallis, Oregon 97331, USA
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Wesselowski S, Saunders AB, Gordon SG. Anatomy, baseline characteristics, and procedural outcome of patent ductus arteriosus in German Shepherd dogs. J Vet Intern Med 2018; 33:471-477. [PMID: 30556180 PMCID: PMC6430865 DOI: 10.1111/jvim.15401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Accepted: 11/20/2018] [Indexed: 11/26/2022] Open
Abstract
Background German Shepherd dogs (GSD) are predisposed to developing patent ductus arteriosus (PDA) and are reportedly prone to type III (tubular) PDA anatomy. Dogs with type III anatomy are not considered favorable candidates for device‐based intervention. Objective To describe the PDA anatomy, baseline characteristics, and procedural outcome of GSD with PDA. Animals Twenty‐eight client‐owned GSD. Methods Retrospective review of medical records of 28 GSD diagnosed with PDA that underwent surgical ligation or transcatheter device closure between 2007 and 2017. Results German Shepherd dogs with PDA often presented with clinical signs (50%), concurrent congenital heart disease (35.7%), and arrhythmias (29%). Dogs were typically mature at presentation (median age, 12.1 months) and evenly distributed by sex (57% female). The PDA anatomy was classified in 24 of 28 GSD, with type II anatomy being most common (21/24). Three dogs had unusual anatomy (type IV in 1, type V in 2). Median minimal ductal diameter (MDD) in this population was larger than previously reported in a mixed population and ranged between 4.4 and 4.9 mm depending upon imaging modality. Successful closure was achieved using an Amplatz canine duct occluder (ACDO) in 22 dogs or by surgical ligation in 6 dogs. No cases of type III anatomy were confirmed. Conclusions and Clinical Importance The majority of GSD in this population had type II PDA anatomy that was amenable to ACDO deployment. Predisposition for large MDD and occasional, unusual PDA anatomy suggests that transesophageal echocardiography may be beneficial for optimal procedural planning in this breed.
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Affiliation(s)
- Sonya Wesselowski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
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A pictorial view of the three-dimensional representation and comparative two-dimensional image orientation derived from computed tomography angiography in a dog with a patent ductus arteriosus. J Vet Cardiol 2018; 21:34-40. [PMID: 30797443 DOI: 10.1016/j.jvc.2018.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 11/23/2022]
Abstract
Patent ductus arteriosus (PDA) occlusion is one of the more common cardiovascular procedures performed in dogs. Two-dimensional imaging has been the primary method of visualizing the PDA and is the basis of its morphologic description. Transesophageal echocardiographic imaging has further characterized the three-dimensional (3D) variation in ductal morphology and shape (circle, oval). An accurate assessment of the shape and dimensions of a PDA in an individual dog is important when making decisions about definitive closure. Ductal measurements from angiography and echocardiography have not been found to be interchangeable, likely related in part to the static two-dimensional measurement of a 3D structure. We describe the use of computed tomography angiography (CTA) images imported into three software programs as a tool to provide 3D information about PDA anatomy including a comparison to images obtained from classic two-dimensional imaging modalities. These images provide an example of thorax and heart position related to transducer position and the orientation of image acquisition to demonstrate why measurements do not always compare. Additionally, 3D images are useful as a training tool and in the development of devices and training opportunities. Multidimensional imaging provides a unique representation of the 3D anatomical structure of the ductus arteriosus as displayed in these images from a dog with a PDA.
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Lavennes M, Chetboul V, Passavin P, Gouni V, Damoiseaux C, Poissonnier C, Carazo Arias L, Alvarado M, Morlet A, Chevènement O, Behr L, Borenstein N. Successful transcatheter retrieval of embolized Amplatz Canine Duct Occluders in two dogs. J Vet Cardiol 2018; 20:451-457. [DOI: 10.1016/j.jvc.2018.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 07/04/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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Ranganathan B, LeBlanc NL, Scollan KF, Townsend KL, Agarwal D, Milovancev M. Comparison of major complication and survival rates between surgical ligation and use of a canine ductal occluder device for treatment of dogs with left-to-right shunting patent ductus arteriosus. J Am Vet Med Assoc 2018; 253:1046-1052. [DOI: 10.2460/javma.253.8.1046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Beijerink NJ, Bergmann W, Szatmári V. Incomplete endothelialization of an intravascular implant and fatal late-onset bacterial ductal arteritis in a dog with occluded patent ductus arteriosus. J Vet Intern Med 2018. [PMID: 29524349 PMCID: PMC5980296 DOI: 10.1111/jvim.15074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
An 18‐month‐old male Akita Inu dog developed fever and lameness 8 months after successful transcatheter closure of a patent ductus arteriosus with an Amplatz Canine Duct Occluder (ACDO). Corynebacterium species were cultured from 3 blood samples. Echocardiography showed a vegetative process on the aortic valves. The dog died spontaneously 3 days after development of the initial signs. Necropsy confirmed the presence of bacterial ductal arteritis and myocarditis, and revealed an incomplete endothelialization of the intraductal metal implant. The reason for the lack of (neo)endothelialization of the ACDO remains unknown. We conclude that late‐onset bacterial device‐related ductal arteritis can develop in dogs where the implant is incompletely covered by a protective endothelial layer.
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Affiliation(s)
- Niek Jozef Beijerink
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, The Netherlands
| | | | - Viktor Szatmári
- Department of Clinical Sciences of Companion Animals, Utrecht University, Utrecht, The Netherlands
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Doocy KR, Saunders AB, Gordon SG, Jeffery N. Comparative, multidimensional imaging of patent ductus arteriosus and a proposed update to the morphology classification system for dogs. J Vet Intern Med 2018; 32:648-657. [PMID: 29460426 PMCID: PMC5866990 DOI: 10.1111/jvim.15068] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/08/2017] [Accepted: 01/18/2018] [Indexed: 11/26/2022] Open
Abstract
Background Accurately assessing the morphology and shape of the patent ductus arteriosus (PDA) and obtaining measurements are important to avoid procedural complications. Objectives To characterize and compare PDA morphology, shape, and dimensions with angiography and echocardiography. Animals 25 client‐owned dogs with echocardiographically confirmed PDA. Methods Prospective case series. Imaging consisted of single plane angiography, transthoracic echocardiography from the right (TTE‐R) and left (TTE‐L), and two‐dimensional, biplane, and three‐dimensional transesophageal echocardiography (TEE‐2D and TEE‐3D). Measurements included angiographic minimal ductal diameter (MDD), echocardiographic pulmonary ostium in a single dimension (TTE‐R, TTE‐L, and TEE‐2D) and in perpendicular dimensions (TEE‐3D) with similar measurements of the ampulla 3 mm above the MDD or pulmonary ostium. The morphology and shape of the PDA were characterized. Results Catheter‐based occlusion (N = 20) and surgical ligation (N = 5) were performed without complication. Angiographic morphology was classified as type II (N = 19), type III (N = 1), and other (N = 1). Angiographic MDD and TEE‐2D pulmonary ostium measurements were significantly (P = .008) but weakly correlated (r = .56); similar relationships were found for ampulla diameter measurements (P < .0001; r = .75). In general, TEE‐2D did not correlate with other imaging modalities measurements. Based on TEE‐3D measurements, the majority of pulmonary ostium (17/24; 71%) and ampulla (19/24; 79%) were oval. Conclusions and Clinical Importance Measurements using different imaging modalities are not interchangeable. TEE‐3D provided an en face view of the PDA that cannot be replicated with other echocardiographic techniques and demonstrated an oval shape in the majority of dogs. We propose an update to the current classification system to include additional PDA morphologies.
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Affiliation(s)
- Kelley R Doocy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Nicholas Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas
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Wesselowski S, Saunders AB, Gordon SG. Relationship between Device Size and Body Weight in Dogs with Patent Ductus Arteriosus Undergoing Amplatz Canine Duct Occluder Deployment. J Vet Intern Med 2017; 31:1388-1391. [PMID: 28782853 PMCID: PMC5598890 DOI: 10.1111/jvim.14797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/10/2017] [Accepted: 06/27/2017] [Indexed: 11/23/2022] Open
Abstract
Background Deployment of the Amplatz Canine Duct Occluder (ACDO) is the preferred method for minimally invasive occlusion of patent ductus arteriosus (PDA) in dogs, with appropriate device sizing crucial to successful closure. Dogs of any body weight can be affected by PDA. Objectives To describe the range of ACDO sizes deployed in dogs of various body weights for improved procedural planning and inventory selection and to investigate for correlation between minimal ductal diameter (MDD) and body weight. Animals A total of 152 dogs undergoing ACDO deployment between 2008 and 2016. Methods Body weight, age, breed, sex, and MDD obtained by angiography (MDD‐A), MDD obtained by transesophageal echocardiography (MDD‐TEE), and ACDO size deployed were retrospectively evaluated. Results Correlation between body weight and ACDO size, MDD‐A and MDD‐TEE was poor, with R‐squared values of 0.4, 0.36, and 0.3, respectively. Femoral artery diameter in the smallest population of dogs placed inherent limitations on the use of larger device sizes, with no limitations on the wide range of device sizes required as patient size increased. The most commonly used ACDO devices were size 3 through 6, representing 57% of the devices deployed within the entire study population. Conclusions and Clinical Importance Patent ductus arteriosus anatomy varies on an individual basis, with poor correlation between MDD and body weight. Weight‐based assumptions about expected ACDO device size for a given patient are not recommended.
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Affiliation(s)
- S Wesselowski
- College of Veterinary Medicine, Texas A&M University, College Station, TX
| | - A B Saunders
- College of Veterinary Medicine, Texas A&M University, College Station, TX
| | - S G Gordon
- College of Veterinary Medicine, Texas A&M University, College Station, TX
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De Monte V, Staffieri F, Caivano D, Nannarone S, Birettoni F, Porciello F, Di Meo A, Bufalari A. Heart rate and blood pressure variations after transvascular patent ductus arteriosus occlusion in dogs. Res Vet Sci 2017; 113:73-78. [DOI: 10.1016/j.rvsc.2017.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/02/2017] [Accepted: 09/03/2017] [Indexed: 11/26/2022]
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Incidence of postoperative implant-related bacterial endocarditis in dogs that underwent trans-catheter embolization of a patent ductus arteriosus without intra- and post-procedural prophylactic antibiotics. Vet Microbiol 2017; 207:25-28. [DOI: 10.1016/j.vetmic.2017.05.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/26/2017] [Accepted: 05/28/2017] [Indexed: 11/18/2022]
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Wierzbicki MA, Raines SB, Gordon SG, Criscione JC, Saunders AB, Birch S, Due B, Keller B, Nash LD, Miller MW, Maitland DJ. An experimental canine patent ductus arteriosus occlusion device based on shape memory polymer foam in a nitinol cage. J Mech Behav Biomed Mater 2017; 75:279-292. [PMID: 28759840 DOI: 10.1016/j.jmbbm.2017.07.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 12/01/2022]
Abstract
Patent ductus arteriosus (PDA) is a congenital cardiovascular defect in which a fetal connection between the aorta and pulmonary artery does not spontaneously close shortly after birth. If left uncorrected serious complications and even death can occur. Surgical ligation is the traditional treatment method; however, it is an invasive procedure, that motivates development of a minimally invasive option. Shape memory polymer (SMP) foams are unique materials that hold promise in the field of minimally invasive occlusion devices. In this work, a prototype nitinol foam cage (NFC) incorporating SMP foams has been designed and evaluated in multiple mechanical and in vitro verification tests. The NFC demonstrated acceptable fatigue resistance in a preliminary strut integrity test, withstanding one million cycles without complete strut fracture. Radial force analysis of both thick- and thin-walled prototype variations generated less vessel distension and wall tension in a vessel mimic compared to a commercial device. The NFCs exhibited negligible in vitro migration, comparable to that of a commercial device, using simplified, ideal models of PDA. Deployment characteristics of the prototypes were evaluated and compared to that of a commercial device when delivered into physiological models of PDA. During mock deployments, a veterinary cardiologist noted that, while deliverable, the thin-walled NFC prototype exhibited poor deployment characteristics, however the thick-walled NFC had deployment characteristics comparable to that of a commercial device. The promising results of this study warrant further investigation of the NFC device for canine PDA closure.
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Affiliation(s)
- Mark A Wierzbicki
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA
| | - Sarah B Raines
- Department of Electrical Engineering, Texas A&M University, USA
| | - Sonya G Gordon
- Department of Small Animal Clinical Sciences of Veterinary Medicine and Biomedical Sciences, Texas A&M University, USA
| | - John C Criscione
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences of Veterinary Medicine and Biomedical Sciences, Texas A&M University, USA
| | - Scott Birch
- The Center for Educational Technologies, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, USA
| | - Bradley Due
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA
| | - Brandis Keller
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA
| | - Landon D Nash
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA
| | - Matthew W Miller
- Texas Institute for Preclinical Studies, Texas A&M University, MS 4478, College Station, TX 77845, USA
| | - Duncan J Maitland
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843, USA.
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Saunders A, Keefe L, Birch S, Wierzbicki M, Maitland D. Perceptions of transcatheter device closure of patent ductus arteriosus in veterinary cardiology and evaluation of a canine model to simulate device placement: a preliminary study. J Vet Cardiol 2017; 19:268-275. [DOI: 10.1016/j.jvc.2017.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/23/2017] [Accepted: 04/17/2017] [Indexed: 10/19/2022]
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Chetboul V, Damoiseaux C, Behr L, Morlet A, Moise N, Gouni V, Lavennes M, Pouchelon JL, Laborde F, Borenstein N. Intracardiac echocardiography: use during transcatheter device closure of a patent ductus arteriosus in a dog. J Vet Cardiol 2017; 19:293-298. [DOI: 10.1016/j.jvc.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
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Real-time 3D transesophageal echocardiography-guided closure of a complicated patent ductus arteriosus in a dog. J Vet Cardiol 2017; 19:287-292. [DOI: 10.1016/j.jvc.2017.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/07/2017] [Accepted: 04/17/2017] [Indexed: 11/24/2022]
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Chapel EC, Lozier J, Lakritz J, Schober KE. Interventional Closure of a Patent Ductus Arteriosus Using an Amplatz Canine Duct Occluder in an Alpaca Cria. J Vet Intern Med 2017; 31:1221-1224. [PMID: 28544057 PMCID: PMC5508309 DOI: 10.1111/jvim.14736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/24/2017] [Accepted: 04/12/2017] [Indexed: 02/01/2023] Open
Abstract
A 6‐month old female alpaca cria presented to The Ohio State University for evaluation of a cardiac murmur. Echocardiography revealed a left‐to‐right shunting patent ductus arteriosus, a restrictive left‐to‐right shunting perimembranous ventricular septal defect, and secondary moderate left atrial and ventricular dilation. Aortic root angiography demonstrated a type IIA patent ductus arteriosus (PDA). Interventional closure of the PDA was successfully performed, without complication, using an Amplatz canine duct occluder. This case report describes the materials and methods used for interventional closure of a PDA in an alpaca cria.
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Affiliation(s)
- E C Chapel
- College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - J Lozier
- College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - J Lakritz
- College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - K E Schober
- College of Veterinary Medicine, The Ohio State University, Columbus, OH
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Boutet BG, Saunders AB, Gordon SG. Clinical Characteristics of Adult Dogs More Than 5 Years of Age at Presentation for Patent Ductus Arteriosus. J Vet Intern Med 2017; 31:685-690. [PMID: 28370380 PMCID: PMC5435065 DOI: 10.1111/jvim.14689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 11/01/2016] [Accepted: 02/14/2017] [Indexed: 12/02/2022] Open
Abstract
Background The median age at presentation for dogs with patent ductus arteriosus (PDA) is <6 months of age, and closure is associated with a decrease in heart size and increased survival time, which are not well described in older dogs. Objectives To describe the clinical characteristics of dogs with PDA ≥5 years of age at the time of presentation to a veterinary referral hospital. Animals 35 client‐owned dogs. Methods Retrospective case series. Results PDA was diagnosed at a median age of 7.4 years (range, 5.1–12.3 years). Females represented 23/35 (65.7%) of the patients. Concurrent heart disease included degenerative mitral valve disease (DMVD; 13), arrhythmias (11), pulmonary hypertension (7), and other congenital defects (2). Cardiomegaly was documented in the majority of dogs consisting of left ventricular enlargement (91%) and left atrial enlargement (86%). Median vertebral heart size in 24 dogs was 12.9 (range, 10.7–18.2). The PDA shunt direction was left‐to‐right in 33 and bidirectional in 2 dogs. Closure was performed in 26 dogs, including 4 with pulmonary hypertension. In 10 dogs receiving furosemide pre‐operatively for management of heart failure, furosemide was discontinued (8) or the dosage decreased (2) at the time of discharge. Conclusions and Clinical Importance Adult dogs can present with a left‐to‐right shunting PDA that results in cardiomegaly and clinical signs that can improve or resolve with PDA closure. This improvement is also apparent in dogs with PDA complicated by DMVD. Pulmonary hypertension that does not result in complete right‐to‐left shunting should not be considered a contraindication to closure.
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Affiliation(s)
- B G Boutet
- Department of Small Animal Clinical Sciences and the Michael E. DeBakey Institute for Comparative Cardiovascular Sciences and Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - A B Saunders
- Department of Small Animal Clinical Sciences and the Michael E. DeBakey Institute for Comparative Cardiovascular Sciences and Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - S G Gordon
- Department of Small Animal Clinical Sciences and the Michael E. DeBakey Institute for Comparative Cardiovascular Sciences and Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
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Wierzbicki MA, Bryant J, Miller MW, Keller B, Maitland DJ. Mechanical and in vitro evaluation of an experimental canine patent ductus arteriosus occlusion device. J Mech Behav Biomed Mater 2016; 59:156-167. [PMID: 26766327 PMCID: PMC5821254 DOI: 10.1016/j.jmbbm.2015.12.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 12/10/2015] [Accepted: 12/14/2015] [Indexed: 11/30/2022]
Abstract
Patent ductus arteriosus (PDA) is a congenital cardiovascular malformation in which a fetal connection between the aorta and pulmonary artery remains patent after birth. This defect commonly results in clinical complications, even death, necessitating closure. Surgical ligation is the most common treatment but requires a thoracotomy and is therefore invasive. A minimally invasive option is preferable. A prototype device for PDA occlusion which utilizes shape memory polymer foams has been developed and evaluated using mechanical and in vitro experiments. Removal force and radial pressure measurements show that the prototype device exhibited a lower removal force and radial pressure than a commercially available device. The in vitro experiments conducted within simplified and physiological PDA models showed that the prototype does not migrate out of position into the pulmonary artery at either physiological or elevated pressures in multiple model configurations. While the radial pressure and removal force were lower than commercial devices, the device performed acceptably in the in vitro benchtop experiments warranting further prototype development.
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Affiliation(s)
- Mark A Wierzbicki
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Jesse Bryant
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Matthew W Miller
- Texas Institute for Preclinical Studies, Texas A&M University, College Station, TX, USA
| | - Brandis Keller
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA
| | - Duncan J Maitland
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, USA.
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Stauthammer CD, Olson J, Leeder D, Hohnadel K, Hanson M, Tobias AH. Patent ductus arteriosus occlusion in small dogs utilizing a low profile Amplatz® canine duct occluder prototype. J Vet Cardiol 2015; 17:203-9. [PMID: 26363940 DOI: 10.1016/j.jvc.2015.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 04/20/2015] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To develop procedural methodology and assess the safety, utility and effectiveness of a low profile Amplatz(®) canine duct occluder (ACDO) prototype in dogs deemed too small to undergo ductal occlusion with the commercially-available ACDO device. ANIMALS Twenty-one dogs with left-to-right shunting patent ductus arteriosus (PDA). Dogs were ≥1.5 kg but considered too small to accommodate a 6 Fr catheter or 4 Fr sheath within the femoral artery. METHODS Prospective canine study using a low profile ACDO prototype delivered through a 4 Fr catheter via a femoral arterial approach. Procedural methods, fluoroscopy time, perioperative complications, and residual ductal flow were evaluated, and angiographic ductal morphology and dimensions were tabulated. RESULTS All 21 dogs underwent successful ductal occlusion using the prototype device, 4 Fr catheter, and right femoral artery approach. No perioperative complications or device embolization occurred. The median minimal ductal diameter was 1.9 mm (range, 0.4-3.4), and the median device size deployed was 4 mm (range, 3-6). Complete ductal occlusion was noted in 17 dogs (81%) on post-deployment angiography. Twenty dogs (95%) had no residual flow on echocardiography performed the following day. In the 17 dogs (81%) that returned for a long-term (≥3months) follow-up evaluation, all had complete ductal occlusion based on echocardiography. CONCLUSIONS The low profile ACDO prototype is a safe and effective method of PDA occlusion in the small dog. The deployment procedure appears of similar technical difficulty to the commercially available ACDO.
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Affiliation(s)
- Christopher D Stauthammer
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA.
| | - Janet Olson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Damon Leeder
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Kristin Hohnadel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Melissa Hanson
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
| | - Anthony H Tobias
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, MN, USA
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Jeong D, Kang M, Lee C, Kim S, Min S, Hahn T, Park H. Use of Amplatz® canine duct occluder for closing a patent ductus arteriosus in a small-sized dog. J Biomed Res 2014. [DOI: 10.12729/jbr.2014.15.3.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Porciello F, Caivano D, Giorgi ME, Knafelz P, Rishniw M, Moise NS, Bufalari A, Fruganti A, Birettoni F. Transesophageal echocardiography as the sole guidance for occlusion of patent ductus arteriosus using a canine ductal occluder in dogs. J Vet Intern Med 2014; 28:1504-12. [PMID: 25041218 PMCID: PMC4895578 DOI: 10.1111/jvim.12401] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 04/14/2014] [Accepted: 05/29/2014] [Indexed: 11/29/2022] Open
Abstract
Background Transcatheter occlusion of patent ductus arteriosus (PDA) is usually performed by fluoroscopy alone or together with transesophageal echocardiography (TEE). Transthoracic echocardiography (TTE) guidance has been used for deployment of Amplatz Canine Ductal Occluder (ACDO), but sometimes is limited by suboptimal acoustic windows. Transesophageal echocardiography can overcome such issues and provides higher image resolution at the level of the great vessels. Objectives To determine if TEE without fluoroscopy could be used to successfully perform ductal occlusion for the treatment of PDA in dogs. Animals Twenty client‐owned dogs with PDA. Methods A prospective consecutive case series of PDA occlusion was performed using only TEE guidance. Dogs were positioned in right lateral recumbency and the TEE probe was positioned to visualize the descending aorta, PDA, and pulmonary artery. The guide wire, long introducer sheath, and ACDO were imaged by TEE to direct deployment. Results Ductal occlusion was performed successfully without need for fluoroscopy and without complications in 19 dogs. One dog required a second larger ACDO because of embolization of the first device 18 hours after positioning. Conclusions and Clinical Importance We have demonstrated that TEE monitoring without concurrent fluoroscopy can guide each step of transcatheter ACDO embolization thereby providing an alternate method of visualization for this procedure. Use of TEE alone can reduce radiation exposure or is an option when fluoroscopy is not available, and, therefore, should be evaluated in a larger case series to better assess procedural failure rates.
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Affiliation(s)
- F Porciello
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
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Using technology to find the secret places of the heart. Vet J 2014; 200:216-7. [DOI: 10.1016/j.tvjl.2014.02.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/18/2014] [Accepted: 02/20/2014] [Indexed: 11/19/2022]
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Hou CJ, Zhang DZ, Wang QG, Cui CS, Kuang L, Chen B, Wang Y. Promotion of artery occlusion in dogs by percutaneous rotational atherectomy. Ann Vasc Surg 2014; 28:1306-11. [PMID: 24560823 DOI: 10.1016/j.avsg.2014.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study aims to offer experimental data and indirect evidences for the application of percutaneous rotational atherectomy to treat patent ductus arteriosus (PDA). METHODS Eleven dogs (6 male dogs and 5 female dogs; aged 14-20 months, with an average of 16.7±3.2 months; weight 20-25 kg, with an average of 22.7±2.5 kg) were enrolled in this study. The diameters of the left and right arteries ranged from 3.2 to 4.8 mm (average 3.9±0.6 mm) on percutaneous angiography. Percutaneous rotational atherectomy with proper rotablator (the size was 1-1.5 mm larger than the artery diameter) was performed in the arterial intima. After 4 weeks from percutaneous rotational atherectomy, arteriography was conducted to observe the changes in artery diameter. Then all dogs were sacrificed and the pathologic examination was conducted on the left and right axillary arteries. RESULTS There were obvious changes with different degrees in 22 arteries, including 8 arteries with complete occlusion and 12 arteries with stenosis (≥2/3, 1/2, and 1/3 stenosis in 4, 4, and 4 arteries, respectively). The occlusion rate was 36.4% and the total effective rate was 90.9%. It was considered failure in other 2 arteries with <1/3 of stenosis. CONCLUSIONS Percutaneous rotational atherectomy of arterial intima can promote the occlusion of arteries. This has provided a new choice for the treatment of PDA.
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Affiliation(s)
- Chuan-Ju Hou
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China.
| | - Duan-Zhen Zhang
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China
| | - Qi-Guang Wang
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China
| | - Chun-Sheng Cui
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China
| | - Li Kuang
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China
| | - Bing Chen
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China
| | - Yang Wang
- Department of Congenital Heart Disease, Cardiovascular Research Institute of PLA, General Hospital of Shenyang Military Command, Shenyang, China
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Carlson JA, Achen SA, Saunders AB, Gordon SG, Miller MW. Delayed embolization of an Amplatz® canine duct occluder in a dog. J Vet Cardiol 2013; 15:271-6. [DOI: 10.1016/j.jvc.2013.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 08/07/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
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Silva J, Domenech O, Mavropoulou A, Oliveira P, Locatelli C, Bussadori C. Transesophageal Echocardiography Guided Patent Ductus Arteriosus Occlusion with a Duct Occluder. J Vet Intern Med 2013; 27:1463-70. [DOI: 10.1111/jvim.12201] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/10/2013] [Accepted: 08/21/2013] [Indexed: 12/01/2022] Open
Affiliation(s)
- J. Silva
- Department of Cardiology; Clinica Veterinaria Gran Sasso; Milan Italy
| | - O. Domenech
- Istituto Veterinario di Novara; Granozzo con Monticello Italy
| | - A. Mavropoulou
- Department of Cardiology; Clinica Veterinaria Gran Sasso; Milan Italy
| | - P. Oliveira
- Davies Veterinary Specialists; Higham Gobion UK
| | - C. Locatelli
- Dipartimento di Scienze Veterinarie e Sanità Pubblica; Facoltà di Medicina Veterinaria; Università degli studi di Milano; Milan Italy
| | - C. Bussadori
- Department of Cardiology; Clinica Veterinaria Gran Sasso; Milan Italy
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Hariu CD, Saunders AB, Gordon SG, Norby B, Miller MW. Utility of N-terminal pro-brain natriuretic peptide for assessing hemodynamic significance of patent ductus arteriosus in dogs undergoing ductal repair. J Vet Cardiol 2013; 15:197-204. [DOI: 10.1016/j.jvc.2013.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 02/06/2013] [Accepted: 02/26/2013] [Indexed: 10/26/2022]
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