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Markovic L, Scansen B, Ames M, Coleman A. Transcatheter closure of patent ductus arteriosus in 11 dogs and one cat after incomplete or aborted surgical ligation. J Vet Cardiol 2021; 41:1-10. [DOI: 10.1016/j.jvc.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
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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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Abstract
There remain areas of uncertainty in optimal technique, preferred candidates, and expected outcome for small animal patients undergoing cardiac intervention. This article highlights issues within interventional cardiology that are in need of study and offers the author's opinion and experience on topics such as variants of pulmonary valve anatomy and alternatives to conventional balloon dilation for pulmonary valve stenosis, patient selection for cutting or high-pressure balloon dilation of aortic valvar or subaortic stenosis, occlusion of patent ductus arteriosus in very small dogs, ductal stenting in conditions with reduced pulmonary blood flow, and alternative considerations for vascular access and closure.
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Lee Y, Jung J, Park J, Jeong J, Jeon S, Park S, Chang J, Kang JH, Lee C, Chang D. CARDIAC MAGNETIC RESONANCE IMAGING OF PATENT DUCTUS ARTERIOSUS IN THREE DOGS. Vet Radiol Ultrasound 2016; 58:62-75. [DOI: 10.1111/vru.12446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 09/13/2016] [Indexed: 01/20/2023] Open
Affiliation(s)
- Youngjae Lee
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jaihyun Jung
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Junyong Park
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jiyoon Jeong
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Seokho Jeon
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Sunyoung Park
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Jinhwa Chang
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Ji-Houn Kang
- Laboratory of Veterinary Internal Medicine; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
| | - Chulhyun Lee
- Bioimaging Research Team; Korea Basic Science Institute; Cheongju Korea
| | - Dongwoo Chang
- Section of Medical Imaging; Veterinary Medical Center, College of Veterinary Medicine; Chungbuk National University; Cheongju Korea
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Selmic LE, Nelson DA, Saunders AB, Hobson HP, Saunders WB. An Intrapericardial Technique for PDA Ligation: Surgical Description and Clinical Outcome in 35 Dogs. J Am Anim Hosp Assoc 2013; 49:31-40. [DOI: 10.5326/jaaha-ms-5838] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A number of surgical techniques have been reported for dissection and ligation of patent ductus arteriosi (PDAs) in dogs. The objectives of this study were to provide a detailed description of an intrapericardial technique for PDA dissection and ligation and to report the clinical outcome of that technique in dogs. Medical records of 35 dogs were retrospectively reviewed for signalment, clinical signs, echocardiographic findings, surgical time, intra- and postoperative complications, and completeness of ductal closure. Median surgery time was 60 min (range, 35–125 min). Neither intraoperative nor postoperative complications occurred. Within 48 hr of surgery, the continuous left basilar heart murmur was absent in all dogs, and complete echocardiographic closure was confirmed in 29 of 32 dogs. Residual flow was identified echocardiographically in three dogs within 48 hr of surgery. Residual flow was decreased in one dog at 1 mo, which resolved within 33 mo. One dog had mild residual flow postoperatively but did not return for follow-up. The intrapericardial technique was successful for PDA dissection and ligation and had a lower rate (6%) of echocardiographic residual flow compared with previously reported techniques.
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Affiliation(s)
- Laura E. Selmic
- Department of Clinical Sciences, Animal Cancer Center, Colorado State University, Fort Collins, CO (L.S.); and Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (D.N., A.S., H.H., W.S.)
| | - David A. Nelson
- Department of Clinical Sciences, Animal Cancer Center, Colorado State University, Fort Collins, CO (L.S.); and Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (D.N., A.S., H.H., W.S.)
| | - Ashley B. Saunders
- Department of Clinical Sciences, Animal Cancer Center, Colorado State University, Fort Collins, CO (L.S.); and Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (D.N., A.S., H.H., W.S.)
| | - H. Phil Hobson
- Department of Clinical Sciences, Animal Cancer Center, Colorado State University, Fort Collins, CO (L.S.); and Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (D.N., A.S., H.H., W.S.)
| | - W. Brian Saunders
- Department of Clinical Sciences, Animal Cancer Center, Colorado State University, Fort Collins, CO (L.S.); and Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (D.N., A.S., H.H., W.S.)
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Singh MK, Kittleson MD, Kass PH, Griffiths LG. Occlusion Devices and Approaches in Canine Patent Ductus Arteriosus: Comparison of Outcomes. J Vet Intern Med 2011; 26:85-92. [DOI: 10.1111/j.1939-1676.2011.00859.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 10/13/2011] [Accepted: 11/17/2011] [Indexed: 10/14/2022] Open
Affiliation(s)
- M. K. Singh
- William R. Pritchard Veterinary Medical Teaching Hospital
| | | | - P. H. Kass
- Department of Population Health and Reproduction (Kass); University of California; Davis; CA
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Henjes CR, Nolte I, Wefstaedt P. Multidetector-row computed tomography of thoracic aortic anomalies in dogs and cats: patent ductus arteriosus and vascular rings. BMC Vet Res 2011; 7:57. [PMID: 21943366 PMCID: PMC3186751 DOI: 10.1186/1746-6148-7-57] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 09/23/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT) was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography. RESULTS Electrocardiography (ECG)-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats. CONCLUSIONS Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional information can be of help with regard to improved diagnoses of thoracic anomalies and the planning of surgical interventions.
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Affiliation(s)
- Christiane R Henjes
- Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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Henrich E, Hildebrandt N, Schneider C, Hassdenteufel E, Schneider M. Transvenous Coil Embolization of Patent Ductus Arteriosus in Small (≤3.0 kg) Dogs. J Vet Intern Med 2010; 25:65-70. [DOI: 10.1111/j.1939-1676.2010.0637.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tobias AH, Stauthammer CD. Minimally invasive per-catheter occlusion and dilation procedures for congenital cardiovascular abnormalities in dogs. Vet Clin North Am Small Anim Pract 2010; 40:581-603. [PMID: 20610013 DOI: 10.1016/j.cvsm.2010.03.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
With ever-increasing sophistication of veterinary cardiology, minimally invasive per-catheter occlusion and dilation procedures for the treatment of various congenital cardiovascular abnormalities in dogs have become not only available, but mainstream. Much new information about minimally invasive per-catheter patent ductus arteriosus occlusion has been published and presented during the past few years. Consequently, patent ductus arteriosus occlusion is the primary focus of this article. Occlusion of other less common congenital cardiac defects is also briefly reviewed. Balloon dilation of pulmonic stenosis, as well as other congenital obstructive cardiovascular abnormalities is discussed in the latter part of the article.
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Affiliation(s)
- Anthony H Tobias
- Veterinary Clinical Sciences Department, University of Minnesota, St Paul, MN 55108, USA.
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Hildebrandt N, Schneider C, Schweigl T, Schneider M. Long-Term Follow-Up after Transvenous Single Coil Embolization of Patent Ductus Arteriosus in Dogs. J Vet Intern Med 2010; 24:1400-6. [DOI: 10.1111/j.1939-1676.2010.0605.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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11
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Saunders A, Achen S, Gordon S, Miller M. Utility of Transesophageal Echocardiography for Transcatheter Occlusion of Patent Ductus Arteriosus in Dogs: Influence on the Decision-Making Process. J Vet Intern Med 2010; 24:1407-13. [DOI: 10.1111/j.1939-1676.2010.0587.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Gordon SG, Saunders AB, Achen SE, Roland RM, Drourr LT, Hariu C, Miller MW. Transarterial ductal occlusion using the Amplatz® Canine Duct Occluder in 40 dogs. J Vet Cardiol 2010; 12:85-92. [DOI: 10.1016/j.jvc.2010.04.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 04/12/2010] [Accepted: 04/18/2010] [Indexed: 10/19/2022]
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13
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Transvenous occlusion of patent ductus arteriosus in 56 consecutive dogs. J Vet Cardiol 2010; 12:75-84. [DOI: 10.1016/j.jvc.2010.04.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 03/29/2010] [Accepted: 04/14/2010] [Indexed: 11/24/2022]
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Transthoracic echocardiographic guidance of patent ductus arteriosus occlusion with an Amplatz® canine duct occluder. Res Vet Sci 2010; 90:359-62. [PMID: 20646727 DOI: 10.1016/j.rvsc.2010.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 05/06/2010] [Accepted: 05/23/2010] [Indexed: 11/20/2022]
Abstract
Placement of an Amplatz canine duct occluder (ACDO) is usually performed by fluoroscopy (Nguyenba and Tobias, 2007). The latter technical approach presents limitations, mostly due to radiation exposure, making this practice dangerous for the patient and operators. In this study, we describe the successful placement of an Amplatz Canine Duct Occluder device by using transthoracic echocardiographic (TTE) guidance, performed on an 11-month-old female mongrel dog with a grade VI/VI continuous heart murmur diagnosed with patent ductus arteriosus (PDA). The TTE is useful in eliminating exposure to radiation and is more versatile than fluoroscopy in conveying real-time detailed information concerning the position of the ACDO.
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Griffiths LG. Surgery for Cardiac Disease in Small Animals: Current Techniques. Vet Clin North Am Small Anim Pract 2010; 40:605-22. [DOI: 10.1016/j.cvsm.2010.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Miller SJ, Thomas WP. Coil embolization of patent ductus arteriosus via the carotid artery in seven dogs. J Vet Cardiol 2009; 11:129-36. [DOI: 10.1016/j.jvc.2009.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2009] [Revised: 08/16/2009] [Accepted: 09/01/2009] [Indexed: 10/20/2022]
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Nguyenba TP, Tobias AH. The Amplatz canine duct occluder: a novel device for patent ductus arteriosus occlusion. J Vet Cardiol 2007; 9:109-17. [PMID: 18054306 DOI: 10.1016/j.jvc.2007.09.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 09/11/2007] [Accepted: 09/27/2007] [Indexed: 11/16/2022]
Abstract
The Amplatz canine duct occluder (ACDO) is a nitinol mesh device with a short waist that separates a flat distal disc from a cupped proximal disc. The device is designed to conform to the morphology of the canine patent ductus arteriosus (PDA). PDA dimensions are determined by angiography, and a guiding catheter is advanced into the main pulmonary artery via the aorta and PDA. An ACDO with a waist diameter approximately twice the angiographic minimal ductal diameter (MDD) is advanced via the catheter using an attached delivery cable until the flat distal disc deploys within the main pulmonary artery. The partially deployed ACDO, guiding catheter, and delivery cable are retracted until the distal disc engages the pulmonic ostium of the PDA. With the delivery cable stabilized, the catheter is retracted to deploy the waist across the pulmonic ostium and cupped proximal disc within the ductal ampulla. Tension on the delivery cable is released, and correct ACDO positioning and stability are confirmed by observing that the device assumes its native shape, back-and-forth maneuvering of the delivery cable, and a small contrast injection made through the guiding catheter. The delivery cable is detached and removed with the guiding catheter. To assess for any residual ductal flow, an angiogram is performed at the conclusion of the procedure, followed by Doppler echocardiography at 1 day and 3 months post-procedure. PDA occlusion in dogs with the ACDO is straightforward and extremely effective across a wide range of body weights, somatotypes, MDDs, and ductal morphologies.
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Affiliation(s)
- Thaibinh P Nguyenba
- Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN 55108, USA.
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Lee SG, Hyun C. Retrieval of an embolization coil accidentally dislodged in the descending aorta of a dog with a patent ductus arteriosus. J Vet Sci 2007; 8:205-7. [PMID: 17519578 PMCID: PMC2872723 DOI: 10.4142/jvs.2007.8.2.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 3.5-year-old intact female miniature poodle (weighing 2.7 kg) was referred to the Veterinary Teaching Hospital at Kangwon National University, because of inadvertent aortic embolization, by an occlusion coil used for the closure of patent ductus arteriosus (PDA). The coil was found at the site of the branching renal arteries in the abdominal aorta. A foreign body forceps with a three-wire nail tip was used, with fluoroscopic guidance, to retrieve the coil. After the removal, the dog was treated with heparin to prevent thromboembolization.
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Affiliation(s)
- Seung Gon Lee
- Section of Small Animal Internal Medicine, School of Veterinary Medicine, Kangwon National University, Chuncheon 200-701, Korea
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Saunders AB, Miller MW, Gordon SG, Bahr A. Echocardiographic and Angiographic Comparison of Ductal Dimensions in Dogs with Patent Ductus Arteriosus. J Vet Intern Med 2007. [DOI: 10.1111/j.1939-1676.2007.tb02930.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Hogan DF, Green HW, Sanders RA. Transcatheter closure of patent ductus arteriosus in a dog with a peripheral vascular occlusion device. J Vet Cardiol 2006; 8:139-43. [PMID: 19083347 DOI: 10.1016/j.jvc.2005.12.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2005] [Revised: 12/23/2005] [Accepted: 12/24/2005] [Indexed: 11/26/2022]
Abstract
A 4-month-old, intact female mixed-breed dog presented to the Purdue University Veterinary Teaching Hospital for evaluation of a cardiac murmur. A large left-to-right patent ductus arteriosus (PDA) was diagnosed and interventional correction was achieved with a commercially available peripheral vascular occlusion device (VOD). The VOD is composed of a nitinol wire mesh and is similar in composition and shape to a commercially available human PDA occluder, however, it can be deployed through smaller delivery catheters and is much less expensive. The product and procedural details of the device are described.
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Affiliation(s)
- Daniel F Hogan
- Purdue University, School of Veterinary Medicine, Department of Veterinary Clinical Sciences, Lynn Hall, 625 Harrison Street, West Lafayette, IN 47907-2026, USA
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Szatmári V, Stokhof AA. Use of simultaneous fluoroscopic and echocardiographic guidance during transarterial coil placement for embolization of patent ductus arteriosus in dogs. J Am Vet Med Assoc 2006; 228:881-4. [PMID: 16536698 DOI: 10.2460/javma.228.6.881] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use of simultaneous fluoroscopic and transthoracic echocardiographic guidance during transarterial coil placement for embolization of patent ductus arteriosus (PDA) in dogs. DESIGN Descriptive report. ANIMALS 3 dogs with PDA. PROCEDURE Each dog was anesthetized, and a femoral artery was exposed for vascular access. By use of an introducer, a catheter was placed in the thoracic portion of the descending aorta with fluoroscopic guidance, and subsequently, a bolus of iodinated radiographic contrast material was injected to outline the ductus. Under fluoroscopic guidance, 1 coil was positioned in the ductus, but not released. Transthoracic echocardiography was used to ensure that 1 loop of the coil was located in the pulmonary artery. When > 1 loop or no loops were detected in the pulmonary artery, the coil was retrieved and repositioned; when 1 loop of the coil was detected in the pulmonary artery, the coil was detached. After catheter removal, the femoral artery was ligated and the wound was closed. RESULTS In all 3 dogs, successful embolization of the PDA was achieved. Echocardiography prevented unintentional pulmonary artery embolization in 1 dog and suboptimal coil placement in the other 2 dogs. CONCLUSIONS AND CLINICAL RELEVANCE In addition to fluoroscopic control, transthoracic echocardiography appears to aid the appropriate positioning of a transarterial coil for treatment of PDA in dogs. Although transesophageal echocardiography would likely provide better images of the ductus, transthoracic echocardiography is a much cheaper, less specialized, and more widely available alternative.
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Affiliation(s)
- Viktor Szatmári
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 8, 3584 CM Utrecht, The Netherlands
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Campbell F, Thomas W, Miller S, Berger D, Kittleson M. Immediate and Late Outcomes of Transarterial Coil Occlusion of Patent Ductus Arteriosus in Dogs. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb02827.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Gordon SG, Miller MW. Transarterial coil embolization for canine patent ductus arteriosus occlusion. ACTA ACUST UNITED AC 2005; 20:196-202. [PMID: 16180402 DOI: 10.1053/j.ctsap.2005.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Left to right shunting patent ductus arteriosus (PDA) is the most common canine congenital heart defect. If not occluded PDA is associated with high morbidity and mortality. Historically, surgical ligation has been the standard method of correction. Although highly successful, surgical ligation is associated with some operative morbidity and mortality. More recently, minimally invasive transcatheter techniques have been employed for PDA occlusion. Transarterial PDA coil embolization is a safe, cost effective, less invasive alternative offered by many specialty centers for PDA occlusion. This procedure involves catheterization of the femoral artery under general anesthesia. An angiogram is then performed to delineate PDA morphology and facilitate coil selection. Coils are commercially available and composed of surgical stainless steel with prothrombotic poly-Dacron fibers. Coils are advanced through a catheter into the PDA under fluoroscopic guidance until satisfactory angiographic occlusion is documented. Patients are then recovered and released the following day. This procedure requires substantial technical expertise and specialized equipment.
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Affiliation(s)
- S G Gordon
- Department of Small Animal Clinical Science, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4474, USA.
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Saunders AB, Miller MW, Gordon SG, Bahr A. Pulmonary Embolization of Vascular Occlusion Coils in Dogs with Patent Ductus Arteriosus. J Vet Intern Med 2004. [DOI: 10.1111/j.1939-1676.2004.tb02603.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Hogan DF, III HWG, Gordon S, Miller MW. Transarterial Coil Embolization of Patent Ductus Arteriosus in Small Dogs with 0.025-Inch Vascular Occlusion Coils: 10 Cases. J Vet Intern Med 2004. [DOI: 10.1111/j.1939-1676.2004.tb02553.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abstract
Postocclusion survival data from dogs with left-to-right shunting patent ductus arteriosus (PDA) was available from 80 dogs, diagnosed from 1990 to 2000. Of these, 37 had undergone a procedure to close the ductus and were re-evaluated at the time of this study; clinical data from the follow-up examination was compared with that from the original examination. Radiographically, the right ventricle remained apparently enlarged, and the aortic bulge associated with dilation of the descending aorta did not disappear after closure. On M-mode echocardiography, left ventricular chamber diameter in diastole and systole and left ventricular posterior wall in systole decreased significantly. Mitral endocardiosis was a common feature. Residual flow was evident in 46 per cent of the animals. Late closure occurred in 8 per cent of the dogs, and trivial recanalisation in 19 per cent. The maximum survival time postclosure was 168 months and, after non-occlusion, 114 months, suggesting that dogs with PDA follow an unpredictable course. However, there was a significant difference in survival times between the corrected and non-corrected group.
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Affiliation(s)
- N Van Israël
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, Edinburgh University, Roslin EH25 9RG
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Percutaneous angiography of Patent Ductus Arteriosus in dogs: techniques, results and implications for intravascular occlusion. J Vet Cardiol 2003; 5:21-7. [DOI: 10.1016/s1760-2734(06)70048-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Glaus TM, Martin M, Boller M, Stafford Johnson M, Kutter A, Flückiger M, Tofeig M. Catheter closure of patent ductus arteriosus in dogs: variation in ductal size requires different techniques. J Vet Cardiol 2003; 5:7-12. [DOI: 10.1016/s1760-2734(06)70039-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stanley BJ, Luis-Fuentes V, Darke PGG. Comparison of the incidence of residual shunting between two surgical techniques used for ligation of patent ductus arteriosus in the dog. Vet Surg 2003; 32:231-7. [PMID: 12784199 DOI: 10.1053/jvet.2003.50025] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To compare the incidence of residual patent ductus arteriosus (PDA) flow after ligation using 2 different dissection techniques: a standard dissection and a method described by Jackson and Henderson. STUDY DESIGN A randomized, prospective study. ANIMALS Thirty-five dogs admitted for surgical correction of a left to right shunting PDA. METHODS Dogs were randomly assigned: 19 to a standard dissection technique (group S) and 16 to the Jackson and Henderson dissection group (group JH). RESULTS Gender ratio, age at surgery, and diameter of the ductus were not statistically different between groups. Breed distribution was also similar. Because 1 dog had fatal intraoperative hemorrhage, only 34 dogs were available for residual flow comparisons. Twenty-one percent of group S dogs had residual flow compared with 53% in group JH. Whereas no intraoperative complications occurred in group S, 3 were encountered in group JH. CONCLUSIONS The incidence of residual flow was higher when the Jackson and Henderson dissection was used for PDA ligation compared with a standard method of dissection. This was probably because of entrapment of loose connective tissue within the medial aspect of the ligature, impeding complete closure of the ductus. CLINICAL RELEVANCE Ideal PDA closure should result in no residual ductal flow to prevent possible adverse long-term sequelae, such as recanalization and infective endocarditis.
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Affiliation(s)
- Bryden J Stanley
- Department of Clinical Veterinary Studies, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Edinburgh, Scotland
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Schneider M, Hildebrandt N. Transvenous Embolization of the Patent Ductus Arteriosus with Detachable Coils in 2 Cats. J Vet Intern Med 2003. [DOI: 10.1111/j.1939-1676.2003.tb02460.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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31
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Van Israël N, French AT, Dukes-McEwan J, Welsh EM. Patent Ductus Arteriosus in the older Dog. J Vet Cardiol 2003; 5:13-21. [DOI: 10.1016/s1760-2734(06)70040-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Glaus TM, Berger F, Ammann FW, Klowski W, Ohlert S, Boller M, Kästner S, Reusch CE, Sisson D. Closure of large patent ductus arteriosus with a self-expanding duct occluder in two dogs. J Small Anim Pract 2002; 43:547-50. [PMID: 12489744 DOI: 10.1111/j.1748-5827.2002.tb00029.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Of the different catheterisation methods described for closure of patent ductus arteriosus (PDA), coil embolisation is most commonly used in dogs. However, for a PDA larger than 4 to 5 mm in diameter, coil implantation is difficult. For these cases, the Amplatzer duct occluder (ADO) offers an alternative method. This report describes the successful implantation of an ADO in two dogs with large PDAs of approximately 6 mm diameter. The self-expandible device attached to an implantation wire was advanced through a long sheath antegrade to the femoral vein through the right heart and pulmonary artery to the duct and delivered into the PDA. Thereafter the device was released by unscrewing it from the delivery cable. The large PDA in both dogs was totally occluded by these means without any residual shunt. Thus, the ADO is a controlled release implant that also allows occlusion of a large PDA. Its high costs limit its general use in veterinary medicine at the present time.
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Affiliation(s)
- T M Glaus
- Division of Cardiology, Veterinary Hospital, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
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Percutaneous catheter-based treatment of pulmonic stenosis and patent ductus arteriosus in a dog. J Vet Cardiol 2002; 4:29-34. [DOI: 10.1016/s1760-2734(06)70036-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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34
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Van Israël N, French AT, Dukes-McEwan J, Corcoran BM. Review of left-to-right shunting patent ductus arteriosus and short term outcome in 98 dogs. J Small Anim Pract 2002; 43:395-400. [PMID: 12238504 DOI: 10.1111/j.1748-5827.2002.tb00090.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The case records of 98 dogs with a left-to-right shunting patent ductus arteriosus (PDA) were reviewed. There were 35 breeds represented, with a female to male ratio of 3:1. Forty per cent of the dogs were older than one year at initial presentation and 31 per cent had clinical signs attributable to PDA. A left heart base continuous murmur of grade IV/VI or higher was noted in 90 per cent of the dogs. On electrocardiography, the most common abnormalities were tall R waves (63 per cent) and deep QII waves (62 per cent). The radiographic triad of dilation of the descending aorta with enlargement of the main pulmonary artery segment and left atrium, typical of PDA, was noted in only 26 per cent of cases. Two-dimensional (2D) and M-mode echocardiography detected left atrial enlargement (35 per cent) and an increased left ventricular diameter in diastole (82 per cent) and systole (84 per cent) as the most common abnormalities. Doppler echocardiography demonstrated increased aortic outflow velocities in 66 per cent of cases. The overall short-term successful outcome in this study was 95 per cent. There was no significant difference between surgical ductal ligation using a standard technique or the Jackson-Henderson technique in terms of survival, occurrence of haemorrhage or residual shunting. The number of interventional procedures used in this study was too low for statistical comparison, but there appeared to be a trend towards a higher rate of residual shunting and a lower fatality rate using a coil occlusion technique.
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Affiliation(s)
- N Van Israël
- Hospital for Small Animals, Royal (Dick) School of Veterinary Studies, Edinburgh University, Roslin
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van Israél N, French AT. Retrieval of a patent ductus arteriosus coil following embolisation to the right subclavian artery. J Small Anim Pract 2002; 43:136-8. [PMID: 11916059 DOI: 10.1111/j.1748-5827.2002.tb00045.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A two-month-old female Tibetan terrier was re-presented with an incomplete closure of the patent ductus arteriosus. Following a second attempt to close the shunt by coil embolisation, arterial embolisation occurred. The successful removal of the embolised coil is described.
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Affiliation(s)
- N van Israél
- Hospital for Small Animals, Easter Bush Veterinary Centre, Royal (Dick) School of Veterinary Studies, Edinburgh University, Roslin, Midlothian
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Schneider M, Hildebrandt N, Schweigl T, Schneider I, Hagel KH, Neu H. Transvenous Embolization of Small Patent Ductus Arteriosus with Single Detachable Coils in Dogs. J Vet Intern Med 2001. [DOI: 10.1111/j.1939-1676.2001.tb02315.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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