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Parisi C, Phillips V, Ferreira J, Linney C, Mair A. Anaesthetic management and complications of transvascular patent ductus arteriosus occlusion in dogs. Vet Anaesth Analg 2020; 47:581-587. [PMID: 32792269 DOI: 10.1016/j.vaa.2020.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/12/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To retrospectively analyse the anaesthetic management, complications and haemodynamic changes in a cohort of dogs undergoing transvascular patent ductus arteriosus (PDA) occlusion in a tertiary referral centre (from January 2017 to August 2018). STUDY DESIGN Retrospective study. ANIMALS A total of 49 client-owned dogs. METHODS Anaesthetic records of dogs with PDA that underwent transvascular occlusion of the ductus were reviewed. Anaesthetic complications evaluated included tachycardia [heart rate (HR) > 160 beats minute-1], bradycardia (HR < 50 beats minute-1), hypertension [systolic arterial pressure (SAP) > 150 mmHg], hypotension [mean arterial pressure (MAP) < 60 mmHg], hypothermia (<37 °C) and the presence of arrhythmias. Cardiovascular variables [HR and invasive SAP, MAP and diastolic arterial pressure (DAP)] at the time of occlusion device deployment (time 0) were compared with variables at 5 and 10 minutes after deployment. Descriptive statistics, Shapiro-Wilk test and repeated measures analysis of variance followed by a Dunnett's post hoc test were used to analyse the data (p < 0.05). RESULTS Crossbreed dogs were the most commonly represented followed by the Cavalier King Charles Spaniel. The median age was 8 (2-108) months, and female dogs were over-represented (65.3%). The most common American Society of Anesthesiologists score was III. Mean duration of anaesthesia was 96 ± 26 minutes and mean surgery time was 58 ± 21 minutes. Acepromazine with methadone was the most commonly used premedication combination (77.6%). Propofol was the most common induction agent (73.5%). General anaesthesia was maintained with isoflurane in oxygen in all dogs. Complications included hypotension (63%), hypothermia (34%), bradycardia (28%), arrhythmias (16%), hypertension (16%) and haemorrhage (2%). MAP and DAP increased significantly 10 minutes after device deployment compared with time 0. CONCLUSIONS and clinical relevance: Hypotension was the most common complication reported in dogs undergoing transvascular PDA occlusion. No major adverse events were documented.
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Affiliation(s)
- Carmelo Parisi
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | | | | | - Chris Linney
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - Alastair Mair
- Willows Veterinary Centre and Referral Service, Solihull, 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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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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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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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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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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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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Achen S, Miller M, Gordon S, Saunders A, Roland R, Drourr L. Transarterial Ductal Occlusion with the Amplatzer Vascular Plug in 31 Dogs. J Vet Intern Med 2008; 22:1348-52. [DOI: 10.1111/j.1939-1676.2008.0185.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Culp WTN, Weisse C, Berent AC, Getman LM, Schaer TP, Solomon JA. Percutaneous endovascular retrieval of an intravascular foreign body in five dogs, a goat, and a horse. J Am Vet Med Assoc 2008; 232:1850-6. [PMID: 18598155 DOI: 10.2460/javma.232.12.1850] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION-5 Dogs, 1 goat, and 1 horse underwent percutaneous endovascular retrieval of intravascular foreign bodies between 2002 and 2007. CLINICAL FINDINGS-Foreign bodies were IV catheters in 4 dogs, the horse, and the goat and a piece of a balloon valvuloplasty catheter in 1 dog. Location of the foreign bodies included the main pulmonary artery (1 dog), a branch of a pulmonary artery (4 dogs), the right ventricle (the goat), and a jugular vein (the horse). TREATMENT AND OUTCOME-The procedure of percutaneous endovascular retrieval of the foreign body was easy to perform in all instances. One dog was euthanized 41 days after retrieval because of worsening of another disease process, and 1 dog had abnormal neurologic signs secondary to a brain mass. All other animals were clinically normal during the follow-up period (follow-up duration, 3 to 57 months). None of the animals developed long-term complications secondary to the foreign body retrieval procedure. CLINICAL RELEVANCE-Intravascular foreign bodies that result from catheters or devices used during minimally invasive techniques are rare but may cause substantial morbidity. Percutaneous endovascular retrieval of intravascular foreign bodies was easily and safely performed in the 7 animals reported here. Use of percutaneous endovascular retrieval techniques should be considered for treatment of animals with intravascular foreign bodies because morbidity can be substantially decreased; however, proper selection of patients for the procedure is necessary.
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Affiliation(s)
- William T N Culp
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Tanaka R, Soda A, Saida Y, Sugihara K, Takashima K, Shibazaki A, Yamane Y. Evaluation of the efficacy and safety of coil occlusion for patent ductus arteriosus in dogs. J Vet Med Sci 2007; 69:857-9. [PMID: 17827897 DOI: 10.1292/jvms.69.857] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We performed a retrospective study of 56 dogs with Patent Ductus Arteriosus (PDA) to evaluate the indications for and efficacy of transarterial PDA coil embolization. Transarterial PDA coil embolization was conducted in 37 cases (66.1%) and surgical ligation was conducted in 16 cases (28.6%). Three cases (5.4%) were diagnosed as pulmonary hypertension and were excluded from surgical intervention. Although coil dislodgement was observed in the pulmonary artery in one case, no death occurred during coil embolization or surgical ligation. Echocardiography showed that fractional shortening decreased from 35.4 +/- 6.8% to 30.2 +/- 5.9% (P<0.05) after transarterial PDA coil embolization. Although slight residual shunts were observed in 18 cases, transarterial PDA coil embolization was effective treatment of PDA.
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Affiliation(s)
- Ryou Tanaka
- Veterinary Surgery, Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Tokyo, Japan
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Abstract
Congenital heart disease (CHD) is defined as a morphologic defect of the heart or associated great vessels present at birth. Abnormalities are caused by alterations or arrests in particular phases of embryonic development of the fetal heart. The term congenital does not imply that the defect was inherited, and the defect may have occurred spontaneously or secondary to a drug or toxin. By studying families of animals with specific CHDs, many defects have also been shown to be heritable.Additionally, if the defect was caused by a spontaneous de novo mutation,that individual has the potential to transmit the mutation to offspring. The diagnosis of CHD is important not only to the health of the patient but to eliminate affected individuals from the breeding pool.
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Affiliation(s)
- Kristin A MacDonald
- The Animal Care Center of Sonoma, 6470 Redwood Drive, Rohnert Park, CA 94928, 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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