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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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Wang G, Wu Y, Pan Z, Wu C, Li Y, Li H, Wang Q, Liu B, Dai J. Transesophageal echocardiography-guided percutaneous patent ductus arteriosus closure without fluoroscopy. J Cardiothorac Surg 2023; 18:142. [PMID: 37060014 PMCID: PMC10105385 DOI: 10.1186/s13019-023-02248-8] [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: 10/23/2022] [Accepted: 04/02/2023] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVES A retrospective study was performed to summarize the experience of transcatheter closure of patent ductus arteriosus (PDA) through the right femoral vein under the guidance of transesophageal echocardiography (TEE). METHODS From January 2019 to September 2021, 75 children who underwent PDA closure through the right femoral vein under the guidance of TEE were included. The guide wire and delivery sheath were inserted through the ductus arteriosus into the descending aorta via the right femoral vein, and the occluder was subsequently deployed. After discharge, all patients were required for outpatient follow-ups at 1, 3, 6 and 12 months. RESULTS In this group, patients were older than 10 months of age and body weight greater than 8 kg. Among 75 cases with PDA, 63 were tubular type and 12 were conical type. The mean operative time was 40.2 ± 7.3 min. The size of PDA occluder ranged from 4-6 to 12-14 mm. The mean hospital stay was 5.5 ± 0.5 days. One month after discharge, there were 4 cases with a mild residual shunt. Eventually, the residual shunt was not observed during 3, 6, and 12 months of follow-up. CONCLUSIONS PDA closure under the guidance of TEE can be performed through the right femoral vein successfully and effectively. This procedure has no contrast agent usage, radiation exposure, or open incisions.
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Affiliation(s)
- Gang Wang
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Yuhao Wu
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Zhengxia Pan
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Chun Wu
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Yonggang Li
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Hongbo Li
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Quan Wang
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Bo Liu
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China
| | - Jiangtao Dai
- Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, China.
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Stoner CH, Saunders AB. Evaluation of two probes for transesophageal echocardiography in small dogs: imaging capabilities, image quality, and usability. J Vet Cardiol 2023; 45:41-49. [PMID: 36696791 DOI: 10.1016/j.jvc.2022.12.005] [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: 01/19/2022] [Revised: 12/12/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTIONS Patient size is a limiting factor for transesophageal echocardiography (TEE) in small dogs. The objective of this study was to describe imaging capabilities of two probes for TEE in small dogs. ANIMALS, MATERIALS, AND METHODS Prospective study in 10 client-owned dogs weighing <4 kg with congenital heart disease (CHD). Dogs had TEE performed with a microprobe (10T-D, GE Medical) and intracardiac echocardiography (ICE) catheter-based probe (AcuNav™, Biosense Webster) in the esophagus in alternating order. Ease of placement, ability to acquire images of the CHD, image quality, and probe limitations were recorded. RESULTS Median weight was 2.4 kg (range, 1.0-3.2). Congenital abnormalities included patent ductus arteriosus (n = 9) and pulmonary valve stenosis (n = 1). The 10T-D microprobe was easy to place (n = 8) or achievable with gentle manipulation (n = 2), and image quality of the CHD was optimal (n = 8), adequate (n = 1), or poor (n = 1). The ICE probe was difficult to place in the esophagus even with an external support system (n = 9) or could not be placed (n = 1), and image quality of the CHD was optimal (n = 2), adequate (n = 3), or poor (n = 5). Both probes provided images in a 1.0-kg dog. Probe limitations included lack of lateral motion (microprobe), the need for an external support system (ICE probe) and inability to consistently maintain contact with the esophagus (ICE probe). CONCLUSION The 10T-D microprobe provided high-quality TEE images more consistently than the ICE probe in the majority of dogs in this study; however, the lack of lateral motion can diminish its utility in some dogs.
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Affiliation(s)
- C H Stoner
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - A B Saunders
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
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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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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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Stoner CH, Saunders AB, Heseltine JC, Cook AK, Lidbury JA. Prospective evaluation of complications associated with transesophageal echocardiography in dogs with congenital heart disease. J Vet Intern Med 2022; 36:406-416. [PMID: 34997940 PMCID: PMC8965207 DOI: 10.1111/jvim.16356] [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: 06/18/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 01/09/2023] Open
Abstract
Background Transesophageal echocardiography (TEE) is useful in the assessment and procedural monitoring of congenital heart disease (CHD) with a relatively low complication rate in humans. Objectives To evaluate the safety of TEE and report complications in dogs. Animals Forty client‐owned dogs with CHD. Methods Prospective observational study including gastroesophagoscopy before and after TEE imaging. TEE was planned with a GE 6VT‐D adult probe in dogs weighing ≥4 kg and a GE 10T‐D microprobe alternating with an intracardiac echocardiography probe placed in the esophagus in dogs <4 kg. Difficulties with probe placement, probe interference and TEE probe imaging times were recorded. Dogs were monitored in the recovery period after TEE using an established nausea scoring system. Results New gastroesophageal abnormalities were identified after TEE in 4 dogs including 4 areas of mucosal damage involving <25% of the lower esophageal sphincter (n = 4) and 1 lesion at the heart base (n = 1) and were not attributed to longer imaging times or a specific probe. Lesions identified before TEE in 4 dogs remained unchanged after TEE. The 6VT‐D probe could not be placed in 1 dog with enlarged tonsils, and it obstructed fluoroscopic views in 3 dogs. The probes did not compress any structures in dogs in which fluoroscopy was performed (n = 20). Four dogs had evidence to suggest nausea after the procedure. Conclusions and Clinical Importance While major complications remain possible, complications in this study were mild and few in number. Dog size and probe characteristics are factors to consider when performing TEE.
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Affiliation(s)
- Caitlin H Stoner
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Ashley B Saunders
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Johanna C Heseltine
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Jonathan A Lidbury
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
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Porciello F, Marchesi MC, Birettoni F, Spina F, Knafelz P, Bufalari A, Rishniw M, Moise NS, Caivano D. Transthoracic echo-guided pacemaker implantation reduces fluoroscopic use in dogs. Vet J 2021; 277:105762. [PMID: 34655788 DOI: 10.1016/j.tvjl.2021.105762] [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: 04/16/2021] [Revised: 09/21/2021] [Accepted: 10/10/2021] [Indexed: 10/20/2022]
Abstract
Echocardiographic guidance provides an alternative method when fluoroscopy is unavailable, equipment or power failure of fluoroscopic equipment during a procedure occurs or to decrease radiation risk. Recently, transthoracic (TTE) and transesophageal echocardiography were reported as an alternative method to guide interventional procedures in dogs. Therefore, we hypothesized that TTE could be used as an alternative method to visualize endocardial leads during pacemaker implantation in dogs, largely avoiding the use of fluoroscopy. A prospective consecutive case series of pacemaker implantation was performed using TTE guidance. The endocardial lead was imaged by TTE during its intracardiac advancement until the lead tip was positioned at the right ventricular apex. Echocardiographic right parasternal views, optimized to visualize the pacing lead, were used, starting with a short axis image of the right atrium and ending with a long axis view of the right ventricle (RV) optimized to image the RV apex. Proper lead placement was confirmed by both capture threshold, impedance and fluoroscopy. Twenty-one pacemaker implantation procedures by TTE monitoring were successfully performed. The TTE guidance provided images of a quality sufficient to clearly monitor implantation in real-time and allowed for immediate corrections to pacing lead malpositioning or excessive looping. Fluoroscopy was used to confirm the correct placement of the lead that was guided echocardiographically in the initial three procedures, after which a single radiographic image (no cine-mode) was used to identify lead placement and redundancy in the remaining eighteen cases. Static imaging (radiography using the fluoroscope) was used to assess the proper lead redundancy in all procedures because this cannot be evaluated echocardiographically. Pacemaker leads were successfully implanted in the RV of dogs using TTE monitoring. A larger cases series is needed for validation of safety and effectiveness of TTE during this interventional procedure in dogs.
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Affiliation(s)
- F Porciello
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126 Italy.
| | - M C Marchesi
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126 Italy
| | - F Birettoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126 Italy
| | - F Spina
- Veterinary Hospital 'Etiopia', Viale Etiopia 16, Rome, 00199 Italy
| | - P Knafelz
- Veterinary Hospital 'GregorioVII', Piazza di Villa Carpegna 52, Rome, 00165 Italy
| | - A Bufalari
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126 Italy
| | - M Rishniw
- Veterinary Information Network, Davis, CA 95616, USA; Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - N S Moise
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - D Caivano
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, Perugia, 06126 Italy
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Madruga FL, Pereira YM, Panti A, Handel I, Culshaw G. Branham sign in dogs undergoing interventional patent ductus arteriosus occlusion or surgical ligation: A retrospective study. Open Vet J 2021; 11:603-612. [PMID: 35070855 PMCID: PMC8770181 DOI: 10.5455/ovj.2021.v11.i4.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 10/18/2021] [Indexed: 11/14/2022] Open
Abstract
Background: The Branham sign is a baroreceptor response that follows patent ductus arteriosus (PDA) closure. Although described in dogs following both interventional and surgical ductal closure, a direct comparison of the Branham sign elicited by these two techniques has not been made. Aim: Since closure with an Amplatz canine ductal occluder (ACDO) occurs over 10 minutes and surgical ligation (SL) is more rapid, we hypothesized that the Branham sign following occlusion of a PDA with an ACDO would be less severe than following SL. Methods: Clinical records of dogs diagnosed with left-to-right shunting PDA between 2008 and 2018 were retrospectively reviewed. Of 139 dogs undergoing PDA occlusion, only 41 dogs (ACDO n = 32, SL n = 9) were included after applying exclusion criteria. Heart rate (HR) and blood pressure (BP) from occlusion time (T0) until 30 minutes post occlusion (T30) were recorded. Signalment and anesthetic protocol were also recorded. The influence of age and weight on the hemodynamic variations was assessed. Hemodynamic variables and calculations were compared between and within groups using a repeated measures general linear model, and post hoc tests were applied if significance was identified. Results: A mild Branham sign was present in both groups, and hemodynamic changes were not significantly different between groups. In both groups, there was a significant decrease in HR (11 bpm, 5.3–16.3; p < 0.001) (10.4%, 5.4–15.5; p < 0.001) and increase in diastolic BP (9.5 mmHg, 3–16; p = 0.002) (23.5%, 7.1–39.9; p = 0.002), but systolic BP did not change significantly (p = 0.824). Age and weight did not influence Branham sign. Conclusion: The Branham sign in dogs is mild in both groups, lasts for at least 30 minutes, and is independent of the method of PDA closure.
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Affiliation(s)
- Filipe L Madruga
- Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Chester High Road, Neston, Wirral, CH64 7TE, UK
| | - Yolanda Martinez Pereira
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | - Ambra Panti
- Veterinary Specialists Scotland, Department of Veterinary Anaesthesia and Analgesia, 1 Deer Park Road, Livingston, EH54 8AG, UK
| | - Ian Handel
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
| | - Geoff Culshaw
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Roslin, EH25 9RG, UK
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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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Fries RC, Clark-Price SC, Kadotani S, Stack JP, Schaeffer DJ, Lascola KM. Quantitative assessment of left ventricular volume and function by transthoracic and transesophageal echocardiography, ultrasound velocity dilution, and gated magnetic resonance imaging in healthy foals. Am J Vet Res 2020; 81:930-939. [PMID: 33251841 DOI: 10.2460/ajvr.81.12.930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare measurements of left ventricular volume and function derived from 2-D transthoracic echocardiography (2DE), transesophageal echocardiography (TEE), and the ultrasound velocity dilution cardiac output method (UDCO) with those derived from cardiac MRI (cMRI) in healthy neonatal foals. ANIMALS 6 healthy 1-week-old Standardbred foals. PROCEDURES Foals were anesthetized and underwent 2DE, TEE, and cMRI; UDCO was performed simultaneously with 2DE. Images acquired by 2DE included the right parasternal 4-chamber (R4CH), left apical 4- and 2-chamber (biplane), and right parasternal short-axis M-mode (M-mode) views. The longitudinal 4-chamber view was obtained by TEE. Measurements assessed included left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), ejection fraction, stroke volume (LVSV), cardiac output (CO), and cardiac index (CI). Bland-Altman analyses were used to compare measurements derived from biplane, R4CH, and M-mode images and UDCO with cMRI-derived measurements. Repeatability of measurements calculated by 3 independent reviewers was assessed by the intraclass correlation coefficient. RESULTS Compared with cMRI, all 2DE and TEE modalities underestimated LVEDV and LVESV and overestimated ejection fraction, CO, and CI. The LVSV was underestimated by the biplane, R4CH, and TEE modalities and overestimated by UDCO and M-mode methods. However, the R4CH-derived LVSV, CO, and CI were clinically comparable to cMRI-derived measures. Repeatability was good to excellent for measures derived from the biplane, R4CH, M-mode, UDCO, and cMRI methods and poor for TEE-derived measures. CONCLUSIONS AND CLINICAL RELEVANCE All assessed modalities yielded clinically acceptable measurements of LVEDV, LVESV, and function, but those measurements should not be used interchangeably when monitoring patient progress.
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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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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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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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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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15
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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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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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Mantovani MM, Fantoni DT, Gimenes AM, de Castro JR, Flor PB, Ida KK, Schwartz DS. Clinical monitoring of cardiac output assessed by transoesophageal echocardiography in anaesthetised dogs: a comparison with the thermodilution technique. BMC Vet Res 2017; 13:325. [PMID: 29121915 PMCID: PMC5679384 DOI: 10.1186/s12917-017-1227-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 10/25/2017] [Indexed: 12/26/2022] Open
Abstract
Background Cardiac output (CO) is an important haemodynamic parameter to monitor in patients during surgery. However, the majority of the techniques for measuring CO have a limited application in veterinary practice due to their invasive approach and associated complexity and risks. Transoesophageal echocardiography (TEE) is a technique used to monitor cardiac function in human patients during surgical procedures and allows CO to be measured non-invasively. This prospective clinical study aimed to compare the transoesophageal echocardiography using a transgastric view of the left ventricular outflow tract (LVOT) and the thermodilution (TD) technique for the assessment of CO during mean arterial pressure of 65–80 mmHg (normotension) and <65 mmHg (hypotension) in dogs undergoing elective surgery. Eight dogs were pre-medicated with acepromazine (0.05 mg/kg, IM), tramadol (4 mg/kg, IM) and atropine (0.03 mg/kg, IM), followed by anaesthetic induction with propofol (3–5 mg/kg IV) and maintenance with isoflurane associated with a continuous infusion rate of fentanyl (bolus of 3 μg/kg followed by 0.3 μg/kg/min). The CO was measured by TEE (COTEE) and TD (COTD) at the end of expiration during normotension and hypotension (induced by isoflurane). Results There was a strong positive correlation between COTEE and COTD (r = 0.925; P < 0.0001). The bias between COTD and COTEE was 0.14 ± 0.29 L/min (limits of agreement, −0.44 to 0.72 L/min). The percentage error of CO measured by the two methods was 12.32%. In addition, a strong positive correlation was found between COTEE and COTD during normotension (r = 0.995; P < 0.0001) and hypotension (r = 0.78; P = 0.0223). Conclusions The results of this study indicated that the transgastric view of the LVOT by TEE was a minimally invasive alternative to clinically monitoring CO in dogs during anaesthesia. However, during hypotension, the CO obtained by TEE was less reliable, although still acceptable.
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Affiliation(s)
- Matheus M Mantovani
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil.
| | - Denise T Fantoni
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil. .,Faculdade de Medicina Veterinária e Zootecnia da Universidade Federal de São Paulo, Av. Prof Dr Orlando Marques de Paiva 87, São Paulo, SP, 05508-270, Brazil.
| | - André M Gimenes
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Jacqueline R de Castro
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Patrícia B Flor
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
| | - Keila K Ida
- Laboratório de Investigação Médica 8, Anestesiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Denise S Schwartz
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, Brazil
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18
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Colpitts M, Malinowski M, Phillion R, Coleman R, Mitchell L, Malone A, Eberhart L, Sanders R, Langholz D. Echocardiographic imaging options in ovine research subjects. J Vet Cardiol 2017; 19:502-513. [PMID: 29097107 DOI: 10.1016/j.jvc.2017.09.005] [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: 04/10/2017] [Revised: 09/13/2017] [Accepted: 09/21/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To determine the feasibility of acquiring quality transesophageal (TEE), epicardial (EE), and intracardiac (ICE) echocardiographic images in ovine subjects and to discuss the merits of each technique with a focus on ICE image acquisition. ANIMALS Eleven male castrated Dorset adult sheep. METHODS Transesophageal echocardiography was performed under general anesthesia. Epicardial echocardiography was performed as part of an open chest (thoracotomy or sternotomy) experiment. Subjects were recovered with permanent jugular vein indwelling catheter and ICE from this approach was described. Feasibility of each technique was qualitatively assessed based on subjective image quality from three images for each image plane in each sheep. RESULTS Transesophageal echocardiography was technically challenging and did not provide adequate image quality for consistent interpretation. Epicardial echocardiography and ICE had more favorable results with ICE demonstrating unique benefits for post-operative serial monitoring. CONCLUSIONS Epicardial echocardiography and ICE were effective imaging techniques. Epicardial echocardiography required the least specialized training but was considered to have limited feasibility due to its requirement for an open chest procedure. Even with the necessity for permanent indwelling jugular cannulation, ICE was the least invasive of the three imaging techniques and potentially the most practical approach for chronic studies by minimizing post-operative stress. Transesophageal echocardiography was not a feasible technique in this study.
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Affiliation(s)
- M Colpitts
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA.
| | - M Malinowski
- Division of Cardiothoracic Surgery, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA; Medical University of Silesia, Department of Cardiac Surgery, Ziolowa 47, 40-635, Katowice, Poland
| | - R Phillion
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA
| | - R Coleman
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA
| | - L Mitchell
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA
| | - A Malone
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA
| | - L Eberhart
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA
| | - R Sanders
- Michigan State University - College of Veterinary Medicine, Department of Cardiology, 736 Wilson Road, East Lansing, MI 48823, USA
| | - D Langholz
- Division of Cardiovascular Medicine, Spectrum Health, 100 Michigan St NE, Grand Rapids, MI 49503, USA
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19
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Orvalho JS. Real-time Three-dimensional Echocardiography. Vet Clin North Am Small Anim Pract 2017; 47:1005-1019. [DOI: 10.1016/j.cvsm.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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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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21
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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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22
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Goya S, Wada T, Shimada K, Hirao D, Fukushima R, Yamagishi N, Shimizu M, Tanaka R. Effects of postural change on transesophageal echocardiography views and parameters in healthy dogs. J Vet Med Sci 2017; 79:380-386. [PMID: 27980234 PMCID: PMC5326945 DOI: 10.1292/jvms.16-0323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The purpose of the present study is to investigate the effect of postural change on
transesophageal echocardiography (TEE) views and parameters of interest anesthesia
monitoring in healthy dogs. Twelve Beagle dogs were anesthetized and randomly positioned
in one of four postures: right lateral-recumbency, left lateral-recumbency, supine
position and prone position. After examinations in one posture, the same examination was
demonstrated in another posture and repeated in all postures. In each posture, several
standard TEE views were demonstrated: longitudinal cranial-esophageal aorta
long-axis-view, transverse middle-esophageal mitral valve long-axis-view and transgastric
middle short-axis-view. Additionally, echocardiographic parameters were attempted to
measure, and direct blood pressure monitoring was performed in each view. As a result,
oriented views, except for transgastric middle short-axis-view, could be obtained in all
postures. Stroke volume and peak early diastolic velocity of mitral inflow were lower in
supine position compared with those in right and left lateral-recumbency. Heart rate (HR)
and systemic vascular resistance were higher in supine position compared with those in
right and left lateral-recumbency. Left ventricular pre-ejection period/left ventricular
ejection time corrected and uncorrected by HR were higher in supine position compared with
those in right and left lateral-recumbency. In conclusion, longitudinal cranial-esophageal
aorta long-axis-view and transverse middle-esophageal mitral valve long-axis-view provide
useful information of interest anesthesia monitoring, because of their views enable to
certainly obtain TEE parameters in various postures. Furthermore, TEE parameters allow to
detect the changes of preload, afterload and HR that occur in supine position dogs.
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Affiliation(s)
- Seijirow Goya
- Department of Veterinary Surgery, Faculty of Veterinary Medicine, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-0052, Japan
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23
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Birettoni F, Caivano D, Bufalari A, Giorgi M, Miglio A, Paradies P, Porciello F. Transthoracic ultrasound guided balloon dilation of cor triatriatum dexter in 2 Rottweiler puppies. J Vet Cardiol 2016; 18:385-390. [DOI: 10.1016/j.jvc.2016.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/06/2016] [Accepted: 06/20/2016] [Indexed: 11/15/2022]
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Landsman TL, Bush RL, Glowczwski A, Horn J, Jessen SL, Ungchusri E, Diguette K, Smith HR, Hasan SM, Nash D, Clubb FJ, Maitland DJ. Design and verification of a shape memory polymer peripheral occlusion device. J Mech Behav Biomed Mater 2016; 63:195-206. [PMID: 27419615 PMCID: PMC5508979 DOI: 10.1016/j.jmbbm.2016.06.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
Shape memory polymer foams have been previously investigated for their safety and efficacy in treating a porcine aneurysm model. Their biocompatibility, rapid thrombus formation, and ability for endovascular catheter-based delivery to a variety of vascular beds makes these foams ideal candidates for use in numerous embolic applications, particularly within the peripheral vasculature. This study sought to investigate the material properties, safety, and efficacy of a shape memory polymer peripheral embolization device in vitro. The material characteristics of the device were analyzed to show tunability of the glass transition temperature (Tg) and the expansion rate of the polymer to ensure adequate time to deliver the device through a catheter prior to excessive foam expansion. Mechanical analysis and flow migration studies were performed to ensure minimal risk of vessel perforation and undesired thromboembolism upon device deployment. The efficacy of the device was verified by performing blood flow studies that established affinity for thrombus formation and blood penetration throughout the foam and by delivery of the device in an ultrasound phantom that demonstrated flow stagnation and diversion of flow to collateral pathways.
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Affiliation(s)
- Todd L Landsman
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA
| | - Ruth L Bush
- College of Medicine, Texas A&M University Health Science Center, MS 1359, 8447 State Highway 47, HPEB 3060, Bryan, TX 77807-3260, USA
| | - Alan Glowczwski
- Texas A&M Institute for Preclinical Studies, Texas A&M University, MS 4478, College Station, TX 77845-4478, USA
| | - John Horn
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA
| | - Staci L Jessen
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA
| | - Ethan Ungchusri
- College of Medicine, Texas A&M University Health Science Center, MS 1359, 8447 State Highway 47, HPEB 3060, Bryan, TX 77807-3260, USA
| | - Katelin Diguette
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA
| | - Harrison R Smith
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA
| | - Sayyeda M Hasan
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA
| | - Daniel Nash
- Maverick Regional Anesthesia Education, LLC, 10592 County Road 175, Iola, TX 77861, USA
| | - Fred J Clubb
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA; Department of Veterinary Pathobiology, Cardiovascular Pathology Laboratory, College of Veterinary Medicine, Texas A&M University, MS 4467, College Station, TX 77843-4467, USA
| | - Duncan J Maitland
- Department of Biomedical Engineering, Texas A&M University, MS 3120, 5045 Emerging Technologies Building, College Station, TX 77843-3120, USA.
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