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1.
Background: Transarterial ductal occlusion with the Amplatzer vascular plug was first reported in dogs by Hogan et al in 2005. Hypothesis: Use of the Amplatzer vascular plug is a safe, efficacious method of patent ductus arteriosus (PDA) occlusion. Animals: Thirty‐one client‐owned dogs with PDA. Methods: Records of 31 dogs in which transarterial occlusion of PDA with an Amplatzer vascular plug was attempted were reviewed. Results: All dogs had a type II PDA, with 27 dogs having type IIA morphology and 4 dogs having type IIB morphology. Appropriate device deployment was achieved in 29 of 31 dogs. Postdeployment angiography in 21 dogs documented complete occlusion in 10 dogs, trivial residual flow in 5 dogs, mild residual flow in 2 dogs, moderate residual flow in 3 dogs, and severe residual flow in 1 dog. Transthoracic color Doppler echocardiography documented complete occlusion in 22 dogs, whereas 2 dogs had trivial residual flow, 2 dogs had mild residual flow, 2 dogs had mild to moderate residual flow, and 1 dog had severe residual flow. Of the 7 dogs with residual flow, 2 had complete occlusion 2–4 months postoperatively, 1 had moderate residual flow 1 month postoperatively, and 4 were lost to follow‐up. One dog required a larger device than was able to be deployed through the largest sheath placed in the femoral artery. Pulmonary embolization of the device occurred in 1 dog. Conclusion: We conclude that ductal occlusion with an Amplatzer vascular plug is a safe and efficacious therapy for PDA in dogs.  相似文献   

2.
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.  相似文献   

3.
ObjectivesTo describe the use of the Amplatzer vascular plug II (AVPII) for transvenous occlusion of patent ductus arteriosus in a non-selective population of dogs, with a focus on the surgical technique, short term outcome and associated complications.Animals, materials and methodsRetrospective study. Records of thirty-two consecutive dogs treated for a left-to-right shunting patent ductus arteriosus with the AVPII were reviewed.ResultsDuctal occlusion with an AVPII occlusion device was attempted in 32 dogs weighing 1.1–53.8 kg. Transvenous occlusion was successful in 30 dogs. One dog required a transarterial approach for occlusion. One dog died during catheterisation of the right heart but prior to transductal catheterisation. Mean ductal ampulla diameter was 7.9 mm (range, 4.1–15.4 mm) and median size of deployed devices was 10 mm (range 4–20 mm). Mean device to ampulla ratio was 1.34 ± 0.15. Device was positioned in situ with no residual flow on follow-up echocardiographic assessment (> one month) in all dogs where deployment was attempted. Occlusion success rate was 96.9% and mortality rate was 3.1%. Four dogs (13.3%) demonstrated minor complications, with none having long-term significance.ConclusionsThe use of AVPII device via a transvenous approach is a feasible and effective method for occlusion of a left-to-right shunting patent ductus arteriosus in dogs of a wide range of weight. The method described may complement existing catheter-based occlusion methods.  相似文献   

4.
This study was designed to evaluate the feasibility and limitations of transcatheter embolization coil occlusion of patent ductus arteriosus in dogs using a carotid artery approach. Seven dogs examined at the University of California, Davis Veterinary Medical Teaching Hospital in 2002-2003 for evaluation of heart disease had congenital patent ductus arteriosus diagnosed by characteristic physical, electrocardiographic, radiographic, and anatomic and Doppler echocardiographic findings. Dogs were anesthetized for transesophageal echocardiography and transcatheter coil embolization of the ductus via the right external carotid artery. Coil embolization was achieved in all seven cases, using one to four detachable embolization coils. There were no major complications. Minor complications occurred in two dogs (additional coils placed using a femoral arterial approach and coil embolization of a left femoral artery branch). One dog was examined only 24 h post-operatively and had no murmur and trivial residual ductal flow by Doppler echocardiography. The other 6 dogs were clinically healthy when examined up to three years post-intervention. One dog had a very soft continuous murmur and mild residual ductal flow; the other five had no audible continuous murmur, with only one dog having trivial residual ductal flow identified by Doppler echocardiography. Although technically challenging, coil embolization via the carotid artery is a viable alternative approach for transcatheter closure of patent ductus arteriosus in some dogs.  相似文献   

5.
Two dogs with a history of coughing and exercise intolerance were suspected to have a patent ductus arteriosus (PDA), and the presence of a type III PDA was confirmed by radiography, electrocardiography, ultrasonography and angiography. Transarterial coil embolisation was carried out by using a modified technique. An occlusion balloon catheter was inserted through a femoral vein and placed at the pulmonary side of the ductus before the embolisation coils were put in place. Both dogs remained healthy during a follow-up period of nine months.  相似文献   

6.
A 7-month-old female, spayed border collie was referred to the Ontario Veterinary College due to a continuous murmur noted by the referring veterinarian prior to ovariohysterectomy. Auscultation confirmed a grade VI/VI continuous murmur. An echocardiogram confirmed patent ductus arteriosus (PDA). An Amplatz canine ductal occluder device was successfully placed for occlusion of blood flow though the ductus.  相似文献   

7.
Two Pomeranian dogs referred for interventional correction of a left-to-right shunting patent ductus arteriosus (PDA) had inadequate femoral arterial access for any occlusion device other than micro coils. The decision was made to attempt correction of the PDA using the Amplatzer™ Vascular Plug 4 (AVP4) from a femoral venous approach. An AVP4 was successfully deployed in each dog with complete occlusion noted within 5 min. Complete occlusion was persistent at 24 h after the procedure, while both dogs were subclinical, had no residual ductal flow, and complete or near complete reverse cardiac remodeling at subsequent visits. This report demonstrates the feasibility of PDA occlusion with the AVP4 from the femoral venous approach in small dogs where femoral arterial access is inadequate for other occlusion devices.  相似文献   

8.
Background:Catheter closure of patent ductus arteriosus Botalli (PDA) is increasingly replacing traditional surgical ligation via thoracotomy. A variety of techniques have been described in dogs, although the technique and implant chosen may depend on the minimum ductus diameter.Objectives:To evaluate the feasibility and treatment of choice of catheter closure of large and small PDAs in dogs.Methods:In 16 dogs with a PDA, catheter closure was performed using transarterial embolisation using detachable or free coils, or transvenously using an Amplatzer, duct occluder (ADO).Results:In 8 dogs, closure of PDA with a minimum diameter of < 4 mm was achieved using detachable coils; 2 or more coils were required in 3 dogs. In 5 dogs with minimum ductus diameters of > 4 mm, detachable coils were not applicable. In one of these dogs, (incomplete) surgical ligation was performed and later a free coil placed for complete closure. In 2 dogs with moderately large PDA (5 mm), several free coils were implanted. Complete closure was not achieved in either dog and transient haemolysis occurred as a complication. In 2 dogs with a very large PDA (6 mm), implanted free coils embolised to pulmonary arteries and closure was then achieved using an ADO. In 3 dogs with an excessively large PDA (7.5-10 mm) closure was successfully achieved using an ADO with no complications.Conclusions:Coil embolisation is readily feasible for closure of PDA < 4 mm, less feasible for PDA < 5 mm and unlikely to be feasible to close PDA > 5 mm. Detachable coils are safe for PDA < 4 mm, and the ADO is an excellent device for PDA > 5 mm.  相似文献   

9.
Patent ductus arteriosus (PDA) is the most common congenital cardiac disease in the dog and generally leads to severe clinical signs, including left-sided congestive heart failure. Historically, definitive treatment consisted of surgical ligation; however, the use of vascular occlusion devices by minimally invasive techniques has gained popularity in veterinary medicine during the past decade. Adequate vascular access is a major limiting factor for these minimally invasive techniques, precluding their use in very small dogs. The clinical management of PDA with 0.025-in vascular occlusion coils in a minimally invasive transarterial technique in 10 dogs is described. The dogs were small (1.38 +/- 0.22 kg), were generally young (6.70 +/- 5.74 months), and had small minimal ductal diameters (1.72 +/- 0.81 mm from angiography). Vascular access was achieved, and coil deployment was attempted in all dogs with a 3F catheter uncontrolled release system. Successful occlusion, defined as no angiographic residual flow, was accomplished in 8 of 10 (80%) dogs. Successful occlusion was not achieved in 2 dogs (20%), and both dogs experienced embolization of coils into the pulmonary arterial tree. One of these dogs died during the procedure, whereas the other dog underwent a successful surgical correction. We conclude that transarterial PDA occlusion in very small dogs is possible with 0.025-in vascular occlusion coils by means of a 3F catheter system and that it represents a viable alternative to surgical ligation. The risk of pulmonary arterial embolization is higher with this uncontrolled release system, but this risk may decrease with experience.  相似文献   

10.
ObjectiveTo report on transvenous detachable coiling in small dogs deemed ineligible for traditional transarterial patent ductus arteriosus occlusion and compare transthoracic echocardiographic and angiographic measurements to determine their equivalence.Materials and methodsA retrospective study of 35 dogs that underwent transvenous coiling of a patent ductus arteriosus. Demographic information, echocardiographic and angiographic studies, surgery reports, and follow-up evaluation of residual flow were obtained. A Bland-Altman analysis was used to compare echocardiographic and angiographic measurements of the minimal ductal diameter (Echo-MDD, Ang-MDD) and ampulla diameter (Echo-A, Ang-A).ResultsThirty-four of 35 dogs had successful deployment of a coil, with one dog undergoing occlusion with a different device after the exteriorized coil pulled through the ductus. Complete occlusion was achieved in 18 dogs within 24 h; four dogs were lost to follow-up, and the remaining 12 dogs had no residual flow or a significant reduction in shunting with normalization in cardiac chamber dimensions by a median of 99 days. Thirty percent of dogs (11/35) experienced perioperative complications of which 10 were minor complications. The analysis of 26 dogs with both echocardiographic and angiographic ductal measurements showed a −0.14 mm mean difference (95% limits of agreement −1.08 to 0.8 mm) in minimal ductal diameter and −0.68 mm mean difference (95% limits of agreement −2.73 to 1.37 mm) in ampulla diameter.ConclusionsDogs less than 3 kg deemed too small for transarterial occlusion can successfully undergo transvenous coil embolization of patent ductus arteriosus.  相似文献   

11.
OBJECTIVE; To describe use of coil embolization to occlude residual flow through a patent ductus arteriosus (PDA) after incomplete surgical ligation. STUDY DESIGN: Clinical study. ANIMALS: Dogs (n=4) with continuous murmur after surgical ligation of PDA. METHODS: After PDA ligation, residual ductal flow through the PDA was visible on color-flow Doppler examination and left ventricular end-diastolic diameter remained increased. Coil embolization by an arterial approach was performed to achieve complete occlusion of the PDA. RESULTS: Embolization coils were delivered without complications and hemodynamically successful occlusion was achieved. Doppler-visible flow resolved in 2 dogs within 3 months after embolization. Left ventricular end-diastolic diameter indexed to body weight decreased in all dogs. CONCLUSIONS: Transcatheter coil embolization appears to be a safe and minimally invasive procedure for complete occlusion of residual PDA flow after incomplete surgical ligation. CLINICAL RELEVANCE: Transcatheter coil embolization should be considered for correction of hemodynamically significant residual shunts in dogs that have incomplete PDA occlusion after open surgical ligation.  相似文献   

12.
BACKGROUND: Infection is an infrequent but major complication of cardiovascular device implantation. HYPOTHESIS: Treatment of patients with cardiovascular implant infection with antibiotic therapy and removal of the device is superior to antibiotic therapy alone. METHODS: Medical records were reviewed for dogs that received a cardiovascular device from June 2001 to August 2006 at the University of Minnesota Veterinary Medical Center and the University of Missouri Veterinary Medical Teaching Hospital. RESULTS: Six of 63 (9.5%) pacemaker systems and 2 of 47 (4.3%) patent ductus arteriosus (PDA) occlusion devices became infected. Median time from procedure to diagnosis of implant infection was 62 days (range, 5 to 419). Median age of dogs with pacemaker infections was 8.5 years (range, 6.2 to 11.9). Pseudomonas aeruginosa and Staphylococcus spp were the most commonly cultured isolates. Four dogs were treated with antibiotics and pacemaker replacement. All 4 recovered completely from their infections. One was alive at the end of the study period, and 3 had been euthanized. However, the reasons for euthanasia were unrelated to pacemaker infection. In contrast, both dogs with infected pacemakers that were treated with antibiotics alone were euthanized because of complications attributable to infection. Infection of PDA occlusion devices occurred in puppies < 16 weeks of age, and Pasteurella spp were isolated from both. One was successfully treated with a combination of antibiotics and surgery, and the other was euthanized without treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Antibiotic therapy alone is associated with chronic complications in patients with cardiovascular implants and is unlikely to effect a cure.  相似文献   

13.
BACKGROUND: Per-catheter patent ductus arteriosus (PDA) occlusion in dogs with devices intended for humans is associated with technical difficulties, high rates of procedure abandonment, device migration, and residual ductal flow. HYPOTHESIS: Use of a custom-made canine duct occluder (Amplatz Canine Duct Occluder, ACDO) would be feasible in dogs of varying weights and somatotypes and effective in occluding a wide range of PDA shapes and sizes. ANIMALS: Eighteen client-owned dogs of various breeds with PDA. Weights ranged from 3.8 to 32.3 kg (median, 17.8 kg), and angiographic minimal ductal diameters ranged from 1.1 to 6.9 mm (median, 3.7 mm). Ductal morphologies included types IIA, IIB, and III. METHODS: Per-catheter PDA occlusion with the ACDO was performed in all dogs. Persistent or recurrent ductal flow was assessed at the end of the procedure by angiography and at 1 day, 3 months, and >or=12 months after the procedure by echocardiography. RESULTS: Successful ACDO placement was achieved in all 18 dogs. One dog required a 2nd procedure with a larger ACDO after the 1st device migrated to the pulmonary vasculature. Complete occlusion was confirmed in 17 of 18 dogs during the procedure, as well as at 1 day and 3 months after the procedure, and in 12 of 13 dogs evaluated at >or=12 months after the procedure. CONCLUSIONS AND CLINICAL IMPORTANCE: Per-catheter PDA occlusion in dogs with the ACDO is feasible and effective in dogs of a wide range of weights and somatotypes and with PDAs of varying shapes and sizes.  相似文献   

14.
OBJECTIVE: To present details of surgical management of an unusual vascular ring anomaly in two German Shepherd littermates. STUDY DESIGN: Clinical case report. STUDY POPULATION: Three-month-old intact male and female German Shepherd littermates. RESULTS: In each dog, the esophagus was obstructed by a vascular ring comprised of the left aortic arch, an anomalous patent right ductus arteriosus, and the pulmonary artery ventrally. Surgical treatment consisted of dividing and oversewing the patent right ductus arteriosus. Neither dog has clinical signs of esophageal disease one year after treatment. CONCLUSION AND CLINICAL RELEVANCE: This vascular ring anomaly should be considered a possibility in any young dog with esophageal obstruction and a machinery murmur.  相似文献   

15.
The purpose of this study is to report our initial experience with the use of spring coils to close the patent ductus arteriosus in the dog. There are few large-patient series reported in the veterinary literature. Coil closure was attempted in 15 dogs (median weight, 6.5 kg; range, 1.2 to 38.7 kg) presenting with a patent ductus arteriosus between May 1997 and May 1999. Arterial catheterization followed by angiography was used to decide if coil placement was adequate. A 5- or 8-mm embolization coil, depending on the angiographic diameter of the ductus, was delivered, with 1 loop in the pulmonary arterial side and the remainder of the coil in the aortic side of the duct. Additional coils were used if a residual shunt was present, and closure was confirmed by aortography. Patients were discharged the day after the procedure. Successful coil closure, without residual shunt on angiography, was achieved in 11 of 13 dogs in which coils were released. In 6 dogs, a coil embolized to the pulmonary artery. Four of these dogs had successful closure with multiple coils, and 2 others had surgery. None of these dogs experienced adverse effects. In 2 dogs with conical patent ductus arteriosus >5 mm in minimal diameter, coil closure was not done. We conclude that the patent ductus arteriosus size and anatomical shape are crucial in deciding whether coil closure is the method of choice. In selected cases, coil closure represents an elegant alternative to surgical ligation. Although pulmonary embolism occurred commonly, it did not cause any obvious clinical problem.  相似文献   

16.
A 14-week-old border collie with a history of exercise intolerance was confirmed to have a patent ductus arteriosus (PDA) from colour flow Doppler echocardiography. Under general anaesthesia, angiography was performed to gauge accurately the width of the ductus, and then two intravascular embolisation coils were introduced into the ductus via percutaneous catheterisation of the femoral vein. The coils were both 8 mm in diameter, each with four loops. This led to an immediate disappearance of the murmur. Some slight residual flow was detected at the time of the procedure by angiography, but by 10 days postoperatively there was no PDA flow detectable. The time taken to complete the procedure was 55 minutes, with a total fluoroscopy time of 15 minutes. Placement of intravascular embolisation coils represents a viable alternative to traditional surgical methods of ductus closure.  相似文献   

17.
OBJECTIVE: To report a technique for minimally invasive occlusion of patent ductus arteriosus (PDA) and outcome in 5 dogs. STUDY DESIGN: Clinical cases. Animals: Five, 4-6-month-old, dogs with PDA. MATERIALS AND METHODS: Titanium ligating clips were used for PDA closure in all dogs. Three dogs had video-enhanced mini-thoracotomy PDA occlusion. Two other dogs had thoracoscopic PDA occlusion using a custom-designed thoracoscopy clip applicator. RESULTS: Thoracoscopic PDA occlusion was successful in both dogs in which it was attempted. Complete PDA closure was achieved in 4 dogs. Three months after surgery, the largest dog had residual ductal flow that hemodynamically was insignificant. CONCLUSIONS: Although technically demanding, minimally invasive PDA occlusion is a safe and reliable technique in dogs. Preoperative measurement of the diameter of the PDA is crucial to determine if complete closure with metal clips can be achieved. CLINICAL RELEVANCE: Minimally invasive PDA occlusion should be considered as an alternative to occlusion via conventional thoracotomy.  相似文献   

18.
Background: Appropriate device selection for transcatheter occlusion of patent ductus arteriosus (PDA) is essential to procedural success. Objectives: To determine if transesophageal echocardiography (TEE) influences device selection for PDA occlusion and to report benefits, limitations, and complications associated with TEE. Animals: Twenty‐two client‐owned dogs with left‐to‐right shunting PDA. Methods: PDA dimensions were obtained via transthoracic echocardiography (TTE) and then TEE followed by angiography. Based solely on information from TTE and angiography, an initial device type and size were selected. After initial device selection, TEE measurements were disclosed and changes in device selection were recorded. After device release, angiography, TEE, or both were performed to assess occlusion. Results: An Amplatz canine duct occluder (ACDO) was securely positioned and released in 21 dogs and an embolization coil was deployed in 1 dog. Based on TEE evaluation, initial selected device type was unchanged but ACDO size was changed in 3 dogs. TEE was utilized throughout the procedure allowing real time visualization of device deployment, release and assessment of closure in 17 dogs. No complications occurred related to TEE. Complete PDA closure was achieved in all dogs. Conclusions and Clinical Importance: TEE provided anatomic information regarding PDA morphology that closely approximated angiographic ductal dimensions while aiding in device deployment, release and confirmation of closure. We conclude that TEE provides complementary anatomical and intraprocedural information and is well tolerated in dogs.  相似文献   

19.
Three dogs presented for the evaluation of cardiac murmurs were diagnosed with aberrant arteriovenous shunts. All cases demonstrated the following findings: 1) relatively soft continuous murmur loudest at the left heart base resembling patent ductus arteriosus (PDA); 2) shunt flow signals in the pulmonary artery on echocardiography; and 3) no PDA on selective angiography, but evidence of anomalous shunting vessels from thoracic aorta to pulmonary vasculature. An aberrant arteriovenous shunt should be considered when a continuous murmur of relatively small intensity is heard.  相似文献   

20.
The therapeutic possibilities in veterinary cardiology have developed rapidly in the past few years. Whereas until recently cardiac intervention in dogs could only be performed by thoracotomy, new minimally invasive techniques are adopted. Procedures like balloondilatation of pulmonic stenosis, coil embolisation of patent ductus arteriosus, pacemaker implantation in symptomatic bradyarrhyhtmia, and palliative balloon pericardiotomy are becoming more and more established. These alternative interventional methods are attractive, because no postsurgical pain and no complications potentially associated with thoracotomy ensue. The knowledge of such new treatment modalities and particularly the indications for an intervention are prerequisites to apply them optimally and broadly.  相似文献   

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