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1.
A dog that was referred to the University of Florida Veterinary Medical Center was discovered to have a bamboo skewer within the right atrium and right ventricle, traversing the tricuspid valve. The skewer was ingested approximately four months prior to referral and was partially removed via gastrotomy. The presenting complaint at the time of referral included coagulopathy, anemia and leukocytosis. A linear, hyperechoic structure was identified in the right heart during an echocardiogram. The foreign body was suspected to be a portion of the skewer that the patient had previously ingested. Cardiopulmonary bypass was performed and the foreign body was removed successfully. Complications following surgery included the development of tricuspid valve and ventricular wall thrombi, atrial flutter and amiodarone toxicity. Many indications have been described in the veterinary literature for cardiopulmonary bypass. However, to the best of the authors' knowledge, successful removal of an intracardiac foreign body with cardiopulmonary bypass has not been reported in a veterinary patient. This represents a new indication for cardiopulmonary bypass in veterinary medicine.  相似文献   

2.
Echocardiographically documented tricuspid valve regurgitation appeared immediately after surgical treatment of cor triatriatum dexter in a two-month-old rottweiler. Medical treatment was instituted with benazepril, spironolactone and furosemide. Pimobendan was added after five months, and all treatment was discontinued two months later when clinical signs of ascites and hepatomegaly had resolved and tricuspid valve regurgitation was markedly reduced on echocardiography. To the authors' knowledge, this is the first report describing the development and spontaneous improvement of haemodynamically significant tricuspid valve regurgitation following surgical treatment of cor triatriatum dexter in a dog. It is hypothesised that the increase in right atrial volume and pressure following cor triatriatum dexter repair and transient ischaemia of papillary muscles led to dilatation of the right atrioventricular annulus and subsequent severe tricuspid valve regurgitation in the face of an anatomically normal valve. Time and pharmacological preload reduction as well as normalisation of right atrial inflow and subsequent cardiac remodelling substantially reduced tricuspid valve regurgitation and eliminated clinical signs of heart failure. It is also possible that heart recovery has been spontaneous.  相似文献   

3.
A 1.5-kg, 6-mo-old male patas monkey (Erythrocebus patas) was cyanotic and panting. Evaluation of the heart by electrocardiography, thoracic radiography, two-dimensional echocardiography, and Doppler color-flow echocardiography revealed a ventricular septal defect (VSD) with right-to-left shunting as well as tricuspid valve dysplasia with dilated annulus of the tricuspid ring, dilated right atrium, dilated right ventricle, and deformity of the tricuspid valve. Because of the severity of the cardiac disease, the patas monkey had complications recovering from anesthesia and died 3 days later. Gross postmortem findings included VSD, tricuspid dysplasia, and cerebral hemorrhage.  相似文献   

4.
A 4-year-old, intact male Dogue de Bordeaux dog with congenital valvular pulmonic stenosis, tricuspid valve dysplasia, and chronic atrial fibrillation underwent ultrasound-guided balloon valvuloplasty in addition to pharmacological treatment. Owner compliance to prescribed pharmacotherapy proved very poor, and concerns developed regarding the ability to successfully control heart rate and symptoms using drug therapy alone. These concerns were addressed by the implantation of a novel vagal stimulation system that was programmed to prevent a ventricular rate of >145 bpm. Consequently, post-operative ventricular response rate decreased from up to 250 to 140 bpm. Successful ventricular rate control was maintained for 291 days post-operatively, following which euthanasia was elected by the owner due to persistent right-sided congestive heart failure. To the authors' knowledge, this is the first report of successful continuous rate control using a vagal stimulating system in a closed-chest, client-owned dog with chronic atrial fibrillation secondary to spontaneously occurring organic heart disease.  相似文献   

5.
Clinical findings in fifteen dogs with tricuspid valve dysplasia are described. Thirteen dogs had loud systolic heart murmurs. Eleven of them hat a palpable precordial thrill over the same location. In 14 dogs, right heart enlargement was suspected on thoracic radiographs and electrocardiography. Right atrial dilation was seen echocardiographically in all dogs. Fourteen dogs had additional right ventricular dilatation, some with hypertrophy as well. Doppler echocardiography revealed tricuspid valve regurgitation. Seven dogs remained free of clinical symptoms to date. If symptoms of decompensation develop with tricuspid dysplasia, diuretics, ACE inhibitors and eventually positive inotrope drugs are indicated. Antiarrhythmic drugs may become necessary in cases of supraventricular tachyarrhythmias.  相似文献   

6.
OBJECTIVE: To describe surgical treatment of tricuspid valve stenosis using the Fontan procedure in a young dog. STUDY DESIGN: Case report. SAMPLE POPULATION: One client-owned dog RESULTS: A six month old female Labrador retriever was diagnosed with tricuspid obstruction. The dog had a displaced tricuspid valve and small right ventricle and had progressed to right-sided (backward) cardiac failure. A Fontan procedure (connection of the right atrium to the pulmonary artery with a prosthetic conduit) was performed. Within three days the right atrial pressure had dropped from a preoperative value of 33 mm Hg to 8 mm Hg and the ascites was significantly reduced. The dog died suddenly two months after surgery. Postmortem examination of the heart showed a greatly enlarged right atrium and hypoplastic right ventricle. The tricuspid valve leaflets were fused and displaced ventrally leaving an opening measuring 3x5 mm between the chambers. The conduit was intact with no evidence of leakage or thrombosis. CONCLUSIONS: Palliation of tricuspid stenosis using the Fontan procedure can be performed in dogs. Sudden death may occur and is most likely because of cardiac arrythmias.  相似文献   

7.
Background: Focal atrial tachycardia (FAT) is a common supraventricular tachycardia in dogs. Objective: To evaluate electrophysiologic characteristics and topographic distribution of FAT. Animals: Sixteen dogs with symptomatic FAT. Methods: Retrospective case series. Electrophysiological studies were performed to test the inducibility of documented and no documented arrhythmias. Once induced for each dog, FAT was analyzed for electrogenic mechanism, endocardial electrogram, and location. Results: Nineteen FATs could be studied in 16 dogs, 12 were automatic, 4 nonautomatic, and 3 incessant. Two dogs had >1 focus. Mean atrial cycle length (CL) was 238.2 ± 69.2 (SD) milliseconds, mean ventricular CL of 292.7 ± 72.5 (SD) milliseconds, with atrioventricular block in 6 cases. Mean presystolic atrial activity recorded at the ectopic focus was –39.9 ± 17.7 (SD) milliseconds. Atrial potentials were fragmented in 11 dogs and were low amplitude in 6 dogs. Sixty‐three percent of ectopic foci were distributed within the right atrium (5 crista terminalis, 3 triangle of Koch, 2 tricuspid valve annulus, 1 interatrial septum, and 1 right auricle) and 37% in the pulmonary veins (PVs) (4 right superior PV, 2 left superior PV, and 1 right inferior PV). Persistent atrial fibrillation (AF) and paroxysmal AF were triggered by FATs in 7 dogs (2 with multiple ectopic foci and 4 with at least one PV focus). Conclusion and Clinical Relevance: According to our findings, dogs have a predominance of right‐sided FAT. The majority of FATs are automatic and can trigger AF, particularly in the case of PV location.  相似文献   

8.
A 3-year-old male pygmy goat was evaluated because of a grade III/V plateau pansystolic murmur that was auscultated over the tricuspid valve area and a grade II/V plateau pansystolic murmur that was auscultated over the left heart base. Echocardiography revealed a large right atrium and ventricle, an atrial septal defect, and a dysplastic tricuspid valve displaced apically into the right ventricle. Contrast echocardiography and color-flow Doppler echocardiography revealed flow from right to left through the atrial septal defect and severe tricuspid regurgitation. A diagnosis of tricuspid valve dysplasia and severe tricuspid regurgitation was made. This anomaly (Ebstein's anomaly) of the tricuspid valve should be considered in goats that have systolic, with or without diastolic, murmurs over the tricuspic valve. Two-dimensional echocardiography can confirm the diagnosis of the anomaly. The associated tricuspid regurgitation and interatrial right-to-left shunt flow can be detected and semiquantitated by use of contrast, continuous wave, and color-flow Doppler echocardiography.  相似文献   

9.
OBJECTIVE: To investigate the relationship between preload and tricuspid valve annulus-derived tissue Doppler imaging (TDI) as an index of right ventricular (RV) filling in dogs. ANIMALS: 7 Beagles. PROCEDURES: Peak systolic RV pressure and RV end-diastolic pressure (RVEDP) were measured in anesthetized dogs. Pulsed Doppler was used to measure tricuspid valve inflow and pulmonary valve outflow velocities. The TDI velocities were measured at the lateral corner of the tricuspid valve annulus. Lactated Ringer's solution was infused at 200 mL/kg/h for 60 minutes via the cephalic vein. RESULTS: IV infusion significantly increased heart rate, RV pressure, and RVEDP. Early diastolic flow (E-wave) and ejection time significantly increased. The myocardial performance index (MPI) significantly decreased. Intravenous infusion significantly increased the ratio of the E'-wave (peak myocardial velocity during early diastole) to the A'-wave (peak myocardial velocity during late diastole; E':A' ratio) and myocardial velocity during systole (S'), early diastole (E'), and late diastole (A'). The TDI-isovolumic relaxation time and TDI-MPI decreased significantly. The RVEDP was correlated with late diastolic flow (A-wave), ratio of the E-wave to the A-wave (E:A ratio), E'-wave, A'-wave, S'-wave (peak myocardial velocity during systole), TDI-isovolumic relaxation time, TDI-MPI, and ratio of the E-wave to the E'-wave (E: E' ratio). The A-wave and E:A ratio and TDI-derived isovolumic relaxation time, S' duration, and E'-wave could predict the RVEDP. CONCLUSIONS AND CLINICAL RELEVANCE: The TDI velocities were affected by RV filling pressure in healthy dogs, whereas other TDI profiles, such as MPI and E':A' ratio, were independent of acute filling abnormalities.  相似文献   

10.
Safe and effective echocardiography would represent a valuable tool for marine mammal veterinarians and physiologists evaluating the dolphin heart. Unfortunately, conventional ultrasound technology (transthoracic echocardiography) has been limited by logistic, anatomic, and behavioral challenges. Five mature male Atlantic bottlenose dolphins (Tursiops truncatus) were trained for echocardiographic imaging (four for both transthoracic and transesophageal imaging, and one for only transthoracic imaging). It was noted that transesophageal image quality transiently improved when the dolphins spontaneously exhaled. Subsequently, dolphins were conditioned to hold their breath following forced exhalation, and imaging proceeded during such behavioral breath holds. Over 25 transthoracic and 100 transesophageal echocardiographic studies were performed, including both two-dimensional imaging and color flow mapping. Transthoracic imaging yielded poor-quality images of only small portions of the heart. In contrast, transesophageal imaging, which improved dramatically with behavioral breath holding following exhalation, yielded consistently high-quality images of the entire heart (mitral, tricuspid, aortic, and pulmonary valves, atrial and ventricular septa, left and right atria, left and right ventricles, and ascending aorta and main pulmonary artery). Color flow mapping demonstrated mild tricuspid regurgitation in all dolphins, and mild aortic regurgitation in one dolphin found to have a pedunculated mass arising from the sinutubular junction just above the aortic valve. There were no complications in nonsedated dolphins. The heart of the bottlenose dolphin can be safely, effectively, and reproducibly evaluated with the use of transesophageal echocardiography in conjunction with behavioral breath holding following forced exhalation. This approach, and the normative echocardiographic data generated from this work, lays the foundation for future echocardiographic studies of cetaceans.  相似文献   

11.
DOPPLER ECHOCARDIOGRAPHY IN THE NORMAL DOG: PART II   总被引：1，自引：0，他引：1  
Doppler echocardiography was used to determine blood flow velocities in the normal canine heart. The areas examined were the mitral valve, left atrium, tricuspid valve, right atrium, aortic valve, left ventricular outflow tract, pulmonic valve and right ventricular outflow tract. This study then statistically evaluated the influence of breed, age, sex, heart rate, mass and various interactions of these factors on the cardiac flow values determined. Mass and heart rate had the most significant effect on the various determinations with decreasing mass and increasing heart rates generally resulting in increasing peak and mean velocities. The pulmonary artery was statistically judged as being the flow area most susceptible to such influences. Comparisons were made between pulsed and continuous wave Doppler for peak velocities over the four valve areas with only aortic flow, as measured from the left caudal view, showing a significant difference between the two techniques. Mitral flow as compared to tricuspid flow showed a statistically significant difference between peak late diastolic velocities only. The ratio of early mitral diastolic flow to late mitral diastolic flow was always greater than one. Pulmonary flow showed a number of statistically significant differences when compared to aortic flow.  相似文献   

12.
A one-year-old French Bulldog was referred for the management of a severe form of pulmonary valve stenosis (PS) complicated by right-sided congestive heart failure.Echocardiography showed severe valvular PS with right ventricular concentric hypertrophy, dilatation and severe right atrial enlargement. A pulmonary balloon valvuloplasty (PBV) was performed with a balloon-to-pulmonary annulus ratio of 1.36. Echocardiography immediately after PBV showed a significant reduction in right atrial and ventricular size, improved opening and mobility of the pulmonary valve leaflets, and a 75% reduction in the pulmonary pressure gradient from 158 mmHg pre-operative to 40 mmHg post-operative. The dog recovered well from anesthesia, but 2 h later, it suddenly showed severe respiratory distress. Focus cardiac ultrasound showed increased left cardiac size with echocardiographic signs of high left ventricular filling pressure. Bedside lung ultrasound showed diffuse numerous-to-confluent B lines, compatible with a severe alveolar-interstitial syndrome. The dog was treated with furosemide, helmet continuous positive airway pressure, and then mechanical ventilation but without success.At post-mortem evaluation, histological examination of the lung showed diffuse, severe broncho-alveolar edema with mixed leukocyte, fibrin, and red blood cell infiltrate. Moreover, severe congestion and multifocal alveolar hemorrhages were evident. All findings were compatible with fatal acute lung injury after PBV secondary to pulmonary reperfusion-ischemia injury and increased pulmonary capillary hydrostatic pressure. Based on the present case, acute lung injury should be considered as a rare but serious complication of PBV.  相似文献   

13.
Pulsed-wave Doppler echocardiography was performed on 30 clinically normal 1- to 6-year-old racing Standardbreds. There were 13 females, 13 geldings, and 4 stallions. Cardiac disease was not detected with M-mode, 2-dimensional real-time or pulsed-wave Doppler echocardiography. Normal flow velocities for right and left atrial outflow, right and left ventricular outflow, the aorta, and pulmonary artery were determined. Peak flow velocities for right and left atrial outflow occurred during the rapid filling phase and were higher toward the mitral valve (mean, 0.70 +/- 0.24 m/s) than toward the tricuspid valve (mean, 0.49 +/- 0.17 m/s). Peak flow velocities in the right and left ventricular outflow tracts were similar (means, 0.81 +/- 0.10 m/s and 0.75 +/- 0.39 m/s, respectively). Peak flow velocities in the pulmonary artery (mean, 1.09 +/- 0.42 m/s) and aorta (mean, 1.01 +/- 0.29 m/s) were similar, although flow peaked earlier in systole in the aorta than in the pulmonary artery.  相似文献   

14.
OBJECTIVE: To determine ECG and echocardiographic measurements in healthy anesthetized Grevy's zebras (Equus grevyi). ANIMALS: 20 healthy zebras. PROCEDURES: Auscultation, base-apex ECG, and echocardiography were performed on anesthetized zebras. RESULTS: Low-grade systolic murmurs were detected in the left basilar region in 4 of 20 zebras. Evaluation of ECGs from 19 zebras revealed sinus rhythm with a predominantly negative QRS complex and a mean +/- SD heart rate of 67 +/- 10 beats/min. Echocardiograms of sufficient image quality were obtained for 16 zebras. Interventricular septal thickness in diastole, left ventricular chamber in diastole and systole, left atrial diameter, and left ventricular mass were significantly and moderately correlated with estimated body weight (r values ranged from 0.650 to 0.884). Detectable swirling of blood in the right and sometimes the left ventricles was detected in 9 of 16 zebras, whereas physiologic regurgitation of blood was detected for the aortic valve in 3 zebras, pulmonary valve in 2 zebras, mitral valve in 2 zebras, and tricuspid valve in 1 zebra. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study provide reference information for use in the cardiac evaluation of anesthetized Grevy's zebras.  相似文献   

15.
Body weight, heart rate, and 19 M-mode echocardiographic variables were measured in 41 nonanesthetized healthy cats. Estimated limits were determined for the echocardiographic variables, and each variable was then correlated to body weight, heart rate, and the 18 other variables. A significant (P less than 0.05) positive correlation to body weight was found with aortic diameter, left atrial dimension, septal and left ventricular systolic and left ventricular diastolic wall thicknesses, and left and right ventricular diastolic and right ventricular systolic internal dimensions. Significant inverse correlation (P less than 0.05) to heart rate was found with body weight, left ventricular systolic and diastolic and right ventricular systolic internal dimensions, left atrial dimension, left atrial dimension to aortic ratio, mitral valve E point to ventricular septal separation, and left ventricular ejection time. Left ventricular shortening fraction in the short axis and velocity of circumferential fiber shortening were significantly correlated (P less than 0.05) to heart rate. Significant correlation (P less than 0.05) was also found between many echocardiographic variables.  相似文献   

16.
Pulmonary hypertension has been associated with mitral insufficiency caused by chronic degenerative valve disease in dogs. Our aim was to search for associations between left atrial to aortic root ratio, end‐systolic and end‐diastolic volume indices, and changes in the right ventricular to right atrial pressure gradient as estimated by the peak velocity of tricuspid regurgitation in dogs with chronic degenerative valve disease and different classes of heart failure. Dogs, for which follow‐up was available were evaluated for changes in the right ventricular to right atrial systolic pressure gradient over time. Three hundred and forty‐four dogs were studied; 51 in the International Small Animal Cardiac Health Council class 1a, 75 in class 1b, 113 in class 2, 97 in class 3a, and 8 in class 3b. The mean values for right ventricular to right atrial systolic pressure gradient, end‐systolic volume index, end‐diastolic volume index, and left atrial to aortic ratio were 49.2 ± 17.1 mmHg, 149.12 ± 60.8 and 37.7 ± 21.6 ml/m2, and 1.9 ± 0.5, respectively. A weak positive correlation was found between the right ventricular to right atrial systolic pressure gradient and the left atrial to aorta ratio (r=0.242, P<0.0001), end‐diastolic volume index (r=0.242, P<0.0001), and end‐systolic volume index (r=0.129, P<0.001). Follow up was available for 49 dogs. Of these, 18 had an increased, 12 a decreased, and 19 a stable right ventricular to right atrial systolic pressure gradient despite therapy. The equivalence point between the sensitivity and specificity curves of about 80% in the coincident point corresponded to a right ventricular to right atrial systolic pressure gradient of 48 mmHg. Our results suggest an association between the progressive nature of chronic degenerative mitral valve disease and pulmonary hypertension. It is of clinical interest that, with a right ventricular to right atrial systolic pressure gradient pressure gradient at or above 48 mmHg, pulmonary hypertension does not appear to improve despite therapy targeted at lowering the left atrial load.  相似文献   

17.
Acquired tricuspid valve stenosis (TVS) is a rare complication of endocardial lead placement in humans that has not been described in the veterinary literature. We describe a 6.5-year-old Border terrier that was presented with right-sided congestive heart failure 5.5 years after placement of a transvenous pacemaker. Severe TVS was confirmed by cardiac ultrasonography and appeared to be secondary to excessive endocardial pacemaker lead within the right atrium. Repositioning of the lead proved impossible and subsequent postmortem examination demonstrated fusion of the tricuspid valve (TV) leaflets around the endocardial lead with associated narrowing of the tricuspid valve orifice. In addition, the loop of the endocardial lead was anchored by thick fibrous tissue to the right atrial wall. This case report suggests that if sufficient endocardial lead is left inside the heart, in dogs undergoing transvenous pacemaker therapy, the redundant lead can become adherent to the tricuspid valve apparatus and cause valvular stenosis.  相似文献   

18.
M-mode, 2-dimensional, and contrast echocardiographic studies were used to detect tricuspid atresia in 2 foals. M-mode echocardiographic findings included a small right ventricle, large left ventricle, large mitral valve excursion, large left atrium (foal 2), dropout of the cranial aspect of the aortic root, and a thick band of echoes in the tricuspid valve region. These findings were confirmed by 2-dimensional echocardiography. In addition, a large right atrium, persistent foramen ovale, ventricular septal defect, and large mitral valve apparatus were imaged. One foal also had a thick right atrial wall. Contrast echocardiography confirmed the intracardiac flow of blood from right to left atrium and then to the left ventricle, followed by simultaneous opacification of the right ventricle and aorta. The use of these echocardiographic techniques enables accurate antemortem diagnosis and prognosis of tricuspid atresia in the foal.  相似文献   

19.
A 7-week-old Wire Fox Terrier was admitted with pulmonary atresia with intact ventricular septum. The right ventricle and tricuspid valve were hypoplastic, and venous return to the right atrium reached the left side through an atrial septal defect. Oxygenation was via hyperplastic bronchial arteries. There was no evidence of the ductus arteriosus. Physical examination, plain and contrast radiography, and electrocardiography were performed. Clinical findings for this combination of defects were similar to those of more common defects (tetralogy of Fallot, patent ductus arteriosus.  相似文献   

20.
The aim of this study was to investigate the potential haemodynamic effects of valvular insufficiency and recurrent airway obstruction (RAO) in horses with atrial fibrillation (AF). Therefore in ten healthy horses (group 1) and 40 horses with AF a clinical examination, a lung examination, echocardiography and right heart catheterization for measurement of intracardic and pulmonary pressures were performed. According to the clinical findings the horses with AF were subdivided into 4 groups (group 2: AF; group 3: AF/valvular insufficiency; group 4: AF/RAO; group 5: AF/valvular insufficiency/RAO). Most of the horses of group 3 and 5 suffered from two valvular insufficiencies (mitral and tricuspid valve insufficiency: n=11, mitral and aortic valve insufficiency: n=2). The remaining horses showed a single mitral (n=6), tricuspid (n=2) or aortic valve insufficiency (n=1) or more than two valvular insufficiencies (n=4). In group 2 right ventricular mean pressure (RVPm) was higher than in group 1 and 4 (P<0.025); diastolic right ventricular pressure was higher than in group 1; PWP was higher than in group 1 and group 4; PDP was lower compared to group1. Compared to group1 in group 3 left atrial diameter (LA) was greater; the PAPs was higher and the PDP lower (P<0.05). In group 4 RVPm and PWP was lower compared to group 2. In group 5 LA, fractional shortening and diastolic left ventricular diameter were greater, PWP and PAPs were higher and PDP lower compared to group1. Twenty six of the 40 horses with AF (65%) were treated. Successful cardioversion to sinus rhythm occurred in 15 horses (58%). Therapy was successful in 50% of the treated horses of group 2 and 3, in 67% of the treated horses of group 4 and in 63% of the treated horses in group 5. In conclusion the presence of valvular insufficiency or RAO influences the haemodynamics of horses with AF.  相似文献   

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