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1.
A retrospective study was undertaken to characterise the biological behaviour of splenic haemangiosarcoma (HSA) in dogs. Metastatic pattern data for 25 dogs with splenic HSA that were presented for clinical signs relating to splenic lesions (eg, abdominal mass and, or, haemoperitoneum) and had undergone necropsy were analysed. Six of 25 dogs with splenic HSA that were presented for abdominal mass/haemoperitoneum had right atrial HSA. Fifteen of 19 (79 per cent dogs) with splenic HSA associated with abdominal mass/hemoperitoneum without right atrial involvement had disease confined to the peritoneal cavity. The most common metastatic sites in these dogs were liver, omentum and mesentery. Extraperitoneal metastases were seen in four of 19 (21 per cent) dogs without right atrial involvement. Analysis of signalment data of dogs in this series and the literature revealed no differences between dogs with disease confined to the peritoneal cavity and dogs with extraperitoneal metastases. The subjectivity of primary site designation, importance of ante mortem identification of individuals with concurrent right atrial involvement, and need for more aggressive therapy directed at intraperitoneal metastases are discussed.  相似文献   

2.
BACKGROUND: Hemangiosarcoma (HSA) is a common solid tumor of the spleen, heart, and skin of dogs. Renal HSA represents an uncommon anatomic variant, with little reported about its biologic behavior and clinical outcome. HYPOTHESIS: That renal HSA is associated with longer survival than other visceral forms of HSA. ANIMALS: 14 dogs with renal HSA. METHODS: Medical records from 1999 to 2004 were searched for dogs with histopathologically confirmed renal HSA, and data relevant to clinical signs, treatments, and outcomes were abstracted. RESULTS: Clinical signs were nonspecific, and the median duration of clinical signs before diagnosis was 60 days. Two dogs presented in cardiovascular collapse secondary to hemoperitoneum. Common hematologic and biochemical abnormalities were anemia (9/14), hematuria (7/14), and proteinuria (7/14). One dog had pulmonary metastasis at diagnosis. All dogs had evidence of a renal mass visualized by abdominal radiography (14/14), ultrasound (9/14), or both. All dogs underwent nephrectomy, and 4/14 dogs also received adjunctive chemotherapy. Median survival time of all dogs was 278 days (range 0-1,005 days), and dogs with hemoperitoneum had significantly shorter survival times than dogs without hemoperitoneum (62 days versus 286 days, P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: These results indicate that hemoperitoneum and distant metastasis at diagnosis appear to occur less frequently in dogs with renal HSA compared with other visceral forms of HSA. Furthermore, dogs with renal HSA have protracted disease progression, with improved 1-year survival rates and longer median survival time compared to dogs with splenic, cardiac, and retroperitoneal HSA.  相似文献   

3.
Thoracic radiographic and postmortem findings were compared in dogs with histologically confirmed hemangiosarcoma (HSA). On the basis of results of radiography, a false-negative diagnosis was made for pulmonary HSA in 10 (21.7%) of 46 dogs, and in 26 (53.1%) of 49 dogs for cardiac HSA. The incidence of false-negative radiographic diagnosis for pulmonary HSA was lower in dogs when left and right lateral views were obtained. The radiographic sensitivity was 78%, and the negative-predictive value was 74% for pulmonary HSA. The radiographic sensitivity was 47%, and the negative-predictive value was 43% for cardiac HSA.  相似文献   

4.
Cardiopulmonary function values were determined before and after surgical removal of adult heartworms in 25 dogs with spontaneous and 4 dogs with drug-induced caval syndrome (CS). Fifteen dogs with spontaneous CS (recovery group) and 4 dogs with drug-induced CS (drug-induced CS group) recovered after removal, and 10 dogs with spontaneous CS were euthanatized or died (nonsurviving group). Before heartworm removal, injected radiographic contrast medium was regurgitated from the right ventricle to the right atrium. Mean pulmonary arterial pressure and total pulmonary resistance were not statistically different between the recovery and nonsurviving groups of dogs, but the end-diastolic right ventricular pressure (mean +/- SD, 6.9 +/- 9.1 mm of Hg) and the a (8.7 +/- 9.2 mm of Hg)- and v (6.3 +/- 8.5 mm of Hg)-waves of the right atrial pressure curve in the recovery group were less, respectively, than the end-diastolic right ventricular pressure (17.3 +/- 6.0 mm of Hg) and the a (15.8 +/- 6.1 mm of Hg)- and v (21.4 +/- 6.9 mm of Hg)-waves in dogs of the nonsurviving group. After heartworm removal, contrast medium regurgitation disappeared, and cardiac output of the right ventricle increased in dogs of the recovery (from 2.08 +/- 0.72 to 2.38 +/- 0.68 L/min; P less than 0.05) and drug-induced CS (from 1.42 +/- 0.19 to 1.88 +/- 0.26 L/min, P less than 0.05) groups. However, regurgitation remained, and cardiac output did not increase in some dogs of the nonsurviving group.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

5.
BACKGROUND: Hemangiosarcoma (HSA) is a highly metastatic and often rapidly fatal tumor of dogs. At present, adjuvant chemotherapy is the only proven effective treatment for dogs with HSA, though the benefits from chemotherapy are modest. Administration of immunotherapy together with chemotherapy has also been reported to improve survival in dogs with HSA. Therefore, we evaluated safety and immunologic responses to a novel tumor vaccine administered together with doxorubicin chemotherapy in dogs with different stages of HSA. HYPOTHESIS: That tumor vaccination could be safely and effectively combined with doxorubicin chemotherapy for treatment of dogs with HSA. ANIMALS: Twenty-eight dogs with various stages of HSA were enrolled in the study. METHODS: The HSA vaccine was prepared with lysates of allogeneic canine HSA cell lines mixed with an adjuvant composed of liposome-DNA complexes. Dogs received a series of 8 immunizations administered over a 22-week period, and most also received chemotherapy. Clinical adverse effects were noted, immune responses were measured by enzyme-linked immunosorbent assay (ELISA) and flow cytometry, and survival times were calculated. RESULTS: The most common adverse effects observed in vaccinated dogs also treated with doxorubicin chemotherapy were diarrhea and anorexia. Vaccinated dogs were found to mount strong humoral immune responses against a control antigen and, most dogs also mounted antibody responses against canine HSA cells. Thirteen dogs with stage II splenic HSA that received the tumor vaccine plus doxorubicin chemotherapy had an overall median survival time of 182 days. CONCLUSIONS: We conclude that an allogeneic tumor lysate vaccine is safe in dogs with HSA and can elicit humoral immune responses in dogs that are receiving concurrent doxorubicin chemotherapy.  相似文献   

6.
Canine mast cell tumor staging is commonly performed using abdominal ultrasonography and fine‐needle aspiration cytology of masses, lymph nodes, and hepatic and splenic parenchyma. Computed tomography is used for abdominal, thoracic, or whole body imaging in staging mast cell tumors in the authors’ institution enabling evaluation of multiple body areas in one examination. The aim of this study was to compare the CT examinations acquired for staging of mast cell disease to their subsequent liver and spleen cytology findings. Medical records of dogs with primary mast cell tumors that underwent abdominal CT and concurrent liver and spleen aspirates were reviewed. The CT examinations were evaluated for attenuation, size, and margination of the liver and spleen. The relationship between CT findings and cytology results was analyzed. Forty‐nine dogs matched the inclusion criteria: five of forty‐nine dogs with cutaneous mast cell tumors were positive for metastasis from liver and/or spleen aspirates. Of the five dogs with cytological evidence of liver or spleen metastasis, four had normal CT liver attenuation and size, one dog had concurrent primary hepatocellular neoplasia, four dogs had abnormal splenic parenchyma (two nodular and two diffuse heterogeneity), and one dog had a normal attenuation of the spleen. In four dogs, the spleen was subjectively enlarged. Computed tomographic evaluation of the liver showed no consistent pattern associated with mast cell metastasis and did not predict cytology results. Multifocal splenic hypoattenuating lesions more commonly coincided with mast cell metastasis. Sampling of the liver and spleen remains to be considered in the absence of abnormal CT findings for full staging.  相似文献   

7.
Cytologic sampling of the ultrasonographically normal spleen and liver is not implemented routinely in the clinical staging of canine cutaneous mast cell tumors and normal ultrasound findings are often accepted as sufficient evidence for ruling out splenic or liver metastasis. Our objective was to define the specificity and sensitivity of ultrasound findings for diagnosis of mast cell infiltration when verified with cytologic evaluation, and to define the prognostic role of cytologic evaluation of liver and splenic aspirates. Dogs with a diagnosis of clinically aggressive grade II, or grade III mast cell tumor treated with a combination vinblastine/CCNU chemotherapy protocol, were selected retrospectively based on availability of cytologic evaluation of spleen plus or minus liver for staging. Out of 19 dogs, 10 dogs had a grade II tumor and nine a grade III tumor. Seven dogs had mast cell infiltration of the spleen, liver, or both. The sensitivity of ultrasound for detecting mast cell infiltration was 43% for the spleen and 0% for the liver. Dogs with positive cytologic evidence of mast cell infiltration to spleen, liver, or both had significantly shorter survival (100 vs. 291 days) than dogs without evidence of mast cell infiltration (P<0.0001). Routine splenic aspiration should be performed regardless of ultrasonographic appearance in dogs with a clinically aggressive mast cell tumor.  相似文献   

8.
Canine dermal haemangiosarcoma (HSA) is believed to have a better prognosis compared to HSA in other organs, but outcome has only been reported in a small number of dogs. The purpose of this study was to assess outcome and prognostic factors in a larger cohort of dogs with dermal HSA. Clinical data was collected retrospectively for 94 dogs and histopathology was reviewed in 53 dogs. Median overall survival time was 987 days. Dogs of predisposed breed with ventral location and histologic solar changes had longer survivals. Loco-regional recurrence occurred in 72/94 (77%) dogs. Predisposed breeds with ventral location and multiple masses were more likely to develop recurrence. Non-predisposed breeds with invasive tumours were more likely to develop metastasis. Results suggest that dogs with solar-induced dermal HSA may have high recurrence rates, but prolonged survivals. Dogs with non-solar tumours may be at increased risk for metastasis and shorter survival.  相似文献   

9.
BACKGROUND: Canine splenic hemangiosarcoma (HSA) is a fatal malignancy, and most affected dogs die within a few months of diagnosis. Most dogs present with signs from tumor rupture, resulting in hemoabdomen and intra-abdominal dissemination. The abdomen is also the main site of disease recurrence. HYPOTHESIS: Intraperitoneal (IP) administration of doxorubicin will delay or prevent intra-abdominal tumor recurrence and prolong survival in dogs with HSA. ANIMALS: Fourteen dogs with splenic HSA. METHODS: A prospective, unmasked, uncontrolled clinical trial. After staging of disease status and splenectomy, pegylated liposomal encapsulated doxorubicin was administered intraperitoneally (1 mg/kg body weight) every 3 weeks for 4 cycles. All dogs were monitored for recurrence of HSA. Samples of plasma and abdominal fluid were collected for measurement of doxorubicin concentration and pharmacokinetic analysis. Nonlinear mixed-effect modeling was used to describe the pharmacokinetics of liposomal doxorubicin administered IP. RESULTS: All 14 dogs died, 12 because of HSA and 2 from other causes. Postmortem examination was performed on 12 dogs. All 12 dogs died because of HSA-related causes and had hepatic metastases and hemoabdomen. The IP-treated dogs had fewer serosal, mesenteric, and omental metastases than historical controls treated with systemic doxorubicin. Results of the postmortem examination and pharmacokinetic analysis confirmed that IP delivery of doxorubicin resulted in an effective drug concentration with a clearance comparable with that after i.v. delivery. CONCLUSIONS AND CLINICAL IMPORTANCE: IP pegylated liposomal encapsulated doxorubicin administration did not prevent intraabdominal recurrence of HSA in dogs.  相似文献   

10.
A Veterinary Medical Database search from 1982 to 1995 identified 1,383 dogs with tumors of the heart from a total population of 729,265 dogs (0.19% incidence). Hemangiosarcoma (HSA) was the most common cardiac tumor identified. In the subset of dogs with specific histologic diagnoses, the number with HSA was almost 10-fold that of the 2nd most common tumor, aortic body tumor. Primary heart tumors were more common than cardiac metastases. When biologic behavior was noted, most heart tumors were classified as malignant. Cardiac tumors (excluding lymphoma) occurred most often in dogs between the ages of 7 and 15 years. In very old dogs (>15 years), the frequency of cardiac tumors was the same or lower than that of the youngest age group. Tumors occurred with similar frequency in males and females, but the relative risk for spayed females was >4 times that for intact females. For HSA, spayed females had >5 times greater relative risk than did intact females. The risk for castrated males was slightly greater than that for intact males, which had 2.4 times the relative risk of intact females. Thus, neutering appeared to increase the risk of cardiac tumor in both sexes. Intact females were least likely to develop a cardiac tumor, whereas spayed females were most likely to develop a tumor. Twelve breeds had greater than average risk of developing a cardiac tumor, whereas 17 had lower risk.  相似文献   

11.
Splenectomy followed by adjuvant chemotherapy is commonly used to treat canine splenic haemangiosarcoma (HSA), although it is unclear if different treatment protocols may have a similar efficacy. The objective of this retrospective study was to assess outcome in dogs with stage I and II splenic HSA treated with either first‐line adjuvant anthracycline (AC) or metronomic (MC)‐based chemotherapy protocols, by comparing median time to progression (TTP) and median survival time (MST). Medical records of nine institutions were searched for dogs diagnosed with stage I and II splenic HSA that underwent adjuvant treatment with AC‐ or MC‐based protocols following splenectomy. Patients treated with MC following AC were included in an additional group (AMC). Ninety‐three dogs were included: 50 in the AC group, 23 in the AMC group and 20 in the MC group. The overall MST was 200 days (range 47‐3352) and the overall median TTP was 185 days (range 37‐1236). The median TTP of stage I dogs was significantly longer compared to stage II dogs (338 vs 151 days, respectively, P = .028). When adjusting for treatment type, the MST was 154 days for the AC group (range 47‐3352 days), 338 days for the AMC group (range 79‐1623 days) and 225 days for the MC group (range 57‐911 days). The difference in MST and median TTP was not found to be statistically significant between treatment groups. This study suggests that adjuvant MC in canine splenic HSA may result in a similar outcome when compared to other treatment protocols. Further studies are warranted to confirm these findings.  相似文献   

12.
Introduction:  Canine hemangiosarcoma (HSA) is a fatal malignancy and most dogs die within 6–8 months of diagnosis. The spleen is a common primary site, representing 50% of all cases. These dogs typically present with clinical signs due to tumor rupture and intra‐abdominal dissemination; the abdomen is also the main site of disease progression when these patients fail. Direct delivery of chemotherapy into the abdominal cavity may therefore be a rational approach in this malignancy.
Methods:  14 dogs with stage 2 or 3 splenic HSA were recruited. Doxil at a dose of 1 mg/kg was diluted in saline and administered via ultrasound‐guidance into the abdominal cavity. The dogs were scheduled to receive 4 treatments every 3 weeks. Samples of plasma and abdominal fluid were collected for pharmacokinetic analysis. All dogs were monitored for recurrence and complete necropsies were requested at death.
Results:  8 dogs with stage 3 and 6 dogs with stage 2 HSA were enrolled. All 14 dogs have died, 12/14 due to tumor and 2 from other causes. There was no difference in median survival days between stages (stage 2: 244, stage 3: 125, p = .22). All 12 dogs that died due to tumor‐related causes failed with intra‐abdominal recurrence. Necropsies showed that the dogs in this study had relatively fewer extra‐abdominal metastasis compared to dogs treated with systemic chemotherapy. Pk analysis showed detectable plasma doxorubicin 1 and 2 weeks after treatment.
Conclusion:  Direct abdominal administration of Doxil did not prevent intra‐abdominal recurrence; however, it appeared to provide effective systemic coverage.  相似文献   

13.
The case records of 26 dogs with pericardial effusion were examined. Sixteen dogs with confirmed right atrial/auricular masses were found. Eighteen masses were identified, of which 16 were confirmed as hemangiosarcomas. Eleven dogs had an abnormal mass detected during the echocardiographic examination, and tumor location was correctly predicted in nine of the 11 dogs. Six of seven tumors, which were not detected during the echocardiogram, were located in the right auricle. Pericardial effusion was apparently not necessary for the echocardiographic detection of a right atrial/auricular mass. Of ten dogs with pericardial effusion due to causes other than a cardiac mass, one abnormal mass-like lesion was seen during echocardiographic examination.  相似文献   

14.
Splenic Infarction in 16 Dogs: A Retrospective Study   总被引：2，自引：0，他引：2  
Sixteen dogs with splenic infarction due to causes other than splenic torsion were identified. Dogs with splenic infarction often had multiple concurrent diseases, and surgical management of splenic infarction was associated with high mortality. Splenic infarction occurred in dogs with hypercoagulable conditions associated with liver disease, renal disease, and hyperadrenocorticism, or as a consequence of uniform splenomegaly, neoplasia, or thrombosis associated with cardiovascular disease. Clinical signs and common laboratory findings generally reflected the underlying disease process. A variety of splenic abnormalities were detected by abdominal ultrasound in 15 dogs, with the ventral extremity of the spleen being most often abnormal. Four dogs were euthanized or died because of the presence of severe systemic disease, whereas 12 dogs underwent laparotomy. Complete splenectomy was performed in 9 dogs and partial splenectomy was performed in 2 dogs. Seven dogs died in the immediate postoperative period, 3 required chronic veterinary care, and 2 had uncomplicated long-term recoveries. Splenic infarction should be regarded as a sign of altered blood flow and coagulation, rather than as a primary disease, and surgical management should be reserved for patients with life-threatening complications such as hemoabdomen or sepsis.  相似文献   

15.
Background: Splenic venous thrombosis (SVT) is usually considered an incidental finding on abdominal ultrasound examination but can indicate the presence of underlying disease. Concurrent disease processes and conditions in dogs with SVT have not been identified previously. Objectives: To identify concurrent diseases and conditions in dogs with SVT. Animals: Eighty dogs with SVT. Methods: Retrospective review. Medical records from 1994 through 2008 were searched for dogs with SVT identified by ultrasound examination. These records were then reviewed for signalment, medical history, clinicopathologic testing, diagnostic imaging, and clinical diagnosis. Results: The most common concurrent conditions were neoplasia (54%), exogenous corticosteroid administration (43%), systemic inflammatory response syndrome (26%), disseminated intravascular coagulation (20%), pancreatitis (18%), and immune‐mediated disease (16%). The most common neoplastic disease was lymphoma, and the most common immune‐mediated disease was immune‐mediated hemolytic anemia. Protein‐losing nephropathy and naturally occurring hyperadrenocorticism were identified in <10% of the dogs. Concurrent splenic infarcts were identified in 33% of dogs, and concurrent portal vein thrombi were found in 18% of dogs. Conclusions: SVT is a sonographic finding of clinical importance, and dogs with SVT can have 1 or more coexisting diseases.  相似文献   

16.
Conflicting evidence exists regarding the importance of routine abdominal ultrasound (US) with hepatic and splenic fine needle aspiration (FNA) cytology during staging of canine mast cell tumours (MCT). The objective of this study was to correlate ultrasonographic and cytologic findings in dogs with strictly defined high‐risk MCTs and to determine the influence on outcome. Our hypothesis was that US poorly predicts visceral metastasis in high‐risk MCTs and that early metastasis is associated with improved outcome when compared to overt metastasis. US of liver and spleen correlated to cytologic results, categorized as no metastasis, early metastasis or overt metastasis. Of 82 dogs prospectively enrolled, 18% had early visceral metastasis and 7% had overt metastasis on cytology; 67% with visceral metastasis had regional LN metastasis. US was a poor predictor of metastasis with sensitivity, specificity, positive predictive value and negative predictive value for the spleen of 67%, 68%, 21% and 94%, respectively and for the liver of 29%, 93%, 56% and 82%, respectively. Median time to progression (TTP) for dogs with no metastasis, early metastasis and overt metastasis was not reached, 305 and 69 days, respectively (P < .001). Median survival time (MST) for the 3 groups were not reached, 322 and 81 days, respectively (P < .001). High Patnaik or Kiupel grade, early metastasis, overt metastasis and adequate local control were significantly associated with outcome. Early visceral metastasis was associated with poorer outcome compared to dogs without metastasis, however, a subset of dogs experienced long‐term control.  相似文献   

17.
The echocardiographic (M-mode and 2-dimensional) features (before and after pericardiocentesis) of 4 dogs with pericardial effusion and clinical evidence of cardiac tamponade were reviewed. M-Mode echocardiography revealed pericardial effusion, with exaggerated swinging motion of the heart and abnormal septal motion in all 4 dogs. In each case, 2-dimensional echocardiography demonstrated right ventricular diastolic free-wall collapse. Three dogs had right atrial diastolic collapse as well. Clinical signs improved, and right ventricular and right atrial diastolic collapse subsided after pericardiocentesis. Two-dimensional echocardiographic features of right atrial and ventricular collapse were used as indicators for determining the presence of cardiac tamponade.  相似文献   

18.
Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are sensitive and specific markers for myocardial ischemia and necrosis. Dogs with pericardial effusion frequently have myocardial ischemia and necrosis, and these changes are more severe in dogs with hemangiosarcoma (HSA). We investigated the utility of using serum cTnI and cTnT concentrations to identify the idiopathic pericardial effusion from that associated with HSA. Blood samples for measurement of cTnI and cTnT concentrations were collected before pericardiocentesis in 37 dogs with pericardial effusion. Eighteen dogs had a mass consistent with HSA, 6 dogs had idiopathic pericardial effusion, 1 dog had mesothelioma, and 1 dog had a heart base tumor. No final diagnosis was achieved for 11 dogs. Dogs with pericardial effusion had significantly higher serum concentrations of cTnI (P < .001) but not cTnT (P = .16) than did normal dogs. Dogs with HSA had significantly higher concentrations of cTnI (2.77 ng/dL; range: 0.09-47.18 ng/dL) than did dogs with idiopathic pericardial effusion (0.05 ng/dL; range: 0.03-0.09 ng/dL) (P < .001). There was no difference in the concentration of cTnT between dogs with HSA and those with idiopathic pericardial effusion (P = .08). Measurement of cTnI may be useful in helping to distinguish between idiopathic pericardial effusion and pericardial effusion caused by HSA.  相似文献   

19.
Background: Transcatheter atrial septal defect (ASD) closure in the dog was first reported in 2005.
Objectives: Describe the technique and both short- and mid-term outcome of transcatheter ASD closure with the Amplatzer® atrial septal occluder (ASO).
Animals: Thirteen client-owned dogs with ASD.
Methods: Records of the initial 13 dogs in which transcatheter ASD closure was attempted at Texas A&M University were reviewed.
Results: All dogs had hemodynamically relevant septum secundum ASD. Two dogs had concurrent congenital abnormalities. ASOs were deployed in 13 dogs and released in 12. Eleven were released by a right jugular approach and 1 by a transatrial approach through a right lateral thoracotomy. Transthoracic echocardiographic estimates of ASD size were 14.0 ± 5.4 mm (mean ± 1 standard deviation) with a range of 7–22 mm. Accidental right atrial release occurred in 1 dog and embolization after release occurred in 2 dogs. Transcatheter ASD closure was successful in 10 dogs. Transthoracic color Doppler echocardiography the day after ASD closure indicated complete occlusion in 5 dogs, trivial to mild residual shunting in 4 dogs, and moderate residual shunting in 1 dog. Follow-up echocardiograms (mean of 12.4 ± 7.4 months postprocedure) were available for 9 dogs. There was no residual ASD shunting in 6 dogs. In 3 of the 5 dogs with postoperative residual shunting it was judged to be decreased and hemodynamically unimportant relative to the dogs' postoperative evaluations. The mean length of event-free survival in the 10 dogs that underwent successful transcatheter ASD closure was 22.2 ± 10.2 months.  相似文献   

20.
Cardiopulmonary values were determined in dogs with an artificial model of heartworm caval syndrome, which was produced by insertion of heartworm-like silicone tubes into the tricuspid valve orifice and right atrium. Fifteen to 25 tubes with some knots were inserted in 6 dogs (knot group), and 7 to 11 tubes (small-number group) or 29 to 37 tubes (large-number group) without a knot in 3 dogs, respectively. After tube insertion, angiographic contrast medium infused into the right ventricle regurgitated to the right atrium in all cases, and the regurgitation was the most severe in the large-number group. On electrocardiographic findings, the atrial and/or ventricular premature beat developed. The height of a- and v-wave of right atrial pressure curves elevated in all groups. The elevation in v-wave was obvious in the large-number group. The pulmonary arterial pressure tended to fall or to elevate slightly, and total pulmonary resistance increased in all groups. The right cardiac output decreased significantly in all cases. The right heart hemodynamics of the model might resemble those in spontaneous cases without disturbed pulmonary circulation.  相似文献   

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