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犬二尖瓣置换术的技术与结果

Technique and outcome of mitral valve replacement in dogs.

作者信息

Orton E Christopher, Hackett Timothy B, Mama Khursheed, Boon June A

机构信息

James L. Voss Veterinary Teaching Hospital, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.

出版信息

J Am Vet Med Assoc. 2005 May 1;226(9):1508-11, 1500. doi: 10.2460/javma.2005.226.1508.

Abstract

Eight dogs with naturally occurring severe mitral regurgitation underwent mitral valve replacement with a mechanical valve prosthesis during cardiopulmonary bypass. Dogs received warfarin orally after surgery to maintain a prothrombin time-based international normalized ratio from 2.5 to 3.5. Seven dogs survived surgery. Left ventricular diastolic volume index decreased significantly from 206 +/- 91 mL/m2 before surgery to 121 +/- 47 mL/m2 after surgery. Left atrium-to-aorta ratio decreased significantly from 2.66 +/- 0.4 before surgery to 1.73 +/- 0.65 after surgery. Left ventricular systolic volume index was not significantly different after surgery (56 +/- 36 mL/m2), compared with before surgery (40 +/- 32 mL/m2). Median survival after surgery was 4.5 months (range, 0.75 months to 5.25 years). Six dogs died of confirmed or suspected thrombosis of the valve prosthesis. Dogs with severe mitral regurgitation tolerated mitral valve replacement well, but a high incidence of prosthetic valve thrombosis limited long-term outcome.

摘要

八只患有自然发生的严重二尖瓣反流的犬在体外循环期间接受了机械瓣膜置换术。术后犬口服华法林以维持基于凝血酶原时间的国际标准化比值在2.5至3.5之间。七只犬术后存活。左心室舒张容积指数从术前的206±91 mL/m²显著降至术后的121±47 mL/m²。左心房与主动脉比值从术前的2.66±0.4显著降至术后的1.73±0.65。与术前(40±32 mL/m²)相比,术后左心室收缩容积指数无显著差异(56±36 mL/m²)。术后中位生存期为4.5个月(范围为0.75个月至5.25年)。六只犬死于确诊或疑似人工瓣膜血栓形成。患有严重二尖瓣反流的犬对二尖瓣置换术耐受性良好,但人工瓣膜血栓形成的高发生率限制了长期预后。

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