Shimizu M, Tanaka R, Hoshi K, Hirao H, Kobayashi M, Shimamura S, Yamane Y
Department of Veterinary Surgery, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu-shi, Tokyo 183-0054, Japan.
Aust Vet J. 2006 Apr;84(4):117-21. doi: 10.1111/j.1751-0813.2006.tb13393.x.
An 8-month-old entire Miniature Dachshund, weighing 4.2 kg, was presented for examination following delvelopment of a cough. Ventricular septal defect had been diagnosed tentatively in its infancy on the basis of a cardiac murmur detected by auscultation and echocardiography. Echocardiography using a B mode right parasternal long-axis view showed a defect at the atrioventricular junction and a thickened cusp of the aortic valve prolapsing into the defect. Colour-flow Doppler showed shunt blood flow across the defect at the level of the atrioventricular junction, from left to right. The sinus of Valsalva was dilated, with turbulent blood flow. Aortic regurgitation was also observed. Cardiac catheterisation studies confirmed the diagnosis of a supracristal ventricular septal defect with aortic regurgitation. Despite medication with digoxin, enalapril and aminophylin, started from the first admission, left ventricular internal dimensions gradually increased, and fractional shortening of the left ventricle gradually decreased. Surgery, with the aid of extracorporeal circulation, to close the ventricular septal defect, was performed 1 year after the initial examination. The aortic valve was left untreated. Postoperatively, the systolic murmur disappeared. Shunt flow from the left to the right ventricle was no longer observed on echocardiography, however there was still a small amount of aortic regurgitation during diastole visualised with colour-flow Doppler echocardiography. The prolapse of the cusp of the aortic valve on B-mode echocardiography was no longer observed and thickening of the cusp had not progressed. Left ventricular function measurement using M mode echocardiography showed a reduced left ventricular volume overload with reduced left ventricular internal dimensions and increased fractional shortening. The cough was relieved and no follow-up medication was scheduled. Early surgical closure of the ventricular septal defect improved the patient's condition and controlled prolapse and thickening of the aortic valve.
一只8个月大、体重4.2千克的未绝育迷你腊肠犬，因出现咳嗽前来就诊。该犬幼年时，根据听诊和超声心动图检测到的心脏杂音，初步诊断为室间隔缺损。使用B型右胸骨旁长轴视图的超声心动图显示，房室交界处有缺损，主动脉瓣增厚的瓣叶脱垂至缺损处。彩色多普勒显示，在房室交界处水平，有从左向右穿过缺损的分流血流。主动脉窦扩张，有湍流。还观察到主动脉反流。心导管检查证实诊断为嵴上型室间隔缺损合并主动脉反流。尽管从首次入院起就使用地高辛、依那普利和氨茶碱进行药物治疗，但左心室内径逐渐增大，左心室缩短分数逐渐降低。在初次检查1年后，借助体外循环进行了手术以闭合室间隔缺损。主动脉瓣未作处理。术后，收缩期杂音消失。超声心动图未再观察到从左心室到右心室的分流，但彩色多普勒超声心动图显示舒张期仍有少量主动脉反流。B型超声心动图上不再观察到主动脉瓣瓣叶脱垂，瓣叶增厚也未进展。使用M型超声心动图测量左心室功能显示，左心室容量超负荷减轻，左心室内径减小，缩短分数增加。咳嗽缓解，未安排后续药物治疗。早期手术闭合室间隔缺损改善了患者状况，控制了主动脉瓣脱垂和增厚。
