Saunders Ashley B, Miller Matthew W, Gordon Sonya G, Bahr Anne
Departments of Small Animal Veterinary Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station 77843-4474, USA.
J Vet Intern Med. 2007 Jan-Feb;21(1):68-75. doi: 10.1892/0891-6640(2007)21[68:eaacod]2.0.co;2.
Transcatheter occlusion of patent ductus arteriosus (PDA) is a minimally invasive treatment option in dogs. Device selection based on appropriately acquired PDA dimensions and morphology can minimize procedural complications, including minimizing residual ductal flow and inappropriate embolization.
Transesophageal echocardiographic (TEE) derived minimum ductal diameter measurements would most accurately reflect angiographic measurements. Color Doppler (CD) TEE and transthoracic echocardiographic (TTE) ductal measurements would overestimate two-dimensional (2D) measurements.
Fifteen client-owned dogs with PDA.
PDA dimensions obtained with angiography, 2D and CD TTE, 2D and CD TEE from the right and left views were prospectively evaluated.
PDA dimensions were measured by using TEE most closely approximated angiographic measures. CD TTE and TEE frequently overestimated angiographic measures of minimum ductal diameter. TEE accurately identified a type III (tubular) PDA morphology in 1 dog. Fourteen of 15 dogs were determined to have hemodynamically significant reductions in left to right shunting documented by a first-pass nuclear angiocardiographic ratio of pulmonary to systemic blood flow < or = 1.2 and trivial (n = 3) to no (n = 11) CD TTE flow at approximately 1 month after PDA occlusion.
TEE provided accurate anatomic information regarding PDA morphology and closely approximated angiographic ductal dimensions while aiding in both coil deployment and confirmation of intra-operative ductal closure.
经导管封堵犬动脉导管未闭(PDA)是一种微创治疗选择。根据适当获取的PDA尺寸和形态选择封堵装置可将手术并发症降至最低,包括将残余导管血流和不适当栓塞降至最低。
经食管超声心动图(TEE)得出的导管最小直径测量值最能准确反映血管造影测量值。彩色多普勒(CD)TEE和经胸超声心动图(TTE)的导管测量值会高估二维(2D)测量值。
15只患PDA的家养犬。
前瞻性评估通过血管造影、2D和CD TTE、从左右视图获取的2D和CD TEE获得的PDA尺寸。
使用TEE测量的PDA尺寸最接近血管造影测量值。CD TTE和TEE经常高估导管最小直径的血管造影测量值。TEE准确识别出1只犬的III型(管状)PDA形态。15只犬中有14只在PDA封堵后约1个月时,首次通过核素心血管造影测得的肺循环与体循环血流量之比≤1.2,且CD TTE血流轻微(n = 3)至无(n = 11),证明左向右分流有血流动力学意义的降低。
TEE提供了关于PDA形态的准确解剖信息,非常接近血管造影的导管尺寸,同时有助于线圈置入和术中导管闭合的确认。