Van Israël Nicole, French Anne T, Dukes-McEwan Joanna, Welsh Elizabeth M
J Vet Cardiol. 2003 May;5(1):13-21. doi: 10.1016/S1760-2734(06)70040-6.
The objectives of this study were to describe the clinical course of Patent Ductus Arteriosus (PDA) in older canine patients (defined as patients greater than 24 months at the time of presentation) with and without intervention. This study was also undertaken to evaluate if adult dogs with persistent flow across the ductus should still be closed, what the benefits are from late closure, and to hypothesise why some animals still continue to deteriorate despite closure.
Currently accepted therapies for patent ductus arteriosus are surgical ligation and transcatheter coil embolisation. The majority of dogs are diagnosed and treated at young age. Some older dogs survive with few clinical signs and live a normal life span without intervention. Some dogs deteriorate despite intervention.
The case records of 24 dogs that had reached 24 months of age before diagnosis were reviewed and those animals that had no concurrent congenitaal cardiac diseases were included in the study (n = 21). Those animals that were still alive were requested to participate in a long-term follow-up study.
After closure of the ductus (n = 16), the clinical signs disappeared in all but one animal. On follow-up of these animals, there was echocardiographic evidence of left ventricular systolic and diastolic dysfunction in many. Late cardiac death was recorded in 3 animals. In dogs where there was no intervention congestive heart failure was a common, but not an inevitable sequel. Development of mitral valve endocardiosis was a common feature.
Older animals with PDA follow an individual course, independent of pre-existing heart failure. Irreversible left ventricular dysfunction is common, however it does not seem to affect the clinical course. These data show a favourable outcome in a high percentage of adult dogs diagnosed with PDA that undergo closure. Outcome without intervention was less favorable.
本研究的目的是描述老年犬（定义为就诊时年龄大于24个月）动脉导管未闭（PDA）在接受和未接受干预情况下的临床病程。本研究还旨在评估持续存在导管分流的成年犬是否仍应进行封堵、晚期封堵的益处是什么，并推测为何有些动物在封堵后仍继续恶化。
目前公认的动脉导管未闭治疗方法是手术结扎和经导管线圈栓塞。大多数犬在幼年时被诊断和治疗。一些老年犬在几乎没有临床症状的情况下存活，未经干预可正常寿命。一些犬尽管接受了干预仍会恶化。
回顾了24只在诊断前已达24个月龄的犬的病例记录，将那些无并发先天性心脏病的动物纳入研究（n = 21）。要求那些仍存活的动物参加长期随访研究。
在封堵导管后（n = 16），除一只动物外，所有动物的临床症状均消失。对这些动物进行随访时，许多动物有超声心动图证据显示左心室收缩和舒张功能障碍。有3只动物记录到晚期心源性死亡。在未接受干预的犬中，充血性心力衰竭是常见但并非不可避免的后遗症。二尖瓣心内膜炎的发生是一个常见特征。
患有PDA的老年动物病程各异，与既往是否存在心力衰竭无关。不可逆的左心室功能障碍很常见，但似乎不影响临床病程。这些数据表明，在接受封堵的成年PDA犬中，高比例的预后良好。未经干预的预后较差。
