Gordon Sonya G, Nelson David A, Achen Sarah E, Miller Matthew M, Roland Risa M, Saunders Ashley B, Drourr Lori T
Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA.
J Am Vet Med Assoc. 2010 Feb 15;236(4):434-9. doi: 10.2460/javma.236.4.434.
A 3-year-old sexually intact male Standard Poodle was admitted to the veterinary teaching hospital for transcatheter closure of a large atrial septal defect (ASD).
The dog had exercise intolerance and was thin. Findings on physical examination were within normal limits with the exception of a left base systolic heart murmur (grade 5/6). The dog was not receiving any medications. Echocardiography and thoracic radiography confirmed the diagnosis of ASD and revealed compensatory changes consistent with a large left to right shunting ASD. Results of serum biochemical analysis and CBC were within reference range limits.
Transcatheter ASD closure with an atrial septal occluder (ASO) was performed and failed. An open heart surgical approach under cardiopulmonary bypass was declined by the dog's owners. The dog underwent a novel hybrid approach involving active device fixation under temporary inflow occlusion after transatrial device deployment. The dog recovered with some manageable postoperative complications. As of the last follow-up examination, the dog had 10 months of event-free survival.
Transcatheter closure by use of an ASO and open heart patch repair with cardiopulmonary bypass to surgically treat dogs with ASD has been reported. Transcatheter closure is not possible in dogs with large ASD. The novel hybrid procedure reported herein represented a viable alternative to euthanasia.
一只3岁未绝育的雄性标准贵宾犬因经导管封堵大型房间隔缺损（ASD）入住兽医教学医院。
该犬有运动不耐受且消瘦。体格检查结果除左心基部收缩期心脏杂音（5/6级）外均在正常范围内。该犬未接受任何药物治疗。超声心动图和胸部X线检查确诊为ASD，并显示出与大型左向右分流ASD一致的代偿性改变。血清生化分析和血常规结果在参考范围内。
行经导管使用房间隔封堵器（ASO）封堵ASD，但失败了。犬主拒绝了在体外循环下进行心脏直视手术的方法。该犬接受了一种新型混合方法，即在经心房置入装置后，在临时入流阻断下进行主动装置固定。该犬术后恢复，有一些可控制的并发症。截至最后一次随访检查，该犬已无事件存活10个月。
已有报道使用ASO行经导管封堵以及在体外循环下进行心脏直视修补术来治疗犬ASD。对于大型ASD的犬，经导管封堵是不可能的。本文报道的新型混合手术是安乐死的一种可行替代方法。
