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经静脉单圈栓塞犬动脉导管未闭的长期随访。

Long-term follow-up after transvenous single coil embolization of patent ductus arteriosus in dogs.

机构信息

Small Animal Clinic, Internal Medicine, Justus-Liebig-University Giessen, Giessen, Hessen, Germany.

出版信息

J Vet Intern Med. 2010 Nov-Dec;24(6):1400-6. doi: 10.1111/j.1939-1676.2010.0605.x. Epub 2010 Oct 12.

Abstract

BACKGROUND

Long-term follow-up studies after interventional therapy of patent ductus arteriosus (PDA) in dogs are rare.

HYPOTHESIS

Transvenous PDA embolization with a single detachable coil is a highly effective method in patients with an angiographically determined PDA≤4.0 mm.

ANIMALS

Twenty-eight dogs with an angiographic PDA≤4.0 mm were included.

METHODS

Prospective follow-up study after PDA coil embolization.

RESULTS

The median follow-up time was 792 days (range, 2-3, 248 days). The rate of complete closure demonstrated by Doppler color flow was 54% at day 3 after intervention and the final cumulative rate was 71%. The rate of complete closure was significantly different between small and moderately sized PDA over the study period (P<.0001) and finally was 100 and 50%, respectively. In 16 dogs with complete closure, no recanalization was found. Disappearance of the continuous heart murmur was found in 89% after 3 days, and this increased to a final cumulative rate of 96%. Indexed left ventricular internal diameter in diastole (LVDd-I) decreased significantly (P<.0001). In the group with moderately sized PDA, a significant difference (P=.0256) was seen in LVDd-I between patients with and without residual shunt after exclusion of patients with persistent severe mitral valve regurgitation.

CONCLUSION AND CLINICAL IMPORTANCE

Long-term follow-up after single coil embolization showed complete closure in all small PDA but a residual shunt with mild hemodynamic consequences was present in half of the moderately sized PDA.

摘要

背景

犬动脉导管未闭(PDA)介入治疗后的长期随访研究较为罕见。

假说

经静脉 PDA 栓塞术使用单个可分离的线圈是一种非常有效的方法,适用于血管造影确定的 PDA≤4.0mm 的患者。

动物

28 只血管造影 PDA≤4.0mm 的犬被纳入研究。

方法

PDA 线圈栓塞后的前瞻性随访研究。

结果

中位随访时间为 792 天(范围,2-3,248 天)。经多普勒彩色血流显示,介入后第 3 天完全闭塞率为 54%,最终累计闭塞率为 71%。在研究期间,小和中度 PDA 的完全闭塞率差异有统计学意义(P<.0001),最终分别为 100%和 50%。在 16 只完全闭塞的犬中,未发现再通。3 天后,连续心杂音消失率为 89%,最终累积消失率为 96%。舒张末期左心室内径指数(LVDd-I)显著降低(P<.0001)。在中度 PDA 组中,排除持续性严重二尖瓣反流患者后,LVDd-I 在有和无残余分流的患者之间存在显著差异(P=.0256)。

结论和临床意义

单线圈栓塞后的长期随访显示,所有小 PDA 均完全闭塞,但中度 PDA 中有一半存在轻度血流动力学后果的残余分流。

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