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犬动脉导管未闭:102 只犬(2003 - 2011 年)临床表现、诊断及介入技术比较的回顾性研究

[Patent ductus arteriosus in the dog: a retrospective study of clinical presentation, diagnostics and comparison of interventional techniques in 102 dogs (2003-2011)].

作者信息

Meijer M, Beijerink N J

机构信息

Universiteit van Utrecht, Faculteit Diergeneeskunde, Departement Geneeskunde van Gezelschapsdieren, Yalelaan 108, P.O. Box 80154, 3508 TD Utrecht, Nederland.

出版信息

Tijdschr Diergeneeskd. 2012 Jun 1;137(6):376-83.

Abstract

A left-to-right shunting patent ductus arteriosus (PDA) is a common congenital heart defect in dogs. If it is left uncorrected, life expectancy in most cases is decreased due to the development of left-sided congestive heart failure. The aim of this study was to describe the dogs diagnosed with PDA in the Utrecht University Companion Animal Clinic from 2003 to 2011. The medical records of 102 patients were retrieved, and the clinical presentation and outcome of PDA closure by surgical ligation or transarterial catheter occlusion (TCO) were reviewed. In the TCO group, the result of coiling was compared with the placement of an Amplatz Canine Duct Occluder (ACDO). A predisposition to PDA was found in the German Brak, Stabyhoun, and Schapendoes. Dogs treated with surgical ligation were significantly older and heavier than those treated with TCO; within the TCO group, dogs treated with ACDO were significantly older and heavier The initial success rate (complete disappearance of the audible murmur in a patient that survived the procedure) was not significantly different between the different treatment modalities. Major complications were more common with surgical ligation, but the incidence of minor complications was not significantly different. There was no diference in survival between dogs treated with surgical ligation and dogs treated with TCO. This study shows a previously unreported predisposition to PDA in certain breeds. Both surgical ligation and TCO are suitable techniques for PDA closure, although major complications were more common with surgical ligation. ACDO appears to be the method with the least complications and thus can be considered the safest method.

摘要

动脉导管未闭(PDA)导致的左向右分流是犬类常见的先天性心脏缺陷。如果不进行纠正,大多数情况下由于左侧充血性心力衰竭的发展,预期寿命会缩短。本研究的目的是描述2003年至2011年在乌得勒支大学伴侣动物诊所被诊断为PDA的犬只情况。检索了102例患者的病历,并回顾了通过手术结扎或经动脉导管封堵术(TCO)关闭PDA的临床表现和结果。在TCO组中,将弹簧圈封堵的结果与放置Amplatz犬用导管封堵器(ACDO)的结果进行了比较。发现德国刚毛指示犬、斯塔比猎犬和荷兰牧羊犬易患PDA。接受手术结扎治疗的犬只比接受TCO治疗的犬只年龄显著更大、体重更重;在TCO组中,接受ACDO治疗的犬只年龄显著更大、体重更重。不同治疗方式之间的初始成功率(在手术存活的患者中可闻及杂音完全消失)没有显著差异。手术结扎更容易出现主要并发症,但轻微并发症的发生率没有显著差异。手术结扎治疗的犬只和TCO治疗的犬只在生存率上没有差异。本研究显示了某些品种犬对PDA有此前未报道的易感性。手术结扎和TCO都是关闭PDA的合适技术,尽管手术结扎更容易出现主要并发症。ACDO似乎是并发症最少的方法,因此可被认为是最安全的方法。

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