Stauthammer Christopher D, Tobias Anthony H, Leeder Damon B, Krüger Maxie U
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.
J Am Vet Med Assoc. 2013 Jun 15;242(12):1722-6. doi: 10.2460/javma.242.12.1722.
To investigate cardiovascular changes and survival times following complete interventional device occlusion of uncomplicated left-to-right shunting patent ductus arteriosus in dogs.
Retrospective cohort study.
24 dogs with uncomplicated patent ductus arteriosus that was fully occluded and reevaluated within 24 hours, approximately 3 months, and 1 year after the procedure.
Information on medical history, diagnostic imaging findings, treatment received, and survival times were obtained from medical records. Patients were allocated into 2 groups on the basis of age (< 1 year [n = 14] and ≥ 1 year [10]) at the time of the procedure. Additional follow-up information was obtained through interviews of owners and referral veterinarians.
Following ductal occlusion, decreases were detected in vertebral heart scale size, left ventricular chamber diameter in diastole and in systole, left atrial dimension, fractional shortening, aortic velocity, and ventricular wall thickness. There were no differences between age groups for postocclusion changes except vertebral heart scale size. Systolic dysfunction was detected in 14 (58%) patients on the final visit. Median survival time for all dogs after ductal occlusion was > 11.5 years.
Complete ductal occlusion resulted in immediate removal of the volume overload state and eventual return of cardiac chamber dimensions to reference range, suggesting regression of eccentric hypertrophy. Systolic dysfunction persisted in some dogs but appeared to be clinically unimportant. Most cardiovascular changes were independent of patient age at the time of the procedure.
研究犬单纯性左向右分流动脉导管未闭经介入装置完全封堵术后的心血管变化及生存时间。
回顾性队列研究。
24只患有单纯性动脉导管未闭的犬,在术后24小时内、约3个月和1年后进行完全封堵并重新评估。
从病历中获取病史、诊断性影像学检查结果、接受的治疗及生存时间等信息。根据手术时的年龄(<1岁[n = 14]和≥1岁[10])将患者分为2组。通过对犬主和转诊兽医的访谈获得额外的随访信息。
导管封堵后,椎体心脏大小、舒张期和收缩期左心室腔直径、左心房大小、缩短分数、主动脉流速和心室壁厚度均减小。除椎体心脏大小外,各年龄组封堵后的变化无差异。末次随访时,14只(58%)患者检测到收缩功能障碍。所有犬导管封堵后的中位生存时间>11.5年。
完全导管封堵可立即消除容量超负荷状态,并最终使心腔大小恢复至参考范围,提示离心性肥厚消退。部分犬的收缩功能障碍持续存在,但似乎在临床上并不重要。大多数心血管变化与手术时患者的年龄无关。