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犬医源性室间隔缺损封堵器栓塞及经导管取出术

Iatrogenic embolization and transcatheter retrieval of a ventricular septal defect occluder in a dog.

作者信息

Durham Jaylyn A, Scansen Brian A, Bonagura John D, Schober Karsten E, Cheatham Sharon L, Cheatham John P

机构信息

Department of Clinical Sciences, The Ohio State University College of Veterinary Medicine, 601 Vernon L Tharp St., Columbus, OH 43210, USA.

Department of Clinical Sciences, The Ohio State University College of Veterinary Medicine, 601 Vernon L Tharp St., Columbus, OH 43210, USA.

出版信息

J Vet Cardiol. 2015 Dec;17(4):304-13. doi: 10.1016/j.jvc.2015.08.003. Epub 2015 Oct 26.

Abstract

A 7-month-old Irish Setter underwent transcatheter therapy of a muscular ventricular septal defect (VSD) and pulmonary valve stenosis. Standard devices for muscular VSD closure could not span the interventricular septum due to right ventricular hypertrophy, and an Amplatzer post-infarction muscular VSD occluder with a wider waist was successfully implanted. Following VSD closure, inflation of the balloon dilation catheter during balloon pulmonary valvuloplasty resulted in iatrogenic embolization of the VSD occluder to the left ventricular outflow tract. Retrieval and reimplantation of the device was achieved using a snare catheter. This report describes a potential complication and management during intracardiac device implantation in a dog. Additionally, the case illustrates that the Amplatzer post-infarction muscular VSD occluder holds potential value in animals with a hypertrophied interventricular septum that cannot be spanned using a conventional device.

摘要

一只7个月大的爱尔兰雪达犬接受了经导管治疗肌部室间隔缺损(VSD)和肺动脉瓣狭窄。由于右心室肥厚,用于闭合肌部室间隔缺损的标准装置无法跨越室间隔,于是成功植入了腰部更宽的Amplatzer心肌梗死后肌部室间隔缺损封堵器。在室间隔缺损闭合后,球囊肺动脉瓣成形术中球囊扩张导管的充盈导致室间隔缺损封堵器医源性栓塞至左心室流出道。使用圈套导管实现了装置的取出和重新植入。本报告描述了犬心内装置植入过程中的一种潜在并发症及处理方法。此外,该病例表明,Amplatzer心肌梗死后肌部室间隔缺损封堵器对于室间隔肥厚且无法使用传统装置跨越的动物具有潜在价值。

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