Pariaut Romain, Jung Seung Woo, Vila Jorge, Newhard Daniel K
Department of Clinical Sciences, Cornell University, Ithaca, New York.
Department of Clinical Sciences, Auburn University, Auburn, Alaska.
J Vet Emerg Crit Care (San Antonio). 2020 May;30(3):295-301. doi: 10.1111/vec.12948. Epub 2020 Feb 19.
To report on the spontaneous resolution of caval syndrome in 5 dogs selected for their response to medical stabilization prior to scheduled heartworm extraction.
Five dogs with heartworm caval syndrome were treated with sildenafil, fluid, and supplemental oxygen therapy. Moreover, 4 of 5 dogs were also administered pimobendan to achieve hemodynamic stabilization in preparation for percutaneous heartworm extraction. Spontaneous heartworm migration back into the pulmonary arteries was detected from 2 h to 5 days after treatment initiation.
Unanticipated spontaneous resolution of caval syndrome was documented in a low number of dogs after initiation of a patient stabilization protocol aiming at improving right ventricular hemodynamics and reducing pulmonary artery pressure prior to scheduled heartworm extraction. At this time, it is unknown if intervention to improve the hemodynamic status of the animal prior to heartworm extraction improves procedure outcome, and which factors contributed to the migration of the heartworms back into the pulmonary arteries in these selected cases. Therefore, this approach cannot be recommended in place of current recommendations for treatment of caval syndrome.
报告5只犬的心腔综合征自然缓解情况，这些犬因在预定的心丝虫摘除术前对药物稳定治疗有反应而被挑选出来。
5只患有心丝虫腔静脉综合征的犬接受了西地那非、补液和补充氧气治疗。此外，5只犬中有4只还使用了匹莫苯丹以实现血流动力学稳定，为经皮心丝虫摘除术做准备。在开始治疗后2小时至5天内检测到心丝虫自发迁移回肺动脉。
在针对预定的心丝虫摘除术前旨在改善右心室血流动力学和降低肺动脉压力的患者稳定方案开始后，少数犬出现了意外的心腔综合征自然缓解情况。目前尚不清楚在心丝虫摘除术前改善动物血流动力学状态的干预措施是否能改善手术结果，以及在这些选定病例中哪些因素导致心丝虫迁移回肺动脉。因此，不建议采用这种方法替代目前的心腔综合征治疗建议。
