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一只患有心源性主动脉血栓栓塞的猫的手术取栓术。

Surgical embolectomy in a cat with cardiogenic aortic thromboembolism.

作者信息

Vezzosi T, Buralli C, Briganti A, Vannozzi I, Giacomelli E, Talamanca G F, Sansoni A, Domenech O, Tognetti R

机构信息

Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122, San Piero a Grado, Pisa, Italy; Department of Cardiology, Anicura Istituto Veterinario di Novara, Strada Provinciale 9, Granozzo con Monticello, 28060, Novara, Italy.

Department of Veterinary Sciences, University of Pisa, Via Livornese Lato Monte, 56122, San Piero a Grado, Pisa, Italy.

出版信息

J Vet Cardiol. 2020 Apr;28:48-54. doi: 10.1016/j.jvc.2020.03.002. Epub 2020 Mar 29.

Abstract

A seven-year-old, spayed female, domestic longhair cat was referred for management of a sudden aortic thromboembolism (ATE). Echocardiography showed hypertrophic cardiomyopathy with severe left atrial enlargement. Ultrasonography of the abdominal aorta confirmed a large thrombus at the level of the aortic trifurcation, involving both iliac arteries. Considering the recent onset and bilateral involvement of the iliac arteries, the cat underwent emergent surgical embolectomy (SE) of the aortoiliac embolus. A standard caudal celiotomy was performed and the abdominal aorta was identified. Vessel loops with tourniquets were placed around the abdominal aorta proximal to the thrombus and on both iliac arteries distal to the thrombus. A full-thickness incision was made in the ventral surface of the aorta. The aortic thromboembolus was removed. The trifurcation was subsequently flushed with sterile saline. The SE resulted in a good outcome, with both clinical and ultrasound signs of complete reperfusion of the rear limbs within a few hours. Long-term treatment included antiplatelet drugs, furosemide and benazepril. Eighteen months after surgery, the cat was free of clinical signs, without recurrence of ATE or congestive heart failure. Based on the present case, SE could be considered as a feasible alternative to traditional conservative treatment in cats with a very recent onset of bilateral ATE.

摘要

一只七岁已绝育的雌性家猫因突发主动脉血栓栓塞(ATE)前来就诊。超声心动图显示肥厚型心肌病伴严重左心房增大。腹主动脉超声检查证实主动脉分叉处有一个大血栓,累及双侧髂动脉。考虑到血栓近期形成且双侧髂动脉受累,该猫接受了主动脉髂动脉栓子的急诊手术取栓术(SE)。进行了标准的尾侧剖腹术并识别出腹主动脉。在血栓近端的腹主动脉周围以及血栓远端的双侧髂动脉上放置了带止血带的血管环。在主动脉腹侧面做了一个全层切口。取出了主动脉血栓栓子。随后用无菌盐水冲洗分叉处。急诊手术取栓术取得了良好效果,术后数小时内后肢完全再灌注的临床和超声迹象均显示良好。长期治疗包括抗血小板药物、呋塞米和贝那普利。术后18个月,该猫无临床症状,未出现主动脉血栓栓塞或充血性心力衰竭复发。基于本病例,对于近期突发双侧主动脉血栓栓塞的猫,急诊手术取栓术可被视为传统保守治疗的一种可行替代方案。

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