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先天性心脏病犬经食管超声心动图相关并发症的前瞻性评估。

Prospective evaluation of complications associated with transesophageal echocardiography in dogs with congenital heart disease.

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

出版信息

J Vet Intern Med. 2022 Mar;36(2):406-416. doi: 10.1111/jvim.16356. Epub 2022 Jan 8.

Abstract

BACKGROUND

Transesophageal echocardiography (TEE) is useful in the assessment and procedural monitoring of congenital heart disease (CHD) with a relatively low complication rate in humans.

OBJECTIVES

To evaluate the safety of TEE and report complications in dogs.

ANIMALS

Forty client-owned dogs with CHD.

METHODS

Prospective observational study including gastroesophagoscopy before and after TEE imaging. TEE was planned with a GE 6VT-D adult probe in dogs weighing ≥4 kg and a GE 10T-D microprobe alternating with an intracardiac echocardiography probe placed in the esophagus in dogs <4 kg. Difficulties with probe placement, probe interference and TEE probe imaging times were recorded. Dogs were monitored in the recovery period after TEE using an established nausea scoring system.

RESULTS

New gastroesophageal abnormalities were identified after TEE in 4 dogs including 4 areas of mucosal damage involving <25% of the lower esophageal sphincter (n = 4) and 1 lesion at the heart base (n = 1) and were not attributed to longer imaging times or a specific probe. Lesions identified before TEE in 4 dogs remained unchanged after TEE. The 6VT-D probe could not be placed in 1 dog with enlarged tonsils, and it obstructed fluoroscopic views in 3 dogs. The probes did not compress any structures in dogs in which fluoroscopy was performed (n = 20). Four dogs had evidence to suggest nausea after the procedure.

CONCLUSIONS AND CLINICAL IMPORTANCE

While major complications remain possible, complications in this study were mild and few in number. Dog size and probe characteristics are factors to consider when performing TEE.

摘要

背景

经食管超声心动图(TEE)在评估和监测先天性心脏病(CHD)方面非常有用,在人类中其并发症发生率相对较低。

目的

评估 TEE 的安全性并报告犬只的并发症。

动物

40 只患有 CHD 的患犬。

方法

前瞻性观察研究,包括 TEE 成像前后的上消化道内镜检查。计划使用 GE 6VT-D 成人探头对体重≥4kg 的犬进行 TEE,使用 GE 10T-D 微探头与置于食管内的心脏内超声心动图探头交替使用对体重<4kg 的犬进行 TEE。记录探头放置困难、探头干扰和 TEE 探头成像时间。使用已建立的恶心评分系统在 TEE 后恢复期对犬进行监测。

结果

4 只犬在 TEE 后发现新的胃食管异常,包括 4 个涉及<25%食管下括约肌的黏膜损伤区域(n=4)和 1 个心脏基部病变(n=1),这些异常与较长的成像时间或特定探头无关。在 TEE 前发现的 4 个病变在 TEE 后没有变化。1 只扁桃体肿大的犬无法放置 6VT-D 探头,3 只犬的探头干扰了荧光透视视图。在进行荧光透视的 20 只犬中,探头没有压迫任何结构。4 只犬在手术后有恶心的证据。

结论和临床意义

虽然仍有可能发生严重并发症,但本研究中的并发症较轻且数量较少。犬的体型和探头特性是进行 TEE 时需要考虑的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7203/8965207/15f682713477/JVIM-36-406-g001.jpg

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