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经皮跨瓣支架置入术治疗 6 只犬的心房间隔三房心。

Transmembrane stent placement for cor triatriatum dexter in six dogs.

机构信息

University of Minnesota, Veterinary Medical Center, St. Paul, MN, USA.

University of Minnesota, Veterinary Medical Center, St. Paul, MN, USA.

出版信息

J Vet Cardiol. 2022 Jun;41:79-87. doi: 10.1016/j.jvc.2022.01.007. Epub 2022 Feb 7.

Abstract

OBJECTIVES

Report the long-term outcomes following transmembrane stent placement as a therapy for Cor Triatriatum Dexter (CTD).

MATERIALS AND METHODS

Retrospective case series including six dogs with CTD treated with transmembrane stent placement. Follow-up information was obtained including the persistence of presenting clinical signs, additional therapies required, and survival.

RESULTS

The median follow-up time was 24 months (range 15-76 months). Long-term outcome was deemed excellent in four dogs (67%), good/fair in one dog (17%), and poor in one dog (17%). Three dogs had persistence of clinical signs of variable severity. These three dogs were Labrador Retrievers or their crosses with varying degrees of tricuspid valve dysplasia (TVD), two of which also had a right to left shunting patent foramen ovale (PFO). One of these three dogs died 23 months post-stent placement during attempted open-heart repair of the TVD and PFO. Another is alive 15 months post-operatively stable on medical therapy for right-sided congestive heart failure secondary to TVD. The final dog demonstrated improved but persistent mild exercise intolerance up to 76 months post-operatively associated with mild TVD and a concurrent PFO.

CONCLUSIONS

Transmembrane stent placement for CTD is a viable long-term treatment option with improvement or resolution of clinical signs. In the presence of concurrent congenital heart disease, specifically Labradors with TVD, additional therapies may be necessary with a corresponding impact on prognosis.

摘要

目的

报告经跨膜支架置入治疗右侧三房心(CTD)的长期疗效。

材料与方法

回顾性病例系列研究,纳入 6 例接受跨膜支架置入治疗的 CTD 犬。获取了随访信息,包括主要临床症状的持续存在、所需的其他治疗方法和生存情况。

结果

中位随访时间为 24 个月(范围 15-76 个月)。4 只犬(67%)的长期预后良好,1 只犬(17%)预后良好/中等,1 只犬(17%)预后较差。3 只犬仍存在不同严重程度的临床症状。这 3 只犬均为拉布拉多犬或其杂交犬,存在不同程度的三尖瓣发育不良(TVD),其中 2 只还存在卵圆孔未闭(PFO)的右向左分流。这 3 只犬中有 1 只在支架置入后 23 个月死于 TVD 和 PFO 的开胸修复术,另 1 只在 TVD 引起的右侧充血性心力衰竭的药物治疗后 15 个月存活,病情稳定,但仍存在运动不耐受。最后 1 只犬在术后 76 个月时运动不耐受仍有改善,但仍持续存在轻度症状,与轻度 TVD 和并发的 PFO 相关。

结论

跨膜支架置入治疗 CTD 是一种可行的长期治疗选择,可改善或消除临床症状。对于存在先天性心脏病的犬,特别是存在 TVD 的拉布拉多犬,可能需要额外的治疗,相应地会影响预后。

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