Department of Clinical Sciences, Colorado State University, Campus Delivery 1678, Fort Collins, CO 80523-1678, USA.
Department of Clinical Sciences, Colorado State University, Campus Delivery 1678, Fort Collins, CO 80523-1678, USA.
J Vet Cardiol. 2022 Jun;41:145-153. doi: 10.1016/j.jvc.2022.02.003. Epub 2022 Feb 24.
Surgical ligation of a left-to-right shunting patent ductus arteriosus was attempted in two animals. In both cases, a young cat and dog, ligation was complicated by poor visualization of the ductus resulting in unsuccessful ligation. Post-operatively, both the cat and dog underwent computed tomography angiography to characterize the location and morphology of the patent ductus arteriosus. In both cases, computed tomography angiography revealed a left-to-right shunting patent ductus arteriosus with an insertion location medial to the left pulmonary artery branch compared to the typical location. We hypothesize that this atypical location resulted in a difficult surgical visualization from the left thoracotomy approach. Transvenous coil embolization of the duct from the external jugular vein was performed in both cases and resulted in successful occlusion. Variations in the medial-lateral insertion of the ductus arteriosus may have consequences for surgical intervention. If an atypical location of a patent ductus arteriosus is suspected on transthoracic echocardiography, computed tomography angiography prior to ligation may be useful to further define ductal location and help guide the surgical approach.
我们尝试对两只动物施行外科结扎术以关闭由左向右分流的未闭动脉导管。在这两种情况下，一只幼猫和一只幼犬，由于未闭动脉导管难以可视化，导致结扎不成功。手术后，猫和狗都接受了计算机断层血管造影术以明确未闭动脉导管的位置和形态。在这两种情况下，计算机断层血管造影术均显示出左向右分流的未闭动脉导管，其插入位置比典型位置更靠近左肺动脉分支。我们推测这种非典型位置导致从左侧开胸手术途径难以进行可视化。我们对这两种情况均通过颈外静脉进行了经静脉线圈栓塞术，从而成功地闭塞了未闭动脉导管。动脉导管的内侧-外侧插入位置的变化可能对手术干预产生影响。如果经胸超声心动图怀疑未闭动脉导管的位置异常，在结扎之前进行计算机断层血管造影术可能有助于进一步明确导管位置并有助于指导手术途径。
