Ro Woong-Bin, Park Hee-Myung, Song Doo-Won, Kim Heyong-Seok, Lee Ga-Won, Kang Jin-Ho, Jo Chan-Ho, Kang Min-Hee
Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul, South Korea.
Royal Dog and Cat Medical Center, Seoul, South Korea.
Front Vet Sci. 2022 Mar 14;9:848313. doi: 10.3389/fvets.2022.848313. eCollection 2022.
A 9-year-old intact female Maltese dog was admitted for further evaluation of previously diagnosed patent ductus arteriosus (PDA). The dog showed severe coughing and exercise intolerance. On physical examination, a grade VI/VI continuous heart murmur was auscultated. Thoracic radiography demonstrated cardiomegaly, pulmonary overcirculation, and moderate bronchointerstitial pattern. Echocardiography revealed severe dilation of the left ventricle and atrium, decreased left ventricular contractility, and left-to-right PDA. On electrocardiography (ECG), R amplitude was increased. Computed tomographic angiography revealed type IIA PDA. The serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration was >10,000 pmol/L. Transarterial occlusion was performed and the Amplatz® Canine Duct Occluder was successfully deployed. On echocardiography 48 h after the procedure, aortic regurgitation (AR) and residual ductal flow were noted. Long-term follow-up on clinical signs, physical examination, radiography, echocardiography, ECG, and serum NT-proBNP were evaluated until 30 months after correction of PDA. The clinical indices of physical examination, thoracic radiography, echocardiography, ECG, and serum NT-proBNP concentration were improved, although the postocclusion AR and residual ductal flow persisted. The dog followed up without clinical signs for 41 months following the correction. To our knowledge, this is the first case report to demonstrate quite a long time of follow-up (41 months) in an older dog with transarterial occlusion of PDA with postocclusion AR and residual flow.
一只9岁未绝育的雌性马尔济斯犬因之前诊断出的动脉导管未闭（PDA）入院做进一步评估。这只犬表现出严重咳嗽和运动不耐受。体格检查时，听诊发现有六级连续性心脏杂音。胸部X线摄影显示心脏肥大、肺循环过度以及中度支气管间质影像。超声心动图显示左心室和左心房严重扩张、左心室收缩力下降以及动脉导管未闭导致的左向右分流。心电图（ECG）显示R波振幅增加。计算机断层血管造影显示为IIA型动脉导管未闭。血清N末端B型脑钠肽前体（NT-proBNP）浓度>10,000 pmol/L。进行了经动脉封堵术，并成功植入了Amplatz®犬用导管封堵器。术后48小时的超声心动图检查发现有主动脉瓣反流（AR）和残余导管血流。对动脉导管未闭矫正术后30个月内的临床症状、体格检查、X线摄影、超声心动图、心电图和血清NT-proBNP进行了长期随访评估。尽管封堵术后的主动脉瓣反流和残余导管血流持续存在，但体格检查、胸部X线摄影、超声心动图、心电图和血清NT-proBNP浓度这些临床指标均有所改善。矫正术后，这只犬在无临床症状的情况下随访了41个月。据我们所知，这是首例关于一只老龄犬经动脉封堵动脉导管未闭且封堵术后存在主动脉瓣反流和残余血流的长达41个月的随访病例报告。
