Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
Department of Cardiac Surgery, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, Belgium.
J Vet Cardiol. 2023 Oct;49:29-37. doi: 10.1016/j.jvc.2023.07.002. Epub 2023 Jul 26.
A four-month-old male Shetland Sheepdog presented with exercise intolerance. Physical examination revealed an IV/VI left cranial systolic heart murmur. Echocardiography showed a severe infundibular pulmonic stenosis and a concomitant restrictive ventricular septal defect. As clinical signs of congestive right-sided heart failure worsened and were refractory to medical treatment, surgical correction was advised. Via sternotomy, with cardiopulmonary bypass and cardioplegic cardiac arrest, ventricular septal defect closure and resection of the stenotic infundibular band were performed through right ventriculotomy, followed by patch enlargement. Postoperative recovery was uneventful and echocardiography showed complete resolution of the stenosis and successful closure of the ventricular septal defect. Follow-up echocardiography revealed restenosis after seven weeks and recurrence of right-sided heart failure three months postoperatively. Stenting of the restenosis was attempted via a hybrid procedure with sternotomy and direct transventricular approach. The dog developed fatal ventricular fibrillation during stent deployment. This is the first dog in which surgical right ventricular patch enlargement under cardiopulmonary bypass is reported for the treatment of a primary infundibular pulmonic stenosis.
一只四个月大的雄性设得兰牧羊犬出现运动不耐受。体格检查发现有 IV/VI 级左心尖收缩期杂音。超声心动图显示严重的漏斗部肺动脉瓣狭窄和伴发的限制性室间隔缺损。由于充血性右心衰竭的临床症状恶化且对药物治疗无反应，建议进行手术矫正。通过胸骨切开术、心肺旁路和心脏停搏，通过右心室切开术进行室间隔缺损闭合和狭窄漏斗部带切除术，随后进行补片扩大。术后恢复顺利，超声心动图显示狭窄完全缓解，室间隔缺损成功闭合。七周后复查超声心动图显示再狭窄，术后三个月再次出现右心衰竭。通过胸骨切开术和直接经心室入路的杂交手术尝试对再狭窄进行支架置入。在支架置入过程中，该犬发生致命性心室颤动。这是首例报道在心肺旁路下进行外科右心室补片扩大术治疗原发性漏斗部肺动脉瓣狭窄的犬。
