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猫持续性动脉导管未闭的诊断与治疗:17例猫的回顾性评估

[Diagnosis and treatment of feline persistent ductus arteriosus: a retrospective evaluation of 17 cats].

作者信息

Masche Anja, Breit Peter, Höpfner Robert, Schmerbach Kay

机构信息

Kleintierspezialisten, Dres. Schmerbach & Höpfner GmbH, Berlin.

出版信息

Tierarztl Prax Ausg K Kleintiere Heimtiere. 2024 Apr;52(2):88-97. doi: 10.1055/a-2290-2441. Epub 2024 May 3.

Abstract

OBJECTIVE

The objective of this study was to evaluate the signalement, clinical features, and echocardiographic findings of cats diagnosed with patent ductus arteriosus (PDA) as well as short- and medium-term outcome after successful ligation of the PDA.

MATERIAL AND METHODS

Over a 10-year period 17 cats were diagnosed with PDA by transthoracic echocardiography. Thirteen cats were surgically treated by thoracotomy and ligation of the PDA.

RESULTS

In all cats, a heart murmur was detected. In 88.2% of the cases, this presented as grade 4 out of 6 murmur (15/17 cats). A continuous murmur was more common (10/17 cats; 58.9%) than a systolic murmur (7/17 cats; 41.1%). Echocardiography showed that left ventricular internal diameter end diastole (LVIDd) and left ventricular internal diameter end systole (LVIDs) were significantly above reference values in the majority of cats. Mean diameter of the PDA measured at the widest point of the vessel was 3.4 mm (± 1.08 mm) and mean maximum flow velocity amounted to 5,06 m/sec (2,6m/sec-6,4m/sec). Surgery was successfully performed in all cats treated by surgical ligation and all of these patients were discharged after postoperative inpatient therapy. One cat experienced perioperative bleeding from the PDA, which was stopped efficaciously. This cat exhibited a residual shunt directly postoperatively; this could no longer be visualized in a re-check echocardiography 3 months later. Six cats were followed over a longer period of time.

CONCLUSIONS

The surgical prognosis in this case study is very good with a postoperative survival rate of 100%.

CLINICAL RELEVANCE

Surgical treatment of PDA is curative in animals not displaying advanced cardiac lesions. The auscultation of a heart murmur can provide initial findings indicative of PDA. Therefore, cardiac auscultation is warranted at every first presentation of a kitten. It must however be taken into consideration that not every cat with PDA necessarily has a continuous murmur but may display a systolic heart murmur. Therefore, it is important give utmost attention to the patients' clinical signs.

摘要

目的

本研究的目的是评估被诊断为动脉导管未闭(PDA)的猫的特征、临床特征和超声心动图表现,以及PDA成功结扎后的短期和中期结果。

材料与方法

在10年期间,通过经胸超声心动图诊断出17只猫患有PDA。13只猫接受了开胸手术和PDA结扎术治疗。

结果

所有猫均检测到心脏杂音。在88.2%的病例中,杂音为6级中的4级(15/17只猫)。连续性杂音比收缩期杂音更常见(10/17只猫;58.9%)(7/17只猫;41.1%)。超声心动图显示,大多数猫的左心室舒张末期内径(LVIDd)和左心室收缩末期内径(LVIDs)显著高于参考值。在血管最宽处测量的PDA平均直径为3.4毫米(±1.08毫米),平均最大流速为5.06米/秒(2.6米/秒 - 6.4米/秒)。所有接受手术结扎治疗的猫手术均成功,所有这些患者在术后住院治疗后出院。一只猫在围手术期出现PDA出血,出血得到有效控制。这只猫术后直接出现残余分流;3个月后的复查超声心动图中已无法看到残余分流。6只猫接受了更长时间的随访。

结论

本病例研究中的手术预后非常好,术后生存率为100%。

临床意义

对于未出现晚期心脏病变的动物,PDA的手术治疗具有治愈性。心脏杂音听诊可提供提示PDA的初步发现。因此,在每只小猫首次就诊时都应进行心脏听诊。然而,必须考虑到并非每只患有PDA的猫都必然有连续性杂音,也可能表现为收缩期心脏杂音。因此,高度关注患者的临床症状非常重要。

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