Ji Yewon, Kang Jinsu, Heo Suyoung, Lee Kichang, Yoon Hakyoung
Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea.
Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea.
Front Vet Sci. 2024 May 22;11:1400076. doi: 10.3389/fvets.2024.1400076. eCollection 2024.
Studies on aberrant bronchoesophageal arteries are limited. Herein, we report a case of a multi-origin systemic-to-pulmonary shunt with suspected bronchoesophageal artery hypertrophy and fistula in a dog.
A 4-year-old castrated male beagle weighing 11 kg underwent routine medical screening. Physical examination revealed a right-sided continuous murmur of grades 1-2. Thoracic radiography revealed a mild cardiomegaly. Echocardiography revealed a continuous turbulent shunt flow distal to the right pulmonary artery (RPA) branch from the right parasternal short axis pulmonary artery view. Computed tomography demonstrated systemic-to-pulmonary shunts originating from the descending aorta at the level of T7-8, the right 5th and 6th dorsal intercostal arteries, and the right brachiocephalic trunk, which formed anomalous networks around the trachea and esophagus that anastomosed into a large tortuous vessel at the level of T6-7 and entered the RPA. Surgical ligation of multiple shunting vessels was performed. Postoperative echocardiography and computed tomography showed decreased left ventricular volume overload and markedly decreased size of the varices. Additionally, most of the shunting vessels were without residual shunt flow.
The present study provides information regarding imaging features and the successful surgical management of multiple systemic-to-pulmonary shunts originating from the descending aorta, right brachiocephalic trunk, and intercostal arteries and terminating at the RPA. Multimodal imaging features after surgical ligation have also been described.
关于异常支气管食管动脉的研究有限。在此,我们报告一例犬的多源性体肺分流病例,怀疑存在支气管食管动脉肥大和瘘管。
一只4岁、体重11千克的去势雄性比格犬接受了常规医学筛查。体格检查发现右侧有1-2级连续性杂音。胸部X线检查显示轻度心脏肥大。超声心动图从右胸骨旁短轴肺动脉视图显示右肺动脉(RPA)分支远端有连续性湍流分流。计算机断层扫描显示体肺分流起源于T7-8水平处的降主动脉、右侧第5和第6肋间背侧动脉以及右头臂干,这些分流在气管和食管周围形成异常网络,在T6-7水平处吻合形成一条粗大迂曲的血管并进入RPA。对多条分流血管进行了手术结扎。术后超声心动图和计算机断层扫描显示左心室容量超负荷减轻,静脉曲张大小明显减小。此外,大多数分流血管无残余分流。
本研究提供了关于起源于降主动脉、右头臂干和肋间动脉并终止于RPA的多源性体肺分流的影像学特征及成功手术治疗的信息。还描述了手术结扎后的多模态影像学特征。