Equine Cardioteam Ghent, Department of Internal Medicine, Reproduction and Population Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
J Vet Intern Med. 2024 Sep-Oct;38(5):2707-2717. doi: 10.1111/jvim.17158. Epub 2024 Jul 31.
Cardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking.
HYPOTHESIS/OBJECTIVES: To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks.
Eleven healthy adult horses.
Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo.
Transseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10-104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1-35) days. Activated clotting time correlated with anti-factor Xa activity in vitro but not in vivo.
Transseptal puncture was successfully performed in all horses. The technique was safe and spontaneous iASD closure occurred in all horses. Clinical application of TSP will allow characterization and treatment of left-sided arrhythmias in horses.
马的心脏导管检查主要在右心进行，因为传统上进入左心需要动脉入路。经房间隔穿刺（TSP）已被用于马，但缺乏关于后续和闭合医源性房间隔缺损（iASD）的数据。
假说/目的：进行 TSP 并评估至少 4 周的术后并发症和 iASD 闭合情况。
11 匹健康成年马。
在全身麻醉下进行 TSP。在穿刺前后测量血清心肌肌钙蛋白 I 浓度。每周使用经胸和心内超声心动图监测 iASD 闭合情况。在体外和体内评估术后依诺肝素治疗期间活化凝血时间和抗因子 Xa 活性之间的关系。
所有马均在 22 分钟（范围 10-104 分钟）的中位数时间内成功进行 TSP。4 匹马需要球囊扩张穿刺部位以推进鞘管。9/11 匹马出现房性心律失常，包括房性期前收缩（N = 1）、房性心动过速（N = 5）和颤动（N = 3）。TSP 后血清心肌肌钙蛋白 I 浓度升高，但 10/11 匹马仍低于参考值。iASD 闭合的中位数时间为 14 天（1-35 天）。体外活化凝血时间与抗因子 Xa 活性相关，但体内不相关。
所有马均成功进行 TSP。该技术安全，所有马均自发闭合 iASD。TSP 的临床应用将允许对马的左心心律失常进行特征描述和治疗。
