Szatmári Viktor, van den Broek Henk, Calero Rodriguez Abraham N
Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands.
Animals (Basel). 2025 Mar 3;15(5):722. doi: 10.3390/ani15050722.
A 1-year-old Maltese-Poodle mixed breed dog was referred to the cardiology service because of severe exercise intolerance and daily exercise-induced syncopal episodes. Physical examination revealed no abnormalities. Echocardiography showed intermittent underfilling of the heart. Abdominal ultrasound examination revealed a segmental aplasia of the caudal vena cava between the kidneys and the liver, and azygos continuation of the cava. The azygos vein dorsal to the right kidney showed a severe aneurysm with stasis of blood. Computed tomographic angiography showed that the right crus of the diaphragm was probably responsible for the intermittent compression of the dilated azygos vein, which was thought to have subsequently led to insufficient venous return to the heart. The underfilled ventricles could not produce sufficient cardiac output, which caused the assumed cerebral hypoperfusion due to presumed systemic arterial hypotension. Under general anesthesia a self-expanding nitinol stent was implanted into the azygos vein at the level of the diaphragm. All clinical signs resolved immediately after surgery. The dog remained free from clinical signs (6 months after surgery). This is the first report that describes the successful treatment of this congenital vascular anomaly. Ultrasonography of the caudal vena cava should be performed in dogs with unexplained syncope.
一只1岁的马尔济斯犬与贵宾犬的混血犬因严重运动不耐受和每日运动诱发的晕厥发作被转诊至心脏病科。体格检查未发现异常。超声心动图显示心脏间歇性充盈不足。腹部超声检查显示肾与肝之间的下腔静脉节段性发育不全，奇静脉延续下腔静脉。右肾背侧的奇静脉显示严重动脉瘤伴血液淤滞。计算机断层血管造影显示，膈肌右脚可能是导致扩张的奇静脉间歇性受压的原因，这被认为随后导致静脉回流至心脏不足。心室充盈不足无法产生足够的心输出量，由于推测的全身动脉低血压导致假定的脑灌注不足。在全身麻醉下，将一个自膨胀镍钛合金支架植入膈肌水平的奇静脉。手术后所有临床症状立即消失。该犬术后6个月仍无临床症状。这是第一份描述成功治疗这种先天性血管异常的报告。对于原因不明的晕厥犬，应进行下腔静脉超声检查。
