Sutherland B J, Kraus M, Barr C, Aronson L, Holt D, Fuller S
Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Rd, Athens, GA 30605, USA.
Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce St, Philadelphia, PA 19104, USA.
J Vet Cardiol. 2025 Aug;60:30-35. doi: 10.1016/j.jvc.2025.05.004. Epub 2025 May 15.
A one-year-old Standard poodle was presented for evaluation of exercise intolerance with suspicion for a large atrial septal defect. Transthoracic echocardiography identified an unrestricted 2-cm secundum-type atrial septal defect with a peak left-to-right flow of 1 m/s yielding a Qp/Qs ratio of 2.1:1 and moderate right-sided chamber dilation. Based on clinical signs and echocardiographic findings, closure was recommended. Transesophageal echocardiography was subsequently performed to help determine the most appropriate closure method, which revealed insufficient posterior rim, and hence, surgical repair was recommended. The defect was closed using fresh autologous pericardium under normothermic cardiopulmonary bypass. Surgery and immediate postoperative recovery were relatively uncomplicated. Intra-operative epicardial and postoperative transthoracic echocardiography showed no residual atrial septal defect. The patient was closely monitored in the intensive care unit until discharge eight days after the procedure with no cardiac medications. Follow-up echocardiogram was performed three weeks postoperatively, showing an intact patch, no evidence of interatrial shunting, and decrease in right-sided chamber size. At six months, echocardiography showed an intact septum, normal right atrial and ventricular size, and resolution of clinical signs. This is the first known report of the use of fresh autologous pericardium as a durable and safe patch choice for atrial septal defect repair in a dog. Autologous pericardium is cost-effective and readily available. It is commonly employed to repair many cardiovascular defects in humans including atrial septal defects, right ventricular outflow tract enlargement, and pulmonary artery augmentation. This report also highlights the benefit of multimodal imaging in clinical decision-making.
一只一岁的标准贵宾犬因运动不耐受前来评估，怀疑患有大型房间隔缺损。经胸超声心动图检查发现一个直径2厘米的继发孔型房间隔缺损，无限制，左向右血流峰值为1米/秒，Qp/Qs比值为2.1:1，右侧心腔中度扩张。根据临床症状和超声心动图检查结果，建议进行封堵。随后进行经食管超声心动图检查以帮助确定最合适的封堵方法，结果显示后缘不足，因此建议进行手术修复。在常温体外循环下使用新鲜自体心包封闭缺损。手术及术后即刻恢复相对顺利。术中的心外膜和术后经胸超声心动图检查均未发现残余房间隔缺损。患者在重症监护病房密切监测，直至术后八天出院，未使用心脏药物。术后三周进行随访超声心动图检查，显示补片完整，无房间隔分流迹象，右侧心腔大小减小。六个月时，超声心动图显示隔膜完整，右心房和心室大小正常，临床症状消失。这是已知的第一例关于在犬类房间隔缺损修复中使用新鲜自体心包作为持久且安全的补片选择的报告。自体心包具有成本效益且易于获取。它常用于修复人类的许多心血管缺损，包括房间隔缺损、右心室流出道扩大和肺动脉增宽。本报告还强调了多模态成像在临床决策中的益处。
