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经导管置入Amplatz犬用导管封堵器治疗动脉导管未闭:200只犬的结局与并发症回顾性分析

Transcatheter Amplatz canine duct occluder placement for patent ductus arteriosus occlusion: a retrospective analysis of outcomes and complications in 200 dogs.

作者信息

Ciccozzi M, Stauthammer C D, Coats C, Oberholtzer S, Masters A, Gavic E, Rendahl A, Tobias A

机构信息

Department of Cardiology, University of Minnesota, Veterinary Medical Center, 1365 Gortner Ave, St Paul, MN 55108, USA.

Department of Cardiology, University of Minnesota, Veterinary Medical Center, 1365 Gortner Ave, St Paul, MN 55108, USA.

出版信息

J Vet Cardiol. 2025 Aug;60:36-45. doi: 10.1016/j.jvc.2025.05.002. Epub 2025 May 8.

Abstract

INTRODUCTION

The Amplatz canine duct occluder (ACDO) is routinely used for patent ductus arteriosus (PDA) occlusion. Limited data are available on clinical outcomes and success rates with ACDO device placement. This study aimed to determine procedural outcome and complications for PDA occlusion with the ACDO in a large cohort of dogs.

ANIMALS, MATERIALS, AND METHODS: A retrospective study of 200 dogs that underwent ACDO placement for PDA occlusion between March 2007 and September 2023 was conducted. Transthoracic echocardiography was performed prior to occlusion, 24 h after occlusion, and during follow-up recheck visits. Procedural success was defined as successful device placement as determined based on fluoroscopy at the time of the PDA occlusion procedure and survival after the procedure.

RESULTS

Dogs had a median weight of 6.5 kg and required a median device size of 6 mm. At 24 h post occlusion, 5% of dogs had trivial flow through the device. Persistent trivial flow was noted on recheck in 5.5% of patients with a median follow-up time of 96 days. Minor complications occurred in 2.5% of dogs. Major complications occurred in 4% of dogs including device embolization in 2% of dogs. Procedural mortality rate was 0.5%. There was a statistically significant reduction in left ventricular and left atrial size at the 24-h postocclusion recheck echocardiogram (P<0.001) and at follow-up rechecks (P<0.001). There was a statistical difference (P<0.050) between echocardiographic and angiographicderived measurements and ratios when selecting device size.

STUDY LIMITATIONS

Retrospective project with 35.5% of study population lost to follow-up.

CONCLUSIONS

The high procedural success and low complication rates support use of the ACDO device as a safe and effective method of PDA occlusion in dogs.

摘要

引言

Amplatz犬用动脉导管封堵器(ACDO)常用于动脉导管未闭(PDA)封堵。关于ACDO装置置入的临床结果和成功率的数据有限。本研究旨在确定在一大群犬中使用ACDO封堵PDA的手术结果和并发症。

动物、材料与方法:对200只在2007年3月至2023年9月期间接受ACDO置入以封堵PDA的犬进行回顾性研究。在封堵前、封堵后24小时以及随访复查期间进行经胸超声心动图检查。手术成功定义为根据PDA封堵手术时的荧光透视确定的装置成功置入以及术后存活。

结果

犬的中位体重为6.5千克,所需装置的中位尺寸为6毫米。封堵后24小时,5%的犬通过装置有微量血流。在中位随访时间为96天的患者中,5.5%在复查时发现持续微量血流。2.5%的犬出现轻微并发症。4%的犬出现严重并发症,包括2%的犬发生装置栓塞。手术死亡率为0.5%。在封堵后24小时复查超声心动图时(P<0.001)以及随访复查时(P<0.001),左心室和左心房大小有统计学意义的减小。在选择装置尺寸时,超声心动图和血管造影得出的测量值及比率之间存在统计学差异(P<0.050)。

研究局限性

回顾性研究项目,35.5%的研究人群失访。

结论

高手术成功率和低并发症发生率支持将ACDO装置作为犬PDA封堵的一种安全有效的方法。

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