Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Retrospective Study of Patent Ductus Arteriosus in 37 Dogs: Clinical Presentations and Interventional Therapy

37마리 개의 동맥관 개존증의 임상소견과 비외과적 치료의 회고연구

  • Park, Jong-In (Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University) ;
  • Choi, Ran (Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University) ;
  • Lee, Seung-Gon (Cardiology Service, College of Veterinary Medicine, North Carolina State University) ;
  • Hyun, Changbaig (Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University)
  • 박종인 (강원대학교 수의학과 소동물 내과교실) ;
  • 최란 (강원대학교 수의학과 소동물 내과교실) ;
  • 이승곤 (미국 노쓰캐롤라이나 대학교, 수의과대학, 심장센터) ;
  • 현창백 (강원대학교 수의학과 소동물 내과교실)
  • Accepted : 2013.04.03
  • Published : 2013.04.30
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Abstract

This retrospective study reviewed the clinical and diagnostic features, therapeutic outcome and compilations of interventional ductal occlusion in 37 dogs with patent ductus arteriosus (PDA). Malteses and female dogs were over-presented. Bounding pulse and left basal continuous murmur were most common findings in physical examination, while the differential cyanosis was rarely observed. Left ventricular (LV) enlargement patterns and sinus tachycardia were common in the ECG. Typical radiographic findings included LV elongation and triple bumps indicating left atrial (LA), aortic and pulmonary dilation. Echocardiographic features were typical shunt flow at the ductus arteriosus and marked LV dilation with mild to moderate mitral regurgitation (MR). The 32 of 37 dogs were interventionally treated with either thromboemolic coils (TCE) or Amplatz canine ductal occluder (ACDO). Transient hemoglobinuria caused by incomplete closure was occurred in 2 dogs treated with TCE, although the hemoglobinuria was disappeared within a week of intervention. The dislodgement of occlusion device was occurred in 2 dogs with TCE and 1 dog with ACDO. However there were no significant complications associated with this dislodgement, since those were dislodged at the lower pulmonary vasculature. We also found that no serious complications and no further medical intervention in 29 dogs having long-term follow-ups.

본 회고 연구에서는 동맥관 개존증에 이환된 개에서 심장중재술을 통한 치료증례의 임상적 특징과 치료예후를 조사하였다. 환축의 구성을 보면, 말티스와 암컷이 차지하는 비중이 컸다. Bounding pulse와 좌심저부의 심잡음이 가장 대표적인 신체검사 소견이며, differential cyanosis은 매우 드물게 관찰되었다. 심전도상 특징은 좌심종대소견과 동성빈맥이였다. 흉부방사선상 좌심실 종대와 대동맥 확장을 동반한 triple bumps가 대표적인 소견이 였다. 심초음파상 특징은 좌심실 종대를 동반한 폐동맥 단축단면상 심각한 와류 소견이였으며, 다수의 환자에서 이첨판 역류 소견도 관찰되었다. 37증례 중 32증례에서 thromboemolic coils (TCE)이나 Amplatz canine ductal occluder (ACDO)를 이용한 심장 중제술적 치료가 실시되었다. 일시적인 혈색소뇨가 관찰되었고 장착된 코일이나 ACDO가 이탈되는 부작용이 확인되었다. 하지만 장기 관찰이 가능했던 29증례에서 특별한 부작용은 관찰되지 않았다.

Keywords

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