Department of Small Animal Medicine and Surgery, and The Michael E. DeBakey Institute of Comparative Cardiovascular Sciences in Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA.
To characterize angiographic morphology and minimum internal transverse diameter of left-to-right shunting patent ductus arteriosus (PDA) in a large series of dogs.
PDA is the most common congenital cardiac malformation in the dog. Transarterial ductal occlusion is increasingly performed to close this defect. While accurate assessment of ductal morphology and luminal diameter is important to assure optimal occlusion using catheter-delivered devices, such information is currently limited.
In 246 dogs representing 31 breeds with left-to-right shunting PDA, right lateral selective aortic angiograms were recorded and reviewed.
PDA morphology conformed to four general phenotypes (types I, IIA, IIB, and III) which varied according to degree of ductal tapering, and the presence, absence, or location of abrupt ductal narrowing. Minimum internal ductal diameter for all dogs averaged 2.9mm (median, 2.5mm; range, 1.0-9.5mm) and was not correlated to age or body weight. There was no significant difference in minimum internal diameters between types I, IIA or IIB PDA, whereas, type III PDA was significantly wider (p=0.024) than other phenotypes. The most frequently-encountered variant (type IIA) was identified in 54.4% of cases (average minimum internal diameter, 2.3mm [median, 2.2mm; range, 1.0-5.5mm]).
PDA angiographic morphology was categorized based upon the degree, presence, or absence of ductal narrowing, and the location of ductal attenuation. When planning PDA repair, this information should assist planning, selection and deployment of transcatheter occluding devices.
"All dimensions were measured precisely to 0.1 mm. Sagittal MPRs and 3-dimensional volume-rendered displays were used for morphologic classification of PDAs according to the description by Miller et al. (Figures 1 and 2) . "
[Show abstract][Hide abstract] ABSTRACT: Diagnosis of extracardiac intrathoracic vascular anomalies is of clinical importance, but remains challenging. Traditional imaging modalities, such as radiography, echocardiography, and angiography, are inherently limited by the difficulties of a 2-dimensional approach to a 3-dimensional object. We postulated that accurate characterization of malformations of the aorta would benefit from 3-dimensional assessment. Therefore, multidetector-row computed tomography (MDCT) was chosen as a 3-dimensional, new, and noninvasive imaging technique. The purpose of this study was to evaluate patients with 2 common diseases of the intrathoracic aorta, either patent ductus arteriosus or vascular ring anomaly, by contrast-enhanced 64-row computed tomography.
Electrocardiography (ECG)-gated and thoracic nongated MDCT images were reviewed in identified cases of either a patent ductus arteriosus or vascular ring anomaly. Ductal size and morphology were determined in 6 dogs that underwent ECG-gated MDCT. Vascular ring anomalies were characterized in 7 dogs and 3 cats by ECG-gated MDCT or by a nongated thoracic standard protocol. Cardiac ECG-gated MDCT clearly displayed the morphology, length, and caliber of the patent ductus arteriosus in 6 affected dogs. Persistent right aortic arch was identified in 10 animals, 8 of which showed a coexisting aberrant left subclavian artery. A mild dilation of the proximal portion of the aberrant subclavian artery near its origin of the aorta was present in 4 dogs, and a diverticulum analogous to the human Kommerell's diverticulum was present in 2 cats.
Contrast-enhanced MDCT imaging of thoracic anomalies gives valuable information about the exact aortic arch configuration. Furthermore, MDCT was able to characterize the vascular branching patterns in dogs and cats with a persistent right aortic arch and the morphology and size of the patent ductus arteriosus in affected dogs. This additional information can be of help with regard to improved diagnoses of thoracic anomalies and the planning of surgical interventions.
BMC Veterinary Research 09/2011; 7(1):57. DOI:10.1186/1746-6148-7-57 · 1.78 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Dans sa forme la plus pure, la radiologie interventionnelle désigne l’utilisation de l’imagerie radiologique afin de guider le chirurgien dans la réalisation d’un nombre varié d’interventions mini-invasives, au travers de l’utilisation d’un équipement spécialisé. Les techniques de radiologie interventionnelle peuvent être plus efficaces, plus sûres, moins douloureuses et associées à un temps de convalescence plus court que pour les techniques de chirurgie conventionnelle. La première technique a été décrite en 1953 lors d’une procédure diagnostique. Dix ans plus tard, la première procédure interventionnelle était décrite. Depuis la radiologie interventionnelle a été utilisée dans un grand nombre de procédures. Certaines ont été transposées en médecine vétérinaire. Chaque année de nouvelles techniques sont développées, offrant au vétérinaire un large choix de techniques, notamment dans le domaine de la médecine cardio-vasculaire des carnivores domestiques.
[Show abstract][Hide abstract] ABSTRACT: The Amplatz canine duct occluder (ACDO) is a nitinol mesh device with a short waist that separates a flat distal disc from a cupped proximal disc. The device is designed to conform to the morphology of the canine patent ductus arteriosus (PDA). PDA dimensions are determined by angiography, and a guiding catheter is advanced into the main pulmonary artery via the aorta and PDA. An ACDO with a waist diameter approximately twice the angiographic minimal ductal diameter (MDD) is advanced via the catheter using an attached delivery cable until the flat distal disc deploys within the main pulmonary artery. The partially deployed ACDO, guiding catheter, and delivery cable are retracted until the distal disc engages the pulmonic ostium of the PDA. With the delivery cable stabilized, the catheter is retracted to deploy the waist across the pulmonic ostium and cupped proximal disc within the ductal ampulla. Tension on the delivery cable is released, and correct ACDO positioning and stability are confirmed by observing that the device assumes its native shape, back-and-forth maneuvering of the delivery cable, and a small contrast injection made through the guiding catheter. The delivery cable is detached and removed with the guiding catheter. To assess for any residual ductal flow, an angiogram is performed at the conclusion of the procedure, followed by Doppler echocardiography at 1 day and 3 months post-procedure. PDA occlusion in dogs with the ACDO is straightforward and extremely effective across a wide range of body weights, somatotypes, MDDs, and ductal morphologies.
Journal of veterinary cardiology: the official journal of the European Society of Veterinary Cardiology 12/2007; 9(2):109-17. DOI:10.1016/j.jvc.2007.09.002 · 1.32 Impact Factor
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