Journal of Veterinary Cardiology最新文献

A 17-week-old, 2.7-kg cat was presented for management of congestive heart failure due to cor triatriatum sinister. Despite aggressive management for congestive heart failure with escalating diuretic doses, the cat remained symptomatic with exercise intolerance and dyspnea. Percutaneous transseptal balloon dilatation was scheduled. Computed tomography was performed prior to the procedure to aid in planning, which confirmed echocardiographic findings and excluded concurrent congenital defects. A transseptal puncture was performed under general anesthesia, and the cor triatriatum sinister membrane was crossed with a guidewire, allowing subsequent inflation with a 4-mm cutting balloon, followed by inflation of a 10-mm low-pressure balloon across the membrane. This resulted in marked improvement in pressure gradient across the membrane. Pulmonary venous puncture resulting in a mediastinal thrombus was the only complication encountered but was self-limiting and did not require any intervention. Diuretics were discontinued at a two-week recheck, and echocardiography confirmed resolution of the transmembrane gradient. A recheck echocardiogram nine weeks postoperatively, however, revealed restenosis of the membrane. Clinical signs of congestive heart failure were recurrent, requiring reinstitution of diuretic therapy. Percutaneous correction of cor triatriatum sinister is a technically challenging but feasible treatment option in small animals, though further investigation is needed to determine if restenosis is a common and/or preventable outcome.

Introduction/Objective

Animals, Materials and Methods

Results

Conclusions

Introduction/Objectives

Animals

Materials and Methods

Results

Discussion

Study Limitations

Conclusions

Introduction/Objectives

This study was performed to evaluate the diagnostic value and net benefits, including cost-effectiveness, of a point-of-care analyser (i-STAT®) for measurement of cardiac troponin I (cTnI) in dogs and cats.

Animals, Materials and Methods

120 dogs and 120 cats presented with signs of cardiac disease and suspected myocardial insult on cardiac assessment. This was a validation study expressed as agreement between the i-STAT® analyser and two common commercial reference methods (IMMULITE® 2000 and ACCESS® hsTnI).

Results

The comparison between methods showed a negative bias between the i–STAT® and the two commercial cTnI assays. The bias was more evident when the i-STAT® values were compared to the traditional cTnI assay (IMMULITE® 2000), with a calculated difference of −1.14 ng/mL (dogs) and −0.96 ng/mL (cats). However, the bias was distinctly lower when the i-STAT® measurements were compared to the high-sensitivity cTnI assay (ACCESS®), namely −0.3 ng/mL in dogs and −0.17 in cats.

Discussion

The i-STAT® method can reliably detect normal, low and elevated cTnI values, which is fundamental to differentiate pets with and without myocardial damage and, with the rapid availability of results, this confirms the clinical utility of the i-STAT® method.

Conclusions

cTnI concentrations measured with the i-STAT® have good comparability with those obtained with both commercial assays for low and elevated cTnI values. However, results should be cautiously interpreted for high troponin values, especially if a strict cut-off value is adopted for diagnostic or prognostic purposes in critical clinical conditions, such as myocarditis or acute myocardial ischaemia.

A dog with immune-mediated thrombocytopenia and a new heart murmur had an echocardiogram in 2016 and was found to have a suspected aorto-left atrial fistula. The echocardiogram findings remained relatively static from 2016 to 2022. This report highlights the use of cardiac-gated computed tomography angiography to allow further understanding of a complex anomaly in a patient with a ruptured sinus of Valsalva aneurysm causing a fistulous connection with the left atrium.

Introduction

Successful closure of patent ductus arteriosus (PDA) can be obtained with surgical ligation or with occlusion via minimally invasive per-catheter techniques. This study was performed to assess feasibility and effectiveness of transjugular PDA occlusion in dogs weighing < 3 kg with a device called Nit-Occlud® PDA.

Animals

Thirteen client-owned dogs.

Materials and Methods

This was a retrospective study. Clinical records of dogs that underwent PDA occlusion with a Nit-Occlud® PDA were reviewed. Data collection included patients’ signalment, clinical findings, pre- and post-procedure echocardiographic measurements, device size, procedure time and clinical outcome.

Results

The median age of these patients was six months (2.5-38.0 months), with a mean body weight of 2.44 ± 0.43 kg. The mean minimal ductal diameter (MDD) was 1.82 ± 0.43 mm, while the mean ampulla diameter (AD) was 5.51 ± 1.89 mm. Duct closure was successful in 12 cases. Minimal or no residual shunt was observed on echocardiography prior to device release. In one dog, the device was not released owing to unsatisfactory occlusion, prompting an alternative occlusion method. Follow-up echocardiographic examinations showed complete ductal closure and reversed cardiac remodelling in all cases where the device was successfully released.

Discussion

The Nit-Occlud® is deployed through a delivery system with an outer diameter of 4 F or 5 F, which makes this solution particularly attractive in patients where vascular access is challenging or unfeasible due to the small size of their vessels.

Conclusions

The Nit-Occlud® PDA appears a feasible and effective occlusion system in small patients weighing <3 kg.

Introduction/Objectives

To compare conventional and three-dimensional (3D) echocardiographic indices of right ventricular (RV) systolic function in dogs with various stages of myxomatous mitral valve disease (MMVD), classified according to the 2009 guidelines of the American College of Veterinary Internal Medicine (ACVIM), with those from normal dogs.

Animals

Seventy-eight unsedated dogs (22 healthy controls, 23 ACVIM stage B1 MMVD, 20 ACVIM stage B2 MMVD, and 13 ACVIM stage C MMVD) were included in the study.

Materials and methods

All dogs underwent conventional and 3D echocardiography. Three-dimensional RV end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) were recorded. Right ventricular EDV, ESV, and SV were indexed to bodyweight. Echocardiographic variables were compared across groups using a Kruskal–Wallis test with subsequent post hoc analysis using Dunn's method for multiple comparisons between groups. A P-value of <0.05 was considered significant.

Results

Right ventricular EDV was smaller in stage B1 (P=0.012), stage B2 (P=0.035), and stage C (P=0.004) dogs than in controls. Stage B2 (P=0.003) and stage C (P<0.001) dogs had smaller RV ESV than controls. Stage B1 dogs had smaller RV SV than controls (P=0.012). Right ventricular EF was greater in stage C dogs than in controls (P=0.003) and in stage B1 (P=0.017) dogs.

Conclusions

Several 3D echocardiographic indices of RV systolic function differ between dogs with advanced MMVD when compared with normal dogs. Further investigation is required to determine if these differences have clinical implications.

An 11-year-old, female, spayed, soft-coated Wheaten terrier presented for acute onset of neurological signs. On presentation, neurological examination showed right thoracic and pelvic limb proprioceptive deficits, absent right menace reflex, and weak right nasal septum response. A left thalamocortical lesion was localized. On thoracic auscultation, an arrhythmia was noted, and electrocardiography showed frequent ventricular premature complexes and rare runs of ventricular tachycardia. Echocardiography identified an interventricular septal mass extending into the lumen of the left ventricle. Thalamocortical metastasis secondary to the cardiac mass was suspected to be the cause of the patient's neurological signs. Humane euthanasia was elected by the owner due to the patients clinical status and poor prognosis. A postmortem examination diagnosed hemangiosarcoma of the interventricular septum, the right ventricular free wall, and left ventricular free wall. The left ventricle adjacent to the paraconal groove showed myocardial necrosis and inflammation. Metastases to the brain and secondary intracranial hemorrhage were found which were suspected to be the cause of the antemortem neurological signs. Concurrent pulmonary and hepatic metastases were noted. This report describes a rare presentation of an intracardiac hemangiosarcoma of the interventricular septum, right ventricle, and left ventricle in a patient presenting with neurological signs.