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Long-term relief of obstruction in a dog with double-chambered right ventricle using combined cutting balloon and high-pressure balloon dilation
Journal of Veterinary Cardiology ( IF 1.2 ) Pub Date : 2021-06-25 , DOI: 10.1016/j.jvc.2021.06.004
R L Winter 1 , W A Clark 1 , S L Kochie 2 , J D Rhinehart 1
Affiliation  

A 4-month-old intact female Golden Retriever dog was diagnosed with double-chambered right ventricle (DCRV) without infundibular stenosis, tricuspid valve dysplasia, and subsequent severe right atrial enlargement and was referred for combined cutting balloon and high-pressure balloon dilation. On presentation, these diagnoses were confirmed, and the peak systolic pressure gradient across the DCRV obstructive lesion assessed by continuous wave Doppler interrogation was 80 mm Hg. The obstructive lesion within the mid-right ventricle had a diameter of 6 mm through which blood flowed from the proximal right ventricular (RV) chamber to the distal RV chamber. The following day, general anesthesia was induced, and a minimally invasive balloon dilation was performed. A cutting balloon was inflated across the mid-RV obstructive lesion, followed by an inflation of a high-pressure balloon across this lesion. The high-pressure balloon catheter that was used had a diameter roughly 1.5 times the diameter of the pulmonary annulus. The following day, echocardiographic evaluation of the patient revealed a peak systolic pressure gradient across the DCRV obstructive lesion of 16 mm Hg, with a RV diameter at the level of obstruction of 11 mm. Twelve months later, the dog remains asymptomatic, right atrial size has decreased, and has a peak systolic pressure gradient across the DCRV lesion of 20 mm Hg.



中文翻译:

使用联合切割球囊和高压球囊扩张术长期缓解双腔右心室犬梗阻

一只 4 个月大的完整雌性金毛犬被诊断出患有双腔右心室 (DCRV),没有漏斗部狭窄、三尖瓣发育不良和随后的严重右心房扩大,并被转诊进行联合切割球囊和高压球囊扩张术。就诊时,这些诊断得到证实,通过连续波多普勒检查评估的 DCRV 阻塞性病变的峰值收缩压梯度为 80 mmHg。右心室中段阻塞性病变的直径为 6 毫米,血液从近端右心室 (RV) 腔流向远端 RV 腔。第二天进行全身麻醉,并进行微创球囊扩张。一个切割球囊在 RV 中段阻塞性病变处充气,然后在该病变处充气高压球囊。使用的高压球囊导管的直径大约是肺环直径的 1.5 倍。第二天,患者的超声心动图评估显示 DCRV 阻塞性病变的峰值收缩压梯度为 16 毫米汞柱,阻塞水平的 RV 直径为 11 毫米。12 个月后,该犬仍无症状,右心房大小减小,并且在整个 DCRV 病变处具有 20 毫米汞柱的峰值收缩压梯度。对患者的超声心动图评估显示,DCRV 阻塞性病变的最大收缩压梯度为 16 毫米汞柱,阻塞水平的 RV 直径为 11 毫米。12 个月后,该犬仍无症状,右心房大小已减小,并且在整个 DCRV 病变处具有 20 毫米汞柱的峰值收缩压梯度。对患者的超声心动图评估显示,DCRV 阻塞性病变的最大收缩压梯度为 16 毫米汞柱,阻塞水平的 RV 直径为 11 毫米。12 个月后,该犬仍无症状,右心房大小减小,并且在整个 DCRV 病变处具有 20 毫米汞柱的峰值收缩压梯度。

更新日期:2021-07-22
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