Abstract:
Transcatheter pulmonary valve implantation (TPVI) is indicated for use in the management of failing pulmonary valves in humans. We report here the long-term follow-up of the first documented transcatheter pulmonary valve implanted in a client-owned dog. A one-year-old Beagle dog with severe congenital type A valvular pulmonic stenosis first underwent percutaneous balloon pulmonary valvuloplasty, leading two years later to severe pulmonary regurgitation. A TPVI using a Melody™ bioprosthetic valve was then successfully performed, with normalization of the right heart cavities. Repeated two- and three-dimensional transthoracic echocardiographic examinations combined with Doppler modes confirmed the appropriate position and function of the valve for four years. Mitral myxomatous valvular degeneration led to refractory left-sided congestive heart failure, and the dog was humanely euthanized. After postmortem examination, X-ray imaging and histopathological evaluation of the stent and the valve were performed. Ex-vivo imaging of the implanted valve using a Faxitron® Path radiography system and microscopic evaluation of the implanted stent and bioprosthetic leaflets did not show any relevant leaflet or stent alterations. This case provides a proof of concept in interventional veterinary cardiology, showing that TPVI can be performed in dogs with subsequent long-term maintaining normal pulmonary valve function.
摘要:
经导管肺动脉瓣植入术(TPVI)适用于治疗人类肺动脉瓣衰竭。我们在此报告了首次记录的经导管肺动脉瓣植入客户拥有的狗的长期随访。1岁的Beagle犬患有严重的先天性A型肺动脉瓣狭窄,首次接受了经皮球囊肺动脉瓣成形术,两年后导致严重的肺反流。然后成功进行了使用Melody™生物人工瓣膜的TPVI,右心腔正常化。重复的二维和三维经胸超声心动图检查结合多普勒模式确认了瓣膜的适当位置和功能四年。二尖瓣粘液瘤样瓣膜变性导致难治性左侧充血性心力衰竭,狗被人道地安乐死了.验尸后,对支架和瓣膜进行X线成像和组织病理学评估。使用Faxitron®Path射线照相系统对植入的瓣膜进行离体成像,并对植入的支架和生物假体小叶进行显微镜评估,未显示任何相关的小叶或支架改变。这个案例提供了介入性兽医心脏病学的概念证明,表明TPVI可以在狗中进行,随后长期维持正常的肺动脉瓣功能。