目的:肺动脉夹层是球囊瓣膜成形术治疗肺动脉狭窄后的一种罕见并发症。我们试图报告狗这种并发症的发生率,并描述人口统计学,临床,程序,和受影响狗的结果数据。
方法:回顾了2002年至2021年在单个学术机构中通过球囊瓣膜成形术治疗的肺动脉狭窄犬的医疗记录。纳入狗进行评估,以评估球囊瓣膜成形术后超声心动图或尸检是否有肺动脉夹层的证据。人口统计,临床,外科,然后记录随访信息。
结果:从210例肺动脉狭窄球囊瓣膜成形术中纳入6只狗,肺夹层发生率为3.9%。有各种各样的标志,肺动脉瓣形态,和每只狗使用的球囊导管类型。所有的狗都有严重的肺动脉狭窄(中位压力梯度为208mmHg,范围94-220mmHg),其中5/6只狗的压力梯度>144mmHg。球囊与肺动脉瓣环的中位数比率为1.35(范围1.25-1.5)。三只狗围手术期死亡,三只狗在术后3.3、4.0和4.1年随访时存活。
结论:肺动脉夹层是肺动脉瓣狭窄球囊瓣膜成形术后的一种罕见并发症。术前肺动脉瓣流速的极端升高是常见的。预后是可变的,围手术期生存率为50%,但出院患者的生存时间延长.
OBJECTIVE: Pulmonary artery dissection is a rare complication following balloon valvuloplasty for pulmonic stenosis. We sought to report the rate of this complication in dogs and describe the demographic, clinical, procedural, and outcome data in affected dogs.
METHODS: Medical records at a single academic institution between 2002 and 2021 were reviewed for dogs with pulmonic stenosis treated by a balloon valvuloplasty. Dogs were included for evaluation if there was evidence of pulmonary artery dissection on echocardiography or necropsy following balloon valvuloplasty. The demographic, clinical, surgical, and follow-up information were then recorded.
RESULTS: Six dogs were included from 210 balloon valvuloplasty procedures for pulmonic stenosis giving a 3.9% rate of pulmonary dissection. There was a variety of signalment, pulmonary valve morphologies, and balloon catheter types used in each dog. All dogs had severe pulmonic stenosis (median pressure gradient of 208 mmHg, range 94-220 mmHg) with 5/6 dogs having a pressure gradient >144 mmHg. The median balloon to pulmonary valve annulus ratio was 1.35 (range 1.25-1.5). Three dogs died perioperatively, and three dogs were alive at follow up 3.3, 4.0, and 4.1 years postoperatively.
CONCLUSIONS: Pulmonary artery dissection is a rare complication following balloon valvuloplasty for pulmonic stenosis. Extreme elevations in preoperative pulmonary valve flow velocity were common. Prognosis is variable, with a potential 50% perioperative survival rate, but extended survival times were noted in those patients discharged from hospital.