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A Retrospective Cohort Evaluation of Left Ventricular Remodeling, Perioperative Complications and Outcome in Medium and Large Size Dogs with Patent Ductus Arteriosus after Percutaneous Closure.
- Source :
- Veterinary Sciences; Dec2023, Vol. 10 Issue 12, p669, 15p
- Publication Year :
- 2023
-
Abstract
- Simple Summary: Patent ductus arteriosus (PDA) is a frequent congenital heart defect in dogs. The persistent flow through the vascular communication induces an excess of blood flow to the pulmonary circulation and the left heart chambers. The ductal closure leads to a reduction in the left chamber's volume. The degree of volume reduction after PDA closure is inferior in large size dogs compared to small breed dogs. The present study evidenced worsening heart remodeling with the deterioration of structural and functional condition in dogs with a higher body weight, a larger dimension of the PDA, a more severe heart enlargement or arrhythmias at presentation. This may be associated with perioperative complications and cardiac death. Therefore, when possible, the therapeutic indication is to perform PDA closure as early as possible, in younger dogs with less heart remodeling and major functional capacity. If patients are presented at an older age, the PDA closure must be performed anyway because the untreated persistence of the pathology can induce complications as congestive heart failure, arrhythmias or sudden death. This retrospective cohort study included one hundred fifty-seven medium and large-size dogs with the aim of evaluating the effect of signalment and echocardiographic features on complications, outcomes and left ventricular modifications before and after patent ductus arteriosus (PDA) closure. The patients were divided in two groups based on the heart remodeling after closure: Group A included dogs that had a reduction in the end-systolic volume index (ESVI) after closure compared to the ESVI measured before; Group B included dogs without a reduction in ESVI after closure. Body weight, minimal ductal diameter (MDD) of PDA, end-diastolic volume index and presence of arrhythmias at presentation were significantly higher in Group B compared to Group A. The shortening fraction and ejection fraction after closure were reduced in both groups, but in Group B there was a major reduction, and the mean values indicated a possible systolic dysfunction. Complications during the procedure and death due to cardiac reasons were greater in Group B compared to Group A. In conclusion, a higher body weight, a larger MDD, a more severe heart enlargement or arrhythmias at presentation increased the risk of developing a worsening structural and functional condition after ductal closure, and this can be associated with perioperative complications and cardiac death. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 23067381
- Volume :
- 10
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- Veterinary Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 174494338
- Full Text :
- https://doi.org/10.3390/vetsci10120669