Ingrid Vernemmen, Eva Buschmann, Glenn Van Steenkiste, Marie Demeyere, Lize-Maria Verhaeghe, Filip De Somer, Katrien M. J. Devreese, Stijn Schauvliege, Annelies Decloedt, Gunther van Loon
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Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking.</p>\n </section>\n \n <section>\n \n <h3> Hypothesis/Objectives</h3>\n \n <p>To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks.</p>\n </section>\n \n <section>\n \n <h3> Animals</h3>\n \n <p>Eleven healthy adult horses.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Transseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10-104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1-35) days. Activated clotting time correlated with anti-factor Xa activity in vitro but not in vivo.</p>\n </section>\n \n <section>\n \n <h3> Conclusions and Clinical Importance</h3>\n \n <p>Transseptal puncture was successfully performed in all horses. 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引用次数: 0
摘要
背景:马匹的心导管检查主要在右心进行,因为进入左心传统上需要动脉途径。经房间隔穿刺术(TSP)已适用于马匹,但缺乏有关随访和先天性房间隔缺损(iASD)闭合情况的数据:动物:11匹健康成年马:动物:11 匹健康成年马:方法:在全身麻醉下进行经脐穿刺。穿刺前后测量血清心肌肌钙蛋白 I 浓度。每周使用经胸超声心动图和心内超声心动图监测iASD闭合情况。在体外和体内评估了术后依诺肝素治疗期间活化凝血时间和抗因子 Xa 活性之间的关系:结果:所有马匹均在 22 分钟(10-104 分钟)的中位时间内成功完成了经窦道穿刺。有 4 匹马需要对穿刺部位进行球囊扩张以推进鞘管。9/11 匹马发生了房性心律失常,包括房性过早去极化(1 匹)、房性心动过速(5 匹)和房颤(3 匹)。TSP 后血清心肌肌钙蛋白 I 浓度升高,但 10/11 匹马的浓度仍低于参考值。iASD 关闭的中位时间为 14 (1-35) 天。活化凝血时间与体外抗因子 Xa 活性相关,但与体内无关:结论和临床意义:所有马匹都成功进行了经脐带穿刺。结论和临床意义:所有马匹都成功进行了经窦道穿刺,该技术安全可靠,所有马匹都能自发闭合iASD。经皮穿刺技术的临床应用将有助于鉴定和治疗马的左侧心律失常。
Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment
Background
Cardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking.
Hypothesis/Objectives
To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks.
Animals
Eleven healthy adult horses.
Methods
Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo.
Results
Transseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10-104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1-35) days. Activated clotting time correlated with anti-factor Xa activity in vitro but not in vivo.
Conclusions and Clinical Importance
Transseptal puncture was successfully performed in all horses. The technique was safe and spontaneous iASD closure occurred in all horses. Clinical application of TSP will allow characterization and treatment of left-sided arrhythmias in horses.
期刊介绍:
The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.