Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

Transcatheter Intravascular Stent Placement in a Shih Tzu Dog with Refractory Pulmonic Stenosis

카테터를 통한 혈관스텐트 장착을 통한 심한 폐동맥협착증 치료 1례

  • Kim, Hyun-Wook (Haemaru Small Animal Referral Hospital) ;
  • Kim, Sung-Soo (Haemaru Small Animal Referral Hospital) ;
  • Lee, Joon-Soek (Section of Small Animal Internal Medicine, Kangwon National University) ;
  • Nam, So-Jeong (Section of Small Animal Internal Medicine, Kangwon National University) ;
  • Choi, Ran (Section of Small Animal Internal Medicine, Kangwon National University) ;
  • Hyun, Chang-Baig (Section of Small Animal Internal Medicine, Kangwon National University)
  • 김현욱 (해마루 동물병원) ;
  • 김성수 (해마루 동물병원) ;
  • 이준석 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 최란 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 남소정 (강원대학교 수의(학부)대학 소동물 내과교실) ;
  • 현창백 (강원대학교 수의(학부)대학 소동물 내과교실)
  • Published : 2009.02.27
Download PDF
⟨ Previous Next ⟩

Abstract

A 4-year-old intact male Shih Tzu dog (5.4 kg of body weight) was referred with primary complaints of heart murmur and exercise intolerance. Diagnostic studies found severe valvular pulmonic stenosis (peak velocity of 6.4 m/s, pressure gradient 165 mmHg). The dog was treated with 3 cm (length) ${\times}$ 1.5 cm (diameter) of Palmaz biliary stent. The outcome of stent placement was favorable and remarkably reduced the severity of PS (6.4 m/s to 3.0 m/s of peak velocity). Clinical condition was remarkably improved with the absence of cardiac murmur, although mild pulmonic regurgitation existed from the day of stent placement. To our best knowledge, this case is the first clinical trial for treating PS with intravascular stent in Korea.

4 년령 시쭈개 (체중 5.4 kg)가 심잡음과 운동불내성으로 내원하였다. 진단검사상 심한 폐동맥협착증으로 진단되었다 (우심실 유출로의 peak velocity of 6.4 m/s, 압력구배 165 mmHg). 본 환견은 3 cm (길이) ${\times}$ 1.5 cm (직경)의 Palmaz biliary stent를 이용하여 치료하였다. 시술후 환견의 폐동맥 협착증은 상당히 많이 개선되었다 (우심실 유출로의 of peak velocity가 3.0 m/s로 감소). 내원전 보였던 임상증상은 더 이상 보이지 않았지만 경미한 폐동맥 패쇄부전이 관찰되었다. 본 증례는 우리나라에서 최초로 시도된 스텐트를 이용한 폐동맥 협착증 증례이다.

Keywords

References

  1. Balfour IC, Rao PS. Pulmonary stenosis. Curr Treatment Opt Cardiovasc Med 2000; 2: 489-498 https://doi.org/10.1007/s11936-000-0044-8
  2. Bussadori C, DeMadron E, Santilli RA, Borgarelli M. Balloon valvuloplasty in 30 dogs with pulmonic stenosis: effect of valve morphology and annular size on initial and 1-year outcome, J Vet Intern Med 2001; 15: 553-558 https://doi.org/10.1111/j.1939-1676.2001.tb01590.x
  3. Butto F, Burke B, Berry JM. Effects of dilating the canine pulmonary annulus with two balloons. Doppler ultrasound and postmortem findings. Invest Radiol 1988; 22: 569-573
  4. Estrada A, Moise NS, Erb HN, McDonough SP, Renaud- Farrell S. Prospective evaluation of the balloon-to-annulus ratio for valvuloplasty in the treatment of pulmonic stenosis in the dog. J Vet Intern Med 200; 20: 862-872 https://doi.org/10.1111/j.1939-1676.2006.tb01799.x
  5. Ford RB, Spaulding GL, Eyster GE. Use of an extracardiac conduit in the repair of supravalvular pulmonic stenosis in a dog. J Am Vet Med Assoc 1978; 172: 922-925
  6. Gibbs JL. Congenital heart disease: Interventional catheterisation. Opening up I: the ventricular outflow tracts and great arteries. Heart 2000; 83: 111-115 https://doi.org/10.1136/heart.83.1.111
  7. Griffiths LG, Janice MB. Transcatheter intravascular stent placement to relieve supravalvular pulmonic stenosis. J Vet Cardiol 2006; 8: 145-155 https://doi.org/10.1016/j.jvc.2006.01.004
  8. Hwang B, Lee PC, Fu YC. Transcatheter implantation of intravascular stents for postoperative residual stenosis of peripheral pulmonary artery stenosis. Angiology 2004; 55: 493-498 https://doi.org/10.1177/000331970405500504
  9. Lee SG, Moon HS, Hyun C. Pulmonic stenosis corrected by balloon valvuloplasty in a Maltese dog Korean J Vet Res 2007; 47: 223-226
  10. Martin MWS, Godman M, Fuentes VL. Assessment of balloon pulmonary valvuloplasty in six dogs. J Small Anim Pract 1992; 33: 443-449 https://doi.org/10.1111/j.1748-5827.1992.tb01200.x
  11. Minors SL, O'Grady MR, Williams RM, O'Sullivan ML. Clinical and echocardiographic features of primary infundibular stenosis with intact ventricular septum in dogs. J Vet Intern Med 2006; 20: 1344-1350 https://doi.org/10.1111/j.1939-1676.2006.tb00749.x
  12. Nakanishi T. Balloon dilation and stent implantation for vascular stenosis. Pediatrics Int 2001; 43: 548-552 https://doi.org/10.1046/j.1442-200X.2001.01462.x
  13. Orton C, Monnet E. Pulmonic stenosis and subvalvular aortic stenosis: Surgical options. Semi Vet Med Surg Small Ani 1994; 9: 221-226
  14. Orton CE. Advances in cardiovascular surgery, Semi Vet Med Surg Small Ani 1994; 9: 167-246
  15. Oyama MA, Sisson DD, Thomas W, Bonagura JD. Acquired valvular heart disease. In: Textbook of Veterinary Internal Medicine, 5th ed. Philadelphia: Saunders. 2005: 972-1021
  16. Rao PS, Thapar MK, Kutayli F. Causes of restenosis after balloon valvuloplasty for valvular pulmonary stenosis. Am J Cardiol 1988; 62: 979-982 https://doi.org/10.1016/0002-9149(88)90909-5
  17. Rao PS. Further observations on the effect of balloon size on the short term and intermediate term results of balloon dilation of the pulmonary valve. Br Heart J 1988; 60: 507- 511 https://doi.org/10.1136/hrt.60.6.507
  18. Rosales AM, Lock JE, Perry SB. Interventional catheterization management of perioperative peripheral pulmonary stenosis: balloon angioplasty or endovascular stent. Cathet Cardiovasc Interv 2002; 56: 272-277 https://doi.org/10.1002/ccd.10192
  19. Saida Y, Tanaka R, Hayama T, Soda A, Yamane Y. Surgical correction of pulmonic stenosis using transventricular pulmonic dilation valvuloplasty (Brock) in a dog. J Vet Med Sci. 2007; 69: 437-439 https://doi.org/10.1292/jvms.69.437
  20. Schneider MBE, Zartner P, Duveneck K. Various reasons for repeat dilation of stented pulmonary arteries in paediatric patients. Heart 2002; 88: 505-509 https://doi.org/10.1136/heart.88.5.505