Immediate and late outcomes of transarterial coil occlusion of patent ductus arteriosus in dogs.
Records from dogs (n = 125) that underwent attempted transarterial coil occlusion of patent ductus arteriosus (PDA) at the University of California, Davis, between 1998 and 2003, were reviewed, and a subset of these dogs (n = 31) in which the procedure was performed at least 12 months earlier were reexamined to determine long-term outcome. Coil implantation was achieved in 108 dogs (86%). Despite immediate complete ductal closure in only 34% of dogs, the procedure was hemodynamically successful as evidenced by a reduction in indexed left ventricular internal diameter in diastole (LVIDd; P < .0001), fractional shortening (P < .0001), and left atrial to aortic ratio (LA: Ao; P = .022) within 24 hours. Complete ductal closure was documented in 61% of dogs examined 12 to 63 months after coil occlusion. Long-standing residual ductal flow in the other 39% of dogs was not associated with increased indexed LVIDd or LA: Ao and was not hemodynamically relevant. Repeat intervention was deemed advisable in only 4 dogs with persistent (n = 1) or recurrent (n = 3) ductal flow. Complications included aberrant embolization (n = 27), death (n = 3), ductal reopening (n = 3), transient hemoglobinuria (n = 2), hemorrhage (n = 1), aberrant coil placement (n = 1), pulmonary hypertension (n = 1), and skin abscessation (n = 1). Serious infectious complications did not occur despite antibiotic administration to only 40% of these dogs. Transarterial coil occlusion was not possible in 14 dogs (11%) because of coil instability in the PDA and was associated with increased indexed minimum ductal diameter (P = .03), LVIDd (P = .0002), LVIDs (P = 0.001), and congestive left heart failure (P = .03) reflecting a relatively large shunt volume.
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California at Davis, Davis, CA 95616, USA. fecampbell@ucdavis.edu
F E
FE
Campbell
W P
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Thomas
S J
SJ
Miller
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D
Berger
M D
MD
Kittleson
D000818:Animals; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D004374:Ductus Arteriosus, Patent / Q000601:surgery / Q000662:veterinary*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000662:veterinary; D007431:Intraoperative Complications / Q000662:veterinary; D011183:Postoperative Complications / Q000662:veterinary; D013997:Time Factors; D016896:Treatment Outcome