title: Utility of transesophageal echocardiography for transcatheter occlusion of patent ductus arteriosus in dogs: influence on the decision-making process.
abstract: BACKGROUND
  Appropriate device selection for transcatheter occlusion of patent ductus arteriosus (PDA) is essential to procedural success.
  
  
  OBJECTIVE
  To determine if transesophageal echocardiography (TEE) influences device selection for PDA occlusion and to report benefits, limitations, and complications associated with TEE.
  
  
  METHODS
  Twenty-two client-owned dogs with left-to-right shunting PDA.
  
  
  METHODS
  PDA dimensions were obtained via transthoracic echocardiography (TTE) and then TEE followed by angiography. Based solely on information from TTE and angiography, an initial device type and size were selected. After initial device selection, TEE measurements were disclosed and changes in device selection were recorded. After device release, angiography, TEE, or both were performed to assess occlusion.
  
  
  RESULTS
  An Amplatz canine duct occluder (ACDO) was securely positioned and released in 21 dogs and an embolization coil was deployed in 1 dog. Based on TEE evaluation, initial selected device type was unchanged but ACDO size was changed in 3 dogs. TEE was utilized throughout the procedure allowing real time visualization of device deployment, release and assessment of closure in 17 dogs. No complications occurred related to TEE. Complete PDA closure was achieved in all dogs.
  
  
  CONCLUSIONS
  TEE provided anatomic information regarding PDA morphology that closely approximated angiographic ductal dimensions while aiding in device deployment, release and confirmation of closure. We conclude that TEE provides complementary anatomical and intraprocedural information and is well tolerated in dogs.
authors.affiliation: Department of Small Animal Clinical Sciences and the Michael E. DeBakey Institute for Comparative Cardiovascular Sciences and Biomedical Devices, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843-4474, USA. asaunders@cvm.tamu.edu
authors.forename: A B
authors.initials: AB
authors.lastname: Saunders
authors.forename: S E
authors.initials: SE
authors.lastname: Achen
authors.forename: S G
authors.initials: SG
authors.lastname: Gordon
authors.forename: M W
authors.initials: MW
authors.lastname: Miller
mesh_terms: D000818:Animals; D006328:Cardiac Catheterization / Q000379:methods / Q000662:veterinary*; D003657:Decision Making; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D017548:Echocardiography, Transesophageal / Q000662:veterinary*; D005260:Female; D008297:Male