Long-term palliation of right-sided congestive heart failure after stenting a recurrent cor triatriatum dexter in a 10½-year-old pug

A 10½-year-old, male neutered, pug presented with increasing ascites over two months. Echocardiography revealed cor triatriatum dexter with no concurrent cardiovascular anomalies, subsequently confirmed by computed tomography angiography. Balloon dilation of the perforated intra-atrial membrane under fluoroscopic guidance resulted in the transient resolution of all clinical abnormalities, but six months later stenosis and ascites recurred. After repeated balloon dilation, a stent was placed across the membrane. The dog remains asymptomatic fourteen months after the second procedure. One noteworthy feature of this case is the onset of congestive heart failure due to a congenital defect only at more than 10 years of age

Nouvelles données sur l’agglomération antique d’<i>Epomanduodurum</i> (Mandeure et Mathay, Doubs)

International audienceDem antiken Mandeure-Mathay (Epomanduodurum), dem aufgrund seiner Größe und seiner bedeutenden Monumentalbauten im Sequanerland der zweite Platz nach dem Civitas-Hauptort Besançon zukommt, ist seit 2001 ein pluridisziplinäres Forschungsprojekt gewidmet. Im Anschluß an einen im Jahrgang 2007 dieser Zeitschrift vorgelegten Beitrag berichtet das vorliegende Dossier über die Forschungen der Jahre 2005 bis 2011. Parallel zur Weiterführung und Vertiefung der im Bereich der Kult- und Monumentalbauten begonnenen Arbeiten, trieb das Forschungsteam während dieses zweiten Projektabschnittes verschiedene Studien zur gesamten antiken Stadtanlage und der sie umgebenden Mikroregion voran. Diese Untersuchungen liefern neue Einsichten zur Entstehung, Entwicklung und zum Niedergang von Epomanduodurum und tragen zu einem vertieften Verständnis der Gestalt dieser Stadt und ihrer religiösen, ökonomischen und sozialen Organisation im Zeitraum vom Ende der Eisenzeit bis zum Frühmittelalter bei.A collective research program is studying since 2001 the ancient agglomeration of Mandeure-Mathay (Epomanduodurum), considered as second one after the chief town Besançon, in the Sequani territory, by its size and its impressive monumental buildings. This article, following a previous paper published in Gallia in 2007, draws up a report of the researches completed between 2005 and 2011. In this second stage, alongside the ongoing in-depth investigations on cult and monumental area, the PCR (Collective Program Research) team intensified its different studies and researches on the ancient agglomeration and its microregional environment. These studies lead to a better understanding of the appearance, development and decline of Epomanduodurum ; a better knowledge of its morphology, and its religious, economic and social organization between the end of the Iron Age and the Early Middle Ages.L’agglomération antique de Mandeure-Mathay (Epomanduodurum), considérée comme la seconde du pays séquane par ses dimensions et l’ampleur de sa parure monumentale, derrière la capitale de cité, Besançon, fait l’objet d’un programme collectif de recherche (PCR), pluridisciplinaire, depuis 2001. Le présent dossier, qui fait suite à un précédent article paru dans Gallia en 2007, dresse un bilan des recherches réalisées entre 2005 et 2011. Dans cette seconde étape, parallèlement à la poursuite et à l’approfondissement des actions engagées sur le secteur cultuel et monumental, l’équipe du PCR a accentué les études et investigations de diverses natures portant sur l’ensemble de l’agglomération antique et sur l’espace microrégional dans lequel celle-ci s’insère. Ces recherches aboutissent à une meilleure compréhension des modalités d’émergence, de développement et de déclin de la ville d’Epomanduodurum, et à une connaissance plus approfondie de sa morphologie et de son organisation religieuse, économique et sociale, entre la fin de l’âge du Fer et le haut Moyen Âge

Natürliche Angiostrongylus vasorum Infektion: Charakterisierung des Krankheitsbildes bei drei Hunden mit pulmonärer Hypertonie

Pulmonary hypertension (PH), together with its accompanying clinical signs and underlying causes, e.g. pulmonary thrombosis, are more and more recognized as an important clinical entity also in dogs. This article characterizes the clinical picture of 3 dogs with PH caused by natural infection with Angiostrongylus vasorum. All 3 dogs were of small breeds ( < 10 kg), the age at the time of diagnosis was 1, 2 and 11 years. Clinically, dyspnea and exercise intolerance were the predominating signs, 2 dogs developed hemoptysis, 1 dog developed right sided congestive heart failure. Severe arterial hypoxemia (PaO2 41 - 53 mmHg) reflected the severity of pulmonary parenchymal and vascular damage. Severe hyperglobulinemia (59 und 88 g/l) in two dogs implicated a long lasting infection. Anthelmintic treatment in 2 dogs resulted in quick clinical, radiographic and echocardiographic normalization. PH is the consequence of multiple causes and pathomechanisms, and the recognition of PH is primarily of differential diagnostic relevance. Prognosis and therapy in cases with PH mainly depend on the underlying cause, rather than on the PH and on its degree

Intrapulmonary arteriovenous anastomoses in dogs with severe Angiostrongylus vasorum infection: clinical, radiographic, and echocardiographic evaluation

BACKGROUND: In both humans and dogs the pulmonary vasculature is able to recruit large-diameter anatomical intrapulmonary arteriovenous anastomoses (IPAVAs). In healthy people the opening of these anastomoses affects the degree of exercise-induced increase in pulmonary arterial pressure. The presence of these IPAVAs can be demonstrated using saline contrast echocardiography. OBJECTIVES: The aims of the present study were to characterize severely affected, naturally infected dogs with Angiostrongylus vasorum, to evaluate if these dogs can open IPAVAs, and to assess if the recruitment of such anastomoses affects the severity of pulmonary hypertension (PH). ANIMALS: Eight client-owned dogs with severe A. vasorum infection were recruited. METHODS: Dogs with A. vasorum infection that presented with severe dyspnea and/or syncope were prospectively screened by echocardiography for the presence of PH and IPAVAs. Only severely affected dogs, based on a combination of clinical, radiographic and echocardiographic abnormalities, were enrolled. RESULTS: Opening of IPAVAs could be demonstrated in three dogs with no to moderate PH, and could not be demonstrated in five dogs with severe PH. In two dogs thoracic radiographs showed only mild interstitial changes, while computer tomography and postmortem examination revealed severe pulmonary interstitial and vascular disease. CONCLUSIONS: These results suggest that dogs may open IPAVAs and that opening of such anastomoses may play a regulatory role in the development of PH. There may be a marked discrepancy between radiographic changes and disease severity in A.vasorum

Echocardiographic assessment of right ventricular systolic function in healthy Beagle dogs compared to high field cardiac magnetic resonance imaging

Ten healthy Beagle dogs were used to compare selected echocardiographic parameters of right ventricular (RV) systolic function with high field cardiac magnetic resonance imaging (MRI). All dogs underwent complete transthoracic echocardiography before and during anesthesia, as well as cardiac MRI with determination of morphology-based ejection fraction, and phase contrast angiography-derived stroke volume. A correlation analysis was carried out between echocardiographic and MRI parameters. The values of fractional area change, tricuspid annular plane systolic excursion, tissue Doppler imaging derived peak velocity of the isovolumic contraction wave and systolic wave of the lateral tricuspid valve annulus showed lower values under general anesthesia. Of all echocardiographic parameters of RV systolic function, only fractional area change (r = 0.671, P = 0.034) and tissue Doppler imaging derived peak velocity of the systolic wave of the lateral tricuspid valve annulus (r = 0.768; P = 0.01), showed a significant correlation with MRI derived stroke volume. None of the echocardiographic parameters correlated with MRI derived ejection fraction. When evaluating the RV echocardiographically, fractional area change and peak velocity of the systolic wave of the lateral tricuspid valve annulus appear to be the most reliable predictors of RV systolic function when compared to MRI under anesthesia

Balloon valvuloplasty of valvular pulmonary stenosis in a neonatal foal

In a 1-day old filly with a loud heart murmur, transthoracic echocardiography revealed right ventricular hypertrophy associated with severe pulmonary valvular stenosis and a transvalvular pressure gradient (between right ventricle and pulmonary artery) of 125 mmHg. Computed tomographic angiography confirmed the finding, with no evidence of other relevant concurrent abnormalities. Balloon valvuloplasty was performed using a single balloon technique. The foal recovered well from anaesthesia. Following the procedure, the right ventricle-pulmonary artery transvalvular gradient decreased to 38 mmHg. At follow up examinations after 1 month, 1 year and 2 years, the filly showed normal exercise capacity and echocardiography confirmed the persistent substantial improvement in the transvalvular outflow gradient

Effect of ventilation technique and airway diameter on bronchial lumen to pulmonary artery diameter ratios in clinically normal beagle dogs

In dogs, a mean broncho-arterial ratio of 1.45 ± 0.21 has been previously defined as normal. These values were obtained in dogs under general inhalational anesthesia using a single breath-hold technique. The purpose of the study was to determine whether ventilation technique and bronchial diameter have an effect on broncho-arterial ratios. Four healthy Beagle dogs were scanned twice, each time with positive-pressure inspiration and end expiration. For each ventilation technique, broncho-arterial ratios were grouped into those obtained from small or large bronchi using the median diameter of the bronchi as the cutoff value. Mean broncho-arterial ratios obtained using positive-pressure inspiration (1.24 ± 0.23) were statistically greater than those obtained at end expiration (1.11 ± 0.20) P = 0.005. There was a strong positive correlation between bronchial diameter and broncho-arterial ratios for both ventilation techniques (positive-pressure inspiration rs  = .786, P < 0.0005 and end expiration rs  = .709, P < 0.0005). Mean broncho-arterial ratio for the large bronchi obtained applying positive-pressure inspiration was 1.39 cm ± 0.20 and during end expiration was 1.22 cm ± 0.20. Mean broncho-arterial ratio for the small bronchi obtained during positive-pressure inspiration was 1.08 cm ± 0.13 and during end expiration was 1.01 cm ± 0.13. There was a statistically significant difference between these groups (F = 248.60, P = 0.005). Findings indicated that reference values obtained using positive-pressure inspiration or from the larger bronchi may not be applicable to dogs scanned during end expiration or to the smaller bronchi

Thoracic computed tomography findings in dogs experimentally infected with Angiostrongylus vasorum

To characterize the computed tomography (CT) features of thoracic lesions caused by infection with Angiostrongylus vasorum, pre- and postcontrast CT was performed in six experimentally infected Beagles 13 weeks postinoculation and in four of these 9 weeks postchemotherapy. Findings were compared with survey radiographs and necropsy findings. A multicentric bronchoalveolar pattern more pronounced at the lung periphery was present radiographically. On CT, the predominant abnormality underlying this alveolar pattern was multiple large nodules merging to areas of consolidation, and containing air bronchograms of varying extent. These nodular changes corresponded to histopathologic granulomata, consisting mainly of macrophages, multinucleated giant cells, and lymphocytes that had accumulated around larvae and eggs. Morphologically, no bronchial changes were observed on CT or histologically. Quantitatively, however, on CT there was evidence of bronchial thickening at 13 weeks postinoculation and mild very peripheral bronchiectasia 9 weeks postchemotherapy. Regional lymph nodes were enlarged after infection, and smaller after treatment. On postcontrast CT, several suspicious intraluminal filling defects suggestive of thrombosis were found; however, the tortuosity of some pulmonary arteries seen radiographically was not present in CT images. After treatment, the consolidations and large nodules had almost completely disappeared. A remaining radiographic interstitial pattern was characterized on CT as ground-glass opacifications, subpleural interstitial thickening, subpleural lines, and interface signs. These interstitial changes reflected fibrosis as documented histopathologically. CT allowed very detailed and accurate characterization of pulmonary parenchymal lesions, bronchi, and lymphnodes and closely reflected histopathological changes

Case report - azygos vein drainage into the left atrium in a dog with cor triatriatum dexter and a patent foramen ovale

A 2-year-old Airedale terrier was presented with exercise intolerance since birth and newly developed chylous pleural effusion. Imaging procedures including echocardiography, cardiac magnetic resonance imaging, computed tomography, and selective angiography revealed an aberrant connection of the azygos vein and the left atrium, a membrane in the right atrium consistent with cor triatriatum dexter, and a patent foramen ovale with right-to-left shunt. Balloon dilation of the membrane in the right atrium seemed to result in transient improvement of exercise tolerance compared with the previous 2 years. When chylothorax relapsed after three months, the dog was euthanized. Necropsy confirmed the azygos vein to left atrial connection, the patent foramen ovale, and the cor triatriatum dexter

Comparison of left and right ventricular stroke volume of dogs calculated on the basis of morphology and blood flow determined by use of cardiac magnetic resonance imaging

OBJECTIVE To compare stroke volume (SV) calculated on the basis of cardiac morphology determined by MRI and results of phase-contrast angiography (PCA) of ventricular inflow and outflow in dogs. ANIMALS 10 healthy Beagles. PROCEDURES Cardiac MRI was performed twice on each Beagle. Cine gradient echo sequences of both ventricles in short-axis planes were used for morphological quantification of SVs by assessment of myocardial contours. From the long-axis plane, SVs in 4-chamber and left ventricular 2-chamber views were acquired at end diastole and end systole. For calculation of SV on the basis of blood flow, PCA was performed for cardiac valves. RESULTS Mean ± SD values for SV quantified on the basis of blood flow were similar in all valves (aortic, 17.8 ± 4.1 mL; pulmonary, 17.2 ± 5.4 mL; mitral, 17.2 ± 3.9 mL; and tricuspid, 16.9 ± 5.1 mL). Morphological quantification of SV in the short-axis plane yielded significant differences between left (13.4 ± 2.7 mL) and right (8.6 ± 2.4 mL) sides. Morphological quantification of left ventricular SV in the long-axis plane (15.2 ± 3.3 mL and 20.7 ± 3.8 mL in the 4- and 2-chamber views) yielded variable results, which differed significantly from values for flow-based quantification, except for values for the morphological 4-chamber view and PCA for the atrioventricular valves, for which no significant differences were identified. CONCLUSIONS AND CLINICAL RELEVANCE In contrast to quantification based on blood flow, calculation on the basis of morphology for the short-axis plane significantly underestimated SV, probably because of through-plane motion and complex right ventricular anatomy