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Catheter-guided percutaneous heartworm removal using a nitinol basket in dogs with caval syndrome.

Yoon WK, Han D, Hyun C - J. Vet. Sci. (2011)

Bottom Line: Carval syndrome is a severe heartworm infection where the worms have migrated to the right atrium and vena cava; this condition is associated with a myriad of clinical signs.In this study, we developed a catheter-guided heartworm removal method using a retrieval basket that can easily access pulmonary arteries and increase the number of worms removed per procedure.With this technique, we successfully treated four dogs with caval syndrome.

View Article: PubMed Central - PubMed

Affiliation: Section of Small Animal Internal Medicine, and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon 200-701, Korea.

ABSTRACT
Carval syndrome is a severe heartworm infection where the worms have migrated to the right atrium and vena cava; this condition is associated with a myriad of clinical signs. Several non-surgical and interventional methods are currently used for mechanical worm removal. However, the success rate and complications related to these methods are heavily dependent on methodology and retrieval devices used. In this study, we developed a catheter-guided heartworm removal method using a retrieval basket that can easily access pulmonary arteries and increase the number of worms removed per procedure. With this technique, we successfully treated four dogs with caval syndrome.

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Related in: MedlinePlus

Heartworm removal procedure. After induce surgical anesthesia, the left jugular vein was exposed. An introducer sheath was inserted into the left external jugular vein guided by the pre-placed guide wire into the right atrium, right ventricle, and pulmonary artery (A). The basket device was inserted into the introducer and spread-folded to catch heartworms under fluoroscopic guidance (B and C).
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Figure 1: Heartworm removal procedure. After induce surgical anesthesia, the left jugular vein was exposed. An introducer sheath was inserted into the left external jugular vein guided by the pre-placed guide wire into the right atrium, right ventricle, and pulmonary artery (A). The basket device was inserted into the introducer and spread-folded to catch heartworms under fluoroscopic guidance (B and C).

Mentions: The dogs were premedicated with or without atropine (0.05 mg/kg, subcutaneous administration; Daewoo, Korea) depending on the presence of tachycardia. Anesthesia was then induced and maintained with propofol (induction 6 mg/kg, intravenous administration; maintenance 0.4 mg/kg; Handok, Korea). After anesthesia induction, venotomy was performed on the left jugular vein with a surgical blade. A fixed core wire guide (curved; Cook Medical, USA) was inserted into the vein and down into the right atrium, right ventricle, and pulmonary artery. An introducer sheath (Flexor Tuohy-Borst Sidearm Introducer; 6-8 Fr according to the size of dog; Cook Medical, USA) was inserted to the left external jugular vein guided by the pre-placed guide wire into the right atrium, right ventricle, and the pulmonary artery (Fig. 1A). The guide wire was then removed from the jugular vein. The basket device (disposable fold angular basket; working width 15~30 mm, tube diameter 1.8~2.4 mm according to the size of dog; Wilson Instruments, USA) was inserted into the introducer and spread-folded to catch heartworms under fluoroscopic guidance (Fig. 1). The procedure was paused for 3~4 heart beats between each attempt to extract the worms. The operation was repeated until no worms were visible by echocardiography.


Catheter-guided percutaneous heartworm removal using a nitinol basket in dogs with caval syndrome.

Yoon WK, Han D, Hyun C - J. Vet. Sci. (2011)

Heartworm removal procedure. After induce surgical anesthesia, the left jugular vein was exposed. An introducer sheath was inserted into the left external jugular vein guided by the pre-placed guide wire into the right atrium, right ventricle, and pulmonary artery (A). The basket device was inserted into the introducer and spread-folded to catch heartworms under fluoroscopic guidance (B and C).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3104177&req=5

Figure 1: Heartworm removal procedure. After induce surgical anesthesia, the left jugular vein was exposed. An introducer sheath was inserted into the left external jugular vein guided by the pre-placed guide wire into the right atrium, right ventricle, and pulmonary artery (A). The basket device was inserted into the introducer and spread-folded to catch heartworms under fluoroscopic guidance (B and C).
Mentions: The dogs were premedicated with or without atropine (0.05 mg/kg, subcutaneous administration; Daewoo, Korea) depending on the presence of tachycardia. Anesthesia was then induced and maintained with propofol (induction 6 mg/kg, intravenous administration; maintenance 0.4 mg/kg; Handok, Korea). After anesthesia induction, venotomy was performed on the left jugular vein with a surgical blade. A fixed core wire guide (curved; Cook Medical, USA) was inserted into the vein and down into the right atrium, right ventricle, and pulmonary artery. An introducer sheath (Flexor Tuohy-Borst Sidearm Introducer; 6-8 Fr according to the size of dog; Cook Medical, USA) was inserted to the left external jugular vein guided by the pre-placed guide wire into the right atrium, right ventricle, and the pulmonary artery (Fig. 1A). The guide wire was then removed from the jugular vein. The basket device (disposable fold angular basket; working width 15~30 mm, tube diameter 1.8~2.4 mm according to the size of dog; Wilson Instruments, USA) was inserted into the introducer and spread-folded to catch heartworms under fluoroscopic guidance (Fig. 1). The procedure was paused for 3~4 heart beats between each attempt to extract the worms. The operation was repeated until no worms were visible by echocardiography.

Bottom Line: Carval syndrome is a severe heartworm infection where the worms have migrated to the right atrium and vena cava; this condition is associated with a myriad of clinical signs.In this study, we developed a catheter-guided heartworm removal method using a retrieval basket that can easily access pulmonary arteries and increase the number of worms removed per procedure.With this technique, we successfully treated four dogs with caval syndrome.

View Article: PubMed Central - PubMed

Affiliation: Section of Small Animal Internal Medicine, and Institute of Veterinary Science, College of Veterinary Medicine, Kangwon National University, Chuncheon 200-701, Korea.

ABSTRACT
Carval syndrome is a severe heartworm infection where the worms have migrated to the right atrium and vena cava; this condition is associated with a myriad of clinical signs. Several non-surgical and interventional methods are currently used for mechanical worm removal. However, the success rate and complications related to these methods are heavily dependent on methodology and retrieval devices used. In this study, we developed a catheter-guided heartworm removal method using a retrieval basket that can easily access pulmonary arteries and increase the number of worms removed per procedure. With this technique, we successfully treated four dogs with caval syndrome.

Show MeSH
Related in: MedlinePlus