Partial Hepatectomy with Temporary Hepatic Vascular Occlusion in Dogs with Hepatic Arteriovenous Fistulas

Whiting, Pamela G.; Breznock, Eugene M.; Moore, Peter F.; Kerr, Larry Y.; Berger, Bruce C.; Gregory, Clare R.; Hornof, William J.

doi:10.1111/j.1532-950x.1986.tb00198.x

Cited by 18 publications

(22 citation statements)

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“…• PRONOSTIC La présence d'ascite, d'hypertension portale et de shunts multiples porto-systémiques extrahépatiques est classiquement interprétée comme un facteur péjoratif (TOBIAS, 2003 ;WHITING et al, 1986)). Cependant, notre expérience nous incline à modérer cette affirmation, car notre analyse rétrospective nous permet d'annoncer un pronostic égal, voire supérieur, à celui des shunts porto-systémiques intrahépa-tiques, affection plus fréquemment rencontrée et traitée chirurgicalement.…”

Section: • Examen Macroscopique Et Histologiqueunclassified

Les fistules artério-veineuses hépatiques chez le chien : diagnostic, traitement, pronostic

Chanoit¹,

Kyles²,

Weisse³

et al. 2005

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La pathologie vasculaire congénitale du foie chez les carnivores domestiques est divisée en 2 entités : les shunts porto-systémiques, qui ont fait l’objet de nombreuses études et publications et les fistules artério-veineuses (FAVH), à l’inverse peu documentées en médecine vétérinaire. Lors de FAVH, une partie de la vascularisation artérielle hépatique communique avec le système porte au sein du parenchyme hépatique. Cette affection touche les animaux jeunes. Les symptômes rencontrés sont : ascite, retard de croissance et parfois, signes neurologiques, dus aux shunts porto-caves multiples résultant de l’hypertension portale. Il existe 3 modalités de traitement chirurgical : 1) résection du ou des lobe(s) hépatique(s) concerné(s), 2) ligature de la branche de l’artère hépatique desservant la fistule ou 3) embolisation par voie endovasculaire de l’artère au niveau de la communication artério-veineuse. Le pronostic de cette affection est variable, bien que le taux de succès thérapeutique soit non négligeable. Dans la plupart des cas, les animaux traités chirurgicalement doivent recevoir des médicaments après l’opération et suivre un régime alimentaire particulier (pauvre en protéines). Le taux de survie est globalement comparable à celui observé lors de shunts porto-systémiques intrahépatiques.

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Section: • Examen Macroscopique Et Histologiqueunclassified

Les fistules artério-veineuses hépatiques chez le chien : diagnostic, traitement, pronostic

Chanoit¹,

Kyles²,

Weisse³

et al. 2005

bavf

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“…All previous case reports of dogs regarding this condition showed vascular abnormality with communication between the portal and hepatic artery [1,3,6,7,9,13]. Dogs with hepatic arteriovenous fistula usually exhibit ascites and secondary multiple portosystemic shunt (PSS) due to portal hypertension [8,12]. This report presents an extremely rare case of a dog with hepatic arteriovenous fistula accompanied by congenital intrahepatic PSS and aortic stenosis.…”

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confidence: 94%

“…Preoperatively, right ventricular enlargement and diuretic drug reactivity ascites in the present case may be results of vicarious high-output heart failure. Hepatic lobectomy is recommended as surgical treatment for hepatic arteriovenous fistula with a single hepatic lobe lesion [6,8,12]. However, hepatic artery ramal ligation technique was chosen in the present case because the lesion extended to multiple lobes [7,12].…”

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“…Hepatic lobectomy is recommended as surgical treatment for hepatic arteriovenous fistula with a single hepatic lobe lesion [6,8,12]. However, hepatic artery ramal ligation technique was chosen in the present case because the lesion extended to multiple lobes [7,12]. Surgical management of intrahepatic PSS was attempted by isolating the shunt vessel from the liver using an ultrasound aspirator [10,11], but this proved to be difficult and the procedure has to be abandoned because of massive bleeding with vascular injury.…”

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confidence: 99%

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Congenital Hepatic Arteriovenous Fistula with Intrahepatic Portosystemic Shunt and Aortic Stenosis in a Dog

Koide¹,

Koide²,

Wada

et al. 2004

The Journal of Veterinary Medical Science

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ABSTRACT. Examination of a 2-month-old male golden retriever presented to the hospital revealed malnutrition, ascites, cardiac murmur and hyperammonemia. Identification of subaortic stenosis and hepatic arteriovenous fistula was made through ultrasonography and angiocardiography. In addition, intrasurgical mesenteric portography showed an intrahepatic portosystemic shunt. The dog did n ot show portal hypertension and secondary multiple extrahepatic portosystemic shunts. Surgical correction was attempted after medical treatment. The hepatic artery branch which was connected to the hepatic arteriovenous fistula was separated, and completely ligated using silk ligature. However, the separation of the intrahepatic shunt blood vessel was unsuccessful and the dog died 15 hr postoperatively. KEY WORDS: canine, hepatic arteriovenous fistula, intrahepatic portosystemic shunt.J. Vet. Med. Sci. 66(3): 299-302, 2004 Hepatic arteriovenous fistula is a condition characterized by a communication between the portal or the hepatic vein and hepatic artery. All previous case reports of dogs regarding this condition showed vascular abnormality with communication between the portal and hepatic artery [1,3,6,7,9,13]. Dogs with hepatic arteriovenous fistula usually exhibit ascites and secondary multiple portosystemic shunt (PSS) due to portal hypertension [8,12]. This report presents an extremely rare case of a dog with hepatic arteriovenous fistula accompanied by congenital intrahepatic PSS and aortic stenosis.A two-month-old male golden retriever was presented to the Koide Animal Hospital, Okayama with a history of ascites which appeared suddenly two weeks before and malnutrition. The dog had been previously diagnosed with aortic stenosis accompanied by hypoalbuminemia and hyperammonemia in another hospital two weeks before and had been undergoing treatment by administration of furosemide (2 mg/kg, twice a day[bid]), spironolactone (1 mg/ kg, bid), alacepril (2 mg/kg, once a day[sid]) and feeding with a protein restricted diet (Hill's Prescription Diet l/d, Hill's pet Nutrition, Inc., Topeka, KS, U.S.A.). A male littermate of the dog had undergone surgical correction of intrahepatic PSS previously.Physical examination revealed that the dog was slightly emaciated, and the body weight was 5.55 kg, systolic ejection murmur over the aortic valve area and continuous murmur (bruit) with thrill through the abdominal wall over the area of the liver. However, there was no sign of ascites during examination.Laboratory examination revealed mild microcytic (mean cell volume = 59 fl), hypochromic (mean corpuscular hemoglobin concentration = 31.5 g/dl) anemia (packed cell volume = 25%), mild prolongation of clotting time by hepaplastin test (25.0 sec; normal, 13-18 sec) and activated partial thromboplastin time (26.9 sec; normal, 18-22 sec), serious panhypoproteinemia (2.5 g of protein/dl, 1.2 g of albumin/dl), high of serum alkaline phosphatase activity (1,513 U/l), slightly high fasting serum bile acid concentration (7.2 µmol/l) and blood am...

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“…In human medicine, hepatic vascular occlusion during hepatic resection is effective in reducing intraoperative bleeding, and various techniques for vascular occlusion have been reported [1,3,14]. In veterinary medicine, two methods of hepatic vascular occlusion have been reported in dogs; one is occlusion of the celiac artery, cra- nial mesenteric artery, portal vein and the prehepatic and posthepatic CVC [2,16], and the other is occlusion of the thoracic aorta, hepatic artery, portal vein and prehepatic and posthepatic CVC [6]. In a previous study, we compared 2 methods, occlusion of the celiac artery, cranial mesenteric artery, hepatic pedicle (the hepatic artery and portal vein) and the prehepatic and posthepatic CVC versus occlusion of the thoracic aorta, hepatic pedicle and prehepatic and posthepatic CVC for 20 min [13].…”

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En Block Resection of a Large Hepatocellular Carcinoma Involving the Caudal Vena Cava in a Dog

Seki

Asano

Ishigaki

et al. 2011

The Journal of Veterinary Medical Science

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ABSTRACT. A 13-year-old neutered female Shih Tzu was referred for investigation of a cranial abdominal mass. Investigations including conventional radiography, abdominal ultrasonography and computed tomography confirmed the mass in the caudate lobe of the liver. As a collateral vein originating from the caudal vena cava (CVC) communicated with the azygos vein, the CVC was ligated and transected cranial to the right renal vein and cranial to the mass under temporary occlusion of the thoracic descending aorta and posthepatic CVC. The mass combined with the CVC was excised. The mass was confirmed as hepatocellular carcinoma (HCC). This report describes the first case with successful en bloc resection of a large HCC involving the CVC in a dog. Hepatocellular carcinoma (HCC) is the most common primary hepatic tumor in dogs [4,11,15]. Canine HCC is classified into three morphologic types, massive, nodular and diffuse, and the most common pattern is a massive lesion that involves a single liver lobe [11]. Therefore, liver lobectomy is the recommended treatment, and the prognosis after surgical resection is good in dogs [7,8]. However, in cases of large or right-divisional hepatic tumors involving the CVC, surgical resection has a risk of large hemorrhage. Partial resection or reconstruction of the CVC may be require when the vessel wall is invaded.A 13-year-old neutered female Shih Tzu (weight 6.6 kg) was referred to the Animal Medical Center of Nihon University for investigation of a cranial abdominal mass. In a physical examination, an enlarged abdomen was observed. Complete blood cell count revealed mild leukocytosis (18,300/ml); other hematological and coagulation parameters were within the normal range. The serum biochemical profile was normal, except for increases in the concentrations of serum alanine aminotransferase (684 U/l), alkaline phosphatase (559 U/l) and aspartate aminotransferase (732 U/l). Radiography revealed a large mass in the caudal side of the liver, displacement of the stomach and intestine (Fig. 1A. B) and a small mass in the left caudal lobe of the lung. In an abdominal ultrasound, a large mixed echogenic mass in the right-divisional hepatic lobe and several splenic nodules were confirmed.Computed tomography (CT) showed a large mass in the caudate lobe occupying the abdominal cavity and displacing the right kidney to the caudal side and the portal vein to the left. In CT angiography, a little contrast medium was detected in the CVC, as blood flow through the CVC was interrupted by the mass (Fig. 2). A collateral vein originating from the CVC caudal to the right renal vein communicated with the azygos vein through a lumber vein (Fig. 3A, B). Further, a single congenital extrahepatic portacaval shunt via the left gastric and phrenic veins was confirmed.The hepatic mass was surgically resected 24 days after the initial presentation. After 0.04 mg/kg atropine (Atropine sulfate; Mitsubishi Tanabe Pharma Corporation.) was administered subcutaneously, general anesthesia was induced with intravenous...

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Partial Hepatectomy with Temporary Hepatic Vascular Occlusion in Dogs with Hepatic Arteriovenous Fistulas

Cited by 18 publications

References 7 publications

Les fistules artério-veineuses hépatiques chez le chien : diagnostic, traitement, pronostic

Les fistules artério-veineuses hépatiques chez le chien : diagnostic, traitement, pronostic

Congenital Hepatic Arteriovenous Fistula with Intrahepatic Portosystemic Shunt and Aortic Stenosis in a Dog

En Block Resection of a Large Hepatocellular Carcinoma Involving the Caudal Vena Cava in a Dog

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