小動物疾病系統

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肺動脈狹窄
作者
陳柏達、賴政宏、鄭豐邦
中文病名 肺動脈狹窄
英文病名 Pulmonic stenosis
疾病描述

 病因:

    肺動脈狹窄常好發於小型犬。其中瓣膜性肺動脈狹窄(valvular pulmonic stenosis)最為常見,部分病例是由於瓣膜尖瓣(valve cusps)的單純融合所造成,但瓣膜的發育障礙(valve dysplasia)又更為常見,其發育障礙的瓣葉(valve leaflets)會呈現變厚、不對稱、部分融合、並伴隨著發育不全的辦環(valve  annulus)。肺動脈狹窄導致右心室(RV)壓力超負荷,造成向心性肥大(concentric hypertrophy),並繼發右心室擴張(dilation);而嚴重的右心室肥大會導致心肌缺血及其後遺症,往往在肥大心室的瓣膜下方的漏斗區(infundibular  region)會形成一個動態的瓣膜下構成物(dynamic subvalvular component)於狹窄處。肺動脈狹窄造成湍流的血流通過狹窄的出口,導致在肺動派幹上狹窄後方處的擴大。而三尖瓣閉鎖不全(tricuspid insufficiency)所導致的右心房(RA)擴張及右心室充盈壓(RV filling pressure)過高會容易誘發房性心動過速(atrial tachyarrhythmias)及鬱血性心衰竭(congestive heart failure, CHF)。若是肺動脈狹窄同時併發有卵圓孔未閉合(patent foramen ovale)或是心房間隔缺損(atrial septal defect),則會發生心房的右至左分流情形(right-to-left shunt)

臨床症狀:

    往往單純的肺動脈狹窄的患畜,儘管是有嚴重的狹窄問題,也常常沒有臨床症狀,但在理學檢查上,中度至重度的病例便可以在右心前區(right precordial)感受到明顯的脈動(impulse);在左心基部可感受到最大的顫動(thrill);股動脈脈動正常或是微弱。同樣地,聽診時可聽到收縮期噴射性心雜音(systolic ejection murmur)出現,最大聲的部位出現在左心基部,此心雜音會沿頭腹側及右側放射擴散;偶爾也能聽到早期收縮喀喇聲(early systolic click),這是由於融合的瓣膜在射血期開始時被突然的制止所造成的;三尖瓣閉鎖不全以及心律不整的心雜音有時也能明確被聽見。部分病例會伴隨有腹水或是其他右側鬱血性心衰竭的病癥;心房或是心室中膈缺損併發右至左分流的病例,則還會發現有發紺(cyanosis)的臨床症狀。

診斷方法

 胸腔放射線影像學檢查,可以發現肺動脈狹窄典型的影徵,包括:明顯的右心室擴大並將心尖位移至左側、背側;右心房也擴大;心臟輪廓於背-腹照或腹-背照呈現倒”D”字形;肺動脈幹膨大,即狹窄處後方擴張造成,於背-腹照或腹-背照其位置位於1點鐘方向;周邊肺臟血管呈現細小、低血流(undercirculated);後腔靜脈呈現正常或是擴張。

  心電圖檢查,在中度或是重度的病例會有明顯的異常,包括:右心室擴大圖型;右心軸位移;偶而尚可見右心房擴大及心率加快圖型。

  心臟超音波檢查,在中度或是重度的病例亦會有明顯的異常,包括:右心室肥厚、擴大;在右心室壓力超過左心室時,室間隔呈現扁平狀,並將其推向左邊;亦常見繼發的右心房擴大,特別是有併發三尖瓣返流的病例;變厚、不對稱、變形或不正常的肺動脈瓣;狹窄處後方擴張所造成肺動脈幹膨大;此外,亦可能看到繼發鬱血性心衰竭所產生的胸水、右心擴大情形。若是搭配使用卜勒心臟超音波(Doppler)檢查,則可以評估肺動脈狹窄的程度及嚴重性。

  心導管探針及心血管造影(cardiac catheterization and angiocardiography)可以評估橫跨動脈狹窄處的壓力差梯度、右心充盈壓以及其他生理數值、解剖構造。

治療方法

 氣球導管擴張術(balloon valvuloplasty)可以適用於中度至重度的肺動脈狹窄情形,特別是漏斗部肥厚沒有太嚴重的病例,它可適度的緩解臨床症狀、延長重度患畜的生命。氣球導管擴張術的操作必須在心導管探針及心血管造影的協助下完成,要將特殊設計的氣球導管通過狹窄的動脈辦處,然後充氣使狹窄的孔洞進而擴大。

    此外,對於肺動脈狹窄的患畜,通常建執行運動限制。β-Blocker的藥物治療也會有改善的幫助,特別是對於漏斗部肥厚嚴重的病例。

    若患畜有其他併發疾病,如鬱血性心衰竭,也必須要一併進行治療。

預防控制方法
相關圖片 <p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖一、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">放射線影像學檢查。</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;
tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">於腹背照下可見患犬之心尖左移,且心臟呈現倒</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">D</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">型,顯示右心擴大。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體"><o:p></o:p></span></p>
Close<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖一、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">放射線影像學檢查。</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;
tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">於腹背照下可見患犬之心尖左移,且心臟呈現倒</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">D</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">型,顯示右心擴大。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體"><o:p></o:p></span></p>

<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖一、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">放射線影像學檢查。</span></b></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph; tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;; mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體; mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language: FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language: FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">於腹背照下可見患犬之心尖左移,且心臟呈現倒</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體">D</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">型,顯示右心擴大。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體"><o:p></o:p></span></p>


<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖二、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">心臟超音波學檢查。</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;
tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">可見患犬右心擴大,右心室游離壁及心中隔心肌明顯增厚。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體"><o:p></o:p></span></p>
Close<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖二、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">心臟超音波學檢查。</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;
tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">可見患犬右心擴大,右心室游離壁及心中隔心肌明顯增厚。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體"><o:p></o:p></span></p>

<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖二、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">心臟超音波學檢查。</span></b></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph; tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;; mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體; mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language: FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language: FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">可見患犬右心擴大,右心室游離壁及心中隔心肌明顯增厚。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體"><o:p></o:p></span></p>


<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖三、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">心臟超音波學檢查。</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;
tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">可見患犬肺動脈幹近端明顯擴張,肺動脈瓣逆流,且於肺動脈瓣遠端可見明顯之噴射血流。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體"><o:p></o:p></span></p>
Close<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖三、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">心臟超音波學檢查。</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph;
tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language:
FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">可見患犬肺動脈幹近端明顯擴張,肺動脈瓣逆流,且於肺動脈瓣遠端可見明顯之噴射血流。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體"><o:p></o:p></span></p>

<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖三、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">心臟超音波學檢查。</span></b></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph; tab-stops:216.0pt"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:</span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;; mso-ansi-language:FR">肺動脈狹窄易造成右心室收縮壓增加</span><span style="font-family:標楷體; mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,導致</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">右心室發生代償性的肥大</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">,</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language: FR">右心室游離壁及心中隔心肌明顯增厚等情形,</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">而右心室</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">過高的壓力同時亦容易造成繼發性的三尖瓣逆流</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">tricuspid regurgitation</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">),</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;mso-ansi-language: FR">使右心房呈現擴張的情形。此圖</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">可見患犬肺動脈幹近端明顯擴張,肺動脈瓣逆流,且於肺動脈瓣遠端可見明顯之噴射血流。</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體"><o:p></o:p></span></p>


<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖四、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">心血管照影檢查(</span></b><b><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">angiocardiography</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">)之影像。</span></b></p>
<p class="MsoNormal"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:將</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">Hexabrix<sup>&reg;</sup> 320</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">照影劑注入</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">Judkins right catheter</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">進行心血管照影,影像中可見其瓣膜本身(實線箭頭)及瓣膜近端(虛線箭頭)皆有狹窄之情形,診斷為瓣膜性及瓣膜下肺動脈狹窄(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">valvular and subvalvular pulmonary stenosis</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)。</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體;mso-font-kerning:0pt;mso-no-proof:yes"><o:p></o:p></span></p>
Close<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖四、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">心血管照影檢查(</span></b><b><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">angiocardiography</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">)之影像。</span></b></p>
<p class="MsoNormal"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:將</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">Hexabrix<sup>&reg;</sup> 320</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">照影劑注入</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">Judkins right catheter</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">進行心血管照影,影像中可見其瓣膜本身(實線箭頭)及瓣膜近端(虛線箭頭)皆有狹窄之情形,診斷為瓣膜性及瓣膜下肺動脈狹窄(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">valvular and subvalvular pulmonary stenosis</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)。</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體;mso-font-kerning:0pt;mso-no-proof:yes"><o:p></o:p></span></p>

<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖四、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">心血管照影檢查(</span></b><b><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">angiocardiography</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">)之影像。</span></b></p> <p class="MsoNormal"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:將</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">Hexabrix<sup>&reg;</sup> 320</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">照影劑注入</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">Judkins right catheter</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">進行心血管照影,影像中可見其瓣膜本身(實線箭頭)及瓣膜近端(虛線箭頭)皆有狹窄之情形,診斷為瓣膜性及瓣膜下肺動脈狹窄(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體">valvular and subvalvular pulmonary stenosis</span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)。</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體;mso-font-kerning:0pt;mso-no-proof:yes"><o:p></o:p></span></p>


<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖五、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">患犬將進行氣球導管擴張術(</span></b><b><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">balloon valvuloplasty</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)。</span></b></p>
<p class="MsoNormal"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:此圖為術中以心血管照影檢查(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">angiocardiography</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)之影像。置入</span><span class="imgtexboxhead2"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">balloon catheter</span></span><span class="imgtexboxhead2"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">(</span></span><st1:chmetcnv unitname="m" sourcevalue="9" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">9 m</span></st1:chmetcnv><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">m&times;<st1:chmetcnv unitname="cm" sourcevalue="2" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on">2 cm</st1:chmetcnv></span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,</span><st1:chmetcnv unitname="cm" sourcevalue="80" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">80 cm</span></st1:chmetcnv><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">Smash<sup>TM</sup></span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,</span><span class="ccbnttl1"><span lang="EN-US" style="font-size:8.5pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體;mso-bidi-font-family:Arial">Boston Scientific</span></span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),延</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">guidewire</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">推送至肺動脈瓣瓣膜處,並以</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">Hexabrix<sup>&reg;</sup> 320</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">照影劑稀釋五倍膨脹及緊縮氣球數次,皆不再觀察到氣球有明顯的</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">因瓣膜狹窄所造成之</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">「腰身」(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">waist</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">)影像,</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">表示瓣膜已被成功擴張</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">。</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體;mso-font-kerning:0pt;mso-no-proof:yes"><o:p></o:p></span></p>
Close<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖五、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">患犬將進行氣球導管擴張術(</span></b><b><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">balloon valvuloplasty</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)。</span></b></p>
<p class="MsoNormal"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:此圖為術中以心血管照影檢查(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">angiocardiography</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)之影像。置入</span><span class="imgtexboxhead2"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">balloon catheter</span></span><span class="imgtexboxhead2"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">(</span></span><st1:chmetcnv unitname="m" sourcevalue="9" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">9 m</span></st1:chmetcnv><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">m&times;<st1:chmetcnv unitname="cm" sourcevalue="2" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on">2 cm</st1:chmetcnv></span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,</span><st1:chmetcnv unitname="cm" sourcevalue="80" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">80 cm</span></st1:chmetcnv><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">,</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">Smash<sup>TM</sup></span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,</span><span class="ccbnttl1"><span lang="EN-US" style="font-size:8.5pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體;mso-bidi-font-family:Arial">Boston Scientific</span></span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;">),延</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體">guidewire</span><span style="font-family:標楷體;
mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">推送至肺動脈瓣瓣膜處,並以</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">Hexabrix<sup>&reg;</sup> 320</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">照影劑稀釋五倍膨脹及緊縮氣球數次,皆不再觀察到氣球有明顯的</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:
&quot;Times New Roman&quot;;mso-ansi-language:FR">因瓣膜狹窄所造成之</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">「腰身」(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:
標楷體">waist</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;
mso-hansi-font-family:&quot;Times New Roman&quot;">)影像,</span><span style="font-family:
標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;;
mso-ansi-language:FR">表示瓣膜已被成功擴張</span><span style="font-family:標楷體;mso-ascii-font-family:
&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">。</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;
mso-fareast-font-family:標楷體;mso-font-kerning:0pt;mso-no-proof:yes"><o:p></o:p></span></p>

<p>&nbsp;<b><span style="mso-bidi-font-size:12.0pt;font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖五、</span></b><b><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">患犬將進行氣球導管擴張術(</span></b><b><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">balloon valvuloplasty</span></b><b><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)。</span></b></p> <p class="MsoNormal"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">圖片說明:此圖為術中以心血管照影檢查(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體">angiocardiography</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">)之影像。置入</span><span class="imgtexboxhead2"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">balloon catheter</span></span><span class="imgtexboxhead2"><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">(</span></span><st1:chmetcnv unitname="m" sourcevalue="9" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">9 m</span></st1:chmetcnv><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:標楷體">m&times;<st1:chmetcnv unitname="cm" sourcevalue="2" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on">2 cm</st1:chmetcnv></span><span style="font-family:標楷體; mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,</span><st1:chmetcnv unitname="cm" sourcevalue="80" hasspace="True" negative="False" numbertype="1" tcsc="0" w:st="on"><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">80 cm</span></st1:chmetcnv><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">,</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">Smash<sup>TM</sup></span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">,</span><span class="ccbnttl1"><span lang="EN-US" style="font-size:8.5pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體;mso-bidi-font-family:Arial">Boston Scientific</span></span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;">),延</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體">guidewire</span><span style="font-family:標楷體; mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">推送至肺動脈瓣瓣膜處,並以</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體">Hexabrix<sup>&reg;</sup> 320</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">照影劑稀釋五倍膨脹及緊縮氣球數次,皆不再觀察到氣球有明顯的</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family: &quot;Times New Roman&quot;;mso-ansi-language:FR">因瓣膜狹窄所造成之</span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">「腰身」(</span><span lang="EN-US" style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family: 標楷體">waist</span><span style="font-family:標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;; mso-hansi-font-family:&quot;Times New Roman&quot;">)影像,</span><span style="font-family: 標楷體;mso-ascii-font-family:&quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;; mso-ansi-language:FR">表示瓣膜已被成功擴張</span><span style="font-family:標楷體;mso-ascii-font-family: &quot;Times New Roman&quot;;mso-hansi-font-family:&quot;Times New Roman&quot;">。</span><span lang="EN-US" style="mso-bidi-font-size:12.0pt;font-family:&quot;Times New Roman&quot;,&quot;serif&quot;; mso-fareast-font-family:標楷體;mso-font-kerning:0pt;mso-no-proof:yes"><o:p></o:p></span></p>


參考文獻

 1.          Ware W, Congenital Cardiac Disease. In: Nelson RW, Couto CG. Small Animal Internal Medicine, 5th ed, Elsevier Mosby, Missouri, 103-106, 2014.

2.          Martin M, Dukes-McEwan J, Congenital heart disease. In: Fuentes VL, Johnson L, Dennis S. BSAVA manual of canine and feline cardiorespiratory medicine, 2nd ed. BSAVA, UK, 242-245, 2010.

3.          Johnson V, Hansson K, Mai W; Dukes-McEwan J, Lester N, Schwarz T, Chapman P, Morandi F. The heart and major vessels. In: Schwarz T, Johnson V, BSAVA  manual of small animal thoracic imaging. BSAVA, UK, 116-120, 2008.

4.          圖片來源:

國立中興大學教學動物醫院民國97年臨床病例報告。

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