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Tierarztl Prax Ausg G Grosstiere Nutztiere 2017; 45(06): 370-376
DOI: 10.15653/TPG-161077
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Schattauer GmbH

Zyanose bei einem Kalb mit einem Double Outlet Right Ventricle

Cyanosis in a calf with a double outlet right ventricle
Nicola Wiedemann
1   Klinik für Kleintiere, Innere Medizin, Klinikum Veterinärmedizin, Justus-Liebig-Universität Gießen
,
Nicolai Hildebrandt
1   Klinik für Kleintiere, Innere Medizin, Klinikum Veterinärmedizin, Justus-Liebig-Universität Gießen
,
Manfred Henrich
2   Institut für Veterinär-Pathologie, Justus-Liebig-Universität Gießen
,
Estelle Henrich
1   Klinik für Kleintiere, Innere Medizin, Klinikum Veterinärmedizin, Justus-Liebig-Universität Gießen
,
Matthias Schneider
1   Klinik für Kleintiere, Innere Medizin, Klinikum Veterinärmedizin, Justus-Liebig-Universität Gießen
› Author Affiliations
Further Information

Publication History

Eingegangen: 22 November 2016

Akzeptiert nach Revision: 09 February 2017

Publication Date:
09 January 2018 (online)

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Zusammenfassung

Ein 4 Tage altes, weibliches Holstein-Friesian-Kalb wurde zur Abklärung von Zyanose und Dyspnoe vorgestellt. Auskultatorisch bestanden ein deutlich verschärftes bronchovesikuläres Atemgeräusch und ein Herzgeräusch Grad IV/VI über der Trikuspidalklappe. Bei der Echokardiographie zeigte sich eine Dextroposition der Aorta im Sinne eines Double Outlet Right Ventricle (> 50% entspringen aus dem rechten Ventrikel). Es lagen zwei große ventrikuläre Septumdefekte und ein Aneurysma-ähnlicher Atriumseptumdefekt vor. Der erste Ventrikelseptumdefekt befand sich im perimembranösen, subpulmonalen Anteil und führte zu einem Übertritt von sauerstoffarmem Blut in die Aorta. Der andere lag entfernt im muskulären Anteil des Septums. Zudem konnte ein großer persistierender Ductus arteriosus dargestellt werden. Die Pulmonalarterie war hochgradig erweitert ohne Vorliegen einer Stenose. Die Befunde ließen sich mittels Angiographie verifizieren. Hierbei fiel zusätzlich auf, dass die Aorta ascendens bis zum Abgang des persistierenden Ductus arteriosus diffus hypoplastisch war. In der anschließenden pathologischen Untersuchung konnten die Befunde bestätigt werden.

Summary

A 4-day-old female Holstein Friesian calf was presented for evaluation of cyanosis and dyspnea. On auscultation, severe bronchovesicular sounds and a systolic heart murmur of grade IV/VI above the tricuspid valve were found. On echocardiography, a marked dextroposition of the aorta (> 50% originating from the right ventricle), leading to both great arteries arising from the right ventricle – a so-called double-outlet right ventricle – was detected. Two ventricular septal defects were present, one in the perimembranous, subpulmonary region, the other non-committed in the muscular region. The subpulmonary ventricular septal defect was responsible for the shunting of unoxygenated blood into the aorta. Additionally, an aneurysma-like atrial septal defect (type secundum) and a large patent ductus arteriosus were visualized. The main pulmonary artery was severely enlarged without the presence of a stenotic defect. The findings could be verified by angiography. Additionally, a diffuse hypoplastic ascending aorta was visualized. Necropsy confirmed the echocardiographic and angiographic findings.

Schlüsselwörter

Angeboren - Herzfehler - Herzgeräusch - Echokardiographie - Missbildung

Keywords

Congenital - heart disease - heart murmur - echocardiography - cyanosis - malformation
 

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