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Topic:Sedation

Sedation in horses involves the administration of pharmacological agents to induce a state of calmness, relaxation, or sleepiness. This practice is commonly employed to facilitate veterinary procedures, diagnostic imaging, or transportation by reducing stress and movement in the animal. The primary sedatives used in equine medicine include alpha-2 adrenergic agonists, such as xylazine and detomidine, and opioids, like butorphanol. These agents act on the central nervous system to achieve the desired sedative effects. The choice of sedative and its dosage depend on various factors, including the horse's age, weight, health status, and the procedure's nature. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, efficacy, and safety considerations of sedation in equine practice.
Urinary effects of xylazine and general anesthesia in horses.
Veterinary anaesthesia and analgesia    November 15, 2016   Volume 29, Issue 2 107 doi: 10.1046/j.1467-2995.2002.00078_25.x
Watson ZE, Steffey EP, Van Hoogmoed LM, Snyder JR.No abstract available
Cardiopulmonary, hematological, serum chemistry and peritoneal fluid alterations associated with abdominal insufflation with carbon dioxide during standing laparoscopy in healthy horses sedated with detomidine and butorphanol.
Veterinary anaesthesia and analgesia    November 15, 2016   Volume 29, Issue 2 107-108 doi: 10.1046/j.1467-2995.2002.00078_26.x
Latimer F, Eades S, Pettifer G, Tetens J, Hosgood G, Moore R.No abstract available
Hormonal, metabolic and physiological effects of laparoscopic surgery using a detomidine-buprenorphine combination in standing horses.
Veterinary anaesthesia and analgesia    November 15, 2016   Volume 30, Issue 2 71-79 doi: 10.1046/j.1467-2995.2003.00097.x
Van Dijk P, Lankveld D, Rijkenhuizen A, Jonker FH.To assess the hormonal, metabolic and physiological effects of laparascopic surgery performed under a sedative analgesic combination of detomidine and buprenorphine in standing horses. Methods: Prospective study. Methods: Eight healthy adult Dutch Warmblood horses and five healthy adult ponies undergoing laparoscopy were studied. Five healthy adult horses not undergoing laparoscopy were used as a control group. Methods: The sedative effect of an initial detomidine and buprenorphine injection was maintained using a continuous infusion of detomidine alone. The heart and respiratory rate, arteria...
Serum concentrations and effects of detomidine delivered orally to horses in three different mediums.
Veterinary anaesthesia and analgesia    November 15, 2016   Volume 29, Issue 4 219-222 doi: 10.1046/j.1467-2995.2002.00096.x
Ramsay EC, Geiser D, Carter W, Tobin T.To compare the effect of orally delivered detomidine on head posture when administered alone or in combination with two different food items, and to determine the serum concentrations of detomidine after oral delivery. Methods: Prospective randomized experimental study. Methods: Fifteen adult grade mares weighing 328-537 kg. Methods: The horses were randomly assigned to one of the three treatment groups (five horses each). The groups were given detomidine (0.06 mg kg): alone; mixed with 3 mL of an apple sauce and gum mixture; or mixed with 3 mL molasses. Head droop, measured before treatment a...
Hormonal, metabolic and physiological effects of laparoscopic surgery using a detomidine-buprenorphine combination in standing horses.
Veterinary anaesthesia and analgesia    November 15, 2016   Volume 30, Issue 2 71-79 doi: 10.1046/j.1467-2995.2003.00097.x
Van Dijk P, Lankveld D, Rijkenhuizen A, Jonker FH.To assess the hormonal, metabolic and physiological effects of laparascopic surgery performed under a sedative analgesic combination of detomidine and buprenorphine in standing horses. Methods: Prospective study. Methods: Eight healthy adult Dutch Warmblood horses and five healthy adult ponies undergoing laparoscopy were studied. Five healthy adult horses not undergoing laparoscopy were used as a control group. Methods: The sedative effect of an initial detomidine and buprenorphine injection was maintained using a continuous infusion of detomidine alone. The heart and respiratory rate, arteria...
Pharmacokinetic and pharmacodynamics of xylazine administered to exercised thoroughbred horses.
Drug testing and analysis    September 13, 2016   Volume 9, Issue 5 713-720 doi: 10.1002/dta.2047
Knych HK, Stanley SD, McKemie DS, Arthur RM, Kass PH.There is limited data describing xylazine serum concentrations in the horse and no reports of concentrations beyond 24 hours. The primary goal of the study reported here was to update the pharmacokinetics of xylazine following intravenous (IV) administration in order to assess the applicability of current regulatory recommendations. Pharmacodynamic parameters were determined using PK-PD modeling. Sixteen exercised adult Thoroughbred horses received a single IV dose of 200 mg of xylazine. Blood and urine samples were collected at time 0 and at various times for up to 96 hours and analyzed...
Dental Disease in Aged Horses and Its Management.
The Veterinary clinics of North America. Equine practice    July 28, 2016   Volume 32, Issue 2 215-227 doi: 10.1016/j.cveq.2016.04.002
Nicholls VM, Townsend N.Improved recognition of equine geriatric conditions has resulted in a surge in our aged population with a concurrent escalation of many age-related dental pathologies. Prevention of these disorder is the ultimate aim but early identification and appropriate management can increase an animal's oral comfort and maximise its masticatory ability. There is only a finite amount of tooth available for eruption in the horse and therefore as the teeth become worn and less efficient as a grinding unit, dietary modification becomes a paramount consideration to accommodate this. Geriatric animals have dif...
Objective assessment of gait in xylazine-induced ataxic horses.
Equine veterinary journal    July 23, 2016   Volume 49, Issue 3 334-340 doi: 10.1111/evj.12602
Nout-Lomas YS, Page KM, Kang HG, Aanstoos ME, Greene HM.There is poor agreement between observers of equine neurological gait abnormalities using the modified Mayhew grading scale. Objective: To stimulate a dose-dependent ataxia in horses through xylazine administration and identify quantifiable relevant gait parameters. Methods: Balanced, randomised, 2-way crossover design. Methods: Eight horses were assessed before and after administration of xylazine (low dose and high dose). Gait analyses performed before and after xylazine administration included: 1) kinematic data collected on an equine high-speed treadmill (flat and 10% decline) and from acc...
Use of a laparoscopic specimen retrieval pouch to facilitate removal of intact or fragmented cystic calculi from standing sedated horses: 8 cases (2012-2015).
Journal of the American Veterinary Medical Association    July 22, 2016   Volume 249, Issue 3 304-310 doi: 10.2460/javma.249.3.304
Katzman SA, Vaughan B, Nieto JE, Galuppo LD.OBJECTIVE To evaluate the use of a laparoscopic specimen retrieval pouch for removal of intact or fragmented cystic calculi from standing horses. DESIGN Retrospective case series. ANIMALS 8 horses (5 geldings and 3 mares) with cystic calculi. PROCEDURES Physical examination and cystoscopic, ultrasonographic, and hematologic evaluations of urinary tract function were performed for each horse. A diagnosis of cystic calculus was made on the basis of results of cystoscopy and ultrasonography. Concurrent urolithiasis or other urinary tract abnormalities identified during preoperative evaluation wer...
Feasibility and safety of lumbosacral epiduroscopy in the standing horse.
Equine veterinary journal    July 4, 2016   Volume 49, Issue 3 322-328 doi: 10.1111/evj.12591
Shrauner B, Blikslager A, Davis J, Campbell N, Law M, Lustgarten M, Prange T.The large size of the adult horse prevents the use of advanced imaging modalities in most areas of the axial skeleton, including the lumbosacral vertebral column. Traditional imaging techniques are frequently unable to pinpoint the underlying pathology in horses with caudal back pain. In man, lumbosacral epiduroscopy is used to diagnose and treat subjects with chronic back and leg pain. This technique may close the diagnostic gap in horses with similar clinical signs. Objective: To evaluate the safety and feasibility of lumbosacral epiduroscopy in the standing adult horse. Methods: Descriptive...
Blood concentrations of remifentanil during and after infusion in horses anesthetized with isoflurane and dexmedetomidine.
Research in veterinary science    June 14, 2016   Volume 107 202-206 doi: 10.1016/j.rvsc.2016.06.008
Benmansour P, Billinsky J, Duke-Novakovski T, Alcorn J.To determine blood remifentanil concentration in isoflurane-anesthetized horses during and after a 1h remifentanil and dexmedetomidine infusion. Methods: Prospective study. Methods: Six adult mixed breed horses with (mean±SD) bodyweight of 507±61kg and 14±4years of age. Methods: Following sedation with xylazine IV, anesthesia was induced with ketamine IV mixed with diazepam IV. Anesthesia was maintained with isoflurane in oxygen. After 52±7min for instrumentation, dexmedetomidine (0.25μgkg(-1) followed by 1.0μg(-1)kg(-1)h(-1)) and remifentanil infusions (6μgkg(-1)h(-1)) were administere...
Scintigraphic Tracking of Allogeneic Mesenchymal Stem Cells in the Distal Limb After Intra-Arterial Injection in Standing Horses.
Veterinary surgery : VS    June 1, 2016   Volume 45, Issue 5 619-624 doi: 10.1111/vsu.12485
Espinosa P, Spriet M, Sole A, Walker NJ, Vaughan B, Galuppo LD.To assess the feasibility of intra-arterial administration of allogeneic mesenchymal stem cells (MSC) in the median artery of standing horses and evaluate the distribution and retention of radiolabeled cells. Methods: In vivo experimental study. Methods: Six research horses. Methods: Technetium(99m) -HexaMethyl-Propylene-Amine Oxime-labeled MSC were injected under ultrasound guidance in the median artery of 6 front limbs of 3 horses, standing under sedation. Scintigraphic images were obtained at the time of injection, and at 1, 6, and 24 hours postinjection. Six additional limbs from 3 horses ...
Long-term monitoring of opioid, sedative and anti-inflammatory drugs in horse hair using a selective and sensitive LC-MS/MS procedure.
BMC veterinary research    June 1, 2016   Volume 12 84 doi: 10.1186/s12917-016-0709-5
Madry MM, Spycher BS, Kupper J, Fuerst A, Baumgartner MR, Kraemer T, Naegeli H.Compared to blood or urine, drugs can be detected for much longer periods in the long hair of horses. The aim of this study was to establish and validate a highly sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the detection and quantification of frequently prescribed opioids, sedatives and non-steroidal anti-inflammatory agents in the mane and tail hair of horses. Based on an average growth rate of about 2 cm per month, times of administration reported by horse owners or veterinary physicians were related to drug localizations in hair. Hair samples were collecte...
Validity and repeatability of goniometry in normal horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    April 28, 2016   Volume 29, Issue 4 314-319 doi: 10.3415/VCOT-15-11-0182
Adair HS, Marcellin-Little DJ, Levine D.To assess validity and inter- and intra-tester reliability of equine goniometry and to establish values for carpal, metacarpophalangeal, tarsal, and metatarsophalangeal flexion and extension in horses. Methods: Seventeen healthy equine subjects of varied breeds were used. Methods: Three investigators blindly and independently measured in triplicate the extension and flexion of carpal, metacarpophalangeal, tarsal, and metatarsophalangeal joints of 17 horses after sedation. Radiographs of these joints in flexion and extension were acquired while under sedation. Goniometric and radiographic measu...
Evaluation of 10-minute versus 30-minute tourniquet time for intravenous regional limb perfusion with amikacin sulfate in standing sedated horses.
The Veterinary record    April 13, 2016   Volume 178, Issue 23 585 doi: 10.1136/vr.103609
Kilcoyne I, Dechant JE, Nieto JE.The objective of the article is to determine the synovial fluid concentrations of amikacin sulfate (AS) after performing an intravenous regional limb perfusion (IVRLP) with the tourniquet in place for 10 minutes and compare this with 30 minutes. This is a randomised crossover experimental design. Animals were seven healthy adult horses. Horses underwent two IVRLP procedures in a randomised, crossover design. The horses received IVRLP with 2 g AS diluted to 60 ml using 0.9% saline in the cephalic vein of alternate limbs with the tourniquet in place for either 10 or 30 minutes, with a ...
Effects of age on the pharmacokinetics of tramadol and its active metabolite, O-desmethyltramadol following intravenous administration to foals.
Equine veterinary journal    April 1, 2016   Volume 48, Issue 1 65-71 doi: 10.1111/evj.12364
Knych HK, Steffey EP, White AM, McKemie DS.Tramadol is an analgesic agent used in man and a number of veterinary species. The pharmacokinetics and behavioural effects of tramadol and its active metabolite have been described in mature horses, but not in young foals. Objective: To characterise the pharmacokinetics, metabolism and some induced behavioural and physiological responses following i.v. tramadol administration in the same group of foals on 4 different occasions, from a few days after birth to age 43 days. Methods: Experimental. Methods: Tramadol was administered i.v. (3 mg/kg bwt) to a group of 8 foals on 4 separate occasion...
Characterization of equine cytochrome P450: role of CYP3A in the metabolism of diazepam.
Journal of veterinary pharmacology and therapeutics    March 11, 2016   Volume 39, Issue 5 478-487 doi: 10.1111/jvp.12303
Nakayama SM, Ikenaka Y, Hayami A, Mizukawa H, Darwish WS, Watanabe KP, Kawai YK, Ishizuka M.Research on drug metabolism and pharmacokinetics in large animal species including the horse is scarce because of the challenges in conducting in vivo studies. The metabolic reactions catalyzed by cytochrome P450s (CYPs) are central to drug pharmacokinetics. This study elucidated the characteristics of equine CYPs using diazepam (DZP) as a model compound as this drug is widely used as an anesthetic and sedative in horses, and is principally metabolized by CYPs. Diazepam metabolic activities were measured in vitro using horse and rat liver microsomes to clarify the species differences in enzy...
Clinical effects and pharmacokinetic variables of romifidine and the peripheral α2 -adrenoceptor antagonist MK-467 in horses.
Veterinary anaesthesia and analgesia    February 26, 2016   Volume 43, Issue 6 599-610 doi: 10.1111/vaa.12354
de Vries A, Pakkanen SA, Raekallio MR, Ekiri A, Scheinin M, Taylor PM, Vainio OM.To investigate the effects of MK-467 on sedation quality, and cardiopulmonary and pharmacokinetic variables in horses sedated intravenously (IV) with romifidine. Methods: Experimental, randomized, crossover design. Methods: Seven healthy mares. Methods: Romifidine (80 μg kg-1 ; R) and MK-467 (200 μg kg-1 ; MK) were administered IV alone and in combination (R + MK). Levels of sedation and borborygmi were scored. Heart rate (HR), direct arterial blood pressure (ABP) and respiratory rate (fR ) were recorded. Arterial and venous blood gas analyses were performed and venous plasma drug conc...
The use of dexmedetomidine continuous rate infusion for horses undergoing transvenous electrical cardioversion–A case series.
The Canadian veterinary journal = La revue veterinaire canadienne    January 8, 2016   Volume 57, Issue 1 70-75 
Marly-Voquer C, Schwarzwald CC, Bettschart-Wolfensberger R.Five horses were presented for treatment of atrial fibrillation by transvenous electrical cardioversion (TVEC). A dexmedetomidine infusion was administered for sedation during positioning of the cardioversion catheters, and continued during general anesthesia. Shocks were applied until return to sinus rhythm. Dexmedetomidine infusion provided excellent conditions for TVEC catheter placement and procedure. Utilisation d’une perfusion continue de dexmedetomidine lors de cardioversion électrique transveineuse chez le cheval: une série de cas. Cinq chevaux présentant une fibrillation atriale ...
Qualitative and Quantitative Characteristics of the Electroencephalogram in Normal Horses during Administration of Inhaled Anesthesia.
Journal of veterinary internal medicine    December 30, 2015   Volume 30, Issue 1 289-303 doi: 10.1111/jvim.13813
Williams DC, Brosnan RJ, Fletcher DJ, Aleman M, Holliday TA, Tharp B, Kass PH, LeCouteur RA, Steffey EP.The effects of anesthesia on the equine electroencephalogram (EEG) after administration of various drugs for sedation, induction, and maintenance are known, but not that the effect of inhaled anesthetics alone for EEG recording. Objective: To determine the effects of isoflurane and halothane, administered as single agents at multiple levels, on the EEG and quantitative EEG (qEEG) of normal horses. Methods: Six healthy horses. Methods: Prospective study. Digital EEG with video and quantitative EEG (qEEG) were recorded after the administration of one of the 2 anesthetics, isoflurane or halothane...
Comparison of two tourniquet application times for regional intravenous limb perfusions with amikacin in sedated or anesthetized horses.
Veterinary journal (London, England : 1997)    November 27, 2015   Volume 208 50-54 doi: 10.1016/j.tvjl.2015.10.017
Aristizabal FA, Nieto JE, Guedes AG, Dechant JE, Yamout S, Morales B, Snyder J.Regional limb perfusion (RLP) in horses has proven to be a simple and effective technique for the treatment of synovial and musculoskeletal infections in the distal portion of the limbs. The ideal tourniquet time needed to achieve therapeutic synovial concentrations remains unknown. The pharmacokinetic effects of general anesthesia (GA) versus standing sedation (SS) RLP on synovial amikacin concentrations are not completely understood. This study investigated the pharmacokinetic effects of RLP under general anesthesia (GA) versus standing sedation (SS) on synovial amikacin concentration follow...
Preliminary investigation comparing a detomidine continuous rate infusion combined with either morphine or buprenorphine for standing sedation in horses.
Veterinary anaesthesia and analgesia    October 19, 2015   Volume 43, Issue 2 189-194 doi: 10.1111/vaa.12316
Potter JJ, MacFarlane PD, Love EJ, Tremaine H, Taylor PM, Murrell JC.To compare sedative and analgesic properties of buprenorphine or morphine for standing procedures combined with a detomidine continuous rate infusion (CRI). Methods: Blinded, prospective, randomized clinical pilot study. Methods: Ten horses presented for dental or sinus procedures. Methods: Horses received 0.02 mg kg(-1) acepromazine intravenously (IV), followed 30 minutes later by detomidine 10 μg kg(-1) IV. Five minutes later, buprenorphine 0.01 mg kg(-1) (n = 6) or morphine 0.1 mg kg(-1) (n = 4) was administered IV. Detomidine was administered by CRI (0.2 μg kg(-1) minute(-1)) and adjuste...
Effect of sedation on fore- and hindlimb lameness evaluation using body-mounted inertial sensors.
Equine veterinary journal    August 24, 2015   Volume 48, Issue 5 603-607 doi: 10.1111/evj.12463
Rettig MJ, Leelamankong P, Rungsri P, Lischer CJ.Diagnostic analgesia is an integral part of equine lameness examinations, but is challenging to perform in uncooperative horses. Using sedation to facilitate this might, because of analgesic and ataxia-inducing effects, interfere with lameness evaluation. Objective: To evaluate whether sedation with low-dose xylazine would alter lameness amplitude as measured by body-mounted inertial sensors. Methods: Controlled experiment. Methods: Forty-four horses were randomly split into 2 groups. Lameness was measured using body-mounted inertial sensors before and after injection of xylazine (0.3 mg/kg b...
Morphine Synovial Fluid Concentrations After Intravenous Regional Limb Perfusion in Standing Horses.
Veterinary surgery : VS    August 1, 2015   Volume 44, Issue 6 679-686 doi: 10.1111/j.1532-950X.2015.12314.x
Hunter BG, Parker JE, Wehrman R, Stang B, Cebra CK.To determine synovial concentrations of morphine after intravenous regional limb perfusion (IVRLP) with morphine or morphine in combination with gentamicin in clinically healthy, standing sedated horses. Methods: Experimental. Methods: Adult horses (n = 6). Methods: IVRLP was performed using 0.1 mg/kg morphine (M) in standing sedated horses. After a 3-week washout period, IVRLP was performed on the same forelimb with a combination of 0.1 mg/kg morphine and 1 g gentamicin (M/G). Synovial fluid from the middle carpal joint of the perfused limb and jugular blood samples were collected i...
The use of low doses of acepromazine as an aid for lameness diagnosis in horses: An accelerometric evaluation.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    July 29, 2015   Volume 28, Issue 5 312-317 doi: 10.3415/VCOT-14-11-0177
López-Sanromán FJ, Gómez Cisneros D, Varela del Arco M, Santiago Llorente I, Santos González M.The aim of the present study was to quantify by accelerometry the trotting pattern of adult horses sedated with two different doses of acepromazine, in order to assess the use of this drug in equine lameness evaluations. Methods: Seven mature horses were used and three treatments were administered to each horse: saline solution, acepromazine (0.01 mg/kg), and acepromazine (0.02 mg/kg). The portable gait analyzer used consisted of three orthogonal accelerometers that measure accelerations along the dorsoventral, longitudinal, and lateral axes. Baseline values were obtained and after treatment, ...
Cervical wedge resection for treatment of pyometra secondary to transluminal cervical adhesions in six mares.
Journal of the American Veterinary Medical Association    June 5, 2015   Volume 246, Issue 12 1354-1357 doi: 10.2460/javma.246.12.1354
Arnold CE, Brinsko SP, Varner DD.6 mares with pyometra secondary to transluminal cervical adhesions were examined. Results: Reasons for hospital admission included infertility (5 mares) and acute colic (1 mare). In the 6 mares, palpation per rectum of the reproductive tract revealed uterine distention, and transrectal ultrasonography confirmed the presence of echogenic fluid accumulation within the uterus. Cervical palpation during vaginal speculum examination indicated transluminal cervical adhesions. Three mares had severe distortion of the cervix as a result of diverticula and fibrosis. All 6 mares had a diagnosis of pyome...
Standing placement of transphyseal screw in the distal radius in 8 Thoroughbred yearlings.
The Canadian veterinary journal = La revue veterinaire canadienne    June 2, 2015   Volume 56, Issue 6 605-609 
Modesto RB, Rodgerson DH, Masciarelli AE, Spirito M.This retrospective study describes placement of distal radial transphyseal screws in Thoroughbred yearlings with carpal varus deformities while standing, and identifes short- and long-term complications following the procedure. Data gathered from 2009 to 2013 identified 8 yearlings that met the inclusion criteria. Horses were sedated intravenously and a single 4.5-mm cortical screw was placed in the distal lateral radial physis following application of local anesthetic and surgical preparation of a pre-placed hole. All horses were evaluated weekly after surgery and screw removal was performed ...
Clinical and pharmacokinetic evaluation of S-ketamine for intravenous general anaesthesia in horses undergoing field castration.
Acta veterinaria Scandinavica    May 3, 2015   Volume 57, Issue 1 21 doi: 10.1186/s13028-015-0112-4
Casoni D, Spadavecchia C, Wampfler B, Thormann W, Levionnois OL.Intravenous anaesthetic drugs are the primary means for producing general anaesthesia in equine practice. The ideal drug for intravenous anaesthesia has high reliability and pharmacokinetic properties indicating short elimination and lack of accumulation when administered for prolonged periods. Induction of general anaesthesia with racemic ketamine preceded by profound sedation has already an established place in the equine field anaesthesia. Due to potential advantages over racemic ketamine, S-ketamine has been employed in horses to induce general anaesthesia, but its optimal dose remains und...
Right atrial and right ventricular ultrasound-guided biopsy technique in standing horses.
Equine veterinary journal    April 29, 2015   Volume 48, Issue 3 346-351 doi: 10.1111/evj.12433
Decloedt A, de Clercq D, Ven S, van der Vekens N, Chiers K, van Loon G.Endomyocardial biopsies could be a valuable tool in equine cardiology for diagnosing myocardial disease, which is probably underdiagnosed in horses because of lack of specific diagnostic measures and limitations of currently available diagnostic methods. Objective: To describe a technique for serial right atrial and right ventricular endomyocardial biopsy in standing horses using a percutaneous approach through the jugular vein. Methods: Prospective study. Methods: Biopsy was performed in 10 healthy standing horses sedated with detomidine, under continuous electrocardiography monitoring. A 10 ...
Laryngoplasty in standing horses.
Veterinary surgery : VS    April 14, 2015   Volume 44, Issue 3 341-347 doi: 10.1111/vsu.12307
Rossignol F, Vitte A, Boening J, Maher M, Lechartier A, Brandenberger O, Martin-Flores M, Lang H, Walker W, Ducharme NG.To describe the clinical experience with standing laryngoplasty in a series of horses mostly nonracing. Methods: Case series. Methods: Seventy-one client-owned horses. Methods: Medical records (April 2008-February 2014) of horses treated by standing laryngoplasty for abnormal respiratory noise and or poor performance were reviewed. Horses were included if they had a diagnosis of idiopathic right or left recurrent laryngeal neuropathy confirmed by videoendoscopy. All horses underwent a unilateral laryngoplasty with a unilateral or bilateral ventriculectomy or ventriculocordectomy. Follow-up end...
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