Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment.

The research paper focuses on the success, follow-ups, and potential risks of transseptal puncture (TSP), a cardiac catheterization procedure, performed in horses. The study highlights that these tests uniformly succeeded, were safe on horses, and didn’t lead to significant post-op complications.

Objective and Methods

• The chief objective of the experiment was to carry out TSP in horses and evaluate the post-operative side effects, as well as the healing of the iatrogenic atrial septal defect (iASD) created during the procedure, over a period of at least four weeks.
• The study was conducted on a group of eleven healthy adult horses, all of which were subjected to TSP while under general anesthesia.
• As part of the procedure, the serum cardiac troponin I concentrations of the horses were measured before and after the puncture.
• The research also involved consistent monitoring of iASD closure using both transthoracic and intracardiac ultrasound scans.
• An important facet of the research was evaluating the connection between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment, both in vitro and in vivo.

Results

• The results indicated that the TSP procedure was successfully executed in all eleven horses, within a median duration of 22 minutes.
• Four horses needed balloon dilatation at the puncture site for sheath advancement, indicating this additional step may sometimes be necessary.
• Nine out of eleven horses were observed to have atrial arrhythmias, which included atrial premature depolarizations, atrial tachycardia, and fibrillation, indicating a certain level of cardiac disturbance following the procedure.
• Although the serum cardiac troponin I concentrations rose post-TSP, these remained within the reference value for majority of the horses.
• iASD closing was noticed in a median time of 14 days post-procedure in all horses signifying good recovery rates.
• Anti-factor Xa activity had a correlation with activated clotting time in vitro but no such correlation was found in vivo.

Conclusions

• The study concludes that TSP procedures can be successfully employed on horses, as it proved safe with minimal post-op complications and no long-standing iASD issues.
• The researchers recommended the adoption of TSP in the clinical diagnosis and treatment of left-sided arrhythmias in horses.