Cardiac magnetic resonance visualizes acute and chronic myocardial injuries in myocarditis

Our objective was to evaluate the ability of CMR to visualize myocardial injuries over the course of myocarditis. We studied 42 patients (39 males, 3 females; age 37 ± 14 years) with myocarditis during the acute phase and after 12 ± 9 months. CMR included function analyses, T2-weighted imaging (T2 ratio), T1-weighted imaging before and after i.v. gadolinium injection (global relative enhancement; gRE), and late gadolinium enhancement (LGE). In the acute phase, the T2 ratio was elevated in 57%, gRE in 31%, and LGE was present in 64% of the patients. In 32 patients (76%) were any two (or more) out of three sequences abnormal. At follow-up, there was an increase in ejection fraction (57.4 ± 11.9% vs. 61.4 ± 7.6; P < 0.05) while both T2 ratio (2.04 ± 0.32 vs. 1.70 ± 0.28; P < 0.001) and gRE (4.07 ± 1.63 vs. 3.11 ± 1.22; P < 0.05) significantly decreased. The LGE persisted in 10 patients. Dilated cardiomyopathy was present in 3 patients and 4 patients received a defibrillator or a pacemaker. A comprehensive CMR approach is a useful tool to visualize myocardial tissue injuries over the course of myocarditis. CMR may help to differentiate acute from healed myocarditis, and add information for the differential diagnoses

Device Thrombogenicity Emulation: A Novel Method for Optimizing Mechanical Circulatory Support Device Thromboresistance

Mechanical circulatory support (MCS) devices provide both short and long term hemodynamic support for advanced heart failure patients. Unfortunately these devices remain plagued by thromboembolic complications associated with chronic platelet activation – mandating complex, lifelong anticoagulation therapy. To address the unmet need for enhancing the thromboresistance of these devices to extend their long term use, we developed a universal predictive methodology entitled Device Thrombogenicity Emulation (DTE) that facilitates optimizing the thrombogenic performance of any MCS device – ideally to a level that may obviate the need for mandatory anticoagulation

Tracheal collapse in a young boxer

A four-month-old, female boxer developed severe inspiratory dyspnea three days after elective ear crop surgery. Radiographs confirmed the diagnosis of collapse of the distal cervical trachea. The puppy was treated with oxygen, aminophylline, and ampicillin, but required emergency tracheostomy to stent the collapsed region. Clinical signs resolved following application of five polypropylene total-ring prostheses, and the puppy continued to do well despite significant growth to maturity.</jats:p

Successful treatment of uterine torsion and fetal retention in a postparturient Great Pyrenees bitch with septic peritonitis and prothrombotic complications

The treatment and favorable outcome of a bitch with uterine torsion and two retained fetuses are described. The condition was corrected surgically by ovariohysterectomy. Complications (i.e., septic shock, peritonitis, and hemostatic abnormalities) were managed with aggressive medical therapy. Torsion of the gravid uterus in dogs is a life-threatening condition which can have a successful outcome if medical complications encountered in the pre- and postoperative periods are treated quickly and effectively.</jats:p

Presumptive, iatrogenic gastric outflow obstruction associated with prior gastric surgery

Iatrogenic gastric outflow obstruction in two dogs appeared to be caused by prior gastric surgery. The obstructions were believed to be anatomical rather than functional based on endoscopic examinations. Initially, the dogs had been evaluated and each had received two abdominal surgeries because of gastrointestinal bleeding, vomiting, or both. Eventually, both dogs were euthanized due to complications arising after attempted surgical correction of the iatrogenic obstructions. While gastric surgery commonly is performed, it seldom is considered to be a potentially harmful procedure. However, as these cases demonstrate, the decision to perform a gastrotomy must be weighed against possible risks and complications. Iatrogenic gastric outflow obstruction associated with surgery may be prevented by minimizing tissue inversion into the gastric lumen when surgery is performed near the pyloric outflow tract. Additionally, when large lesions near the pylorus are resected surgically, preservation of the continuity of the outflow tract is necessary.</jats:p