Background: Angiography and fluoroscopy are the standard methods to guide transcatheter occlusion of patent ductus arteriosus (PDA). The use of iodinated contrast agents and radiation exposure pose risks of animals and staff.Objectives: To assess feasibility of transesophageal echocardiography (TEE) for device size selection and procedure monitoring for PDA occlusion with a duct occluder (DO) without the use of angiography.Animals: Eighty client-owned dogs with left-to-right PDA. Methods: Prospective study. Dogs with left-to-right PDA undergoing transcatheter occlusion were included. Procedures were performed without angiography and device size selection was based on TEE measurements. Procedures were monitored with simultaneous TEE and fluoroscopy and both methods were compared. Visualization of the ductus and dimensions obtained by TEE and transthoracic echocardiography (TTE) were compared.Results: Complete PDA occlusion was achieved in 79/80 cases. TEE was consistently superior to TTE for PDA visualization and the latter showed higher values for ductal dimensions when compared to the former. TEE provided adequate procedure monitoring in 73 cases (91%). Fluoroscopy exposure time (2.77 AE 1.2 minutes (mean, SD)) was lower than previously reported for the same procedure.Conclusions and Clinical Importance: TEE is a useful and efficient tool for device size selection and can be used for procedure monitoring in most cases. Fluoroscopy exposure time can be reduced and the use of contrast agents can be avoided. However, fluoroscopy is required in a minority of cases when TEE monitoring is not feasible or incomplete and should be available for this procedure.

Este estudo trata da observação de um caso de aplicação dos princípios de educação inovadora no treinamento de Condução Veicular Policial (CVP), aplicado durante o Ciclo de Atualização Policial da Polícia Rodoviária Federal (PRF), evento de capacitação profissional realizado anualmente por Policiais Rodoviários Federais como forma de aprimoramento e atualização das técnicas necessárias para o exercício de suas funções. Por meio do emprego de técnicas pedagógicas, como a gamificação, buscou-se induzir nos instruendos o estado de flow na prática de exercícios que simulam situações que poderão ser encontradas nas rotinas operacionais diárias, tendo como objetivo o desenvolvimento de práticas de direção segura para a redução dos índices de vitimização policial por acidentes de trânsito. Os resultados observados apontam para um elevado nível de comprometimento dos instruendos e revelam a importância do treinamento de CVP no âmbito da educação corporativa da PRF.