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Comparison of major complication and survival rates between surgical ligation and use of a canine ductal occluder device for treatment of dogs with left-to-right shunting patent ductus arteriosus

Bharadhwaj RanganathanDepartment of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

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Nicole L. LeBlancDepartment of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

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Katherine F. ScollanDepartment of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

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Katy L. TownsendDepartment of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

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Deepmala AgarwalDepartment of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

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Milan MilovancevDepartment of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, OR 97331.

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Abstract

OBJECTIVE To compare rates of major intraoperative complications and survival to hospital discharge between surgical ligation (SL) and canine ductal occluder (CDO) implantation for treatment of dogs with left-to-right shunting patent ductus arteriosus (PDA).

DESIGN Retrospective cohort study.

ANIMALS 120 client-owned dogs with left-to-right shunting PDA (62 treated by SL and 58 treated by CDO implantation).

PROCEDURES Data were retrieved from medical records of included dogs regarding signalment, medical history, vertebral heart scale, preoperative echocardiographic findings, complications encountered during surgery, and durations of anesthesia and surgery (SL or CDO implantation). Data were compared between dogs treated by SL and those treated by CDO implantation.

RESULTS Dogs treated by CDO implantation were significantly older and heavier than dogs treated by SL and had more pathological cardiac remodeling (as indicated by mitral regurgitation scores, left atrial-to-aortic root diameter ratios, and fractional shortening values). Durations of anesthesia and surgery were also significantly longer for CDO implantation versus SL. The major complication rate for dogs treated by SL (6/62 [10%]) was significantly greater than that for dogs treated by CDO implantation (0/58 [0%]). One dog in the SL group died during surgery. Overall rate of survival to hospital discharge was 99% (119/120).

CONCLUSIONS AND CLINICAL RELEVANCE Both SL and CDO implantation were viable methods for PDA attenuation in the evaluated dogs. Although a greater proportion of dogs had major complications during the SL procedure, the 2 procedures had comparable rates of survival to hospital discharge.

Abstract

OBJECTIVE To compare rates of major intraoperative complications and survival to hospital discharge between surgical ligation (SL) and canine ductal occluder (CDO) implantation for treatment of dogs with left-to-right shunting patent ductus arteriosus (PDA).

DESIGN Retrospective cohort study.

ANIMALS 120 client-owned dogs with left-to-right shunting PDA (62 treated by SL and 58 treated by CDO implantation).

PROCEDURES Data were retrieved from medical records of included dogs regarding signalment, medical history, vertebral heart scale, preoperative echocardiographic findings, complications encountered during surgery, and durations of anesthesia and surgery (SL or CDO implantation). Data were compared between dogs treated by SL and those treated by CDO implantation.

RESULTS Dogs treated by CDO implantation were significantly older and heavier than dogs treated by SL and had more pathological cardiac remodeling (as indicated by mitral regurgitation scores, left atrial-to-aortic root diameter ratios, and fractional shortening values). Durations of anesthesia and surgery were also significantly longer for CDO implantation versus SL. The major complication rate for dogs treated by SL (6/62 [10%]) was significantly greater than that for dogs treated by CDO implantation (0/58 [0%]). One dog in the SL group died during surgery. Overall rate of survival to hospital discharge was 99% (119/120).

CONCLUSIONS AND CLINICAL RELEVANCE Both SL and CDO implantation were viable methods for PDA attenuation in the evaluated dogs. Although a greater proportion of dogs had major complications during the SL procedure, the 2 procedures had comparable rates of survival to hospital discharge.

Contributor Notes

Dr. Agarwal's present address is Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Address correspondence to Dr. LeBlanc (nicole.leblanc@oregonstate.edu).