To determine whether left atrial decompression (LAD) would reduce left atrial pressure (LAP) in dogs with advanced myxomatous mitral valve disease (MMVD) and left-sided congestive heart failure (CHF) and to describe the LAD procedure and hemodynamic alterations and complications.
17 dogs with advanced MMVD and left-sided CHF that underwent LAD.
The medical record database was retrospectively reviewed for all LAD procedures attempted in dogs with MMVD and left-sided CHF between October 2018 and June 2019. Data were collected regarding signalment (age, breed, weight, and sex), clinical signs, treatment, physical examination findings, and diagnostic testing before and after LAD. Procedural data were also collected including approach, technique, hemodynamic data, complications, and outcome.
18 LAD procedures performed in 17 patients were identified. Dogs ranged in age from 7.5 to 16 years old (median, 11 years) and ranged in body weight from 2.9 to 11.6 kg (6.4 to 25.5 lb) with a median body weight of 7.0 kg (15.4 lb). Minimally invasive creation of an atrial septal defect for the purpose of LAD was successful in all dogs without any intraoperative deaths. Before LAD, mean LAP was elevated and ranged from 8 to 32 mm Hg with a median value of 14 mm Hg (reference value, < 10 mm Hg). Following LAD, there was a significant decrease in mean LAP (median decrease of 6 mm Hg [range, 1 to 15 mm Hg]). Survival time following LAD ranged from 0 to 478 days (median, 195 days).
CONCLUSIONS AND CLINICAL RELEVANCE
For dogs with advanced MMVD and left-sided CHF, LAD resulted in an immediate and substantial reduction in LAP.
Objective—To determine signalment, clinical signs,
diagnostic findings, treatment, and outcome for cats
with atrial fibrillation (AF).
Procedure—Medical records of cats that met criteria
for a diagnosis of AF (ECG consisting of at least 2
leads, clear absence of P waves, supraventricular
rhythm, and convincingly irregularly irregular rhythm)
and had undergone echocardiography were reviewed.
Results—There were 41 males (37 castrated) and 9
females (7 spayed). Forty-one were of mixed breeding;
9 were purebred. Mean ± SD age was 10.2 ± 3.7 years.
The most common chief complaints were dyspnea,
aortic thromboembolism, and lethargy. In 11 cats, AF
was an incidental finding. Mean ± SD ventricular rate
was 223 ± 36 beats/min. The most common echocardiographic
abnormalities were restrictive or unclassified
cardiomyopathy (n = 19), concentric left ventricular
hypertrophy (18), and dilated cardiomyopathy (6). Mean
± SD left atrial-to-aortic diameter ratio (n = 39) was 2.55
± 0.80. The most common thoracic radiographic findings
were cardiomegaly, pleural effusion, and pulmonary
edema. Median survival time (n = 24) was 165
days (range, 0 to 1,095 days). Eight of 24 cats lived for
≥ 1 year after a diagnosis of AF was made.
Conclusions and Clinical Relevance—Results suggest
that AF occurs primarily in older adult male cats
with structural heart disease severe enough to lead to
atrial enlargement. Atrial fibrillation in these cats was
most commonly first detected when signs of decompensated
cardiac disease were evident, but also was
commonly identified as an incidental finding. (J Am
Vet Med Assoc 2004;225:256–260)