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Patent ductus arteriosus a. Fine DM, Tobias AH, Spier AW. Cardiovascular device related infections (abstr), in Proceedings . 2005 Am Coll Vet Internal Med Forum. J Vet Intern Med 2005;19:456. References 1 Buchanan JW

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in Journal of the American Veterinary Medical Association

Patent ductus arteriosus is the most common congenital heart defect in dogs, accounting for 25% to 30% of congenital malformations. 1,2 This defect has a significantly lower reported prevalence in cats (0.2 cases/1,000 cats). 3 Patent ductus

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in Journal of the American Veterinary Medical Association

Patent ductus arteriosus is a common congenital cardiovascular disorder in dogs that results in volume overload and eccentric hypertrophy of the left side of the heart. 1 Left ventricular systolic dysfunction may also develop secondary to the

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in Journal of the American Veterinary Medical Association

subsequent to PDA attenuation. ABBREVIATIONS LVFP Left vocal fold paralysis PDA Patent ductus arteriosus a. Weck hemoclip, Teleflex Medical, Research Triangle Park, NC. References 1. Orton EC . Cardiac surgery . In: Tobias

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in Journal of the American Veterinary Medical Association

Patent ductus arteriosus represents the most common congenital cardiac anomaly in dogs. 1 In instances of left-to-right shunting (ie, blood flow from the descending aorta to the pulmonary artery), closure of the PDA stops the detrimental effects

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in Journal of the American Veterinary Medical Association

Introduction A patent ductus arteriosus (PDA) is a congenital heart anomaly characterized by the fetal ductus arteriosus vessel failing to close after birth. 1 The ductus arteriosus functions in utero to bypass the pulmonary system and shunt

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in Journal of the American Veterinary Medical Association

internal diameter during diastole, normalized to body weight LVIDs Left ventricular internal diameter during systole LVIDsN Left ventricular internal diameter during systole, normalized to body weight PDA Patent ductus arteriosus SL Surgical

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in Journal of the American Veterinary Medical Association
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Abstract

Objective—To evaluate the clinical application of a catheter-delivered, self-expanding occluding stent for closure of patent ductus arteriosus (PDA) in dogs.

Design—Prospective study.

Animals—23 client-owned dogs weighing at least 3 kg (6.6 lb).

Procedure—Dogs were evaluated by physical examination, electrocardiography, thoracic radiography, and 2-dimensional, M-mode, spectral and color-flow Doppler echocardiography to confirm the diagnosis and obtain baseline measures. Shunt severity and ductal size and anatomy were established by means of angiography. With fluoroscopic guidance, the occluding stent, attached to a delivery cable, was maneuvered though the right side of the heart into the ductus via a prepositioned introducer sheath. After angiographic verification of appropriate stent placement, the delivery cable was detached, and the introducer sheath was withdrawn. Closure of the PDA was evaluated by means of angiography 15 minutes after stent deployment and by echocardiography 1 and 3 months after the procedure.

Results—There were no operative deaths. There were 2 deployment failures, both attributable to avoidable operator errors. Angiography performed after stent deployment indicated PDA closure in 13 of 20 (65%) dogs. There were 2 postoperative deaths in dogs with heart failure; both deaths were thought to be unrelated to use of the occluding stent. Complete PDA closure, determined by Doppler color-flow echocardiography, was evident in 17 of 19 dogs within 3 months and in 1 additional dog within 1 year of stent deployment, resulting in closure in 18 of 19 dogs completing the study protocol.

Conclusions and Clinical Relevance—Results suggest that a catheter-delivered occluding stent can be used successfully to close PDAs in dogs. (J Am Vet Med Assoc 2003;223:999–1005)

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in Journal of the American Veterinary Medical Association

Summary

Surgical treatment of 201 dogs with patent ductus arteriosus at the College of Veterinary Medicine, The Ohio State University was evaluated retrospectively to determine risk factors for development of surgical complications. During surgery, 15 dogs (7%) died because of hemorrhage associated with ductus dissection (n = 8), pulmonary edema (n = 4), ventricular fibrillation (n = 1), hemorrhage not associated with ductus dissection (n = 1), and cardiac arrest immediately after ductus ligation (n = 1). An additional 8 dogs (4%) died <1 month after surgery (total mortality before, during, and immediately after surgery, 11%). Nineteen dogs (9.5%) developed hemorrhage during surgery. Sixteen dogs developed complications other than hemorrhage (pulmonary edema [n = 4], cardiac arrest [n = 4], iatrogenic lung trauma [n = 3], ventricular fibrillation [n = 2], septicemia [n = 2], and recanalized ductus [n = 2]). Correlation was not found between age, sex, body weight, surgical technique (Jackson method vs standard method of dissection), or surgeon level of training and development of hemorrhage during surgery, other complications, or survival <5 days. Positive correlation (P < 0.05) was found between hemorrhage and death within 5 days after surgery. Positive correlation (P < 0.05) was also found between other complications and death within 5 days after surgery. Nineteen dogs survived surgery, but later died of unrelated causes (mean life span, 57 months); 63 of the dogs were still alive and doing well as of January 1990 (mean life span, 47 months after surgery).

Contrary to previous reports, age, body weight, and surgical technique did not affect results. Surgical complications were uncommon, but frequently resulted in death. Long-term survival was likely if surgical complications did not develop.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine factors associated with long-term survival in dogs treated surgically for patent ductus arteriosus (PDA).

Design—Retrospective case series.

Animals—52 dogs treated surgically for left-to-right shunting PDA.

Procedure—Data pertaining to age, breed, sex, body weight, clinical examination findings, type and duration of medical treatment, results of thoracic radiography and echocardiography, and surgical and postoperative complications were collected from records. Follow-up information was obtained from medical records or telephone interviews with owners or referring veterinarians.

Results—22 dogs had mitral valve regurgitation. Mean weight and age were not significantly different between dogs with or without mitral valve regurgitation. Twenty-four (46.2%) dogs had clinical signs related to cardiac insufficiency. Left atrial dilatation was observed in 56.3% of dogs that were radiographed. Sonographic imaging was used to diagnose left atrial dilatation in 23 dogs and left ventricular dilatation in 25 dogs. The 1- and 2-year survival rates were 92% and 87%, respectively. Diagnosis of mitral valve regurgitation before surgery was not associated with the probability of survival. Age, weight, lethargy, preoperative treatment with angiotensin-converting enzyme inhibitors, and right atrial dilatation on radiographs at the time of surgery were negatively associated with probability of survival.

Conclusions and Clinical Relevance—Surgical treatment of PDA was curative in young dogs without clinical signs of heart failure. Surgical correction of PDA should be recommended as early as possible after diagnosis, and mitral valve regurgitation is not a contraindication for surgery. (J Am Vet Med Assoc 2005;227:1794–1799)

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in Journal of the American Veterinary Medical Association