Journal of Veterinary Cardiology最新文献

A 10-year-old male castrated Somali cat presented with neurologic signs, severe systemic hypertension, and hypokalemia. Abdominal ultrasonography demonstrated a left adrenal mass, and the serum aldosterone concentration was increased. Computed tomography and follow-up diagnostic testing confirmed a left adrenal mass consistent with functional adenocarcinoma; additional findings included chronic airway and parenchymal disease. Transthoracic echocardiography revealed biatrial enlargement, with abdominal and pericardial effusion, consistent with right-sided congestive heart failure. The cat was treated for congestive heart failure and adrenalectomy was performed. Cardiac structure and function returned to normal within 6 months postoperatively. This report highlights a case of reversible congestive heart failure secondary to primary hyperaldosteronism.

A one-year-old male intact American bulldog was presented for evaluation of previously diagnosed pulmonary stenosis. Echocardiography identified ultra-severe stenosis with an instantaneous trans-pulmonary pressure gradient of 240 mmHg. Angiography confirmed the presence of an anomalous coronary artery with a prepulmonic course of the left coronary artery arising from a single right coronary ostium consistent with a type R2A coronary anomaly. A trans-pulmonary stent was successfully placed transvenously with diameter sizing based on coronary compression testing. No coronary compression was present on postimplantation angiography. A marked reduction in the pressure gradient was obtained on postoperative echocardiography (reduction to 68 mmHg), despite selecting a stent diameter less than the pulmonary annulus diameter. This is the first report of the use of coronary compression testing in transvenous trans-pulmonic stent implantation in a dog with a type R2A coronary artery anomaly. Selection of a stent diameter less than the pulmonary annulus diameter conveyed a clinically relevant reduction in the trans-pulmonic pressure gradient while avoiding coronary compression in this case.

An 18-year-old female neutered Domestic Shorthair cat was referred for investigation of seizure-like episodes. Physical and neurological examination were unremarkable, as were systemic arterial blood pressure, cardiac troponin I, complete blood count and biochemistry profile. Diagnostic tests included transthoracic echocardiography which ruled out any structural cardiomyopathy, and electrocardiography which showed an underlying regular wide QRS-complex rhythm with pronounced shortening of the PR interval. Considering the findings, a diagnosis of suspected ventricular pre-excitation secondary to an accessory pathway was made. Further investigations were declined and, as no periods of tachycardia were seen on the five-minute electrocardiogram, no antiarrhythmic treatment was started.

A four-year-old spayed female Shiba Inu dog weighing 6.1 kg presented with ascites. Cor triatriatum dexter (CTD) without any other concurrent cardiovascular anomalies was diagnosed using echocardiography. The ostium of the abnormal membrane dividing the right atrium into two abnormal chambers was surgically excised under cardiopulmonary bypass. All clinical abnormalities were resolved after surgery. However, seven months later, ascites and CTD recurred. A balloon-expandable stent was placed at the site of recurrence, which improved caudal venous return to the right ventricle. After the second procedure, ascites were resolved, and the dog remained asymptomatic for 18 months without complications. There are previous reports of successful surgical resection of the CTD and of stenting in recurrent CTD following balloon dilation in dogs. However, to the authors’ knowledge, no previous reports have described recurrent CTD in dogs after surgical resection of the CTD. In this case, as with recurrent CTD following balloon dilation, stent placement at the site of the CTD can be a viable treatment option when the abnormal membrane recurs.

Introduction/Objectives

Dogs with severe pulmonary stenosis (PS) are routinely treated with balloon valvuloplasty. Success and safety of these procedures require an accurate assessment of the pulmonary valve annulus (PVA) diameter for proper balloon catheter selection. PVA diameter is assessed with angiography (PVA-Ang) and transthoracic echocardiography (PVA-TTE), and both may impact procedural planning for balloon valvuloplasty. The objective of this study was to describe the relationship between PVA-Ang and PVA-TTE in dogs with PS.

Animals, materials and methods

Observational, retrospective study of 59 client-owned dogs. Medical records of dogs diagnosed with PS were reviewed. Images from selective right ventricular angiography and transthoracic echocardiography were reviewed. The PVA diameters were measured at the time of angiography (PVA-Ang) and by a single operator for this study (PVA-TTE). Image quality scores were assigned to echocardiographic images of the PVA based on visualization of PVA margins and valve leaflet hinge points.

Results

In 41/59 (70%) dogs, the diameter of the PVA-Ang was larger than the PVA-TTE, and the median absolute difference between measurements was 1.9 mm (range 0.1–8.4). With worse echocardiographic image quality, the difference in measurement between modalities increased. Dogs with poor echocardiographic image quality had greater differences (range −7.7 to 8.4 mm) between PVA-Ang and PVA-TTE compared to those with excellent image quality (range −2.2 to 3.8 mm), and the absolute differences between poor (median 2.8 mm, range 1.5–8.4 mm) and excellent (median 1.4 mm, 0.2–3.8 mm) image quality were significant (P=0.005).

Conclusions

Diameters of PVA-Ang are greater than PVA-TTE in most dogs, and these differences are most apparent with worse echocardiographic image quality. These differences may be clinically relevant to interventional procedure planning.

Introduction/objectives

In clinical practice, dogs are screened for subaortic stenosis (SAS) using two-dimensional (2DE) and Doppler echocardiography. There is no accepted antemortem diagnostic criterion to distinguish between mild SAS and unaffected, therefore additional means of evaluating the left ventricular outflow tract (LVOT) and aorta may be desirable. This study sought to determine and compare LVOT and aortic orifice areas using 2DE and three-dimensional echocardiography (3DE) in apparently healthy dogs of various breeds and somatotypes.

Animals, materials, and methods

Sixty-nine healthy, privately-owned dogs. The LVOT and aortic orifice areas were determined using 2DE aortic valve (AV) diameter-derived area; the continuity equation (CE); and 3DE planimetry of the LVOT, AV, sinus of Valsalva, and sinotubular junction. Orifice areas were indexed to body surface area (BSA).

Results

Obtaining 3DE images and performing planimetry were feasible in all dogs. The mean indexed area measured using the 2DE AV diameter (2.85 cm²/m²) was significantly lower than that derived from 3DE AV planimetry (3.85 cm²/m²; mean difference, 1.00 cm²/m²; P<0.001). There was poor agreement between the effective area calculated using the CE and the anatomic areas calculated using 2DE AV diameter and 3DE planimetry. The area calculated using the CE was less than all other calculations of area. Interobserver and intraobserver repeatability and reproducibility for 3DE planimetry were excellent.

Conclusions

Methods for determining aortic orifice areas in dogs are not interchangeable, and this must be taken into account if these methods are investigated in the evaluation of dogs with SAS in the future.