A Retrospective Cohort Evaluation of Left Ventricular Remodeling, Perioperative Complications and Outcome in Medium and Large Size Dogs with Patent Ductus Arteriosus after Percutaneous Closure

Abstract

This retrospective cohort study included one hundred fifty-seven medium and large-size dogs with the aim of evaluating the effect of signalment and echocardiographic features on complications, outcomes and left ventricular modifications before and after patent ductus arteriosus (PDA) closure. The patients were divided in two groups based on the heart remodeling after closure: Group A included dogs that had a reduction in the end-systolic volume index (ESVI) after closure compared to the ESVI measured before; Group B included dogs without a reduction in ESVI after closure. Body weight, minimal ductal diameter (MDD) of PDA, end-diastolic volume index and presence of arrhythmias at presentation were significantly higher in Group B compared to Group A. The shortening fraction and ejection fraction after closure were reduced in both groups, but in Group B there was a major reduction, and the mean values indicated a possible systolic dysfunction. Complications during the procedure and death due to cardiac reasons were greater in Group B compared to Group A. In conclusion, a higher body weight, a larger MDD, a more severe heart enlargement or arrhythmias at presentation increased the risk of developing a worsening structural and functional condition after ductal closure, and this can be associated with perioperative complications and cardiac death.

Doppler Ultrasonographic Assessment of Abdominal Aortic Flow to Evaluate the Hemodynamic Relevance of Left-to-Right Shunting Patent Ductus Arteriosus in Dogs

“…Based on the results of this study, abdominal aortic flow assessment could also be useful in dogs to help evaluate the hemodynamic relevance of a PDA and, therefore, the need for surgical closure. At present, as a consequence of the poor survival rate reported, closure of a PDA in dogs is generally recommended in the veterinary literature [24][25][26][27]. However, there are occasional reports of dogs in which closure is not attempted due to them having small PDAs considered to be hemodynamically not significant [5].…”

“…Therefore, while the majority of PDAs in dogs might require closure, it is possible to encounter a minority of patients in which the benefits of an intervention are less clear. It must be remembered that even minimally invasive procedures are not without risks, with various complications reported to occur, such as new-onset arrhythmias, hemorrhage from vascular perforation, embolization of the occlusion device, cardiac arrest and bacterial ductal arteritis [5,6,26,28]. Evaluation of the abdominal aortic flow could therefore help establish the hemodynamic significance of a PDA and the need for treatment.…”

Self-Reported Management of Incidentally Detected Heart Murmurs in Puppies: A Survey among Veterinarians

“…This raises concerns because pet owners depend on their veterinarians’ advice for expert guidance, especially when their puppy might be experiencing a health issue such as a potentially serious heart condition requiring surgical intervention. For two of the most common congenital heart diseases in dogs i.e., left-to-right shunting patent ductus arteriosus and severe valvular pulmonic stenosis, catheter-based interventions have been proven to be safe and successful for decades [ 12 , 13 , 46 , 47 , 48 , 49 , 50 , 51 ]. A recent study on interventional closure of patent ductus arteriosus confirmed again that early intervention gave better results; among others the end-systolic left ventricular volume index was significantly lower in dogs that underwent surgery before 6 months of age [ 51 ].…”