Transpulmonary Stent Implantation for Dysplastic Pulmonary Valve Stenosis with a Single Left Coronary Ostium and Anomalous Prepulmonary Right Coronary Artery in an English Bulldog

Markovic, Lauren E.; Whipp, Christopher J.; Morgan, Keaton RS.; Almeida, Daniel; Hiremath, Gurumurthy

doi:10.1016/j.case.2020.08.009

Cited by 5 publications

(9 citation statements)

References 19 publications

(24 reference statements)

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“…14 Using sequential balloon dilation to assess the impact of stent size selection on coronary perfusion has been described previously. 9 This is the first case report describing in detail the anaesthetic management and perioperative complications of a hybrid transpulmonic stent angioplasty, performed in a dog with an R2A coronary artery anomaly.…”

Section: Discussionmentioning

confidence: 96%

“…Transpulmonary stent angioplasty is a relatively novel technique for managing dogs with circumpulmonary coronary anomalies, but may be challenging to perform in dogs with a large pulmonary artery diameter 14 . Using sequential balloon dilation to assess the impact of stent size selection on coronary perfusion has been described previously 9 . This is the first case report describing in detail the anaesthetic management and perioperative complications of a hybrid transpulmonic stent angioplasty, performed in a dog with an R2A coronary artery anomaly.…”

Section: Discussionmentioning

confidence: 99%

“…The proximity of the circumpulmonary coronary artery to the implant constituted a risk for compression of the single coronary artery during the stent implantation at the level of the pulmonary valve 9 . Coronary artery compression can result in narrowing of the coronary artery, significantly reducing blood flow, which may lead to coronary insufficiency and myocardial ischaemia 9 . Depending on whether the zone of ischaemia is subepicardial or subendocardial, ST‐segment elevation or depression, respectively, can be observed on a surface electrocardiogram 9 .…”

Section: Discussionmentioning

confidence: 99%

“…However, this procedure is contraindicated in patients with PS associated with coronary artery anomalies. In these cases, alternative surgical techniques, such as transvenous right ventricular outflow (RVOT) stenting and hybrid stent techniques, may be considered 7–14 …”

Section: Introductionmentioning

confidence: 99%

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Anaesthetic management of a dog with severe pulmonary stenosis and R2A right coronary artery anomaly undergoing placement of a hybrid transventricular pulmonary stent

Cambruzzi

Borgeat

MacFarlane

2022

Vet Record Case Reports

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A 7‐month‐old, 12.2 kg, male, neutered, English bulldog with severe pulmonary stenosis and R2A right coronary artery anomaly was anaesthetised for placement of hybrid right ventricle to pulmonary artery stent. An alfentanil bolus (10 μg/kg intravenously) was used as premedication. Anaesthesia was induced with midazolam (0.2 mg/kg) and etomidate (1 mg/kg) intravenously, and maintained with sevoflurane in 100% oxygen. Perioperative analgesia was achieved combining locoregional techniques with intravenous analgesics. The main intraoperative complications were hypotension, bradycardia, ventricular premature complexes, ST‐segment depression and transient hypoxaemia. Lidocaine constant‐rate infusion (50 μg/kg/min) and magnesium sulphate constant‐rate infusion (5 mg/kg/h) were used to prevent arrhythmias during the cardiac manipulations and stent placement. Hypotension was treated with dobutamine and noradrenaline constant‐rate infusion. The use of different drugs and anaesthetic techniques (balanced anaesthesia) provided antinociception, muscle relaxation and appeared to be effective in preventing major cardiovascular complications.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Anaesthetic management of a dog with severe pulmonary stenosis and R2A right coronary artery anomaly undergoing placement of a hybrid transventricular pulmonary stent

Cambruzzi

Borgeat

MacFarlane

2022

Vet Record Case Reports

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“…2020, Markovic et al . 2020). The increasing availability of multidimensional imaging also allows for comprehensive descriptions of the anatomy and treatment options for uncommon and rare defects that frequently involve abnormal development or communications with the great vessels, coronary arteries and pulmonary or caval veins (Pelosi et al .…”

Section: Diagnosis and Treatment Optionsmentioning

confidence: 99%

Key considerations in the approach to congenital heart disease in dogs and cats

Saunders

2021

J of Small Animal Practice

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Congenital heart disease is an important subset of all cardiovascular disease in dogs and cats that is present at birth and most often detected in young animals but can be diagnosed in adulthood. The range of abnormalities that can occur during development of the heart is vast incorporating simple and complex defects, varying degrees of severity and clinical presentations that include heart failure and cyanosis. While some defects do not result in morbidity in an individual animal, others cause severe clinical signs and death at a young age. Advances in imaging and expanding treatment options offer increasingly more possibilities in the diagnosis and management of congenital heart disease which is the focus of this review. The objective is to provide a broad overview of current practice and highlight key aspects to guide practitioners in their approach to congenital heart disease diagnosis and knowledge of available treatment options.

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64‐Slice ECG‐gated computed tomographic angiography for assessment of coronary arteries in brachycephalic dogs with pulmonary stenosis

Hallman,

Baumwart,

Hallman

2024

Veterinary Record

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BackgroundBrachycephalic dogs with pulmonary stenosis are known to have a higher incidence of concurrent coronary artery abnormalities than non‐brachycephalic breeds, which increases risk when performing balloon valvuloplasty. The use of ECG‐gated CT angiography has been reported for the evaluation of coronary arteries in normal dogs and dogs with pulmonary stenosis. The purpose of this study was to report findings of coronary artery origination and morphology of main branches using ECG‐gated CT angiography in brachycephalic dogs with pulmonary stenosis.MethodsAn ECG‐gated CT angiographic protocol was used to image coronary artery anatomy in nine brachycephalic dogs with pulmonary stenosis. Images were assessed for quality as well as coronary artery morphology by one veterinary radiologist, one veterinary cardiologist and one veterinary radiology resident.ResultsAll nine dogs had good to excellent image quality. Coronary artery anomalies were identified in three of nine dogs: one R2A anomaly, one L2A anomaly and one L2C anomaly. Two dogs were assessed to be poor balloon valvuloplasty candidates based on CT angiographic images.LimitationCoronary artery morphology was not confirmed via postmortem examination in all patients.ConclusionECG‐gated CT angiography is a minimally invasive imaging modality capable of diagnosing various coronary artery anomalies in brachycephalic dogs with pulmonary stenosis and aiding in the determination of patient candidacy for balloon valvuloplasty.

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Transpulmonary Stent Implantation for Dysplastic Pulmonary Valve Stenosis with a Single Left Coronary Ostium and Anomalous Prepulmonary Right Coronary Artery in an English Bulldog

Abstract: Graphical abstract

Cited by 5 publications

References 19 publications

Anaesthetic management of a dog with severe pulmonary stenosis and R2A right coronary artery anomaly undergoing placement of a hybrid transventricular pulmonary stent

Anaesthetic management of a dog with severe pulmonary stenosis and R2A right coronary artery anomaly undergoing placement of a hybrid transventricular pulmonary stent

Key considerations in the approach to congenital heart disease in dogs and cats

64‐Slice ECG‐gated computed tomographic angiography for assessment of coronary arteries in brachycephalic dogs with pulmonary stenosis

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