Journal of Veterinary Cardiology

Diagnosis and hybrid interventional and surgical removal of ectopic heartworms (Dirofilaria immitis) in a dog
Barnett BG, Hammond HK, Chen CL, Grimes JA and Markovic LE
An adult male castrated French bulldog mix was presented for suspected caval syndrome and bilateral pelvic limb paresis. After emergency transjugular heartworm extraction, abdominal ultrasound revealed occlusive adult heartworms in the abdominal aorta extending into the pelvic limb arteries. Hybrid interventional and surgical extraction was pursued, and heartworms were removed via bilateral femoral arteriotomy and caudal abdominal aortotomy. Ectopic dirofilariasis involving the aorta and pelvic limb arteries is rarely reported; therefore, the underlying mechanism, incidence, and treatment of aberrant heartworms are poorly understood. This case report describes a unique hybrid approach involving heartworm extraction via femoral arteriotomy interventionally and aortotomy surgically.
Efficacy and safety of different antiarrhythmic protocols used for rate control in dogs with secondary atrial fibrillation
Romito G, Bertarello M, Mazzoldi C, Fasoli S, Dondi F, Castagna P, Pelle NG, Paradies P, Valente C, Poser H and Guglielmini C
Studies comparing the effects of antiarrhythmic protocols used for rate control in dogs with secondary atrial fibrillation (AF) are currently limited; therefore, this study aimed to report detailed data on the efficacy and therapy-related side-effects (TRSEs) of different antiarrhythmic protocols in dogs with secondary AF.
Echocardiographic estimates of stroke volume in healthy dogs: comparability, reference intervals, and reproducibility
Davis KE, Visser LC, Boon JA, Ross ES, Sankisov JN and Laws AC
This study aimed to compare estimates of stroke volume (SV) from different anatomic sites and to generate reference intervals for indices such as shunt volume (ShuntVol) or regurgitant volume (RegVol) in a large sample of healthy dogs.
Advanced cardiac imaging
Scansen BA
Unilateral pulmonary edema in a dog with a large, left-to-right shunting patent ductus arteriosus
McMullen M, Maneval KL, Ferrel CS, Holland M and Winter RL
A 4-month-old, 5.0-kg male castrated mixed-breed dog was presented for further evaluation of a heart murmur. A grade 6/6 left basilar, continuous heart murmur, and bounding femoral arterial pulses were observed, consistent with a patent ductus arteriosus (PDA). Transthoracic echocardiography confirmed the diagnosis of a large, left-to-right shunting PDA with severe left heart volume overload. Thoracic radiography revealed severe, alveolar lung disease in the right cranial, right middle, and right caudal lung lobes; no pulmonary infiltrate was observed in the left lung lobes. Unilateral pulmonary edema secondary to the PDA was diagnosed, which later resolved with medical management and transcatheter occlusion of the PDA with an Amplatz Canine Ductal Occluder. Unilateral pulmonary edema secondary to a PDA has not been previously reported in the dog.
Transjugular patent ductus arteriosus occlusion in a cat using the Vet-PDA Occluder™ device
García-Guasch L, Bello AM, García-Urdiales A, Massegur-Yeste D and Olmedo-Bosch C
A 5-month-old, female, entirely domestic short-haired cat was referred for evaluation of a continuous heart murmur. No associated clinical signs were reported. Transthoracic echocardiography revealed a large, left-to-right shunting patent ductus arteriosus (PDA). Transjugular occlusion of the defect was achieved using a Vet-PDA Occluder™ device, a new conic-shaped nitinol spiral device designed for PDA closure in small-sized dogs weighing less than 3 kg. Resolution of the continuous heart murmur was identified after device deployment. This case report demonstrates that the Vet-PDA Occluder™ can be a feasible option in feline patients for the occlusion of PDA and describes the technique step by step.
Agreement of echocardiographic and catheterization-based methods of transpulmonary pressure gradient measurement in dogs
Murphy KE, Markovic LE, Adin DB, Moy-Trigilio KE and Coleman AE
Doppler echocardiographic estimation of transpulmonary pressure gradient (PG) is widely used to determine severity of pulmonary valve stenosis and indication for transcatheter intervention. The objective of this study was to describe agreement between Doppler echocardiographic methods of transpulmonary PG estimation and direct peak-to-peak pressure gradient at catheterization (PG) in dogs. We hypothesized that with reference to PG, mean echocardiographic PG (PG) would have less bias than peak modal instantaneous echocardiographic PG (PG).
Ventricular cardiac hemangiosarcoma with brain metastases in a dog
Yan J, Evered C, Raheb S, Lillie B and Fonfara S
An 11-year-old, female, spayed, soft-coated Wheaten terrier presented for acute onset of neurological signs. On presentation, neurological examination showed right thoracic and pelvic limb proprioceptive deficits, absent right menace reflex, and weak right nasal septum response. A left thalamocortical lesion was localized. On thoracic auscultation, an arrhythmia was noted, and electrocardiography showed frequent ventricular premature complexes and rare runs of ventricular tachycardia. Echocardiography identified an interventricular septal mass extending into the lumen of the left ventricle. Thalamocortical metastasis secondary to the cardiac mass was suspected to be the cause of the patient's neurological signs. Humane euthanasia was elected by the owner due to the patients clinical status and poor prognosis. A postmortem examination diagnosed hemangiosarcoma of the interventricular septum, the right ventricular free wall, and left ventricular free wall. The left ventricle adjacent to the paraconal groove showed myocardial necrosis and inflammation. Metastases to the brain and secondary intracranial hemorrhage were found which were suspected to be the cause of the antemortem neurological signs. Concurrent pulmonary and hepatic metastases were noted. This report describes a rare presentation of an intracardiac hemangiosarcoma of the interventricular septum, right ventricle, and left ventricle in a patient presenting with neurological signs.
Left atrial fractional shortening in cats: a comparison between two echocardiographic views
Machado A, Partington C, Silva J, Gardner L and Novo Matos J
Left atrial fractional shortening (LAFS%) is a widely used index of left atrial systolic function in cats that has been shown to predict development of hypertrophic cardiomyopathy (HCM) and cardiac mortality. It can be determined by two methods: from an M-mode right parasternal short-axis view (LAFS%) or two-dimensional right parasternal long-axis four-chamber view (LAFS%). We aimed to assess the agreement between LAFS% and LAFS% in cats and to evaluate the correlation between LAFS% and LAFS% and left ventricular systolic performance.
Quantification of respiratory sinus arrhythmia in control dogs and in dogs with various severity classes of myxomatous mitral valve disease
Baisan RA, Turcu CA, Bilboc LM, Maftei MC, Vulpe V and Ohad DG
Loss of respiratory sinus arrhythmia (RSA) is a negative prognostic factor in dogs with myxomatous mitral valve disease (MMVD). The aim of this study was to calculate the percentage (%) of RSA in healthy dogs and dogs in various MMVD classes.
Systemic reactive angioendotheliomatosis mimicking hypertrophic cardiomyopathy in a domestic shorthair cat
Herrold E, Schober K, Miller J and Jennings R
A two-year-old, 3.9-kg, male castrated, domestic shorthair cat presented to The Ohio State University Veterinary Medical Center for acute onset neurological signs. During hospitalization, he was diagnosed with an American College of Veterinary Internal Medicine (ACVIM) stage B1 hypertrophic cardiomyopathy phenotype on echocardiogram. His clinical signs acutely worsened, including seizure activity and panting, and he was euthanized. Necropsy revealed the histopathologic diagnosis of systemic reactive angioendotheliomatosis, which notably severely affected the myocardium. In this case report, we present the antemortem diagnostic results and postmortem necropsy results of this rare condition in cats. This case demonstrates that echocardiographic assessment of the heart in cats affected by systemic reactive angioendotheliomatosis may lead to the false diagnosis of hypertrophic cardiomyopathy and thus should be considered as a differential diagnosis in cats with symmetrical left ventricularl wall thickening on echocardiography.
Percutaneous balloon angioplasty as a treatment for cor triatriatum sinister in a cat
Allen J, Phipps K, Barrett K and Day C
A 17-week-old, 2.7-kg cat was presented for management of congestive heart failure due to cor triatriatum sinister. Despite aggressive management for congestive heart failure with escalating diuretic doses, the cat remained symptomatic with exercise intolerance and dyspnea. Percutaneous transseptal balloon dilatation was scheduled. Computed tomography was performed prior to the procedure to aid in planning, which confirmed echocardiographic findings and excluded concurrent congenital defects. A transseptal puncture was performed under general anesthesia, and the cor triatriatum sinister membrane was crossed with a guidewire, allowing subsequent inflation with a 4-mm cutting balloon, followed by inflation of a 10-mm low-pressure balloon across the membrane. This resulted in marked improvement in pressure gradient across the membrane. Pulmonary venous puncture resulting in a mediastinal thrombus was the only complication encountered but was self-limiting and did not require any intervention. Diuretics were discontinued at a two-week recheck, and echocardiography confirmed resolution of the transmembrane gradient. A recheck echocardiogram nine weeks postoperatively, however, revealed restenosis of the membrane. Clinical signs of congestive heart failure were recurrent, requiring reinstitution of diuretic therapy. Percutaneous correction of cor triatriatum sinister is a technically challenging but feasible treatment option in small animals, though further investigation is needed to determine if restenosis is a common and/or preventable outcome.
Persistent left cranial vena cava and right cranial vena cava aplasia in a French bulldog and a Cavalier King Charles spaniel with severe pulmonic stenosis
Huynh J, Benjamin EJ, Degarmo K and Baumwart R
One French bulldog and one Cavalier King Charles spaniel were referred for pulmonary balloon valvuloplasty (PBV) after being diagnosed with severe pulmonic stenosis. In both patients, a dilated coronary sinus was noted on transthoracic echocardiography, suggesting persistent left cranial vena cava. Despite complete preoperative workup being performed, persistent left cranial vena cava with right cranial vena cava aplasia was not identified until after right jugular catheterization. This case study highlights vascular anomalies that hinder traditional approaches to PBV and diagnostic considerations for preoperative workup as recognition of these venous anomalies would have changed the approach to catheterization for PBV, minimizing the risk for complications, saving resources, and decreasing anesthetic time in these patients.
Clinical, electrocardiographic, and diagnostic imaging features and outcomes in cats with electrocardiographic diagnosis of ventricular pre-excitation: a retrospective study of 23 cases (2010-2022)
Gavic EA, Stauthammer CD, Masters AK, Morgan KRS, Rendahl A, Ciccozzi M, Beekmann K, George R, Herrold E, Markovic LE, Schober K, Tjostheim SS and Wright K
Ventricular pre-excitation (VPE) occurs when atrial electrical impulses prematurely excite the ventricles through an aberrant muscle bundle known as an accessory pathway (AP). Orthodromic atrioventricular reciprocating tachycardia is a re-entrant, narrow complex supraventricular tachycardia (SVT), maintained through retrograde conduction over an AP. The study aimed to describe patient signalments, clinical signs, electrocardiographic (ECG) and diagnostic imaging features, treatments, prognostic variables, and outcomes in cats with ECG diagnosis of VPE.
The role of vector-borne pathogens and cardiac Striatin genotype on survival in boxer dogs with arrhythmogenic right ventricular cardiomyopathy
Ditzler B, Lashnits E, Meurs KM, Maggi RG, Yata M, Neupane P and Breitschwerdt EB
Risk factors for severe disease in boxer dogs with arrhythmogenic right ventricular cardiomyopathy (ARVC) are not well understood. This study's objective was to determine whether Striatin genotype or canine vector-borne pathogen (CVBP) exposure/infection in boxer dogs with ARVC was associated with disease severity or survival.
Ruptured left sinus of Valsalva aneurysm into the left atrium in a dog
Fultz SM, Kellihan HB and Nagpal P
A dog with immune-mediated thrombocytopenia and a new heart murmur had an echocardiogram in 2016 and was found to have a suspected aorto-left atrial fistula. The echocardiogram findings remained relatively static from 2016 to 2022. This report highlights the use of cardiac-gated computed tomography angiography to allow further understanding of a complex anomaly in a patient with a ruptured sinus of Valsalva aneurysm causing a fistulous connection with the left atrium.
Evaluation of right ventricular function using conventional and real-time three-dimensional echocardiography in healthy dogs and dogs with myxomatous mitral valve disease
Aherne M, Borgarelli M, Menciotti G, Lahmers SM and Abbott JA
To compare conventional and three-dimensional (3D) echocardiographic indices of right ventricular (RV) systolic function in dogs with various stages of myxomatous mitral valve disease (MMVD), classified according to the 2009 guidelines of the American College of Veterinary Internal Medicine (ACVIM), with those from normal dogs.
Transvenous closure of patent ductus arteriosus with Nit-Occlud® PDA occlusion system in 13 dogs weighing less than 3 kg
Cala A, Ferasin L, Ferasin H, Domenech O, Bini M, Valenti V and Venco L
Successful closure of patent ductus arteriosus (PDA) can be obtained with surgical ligation or with occlusion via minimally invasive per-catheter techniques. This study was performed to assess feasibility and effectiveness of transjugular PDA occlusion in dogs weighing < 3 kg with a device called Nit-Occlud® PDA.
Diagnostic value of a point-of-care cardiac troponin-I assay (i-STAT®) for clinical application in canine and feline cardiology
Ferasin L, Ferasin H, Farminer J, Hudson E and Lamb K
This study was performed to evaluate the diagnostic value and net benefits, including cost-effectiveness, of a point-of-care analyser (i-STAT®) for measurement of cardiac troponin I (cTnI) in dogs and cats.
Cardiac biomarker profiles in dogs with naturally occurring precapillary pulmonary hypertension
Lichtenberger J, Côté E, Forney SD, Barrett KA and Ettinger SJ
This study evaluated circulating amino-terminal pro-B-type natriuretic peptide (NT-proBNP), amino-terminal pro-A-type natriuretic peptide (NT-proANP), and cardiac troponin I (cTnI) concentrations in dogs with precapillary pulmonary hypertension (Pre-PH) and control dogs with respiratory clinical signs but no Pre-PH.
Comparative transcatheter occlusion of patent ductus arteriosus: multicenter collaborative study across pediatric and veterinary cardiology centers
Markovic LE, Hiremath G, Scansen BA, Kellihan HB, Calkins C, Coleman AE, Tjostheim SS, Tainter B, Hodges KM, Cahill E, Carter M and Kim DW
Transcatheter therapeutics have revolutionized treatment of patent ductus arteriosus (PDA). Greater understanding of corrective interventions across species can advance best practices, protocols, and outcomes while minimizing adverse events. The objective of this study was to describe characteristics and outcomes in children and dogs undergoing transcatheter PDA occlusion.