Tetralogy of Fallot with concurrent patent foramen ovale and tricuspid valve dysplasia in a dog.

The echocardiographic findings of a young Pomeranian-cross dog with tetralogy of Fallot, patent foramen ovale, and tricuspid valve dysplasia are described. Ongoing medical management of hypoxemia and erythrocytosis was carried out and the dog survived to 2 years of age. Treatment options for tetralogy of Fallot are discussed.

Tétralogie de Fallot avec persistance du foramen ovale et dysplasie de la valve tricuspide concomitante chez un chien. Les constatations écho-cardiographiques chez un chien Poméranien de race croisée atteint de la tétralogie de Fallot, de la persistance du foramen ovale et d'une dysplasie de la valve tricuspide sont décrites. Une gestion médicale constante de l'hypoxémie et de l'érythrocytose a été réalisée et le chien a survécu jusqu'à l'âge de 2 ans. Les options de traitement pour la tétralogie de Fallot sont discutées.(Traduit par Isabelle Vallières).

Prolonged gestation in two Holstein cows: transabdominal ultrasonographic findings in late pregnancy and pathologic findings in the fetuses.

Prolonged pregnancy in cattle is a rare condition that is commonly accompanied with fetal adenohypophyseal hypoplasia. The final diagnosis is often challenging as breeding date error remains possible in virtually all situations. In this report, fetal wellbeing assessment is depicted in two Holstein cows suffered from prolonged pregnancy. Transabdominal ultrasonographic findings were compatible with healthy non-stressed fetuses. The clinical and pathologic findings encountered in both fetuses expelled after corticosteroid induction of parturition consisted of adenohypophyseal aplasia and hydronephrosis. Other nervous system anomalies (hydrocephaly or holocephaly) were observed. Tetralogy of Fallot was also found in one calf.

Long-term palliation of tetralogy of Fallot in dogs by use of a modified Blalock-Taussig shunt.

OBJECTIVE: To describe a modified Blalock-Taussig shunt (mBT) procedure and assess its use in dogs with clinical signs associated with tetralogy of Fallot (TOF). DESIGN: Descriptive report. ANIMALS: 6 dogs with severe TOF-associated clinical signs. PROCEDURES: Each dog had TOF (confirmed echocardiographically or angiographically) and underwent an mBT shunt procedure for surgical palliation of signs. The surgery was performed through a left fourth rib resection or a left fifth intercostal thoracotomy. The left subclavian artery was dissected free from surrounding mediastinal tissue. The main pulmonary artery trunk was exposed through an incision in the overlying pericardium. A shunt comprised of a 6-mm-diameter tube of expanded polytetrafluoroethylene (5 dogs) or a segment of carotid artery (1 dog) was sutured end to side between the left subclavian artery and pulmonary artery trunk. RESULTS: 5 of the 6 dogs survived the immediate postoperative period. The dog that died shortly after surgery was the smallest of the dogs (weight, 2.9 kg [6.38 lb]) and had received the carotid artery autograft. Three dogs survived long term and 2 dogs died of unknown causes 6 years after undergoing the mBT shunt procedure. In all dogs that survived the mBT procedure, shunt patency was confirmed and quality of life appeared improved. CONCLUSIONS AND CLINICAL RELEVANCE: These findings have suggested that the mBT shunt procedure safely provides long-term palliation of TOF-associated clinical signs in dogs. In addition, it may offer an effective low-risk and lower-cost alternative to open heart repair of TOF.

Evaluation of canine congenital heart disease using an echocardiographic algorithm.

Evaluation of canine congenital heart disease presents a diagnostic challenge to many ultrasonographers. To assist clinicians attempting to examine these patients, an echocardiographic algorithm containing the six most common canine congenital heart diseases (i.e., patent ductus arteriosus, subaortic stenosis, pulmonic stenosis, ventricular septal defect, tricuspid dysplasia, and tetralogy of Fallot) is presented. The algorithm focuses on the underlying disease pathogenesis and the resultant changes in cardiac structure and function that can be readily identified during echocardiographic examination. Use of this algorithm provides a framework from which the ultrasonographer gains both experience and confidence in diagnosing congenital heart disease via echocardiography. This algorithm is supported by a number of still figures within the article as well as real-time echocardiographic images available for viewing at AAHA's website, www.aahanet.org.

Open-heart correction of tetralogy of Fallot in an acyanotic dog.

Tetralogy of Fallot was diagnosed in an acyanotic 11-month-old dog. Predicted pressure gradient across the pulmonic valve, as assessed by use of continuous wave Doppler echocardiography, was 94.5 mm Hg. Bidirectional shunting was identified by means of selective angiography. Open-heart correction was performed, using a transatrial approach with limited ventriculotomy and cardiopulmonary bypass. The hypertrophied infundibulum was resected, the ventricular septal defect was closed primarily, and a transannular pericardial patch graft was applied. Pressure gradients across the pulmonic valve were 52.9 and 22.8 mm Hg 2 weeks and 4 months after surgery, respectively. Advances in cardiopulmonary bypass, anesthetic management, and use of the transatrial approach may improve the success of open-heart correction of tetralogy of Fallot in dogs.

Retrospective study of congenital heart defects in 151 dogs.

The case records of 151 dogs diagnosed with congenital heart disease were reviewed retrospectively. The most common defect was aortic stenosis, accounting for 35 per cent of all cases, followed by pulmonic stenosis (20 per cent), ventricular septal defect (12 per cent), patent ductus arteriosus (11 per cent), mitral valve dysplasia (8 per cent), tricuspid valve dysplasia (7 per cent), endocardial fibroelastosis (1.9 per cent) and tetralogy of Fallot (0.6 per cent). Fifty-one breeds were represented, with golden retrievers, German shepherd dogs and boxers predominating. No overall sex predilection was obvious. Seventy-five per cent of the dogs were asymptomatic at presentation. The defects most often associated with presenting symptoms, such as dyspnoea, syncope, ascites, failure to grow and depression, were mitral valve dysplasia, atrial septal defect, tricuspid valve dysplasia and endocardial fibroelastosis. The latter presented with the most severe signs of heart failure. In some cases of aortic stenosis and pulmonic stenosis, where the defect could not be accurately visualised with two-dimensional echocardiography, Doppler echocardiographic examination was needed for definitive diagnosis.

[Palliative treatment of tetralogy of Fallot using a PTFE (polytetrafluoroethylene) vascular graft]. / Palliative Behandlung von Fallotscher Tetralogie mit einer PTFE-(Polytetrafluorethylene-) Gefässprothese.

The application of a PTFE (polytetrafluorethylene) vascular graft for palliative surgical treatment in a case of tetralogy of Fallot in a dog is described. The surgical procedure took place after an attempt to perform a Blalock anastomosis failed. The surgical technique, the postoperative care and the outcome are presented. The technique and its indications are discussed.

Crossed fat embolism in a cow with tetralogy of Fallot.

A 10-month-old, female Holstein-Friesian cow with tetralogy of Fallot died during surgery for ameliorating pulmonary stenosis. Necropsy revealed no fracture of bones. Microscopically, fat emboli in the capillaries were detected in the brain, kidney, lung, adrenal gland and pituitary. In the kidney, many fat emboli were present in the glomeruli. No significant changes of the neurons were found throughout the brain, and perivascular hemorrhage and/or necrosis were rarely seen accompanying with fat emboli in the cerebral cortex. The trigger for fat embolism might be costectomy, and right-to-left shunt due to heart malformation might be attributed to crossed and systemic distribution of the fat emboli.

Persistent common atrioventricular canal of the complete form associated with anomalies of the aortic arch system in WKY/NCrj rat fetuses.

Atrioventricular (AV) septal defect with a common AV orifice was found in two near-term rat fetuses, which are descendants of an inbred strain, known to genetically develop tetralogy of Fallot, hypertrophic cardiomyopathy, etc. In one fetus the anterior bridging leaflet was almost entirely committed to the left ventricle but in the other it protruded slightly into the right also, coinciding with type A or type B in humans, respectively. The latter fetus had also a subaortic ventricular septal defect with overriding of the aorta and a double aortic arch. Both fetuses had a narrow pulmonary infundibulum with a muscular band, a dysplastic pulmonary valve, and a markedly hypoplastic ductus arteriosus. Complete AV septal defect and tetralogy of Fallot may be linked genetically, with some common underlying developmental processes.

Chylothorax associated with right-sided heart failure in five cats.

Chylothorax associated with right-sided congestive heart failure was diagnosed in 5 cats. One cat had restrictive pericardial disease, with mild pericardial effusion, and a heart-base chemodectoma. Two other cats had congestive cardiac disease (tetralogy of Fallot and tricuspid regurgitation in 1 cat, and endocardial cushion defect and tricuspid dysplasia in the other), and 2 cats had idiopathic cardiomyopathy. All cats had jugular venous distention, and echocardiographic evaluation helped define the nature of the cardiac disease in these cats. Subtotal pericardiectomy resulted in resolution of the chylothorax in the cat with the heart-base tumor, whereas medical management of the right-sided heart failure temporarily decreased pleural effusion in the cat with tetralogy of Fallot and in the 2 cats with cardiomyopathy.

Microsurgical management of tetralogy of Fallot in a cat.

A modified Blalock-Taussig shunt was performed on a cat with tetralogy of Fallot. Previous attempts at such palliative surgery in the cat have failed, due to small vessel size. The use of microvascular instrumentation and technique resulted in a patent shunt in this case.