Clinical and anatomopathological descriptions of dog with arterious Hemitruncus: case report / [Descrições clínicas e anatomopatológicas de cão com hemitruncus arterioso: relato de caso

The anomalous origin of the pulmonary trunk in the ascending aorta, defined as arterious hemitruncus, is a rare congenital malformation in dogs, caused by a defect in the spiral septum. Thus, given the unusual occurrence in the canine species, the systemic severity and the high lethality, the aim of this study was to describe this heart disease in a three-month-old male German Spitz puppy, emphasizing clinical changes of the necropsy and microscopics. The animal had cyanosis, dyspnea and weakness and was forwarded for necropsy after sudden death. Numerous changes were detected in the post-mortem examination, including in the heart, as cardiomegaly and absence of the arterial ligament, which was replaced by the complete fusion between the ascending aorta and the pulmonary trunk, after leaving both the left and right ventricles, respectively and, among the microscopic findings, cardiomyocyte hypertrophy stood out. The association of these findings with the history indicated the diagnosis of arterious hemitruncus followed by cardiorespiratory failure, emphasizing the importance of out complementary cardiological exams in young symptomatic patients for the survival of those affected. Arterious hemitruncus, although rare, must be added in the differential diagnosis of other heart diseases that cause similar clinical signs.(AU)

A origem anômala do tronco pulmonar em aorta ascendente, definida como hemitruncus arterioso, é uma malformação congênita rara em cães, causada por defeito no septo espiral. Assim, diante da ocorrência incomum na espécie canina, da gravidade sistêmica e da alta letalidade, o objetivo deste trabalho foi descrever essa doença cardíaca em um filhote de três meses de idade, macho, Spitz Alemão, enfatizando as alterações clínicas, de necropsia e microscópicas. O animal apresentava cianose, dispneia e fraqueza e foi encaminhado para necropsia após morte súbita. Inúmeras alterações foram detectadas no exame post-mortem, inclusive no coração, como cardiomegalia e ausência do ligamento arterioso, o qual foi substituído pela fusão completa entre aorta ascendente e tronco pulmonar, após a saída de ambas dos ventrículos esquerdo e direito, respectivamente, e, dentre os achados microscópicos, destacou-se a hipertrofia de cardiomiócitos. A associação desses achados com o histórico indicou o diagnóstico de hemitruncus arterioso seguido de insuficiência cardiorrespiratória, ressaltando-se a importância de exames complementares cardiológicos em pacientes jovens sintomáticos na sobrevida dos acometidos. O hemitruncus arterioso, apesar de raro, deve ser acrescido no diagnóstico diferencial de outras cardiopatias que causam sinais clínicos similares.(AU)

A case of a complete atrioventricular canal defect in a ferret.

BACKGROUND: Atrioventricular canal defect is a rare congenital disorder of the heart and describes the presence of an atrial septal defect, a variable presentation of ventricular septal alterations including ventricular septal defect malformations in the mitral and tricuspid valves. The defect has been described in human beings, dogs, cats, pigs, and horses. CASE PRESENTATION: This paper describes the case of a complete atrioventricular canal defect in a four-year-old intact male pet ferret (Mustela putorius furo), which was presented due to posterior weakness, ataxia, and decreased appetite. A loud systolic murmur, dyspnea, and hind limb paraparesis were detected during the clinical examination. Thoracic radiographs showed generalized cardiomegaly and lung edema. ECG showed sinus rhythm with prolonged P waves and QRS complexes. Echocardiography showed a large atrial septal defect, atrioventricular dysplasia, and a ventricular septal defect. Palliative treatment with oxygen, furosemide, spironolactone, enalapril, diltiazem, and supportive care was chosen as the therapy of choice. The ferret recovered gradually during hospitalization. A follow-up examination at three and six months showed stabilization of cardiac function. CONCLUSIONS: To the authors knowledge, this is the first time an atrioventricular canal defect has been described in a pet ferret.

Role of computed tomography angiography in the differentiation of feline truncus arteriosus communis from pulmonary atresia with ventricular septal defect.

Two domestic shorthair cats, a 6-month-old castrated male and a 7-month-old intact female, were diagnosed with complex congenital heart disease. Transthoracic echocardiography in both cats revealed a dilated arterial trunk overriding the interventricular septum with a large ventricular septal defect. The pulmonary trunk and branch pulmonary arteries were not visible using standard echocardiographic views in either cat. The differential diagnosis for both cats included truncus arteriosus communis vs. pulmonary atresia with ventricular septal defect. Each cat underwent computed tomography angiography to determine the origin and extent of the pulmonary blood supply and to better define extra-cardiac anatomy. Computed tomography angiography led to a diagnosis of truncus arteriosus communis with unrestricted pulmonary blood flow in one cat, whereas the other cat was diagnosed with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals serving as the primary source of pulmonary blood flow. Computed tomography angiography allowed for the ante mortem differentiation of truncus arteriosus communis from pulmonary atresia with ventricular septal defect in these two cats, leading to an accurate diagnosis and providing valuable information to therapeutic decision-making for each case.

Aortoseptal angle and pressure gradient reduction following balloon valvuloplasty in dogs with severe subaortic stenosis.

INTRODUCTION: To determine the relationship between aortoseptal angle (AoSA) and the short- and long-term systolic pressure gradient (PG) reduction following combined cutting and high-pressure balloon valvuloplasty (CB/HPBV) in dogs with severe subaortic stenosis. ANIMALS: Retrospective study of 22 client-owned dogs of various breeds with severe subaortic stenosis (mean left ventricular to aortic PG = 143 mmHg; range = 80-322 mmHg) that underwent CB/HPBV. MATERIALS AND METHODS: Initial angiographic and left apical and right-sided parasternal long-axis view echocardiographic video loops were used for measuring the angle between the plane of the interventricular septum and the longitudinal axis of the ascending aorta. The PG reduction ratio immediately after CB/HPBV and 6 and 12 months later were compared with AoSA. RESULTS: Weak correlations were observed for all instances of PG reduction ratio and AoSA type. Significantly greater mean differences of PG reduction ratio were observed for angles >160° than for angles <160° at 24 h (>160° mean: 54.45, standard error [SE]: ±3.8; <160° mean: 39.88, SE: ±2.09), 6 months (>160° mean: 57.73, SE: ±10.9; <160° mean: 28.22, SE: ±3.42), and 12 months (>160° mean: 76.11, SE: ±17.5; <160° mean: 27.61, SE: ±6.44; p=0.003). CONCLUSIONS: Dogs with AoSA >160° on right-sided parasternal long-axis view echocardiograms responded with a greater PG reduction following CB/HPBV than did dogs with AoSA <160°. This suggests that AoSA is associated with long-term outcomes of CB/HPBV, and measurement could help in the evaluation of dogs that are candidates for CB/HPBV.

CONGENITAL CLEFT PALATE AND CARDIAC SEPTAL DEFECTS IN A NEONATAL SOUTHERN BLACK RHINOCEROS (DICEROS BICORNIS MINOR).

A female Southern black rhinoceros ( Diceros bicornis minor) calf died unexpectedly at less than 12 hr of age, after an uncomplicated birth and uneventful early postpartum period. Gross necropsy revealed a 15-cm full thickness cleft palate, a patent foramen ovale, and four septal defects ranging from 0.3 to 1 cm in diameter. Histologic findings did not reveal any significant abnormalities. Karyotyping did not indicate any significant numerical or structural chromosomal abnormalities.

Association between aortoseptal angle in Golden Retriever puppies and subaortic stenosis in adulthood.

BACKGROUND: Predicting subaortic stenosis (SAS) in adult Golden Retriever dogs (GRs) by evaluating them as puppies is hampered by the progressive expression of the SAS phenotype in youth. In some children who develop SAS as adults, an abnormal aortoseptal angle (AoSA) precedes development of stenosis. OBJECTIVES: To determine the normal AoSA in young adult GRs using echocardiography; to assess the value of AoSA in GR puppies for predicting development of the SAS phenotype. ANIMALS: Forty-eight 2- to 6-month-old GR puppies. METHODS: Prospective study. Puppies were recruited from clients and breeders. Puppies were evaluated with a physical examination and an echocardiogram, and this evaluation was repeated when they were 12-18-month-old adults. Puppies were classified as unaffected (WNL) or affected (SAS) retroactively, based on their results as adults. RESULTS: In WNL young adult GRs, mean ± SD AoSA was 152.3 ± 6.5°. Mean ± SD AoSA in SAS puppies (144.9 ± 8.6°) was significantly different from mean AoSA in WNL puppies (155.7 ± 8.8°, P < .01). No puppy with AoSA >160° had the SAS phenotype as a young adult; 93% (75.7-99.1%) of puppies with AoSA <145° had the SAS phenotype as young adults. Peak LVOT velocity increased significantly between evaluations (P < .0001) whereas AoSA did not (P = .45). CONCLUSION AND CLINICAL SIGNIFICANCE: A steep AoSA in GR puppies is associated with the SAS phenotype in young adulthood. Some GR puppies have an abnormal AoSA that persists in young adulthood and is detectable before peak LVOT velocity reaches levels consistent with SAS.

Double-outlet right atrium in a 9 year-old cat.

Double-outlet right atrium (DORA) is a type of atrioventricular septal defect that is described as an extreme leftward deviation of the lower portion of the interatrial septum, resulting in insertion into the atrial wall left and posterior to the mitral orifice. This rare anomaly, which has been reported in humans and only just recently in cats, was identified by transthoracic echocardiography in a 9 year-old cat that was presented for further evaluation of a tachyarrhythmia and cardiomegaly. This case report describes the diagnostic findings in this cat and summarizes the anatomy, classification and clinical consequences of this rare congenital heart defect.

Atrioventricular septal defects: natural history, echocardiographic, electrocardiographic, and radiographic findings in 26 cats.

OBJECTIVES: To evaluate signalment, echocardiographic, electrocardiographic, and radiographic findings as well as natural history in a group of cats with atrioventricular septal defects (AVSD). ANIMALS: 26 client owned cats. METHODS: Medical records were reviewed retrospectively for signalment, morphologic type of AVSD, presence of concurrent congenital heart disease (ConcCHD), diagnostic findings, and natural history. RESULTS: Seventeen cats had an isolated AVSD; 13/17 had a partial and 4/17 had a complete AVSD. Double outlet right atrium (DORA) was diagnosed in 4/17 cats. Of those with a partial AVSD, 7/13 had an atrial communication while 6/13 had a ventricular communication. Congestive heart failure (CHF) developed in 5/17 cats; all 3 cats diagnosed with a DORA not lost to follow-up developed pulmonary edema. Sudden death was documented in 4/17 (23.5%). The 5 year survival was 53.0% (9/17). Concurrent congenital heart disease was identified in 9/26 cats with 7/9 having a conotruncal abnormality. Electrocardiography was performed in 14 cats with 11/14 diagnosed with a conduction disturbance. CONCLUSIONS: Overall the echocardiographic and electrocardiographic findings with AVSD are similar to that seen in humans. Cats may have a higher prevalence than humans of partial AVSD with ventricular communication only as well as a higher prevalence of DORA. Cats with an AVSD have an overall guarded prognosis although some can live for a protracted time.

Double-outlet right ventricle and double septal defects in a Rhesus macaque (Macaca mulatta).

A 6-year-old male India-origin Rhesus macaque (Macaca mulatta) presented with thin body condition and muscular atrophy. Thoracic auscultation revealed a grade VI/VI pansystolic murmur bilaterally. Radiographs showed cardiomegaly with significant left atrial and biventricular enlargement, a dilated pulmonary artery, and hepatomegaly. Electrocardiogram revealed a normal sinus rhythm interspersed with ventricular bigeminy. Hematology showed mild polycythemia and prerenal azotemia. Necropsy demonstrated double-outlet right ventricle with a large subaortic ventricular septal defect, subpulmonary stenosis, small atrial septal defect, and right ventricular hypertrophy. The major histological finding was severe chronic passive hepatic congestion. Double-outlet right ventricle is a rare congenital heart disease, both in human beings and animals.

Ausencia de inserción de las cuerdas tendinosas en los músculos papilares del ventrículo derecho de la cabra / Tendinous chords not inserted in the papillary muscles of the right ventricle of goats

A menudo se describe que la trabécula septomarginal derecha del corazón de las cabras presenta cuerdastendinosas. Sin embargo, en nuestras disecciones este no es un hallazgo frecuente en otras especies animales y elpresente trabajo se diseño para comprobar si las cuerdas tendinosas en esta especie se originan directamente deltabique interventricular. El material utilizado fueron 32 corazones de cabras de ambos sexos, de raza mestiza,conservados en formol al 10%. El ventrículo derecho se abrió mediante un corte en el punto central del troncopulmonar y continuando a través del cono arterioso hasta el borde derecho. Nuestros resultados mostraron que68,8% de los corazones presentaban al menos una larga cuerda tendinosa saliendo de la trabécula septomarginal.El origen fue predominantemente en el tercio de la trabécula cerca del tabique (58,3%), destinadas a la valvaseptal y fi jas en su borde libre (87,5%). La presencia de cuerdas tendinosas originándose directamente del ladoderecho del tabique interventricular se observó en 59,4% de los corazones. Estas son cortas aunque predominanen la región craneodorsal del tabique interventricular (76,7%). Ellas se fi jan a la valva septal (96,8%) y estándestinadas al borde libre (80%). La presencia de cuerdas tendinosas en la trabécula septomarginal no tienerelación con la presencia o ausencia de las cuerdas tendinosas en el tabique(AU)

The right septomarginal trabecula in goats frequently presents tendinous chords emerging from it. Sincewe had not observed such great occurrences in any other animal in which we had investigated the trabecula,we decided to conduct this study with the aim of establishing possible relationships with tendinous chords thatemerge directly from the interventricular septum. The material used consisted of 32 hearts from non-pedigreegoats of both sexes, conserved in 10% formalin. The right ventricle was opened by means of an incision startingat the central point of the pulmonary trunk and continuing through the arterial cone to the right margin. Ourresults demonstrated that 68.8% of the specimens presented at least one long tendinous cord emerging fromthe septomarginal trabecula. This emergence occurred predominantly in the third of the trabecula closest to theseptum (58.3%) and the cord headed to the septal cusp and attached to its free margin (87.5%). The presence oftendinous chords emerging directly from the right side of the interventricular septum was found in 59.4% of thespecimens. These were short, because they were predominantly in the craniodorsal region of the interventricularseptum (76.7%). They attached to the septal cusp (96.8%) and headed for the free margin (80%). The presenceof tendinous chords in the septomarginal trabecula was unrelated to the presence or absence or tendinous chordsin the septum(AU)

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.

Atrioventricular septal defects in three llamas (Lama glama).

Two half-sibling neonatal llamas (Lama glama) and one unrelated adult llama were presented with various complaints, including failure to thrive, respiratory distress, and excessive recumbency. The related camelids were born in successive years to the same dam but from unrelated sires. Thoracic auscultation revealed significant systolic and diastolic murmurs on both sides of the chest in all three llamas, and arterial blood gas evaluation revealed hypoxemia in two llamas. Echocardiographic examinations revealed large atrioventricular septal (AVS) defects in all three llamas. Two llamas were euthanized after diagnosis and the third died 4 mo later. Postmortem examination confirmed large AVS defects in all animals. There also was marked cardiomegaly in each animal. The discovery of such a cardiac anomaly in these three camelids suggests that it may be common in this species and may have a genetic basis.

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.

Congenital heart disease.

The clinical usefulness of M-mode and two-dimensional echocardiography has been proven over the years. M-mode echocardiography allows an 'ice-pick' sampling of the heart, but in conjunction with two-dimensional echocardiography, assessments of cardiac structure and, to some extent, myocardial function can be appreciated. The limitations of these techniques include difficulty in 1) diagnosing subtle congenital heart disease and 2) estimating the severity of valvular lesions (stenosis and regurgitation). Doppler echocardiography overcomes these limitations by detecting abnormal direction, velocity, and turbulence of the blood flow (Chapter 2). This chapter will focus mainly on the two-dimensional and M-mode echocardiographic features of common congenital heart disease.

Atrial septal defect in a bonnet macaque (Macaca radiata).

Atrial Septal Defect was detected at autopsy in a subadult bonnet macaque (Macaca radiata). Case history and autopsy findings were described.

Diseases of the heart.

Diagnostic ultrasound has allowed significant findings to be made in the investigation of cardiac disease in the horse. Because of the limited value of thoracic radiography in the adult horse with cardiac disease, ultrasound is the method of choice to document chamber enlargement, pericardial effusion, valvular abnormalities, and decreased contractility of the myocardium. The apparent changes in the flow characteristics and suspicion of abnormality in the right heart of racehorses need further investigation to fully document the etiopathogenesis of spontaneous contrast.

Diagnostic value of contrast echocardiography in the horse.

M-mode echocardiography is a safe and practical means of using ultrasound to evaluate the dynamic movements of cardiac structures. The technique can be refined by using a simple contrast medium in the form of carbon dioxide mixed with heparinised blood to provide a strong echogenic result. This technique was employed in a series of 15 normal conscious standing horses and in three animals with specific cardiac defects. In the clinical cases it was possible to confirm the diagnosis and differentiate between a congenital septal defect and mitral regurgitation. The method was found to be safe and relatively simple to perform using percutaneous insertion of catheters. The intracardiac catheterisation was trouble free and no clinical side effects to direct injection of the carbon dioxide contrast medium into the heart were demonstrated.