Acquired infundibular pulmonary stenosis associated with a congenital membranous ventricular septal defect (Gasul phenomenon) in a dog and discussion regarding causes of infundibular stenosis.

An aclinical Havanese dog was diagnosed with a membranous restrictive ventricular septal defect. The patient was represented later in their natural history due to the development of syncope. At that time the patient was diagnosed with acquired pulmonary infundibular stenosis. Balloon dilation of the stenosis was performed successfully twice over the patient's lifetime. The patient died suddenly approximately 14 months after the second balloon dilation. A discussion regarding primary infundibular pulmonary stenosis versus causes of acquired infundibular pulmonary stenosis including anomalous muscle bundles (double chamber right ventricle), tetralogy of Fallot, and infundibular stenosis is presented.

Ascending aortic aneurysm associated with tetralogy of Fallot in an adult mare.

Congenital heart disease is relatively uncommon in horses. Only three reports exist that describe a tetralogy of Fallot in adult horses. Whereas in humans the presence of congenital heart disease constitutes a risk factor for developing aortic aneurysms, their association has never been reported in horses. Here, we present a case with a large ascending aortic aneurysm as a complication of a tetralogy of Fallot in an adult mare. The mare was referred with sustained tachycardia and a 5 days history of mild intermittent colic, depression, inappetence and weight loss. Echocardiography was used to characterize the cardiac abnormalities and aortic root dilation. Due to the poor prognosis, the mare was euthanized and post-mortem examination further characterized the abnormalities. At least four factors contributed in this case to the development of aortic haematoma: congenital disease, mucoid extracellular matrix accumulation vasa vasorum dysfunction and inflammatory/degenerative lesions in the aorta's intima. Although colic is primarily caused by gastrointestinal issues, cardiac disease should be suspected in cases with sustained tachycardia, even in absence of murmurs or arrhythmias. Despite the fact that congenital abnormalities are usually detected in foals, they may sometimes remain unnoticed for several years.

An unusual presentation of developmental anomalies of the cardiovascular system including tetralogy of fallot, double outlet right ventricle, patent foramen ovale and persistent right aortic arch in a Friesian calf.

BACKGROUND: Congenital heart diseases are occasionally encountered in the bovine species. Ventricular septal defects (VSD) and atrial septal defects (ASD) are reported to be the most common; however, a vast collection have been reported [1, 2]. Congenital heart diseases is thought to represent less than 3% of all congenital abnormalities in calves [3]. Various cardiac anomalies arise due to defective embryologic development such as defects of the septae or the cardiac chambers [2]. The exact aetiology of these congenial heart anomalies remains to be fully elucidated [4]. VSDs appear to be the most common congenital cardiac anomaly in calves. Other diseases can be subdivided into cyanotic (e.g. ASD or patent ductus arteriosus) and non-cyanotic (e.g. tetralogy of fallot or eisenmengers complex) [5, 6]. An exceptional presentation of an array of congenital anomalies was identified in a Friesian heifer calf. To the authors' knowledge this concurrent collection of congenital abnormalities has never been reported in this species. CASE PRESENTATION: A 3-day old Friesian heifer presented with a history since birth of regurgitation post feeding. The main finding on clinical examination was tachypnoea with a holosystolic murmur. Echocardiography identified a VSD, patent foramen ovale (PFO) (both with left to right blood flow) and tricuspid insufficiency. The calf was subsequently euthanised and underwent gross post-mortem examination. A persistent right aortic arch (PRAA) was identified. The cardiac anomalies identified on the echocardiogram were confirmed along with additional abnormalities; double outlet right ventricle (DORV), partial transposition of the great vessels, pulmonic stenosis, hypoplasia of the right branch of the pulmonary artery and right ventricular hypertrophy. The final diagnosis was Tetralogy of Fallot with DORV, PFO and PRAA. The lungs appeared oedematous and congested due to cardiac malfunction and cranioventral aspiration pneumonia. Free serous fluid was identified in the thoracic cavity. Unilateral renal agenesis of the left kidney was an incidental finding but is of note due to its coexistence with the cardiac abnormalities. CONCLUSIONS: This is an unusual case as it features numerous congenital abnormalities that appeared to negate each other allowing capability with life. To the authors' knowledge, this collection of concurrent cardiac anomalies has not been previously reported in bovines.

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).

Extreme Tetralogy of Fallot With Polycythemia in a Ferret (Mustela putorius furo).

A 5-month-old, intact male ferret (Mustela putorius furo) was presented with apathy, tachypnea and exercise intolerance. On initial physical examination, tachypnea and cyanosis were the two primary clinical signs detected. The complete blood count also revealed a severe polycythemia, with lymphopenia, neutrophilia and eosinophilia. Further diagnostic imaging tests were performed. The thoracic radiographs revealed cardiomegaly and a diffuse alveolar pulmonary pattern. Consequently, an echocardiography was performed and showed an interventricular septal defect, pulmonic artery occlusion, overriding of the aorta and right ventricle hypertrophy. All abnormalities were compatible with a tetralogy of Fallot (TOF). As a treatment plan, a phlebotomy was performed and the ferret was posteriorly maintained with oxygen and fluid therapy. The following day, the hematocrit decreased 11% and the respiratory distress improved. Four days later, the ferret got clinically worse and was euthanized. A necropsy was performed and confirmed the presence of an extreme TOF with a diffused interstitial pneumonia secondary to Pneumocystis carinii. To the author's knowledge, this is the first report of an extreme tetralogy of Fallot with polycythemia in a ferret.

Epidemiological, clinical, and echocardiographic features and survival times of dogs and cats with tetralogy of Fallot: 31 cases (2003-2014).

OBJECTIVE To characterize the epidemiological, clinical, and echocardiographic features of dogs and cats with tetralogy of Fallot (TOF) and determine their survival times. DESIGN Retrospective case series. ANIMALS 15 dogs and 16 cats with a diagnosis of TOF as determined via echocardiography. PROCEDURES Medical records of dogs and cats were reviewed to extract information on signalment, clinical status at the time of TOF diagnosis, echocardiographic findings, and any outcome data. RESULTS The most common canine breeds were terrier types (n = 7). Most animals (28/31 [90%]) had clinical signs of TOF at the time of diagnosis, including cyanosis (16/31 [52%]). Pulmonic stenosis was characterized by a variable systolic Doppler-derived pressure gradient (median [range], 108 mm Hg [26 to 255 mm Hg]). Most ventricular septal defects were large, with a median (range) ratio of the diameter of the ventricular septal defect to that of the aorta of 0.60 (0.18 to 1.15). Median age at cardiac-related death was 23.4 months, with no significant difference between dogs and cats. Median survival time from TOF diagnosis to cardiac-related death was briefer for animals with no or low-grade heart murmur (3.4 months) than for those with higher-grade heart murmur (16.4 months). After adjustment for age and sex, having a lack of or a low- to mild-grade systolic heart murmur was significantly associated with a briefer survival time. CONCLUSIONS AND CLINICAL RELEVANCE With a few exceptions, cardiac-related death occurred predominantly in young adult dogs and cats with TOF, and most animals had severe clinical signs at the time of TOF diagnosis.

Acyanotic tetralogy of Fallot in a Persian cat.

An 8-year-old, intact male Persian cat was presented with a prominent heart murmur, exercise intolerance, anorexia, and periodontitis. There was no cyanosis and no laboratory evidence for systemic hypoxemia. Echocardiography showed a dextropositioned aorta, moderate pulmonic stenosis (maximal velocity 4.06 m/s), ventricular septal defect, and right ventricular hypertrophy. The shunt direction was predominantly left-to-right in systole and minimally right-to-left in diastole. The cat was diagnosed with acyanotic (pink) tetralogy of Fallot and was managed medically with atenolol.

Tétralogie de Fallot acyanotique chez un chat Persan. Un chat Persan mâle intact âgé de 8 ans a été présenté avec un souffle cardiaque évident, une intolérance à l'effort, de l'anorexie et une parodontite. Il n'y avait pas de cyanose ni de résultats de laboratoire indiquant l'hypoxémie systémique. L'échocardiographie a montré une aorte en dextroposition, une sténose pulmonaire modérée (vélocité maximale de 4,06 m/s), une malformation septale ventriculaire et une hypertrophie ventriculaire droite. La direction du shunt était principalement de gauche à droite en systole et minimalement de droite à gauche en diastole. Un diagnostic de tétralogie de Fallot acyanotique (rose) a été posé et a été géré médicalement à l'aide d'aténolol.(Traduit par Isabelle Vallières).

Tetralogy of Fallot in a 6-year-old albino ferret (Mustela putorius furo).

Tetralogy of Fallot associated with bidirectional shunting across a large ventricular septal defect, was found in a 6-year-old ferret. The prognosis associated with tetralogy of Fallot is usually poor. This case is interesting given the advanced age of the ferret. The bidirectional shunting, responsible for an acyanotic disease, may explain the unexpected prolonged survival in this ferret.

Tétralogie de Fallot chez un furet de 6 ans(Mustela putorius furo) . Une tétralogie de Fallot, associée à un shunt bidirectionnel au travers d'une communication interventriculaire béante, a été découverte chez un furet de six ans. Le pronostic de la tétralogie de Fallot est habituellement sombre. La survie prolongée de l'animal est intéressante. Il est probable que le shunt bidirectionnel, responsable d'une maladie acyanotique, explique l'espérance de vie prolongée de ce furet.(Traduit par les auteurs).

Tetralogy of Fallot and atrial septal defect in a white Bengal Tiger cub (Panthera tigris tigris).

A 3-week-old female white Bengal Tiger cub (Panthera tigris tigris) presented with acute onset tachypnoea, cyanosis and hypothermia. The cub was severely hypoxaemic with a mixed acid-base disturbance. Echocardiography revealed severe pulmonic stenosis, right ventricular hypertrophy, high membranous ventricular septal defect and an overriding aorta. Additionally, an atrial septal defect was found on necropsy, resulting in the final diagnosis of Tetralogy of Fallot with an atrial septal defect (a subclass of Pentalogy of Fallot). This report is the first to encompass arterial blood gas analysis, thoracic radiographs, echocardiography and necropsy findings in a white Bengal Tiger cub diagnosed with Tetralogy of Fallot with an atrial septal defect.

Increase in cardiac troponin I in a lamb with tetralogy of fallot.

This study describes a case of tetralogy of Fallot in a lamb showing failure to thrive and signs of respiratory distress. Physical examination, electrocardiography, thoracic radiographies, echocardiography and cardiac troponin I evaluation were performed. The value of cardiac troponin I was compared with the values of 10 healthy lambs of the same age and breed, and the affected animal demonstrated an increase in cardiac troponin I. Due to the poor prognosis, euthanasia was indicated, and necropsy confirmed the diagnosis. This is the first report of an increase in cardiac troponin I in a lamb with tetralogy of Fallot.

Extreme tetralogy of Fallot in a dog.

A four-month-old female Labrador retriever was brought to the Tokyo University of Agriculture and Technology Animal Medical Center for examination of its main symptoms of cough, tachypnea and exercise intolerance. Upon examination, the dog was found to have cyanosis and inadequate growth. Echocardiography revealed tetralogy of Fallot. Cardiac catheterization confirmed that the main pulmonary artery was completely occluded and that blood flowed from the aorta to the pulmonary artery. Accordingly, the animal was diagnosed with extreme tetralogy of Fallot.

Fallot's tetralogy in a European beaver (Castor fiber).

A 20-mo-old, female, 9-kg European beaver (Castor fiber) presented with apathy, reduced appetite of 3-day duration and a grade 5/6 systolic heart murmur. Thoracic radiographs revealed a diffuse broncho-interstitial pattern suspicious for bronchopneumonia. The echocardiographic findings of a hypertrophied right ventricle, ventricular septal defect with overriding aorta, and infundibular pulmonic stenosis were consistent with Fallot's tetralogy. Even though the bronchopneumonia rather than the congenital cardiac defect was considered of primary importance for the presenting clinical signs, the latter was relevant for the decision not to continue any medical treatment. Both disease processes were confirmed on necropsy. Fallot's tetralogy, European beaver, Castor fiber, heart murmur, ultrasound.

Genetic screening of the canine zinc finger protein multitype 2 (cZFPM2) gene in dogs with tetralogy of Fallot (TOF).

A recent genetic study in humans where the ZFPM2 gene was screened for mutations revealed a heterozygous mutation that was found to contribute to several sporadic cases of tetralogy of Fallot (TOF). We hypothesized that this would also hold true for a study group of dogs with TOF. We isolated the full-length cDNA of the canine ZFPM2 and aligned the deduced amino acid sequence against sequences from other species. Our analysis indicated that the canine ZFPM2 was phylogenetically much closer to the human ZFPM2 compared with the mouse or rat sequences. Further gene expression analysis also failed to identify differential gene expression between affected and unaffected dogs. We screened the cZFPM2 for mutations in a group of dogs with TOF but found no significant base changes in either the splice sites or the coding regions.

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.

Systolic anterior motion of the mitral valve associated with right ventricular systolic hypertension in 9 dogs.

OBJECTIVES: To describe the zoographic and echocardiographic characteristics of canine patients in which systolic anterior motion of the mitral valve (SAM) was identified in association with right ventricular systolic hypertension (RVSH). ANIMALS, MATERIALS AND METHODS: Medical records and digitally recorded echocardiographic examinations were reviewed for RVSH and two-dimensional (2DE) or M-mode echocardiographic evidence of SAM. RESULTS: SAM was identified in association with RSVH in 9 patients; 5 had pulmonic stenosis, 2 had tetralogy of Fallot and 2, pulmonary hypertension. Relative to body weight, the end-diastolic and end-systolic left ventricular dimensions were subnormal in all patients. Hyperdynamic left ventricular systolic performance was identified in 8 of 9 patients. In 5 of the 9 patients, SAM was mild or moderate in degree. Left ventricular outflow tract (LVOT) obstruction and mitral valve regurgitation were documented by Doppler studies in only 3 of the 4 patients with marked SAM. However, late systolic acceleration within the LVOT was recorded in 2 additional patients for whom peak velocities were normal. CONCLUSIONS: In the cases described here, the presence of SAM is likely explained by alterations in left ventricular geometry and function associated with diminished pulmonary venous return together with sympathetic activation resulting from subnormal stroke volume. Although the hemodynamic consequences were apparently minor, the association of SAM with right-sided heart disease might be of interest to those engaged in the practice of veterinary echocardiography.

Tetralogy of fallot in a Japanese macaque (Macaca fuscata).

Only a few case reports have described heart diseases in monkeys, and most cases have involved postmortem diagnosis. A newborn female Japanese macaque showed weakness immediately after birth and died 1 d thereafter. Necropsy revealed that the animal had tetralogy of Fallot and patent ductus arteriosus. This report is the first description of tetralogy of Fallot in a monkey.

Pentalogy of Fallot in a Korean Sapsaree dog.

A 5-month-old female Korean Sapsaree dog was presented with severe ascites, cyanosis, respiratory difficulty and exercise intolerance. Diagnostic imaging studies revealed a dextropositioned and over-riding aorta, pulmonary valvular stenosis, ventricular and atrial septal defects, and right ventricular hypertrophy. Based on these findings, the dog was diagnosed as a case of tetralogy of Fallot with atrial septal defect (pentalogy of Fallot). The dog was medically managed by use of diuretics and vasodilators and an occasional phlebotomy.