RESUMEN CORTO - SHORT SUMMARY:

Introduction

Pulmonary atresia is characterised by a complete absence of flow from the heart to the lungs via the pulmonary artery. It is divided into two anatomical types, with an intact ventricular septum (PA-IVS) or with a ventricular septal defect (PA-VSD)(1). This is the first reported echocardiographic and computed tomography angiography (CTA) description of PA-IVS in a dog.

Clinical case description

Two puppies, a five-month-old female entire English cocker spaniel and a 12-week-old female entire Miniature Schnauzer, were diagnosed with complex congenital heart disease. The pulmonary trunk and branch pulmonary arteries were not visible using standard echocardiographic views in either dog. In the first case, transthoracic echocardiography identified a patent foramen ovale and severe right ventricular hypertrophy. CTA confirmed pulmonary atresia with intact ventricular septum with complex collateral circulation serving as a primary source of pulmonary blood flow. No specific treatment was initiated, and the dog remained well for two years, however, with intermittent, mild dyspnoea during heavy exercise. She died suddenly during an episode of respiratory distress at home at the age of 2 years and 5 months. The second case suffered cardiac arrest following sedation for further imaging and had a post-mortem diagnosis of pulmonary atresia, but without an intracardiac shunt; a patent ductus arteriosus serving as the only source of pulmonary blood flow.

Discussion and conclusion

These case reports illustrate that a complex and cyanotic congenital heart disease such as PA-IVS may be found in the relatively clinically well dog with a remarkably long survival (case 1).

Bibliography

1. Leonard H, Derrick G, O’Sullivan J et al: Natural and unnatural history of pulmonary atresia. Heart. 2000;84(5):499–503.

BIBLIOGRAFÍA:

1. Daubeney PE, Sharland GK, Cook AC et al: Pulmonary atresia with intact ventricular septum: impact of fetal echocardiography on incidence at birth and postnatal outcome. UK and Eire Collaborative Study of Pulmonary Atresia with Intact Ventricular Septum. Circulation. 1998 ;98(6):562-6.

2. Oliveira P, Domenech O, Silva J, et al: Retrospective Review of Congenital Heart Disease in 976 Dogs. Journal of Veterinary Internal Medicine 2011; 25(3):477–83.

3. Markovic LE, Scansen BA, Potter BM: Role of computed tomography angiography in the differentiation of feline truncus arteriosus communis from pulmonary atresia with ventricular septal defect. Journal of Veterinary Cardiology 2017; 19(6):514–22.

4. Tou SP, Keene BW, Barker PCA: Pulmonary atresia and ventricular septal defect with aortopulmonary collaterals in an adult dog. Journal of Veterinary Cardiology 2011; 13(4):271–5.

5. Patterson DF, Pyle RL, van Mierop L et al: Hereditary defects of the conotruncal septum in keeshond dogs: Pathologic and genetic studies. The American Journal of Cardiology. 1974;34(2):187–205.

6. Fukushima R, Yoshiyuki R, Machida N et al: Extreme tetralogy of Fallot in a dog. Journal of Veterinary Medical Science. 2013;75(8):1111–4.

7. Nakade T, Uchida Y, Otomo K. Three Cases of Bovine Extreme Tetralogy of Fallot. Journal of Veterinary Medical Science. 1993;55(1):161–7.

8. Stieger-Vanegas SM, Scollan KF, Meadows L et al: Cardiac-gated computed tomography angiography in three alpacas with complex congenital heart disease. Journal of Veterinary Cardiology. 2016;18(1):88–98.

9. Zuberbuhler JR, Anderson RH. Morphological variations in pulmonary atresia with intact ventricular septum. Heart. 1979;41(3):281–8.

10. Leonard H, Derrick G, O’Sullivan J et al: Natural and unnatural history of pulmonary atresia. Heart. 2000;84(5):499–503.

11. Rajiah P, Nazarian J, Vogelius E et al: CT and MRI of pulmonary valvular abnormalities. Clin Radiol. 2014;69(6):630–8.

PULMONARY ATRESIA WITH AN INTACT VENTRICULAR SEPTUM IN TWO DOGS