Transcatheter closure of aneurysmal perimembranous ventricular septal defect with the canine duct occluder in two dogs

Congenital membranous ventricular septal aneurysm has been reported in dogs and can be associated with a perimembranous ventricular septal defect (VSD). The windsock-like ventricular septal aneurysm is formed by tissue of the membranous ventricular septum and portions of the septal leaflet of the tricuspid valve. We report two dogs that underwent transcatheter closure of perimembranous VSD associated with membranous ventricular septal aneurysm using a commercial device marketed for transcatheter closure of patent ductus arteriosus, the canine duct occluder. Partial closure was achieved in the first dog with reduction in left heart dimensions documented on echocardiography both at one day and nine months after procedure. In the second dog, three-dimensional transesophageal echocardiography, cardiac computed tomography, and a three-dimensionally printed whole heart model were used to evaluate feasibility for transcatheter device closure. Complete closure of the VSD was subsequently achieved. Both cases had good short- to medium-term outcomes, no perioperative complications were observed, and both dogs are apparently healthy and receiving no cardiac medications at 34 months and 17 months after procedure. Transcatheter attenuation of perimembranous VSD with membranous ventricular septal aneurysm is clinically feasible using the canine duct occluder, and multimodal cardiac imaging allows accurate assessment and planning prior to transcatheter intervention for structural heart disease in dogs.     

Detachable Coils for Occlusion of Patent Ductus Arteriosus in 2 Dogs

OBJECTIVE: To describe the use of a detachable coil for transcatheter closure (TCC) of patent ductus arteriosus (PDA) in 2 dogs. STUDY DESIGN: Clinical study. ANIMALS: Two female Pembroke Welsh Corgi dogs with PDA. METHODS: Using fluoroscopic guidance, an 8-mm-diameter coil stent with 5 loops (detachable coils for PDA closure) was inserted via catheterization of the femoral artery. The catheter was passed through the PDA into the pulmonary artery. The coil was withdrawn so that 1.5 loops remained on the pulmonary side of the orifice of the ductus. The rest of the loops were pushed out from the catheter into the ductus. After confirming the correct placement of the coil and the effectiveness of the occlusion, the delivery wire was detached from the coil. RESULTS: Insertion of the coil was easily performed, even without previous experience. Immediate and marked decrease of the cardiac murmur was auscultated. Only slight residual flow was detected by angiography conducted 3 months' postoperatively. The dogs experienced quick and uneventful recovery after coil placement and required minimal postoperative care. Follow-up evaluation of the dogs showed no functional clinical signs of PDA, and no cardiac abnormalities were detected on electrocardiographic, phonocardiographic, and echocardiographic examination. In dog 1, the residual flow had disappeared on the color-flow Doppler echocardiographic examination at 18 months' postoperatively. CONCLUSION: TCC using a detachable coil was easy, safe, and effective in 2 dogs with PDA. The minimal residual shunting observed only by echocardiography seemed hemodynamically insignificant. CLINICAL RELEVANCE: This method can be used as an alternative to traditional surgical methods.     

Percutaneous transcatheter coil embolization of a ventricular septal defect in a dog

A 4-month-old male French Bulldog weighing 5.0 kg (11 lb) was referred for a heart murmur. A grade 3/6 systolic murmur was detected at the left heart base and a grade 4/6 systolic murmur was detected at the right heart base. By use of color-flow Doppler ultrasonography and cardiac catheterization, a diagnosis of supracristal ventricular septal defect (VSD) with accompanying aortic regurgitation was made. Percutaneous transcatheter coil embolization was used to close the VSD. Because residual shunt was detected via echocardiography after coil implantation, the residual shunt was followed periodically via echocardiography to detect spontaneous closure of the VSD. Volume overload in the left ventricle was detected in the dog 131 days after admission. Additional coils were placed 137 days after admission. Hemolysis resulting in hemoglobinuria was detected, but this complication was mild. In the dog of this report, results of coil occlusion for correction of VSD were promising. Thus, coil occlusion should be considered as an alternative treatment for VSD in dogs.     

Coil embolization of patent ductus arteriosus via the carotid artery in seven dogs

This study was designed to evaluate the feasibility and limitations of transcatheter embolization coil occlusion of patent ductus arteriosus in dogs using a carotid artery approach. Seven dogs examined at the University of California, Davis Veterinary Medical Teaching Hospital in 2002-2003 for evaluation of heart disease had congenital patent ductus arteriosus diagnosed by characteristic physical, electrocardiographic, radiographic, and anatomic and Doppler echocardiographic findings. Dogs were anesthetized for transesophageal echocardiography and transcatheter coil embolization of the ductus via the right external carotid artery. Coil embolization was achieved in all seven cases, using one to four detachable embolization coils. There were no major complications. Minor complications occurred in two dogs (additional coils placed using a femoral arterial approach and coil embolization of a left femoral artery branch). One dog was examined only 24 h post-operatively and had no murmur and trivial residual ductal flow by Doppler echocardiography. The other 6 dogs were clinically healthy when examined up to three years post-intervention. One dog had a very soft continuous murmur and mild residual ductal flow; the other five had no audible continuous murmur, with only one dog having trivial residual ductal flow identified by Doppler echocardiography. Although technically challenging, coil embolization via the carotid artery is a viable alternative approach for transcatheter closure of patent ductus arteriosus in some dogs.     

Transvenous coil embolization of patent ductus arteriosus in small (≤3.0 kg) dogs

Background: Surgical and interventional therapy for occlusion of a patent ductus arteriosus (PDA) in small dogs is challenging. Interventional closure of a PDA is rarely described in small dogs. Hypothesis: Transvenous single‐coil occlusion of a PDA in small (≤3.0 kg) dogs is possible and safe. Animals: Twenty‐one client‐owned dogs with a left‐to‐right shunting PDA. Methods: Prospective clinical study. Inclusion criteria were a left‐to‐right shunting PDA and a body weight ≤3.0 kg. Dogs with additional congenital cardiac diseases were excluded. Without arterial access, a single detachable coil was implanted by a transvenous approach with a 4 Fr catheter. Results: Twenty‐one dogs were the study population with Chihuahua and Yorkshire Terrier being the commonest breeds (n = 6 and n = 5, respectively). There were 14 female and 7 male dogs. The age range was 1.9–83.5 months (median, 7.7 months), and the body weight was 1.0–2.9 kg (1.87 ± 0.45). By angiography, the minimal ductal diameter measured 1.2–2.4 mm (median, 1.8 mm) and the PDA ampulla diameter was 2.4–5.9 mm (median, 4.6 mm). Coil implantation was successful in all dogs. After detachment of the coil from the delivery cable, repositioning of the pulmonary loop of the coil became necessary in 1 dog. The prevalence of immediate closure was 76%. The prevalence of cumulative closure was 90%. Conclusion: For an experienced cardiologist, transvenous occlusion of a PDA in small dogs is possible with a 4 Fr catheter and a commercial single detachable coil. Arterial access is not essential. The procedure is safe and successful in experienced hands.     

Catheter closure of patent ductus arteriosus in dogs: variation in ductal size requires different techniques

Background:Catheter closure of patent ductus arteriosus Botalli (PDA) is increasingly replacing traditional surgical ligation via thoracotomy. A variety of techniques have been described in dogs, although the technique and implant chosen may depend on the minimum ductus diameter.Objectives:To evaluate the feasibility and treatment of choice of catheter closure of large and small PDAs in dogs.Methods:In 16 dogs with a PDA, catheter closure was performed using transarterial embolisation using detachable or free coils, or transvenously using an Amplatzer, duct occluder (ADO).Results:In 8 dogs, closure of PDA with a minimum diameter of < 4 mm was achieved using detachable coils; 2 or more coils were required in 3 dogs. In 5 dogs with minimum ductus diameters of > 4 mm, detachable coils were not applicable. In one of these dogs, (incomplete) surgical ligation was performed and later a free coil placed for complete closure. In 2 dogs with moderately large PDA (5 mm), several free coils were implanted. Complete closure was not achieved in either dog and transient haemolysis occurred as a complication. In 2 dogs with a very large PDA (6 mm), implanted free coils embolised to pulmonary arteries and closure was then achieved using an ADO. In 3 dogs with an excessively large PDA (7.5-10 mm) closure was successfully achieved using an ADO with no complications.Conclusions:Coil embolisation is readily feasible for closure of PDA < 4 mm, less feasible for PDA < 5 mm and unlikely to be feasible to close PDA > 5 mm. Detachable coils are safe for PDA < 4 mm, and the ADO is an excellent device for PDA > 5 mm.     

Transvenous embolization of small patent ductus arteriosus with single detachable coils in dogs

Transvenous embolization of small patent ductus arteriosus (PDA; < or = 4 mm) with a single detachable coil was attempted in 24 dogs (median age 5.7 months, range, 2.6-65.5 months; median body weight 5.5 kg, range, 1.5-30.0 kg). Angiographic imaging of the duct and pressure measurements were made before and after embolization. The minimal ductal diameter was 2.7 +/- 0.7 mm. In all dogs, a single coil was employed regardless of residual shunting. Ten dogs (PDA minimal diameter range, 1.5-2.2 mm) received a 5-mm coil, and 14 dogs (PDA minimal diameter range, 2.9-3.6 mm) received a 8-mm coil. After coil embolization the angiographic shunt grade decreased significantly (n = 20, P < .001). Residual shunts were assessed by angiography 15 minutes after and by Doppler echocardiography 1-3 days and 3 months after the intervention. In the dogs treated with the 5-mm coils the residual shunt rate was low (0%, 10%, and 0% for angiography and Doppler echocardiography at 1-3 days and 3 months, respectively), in contrast to the dogs treated with the 8-mm coils (91%, 79%, and 67% for angiography and Doppler echocardiography at 1-3 days and 3 months, respectively). After 3 months, no residual murmur was found in dogs treated with the 5-mm coils (0/7), in contrast to murmurs in 5 of 12 (42%) dogs treated with the 8-mm coils. Despite incomplete closure in these dogs, volume loading of the left heart decreased in all dogs. Pulmonic or aortic coil embolism did not occur. Analysis of initial results shows that single detachable coil embolization is possible in all dogs with a small PDA (< or = 4 mm), but only very small PDA (< or = 2.5) could be treated effectively, and for the moderate PDA (2.6-4.0 mm) longer coils or multiple coils may be necessary to achieve complete occlusion.     

Long-term follow-up after transvenous single coil embolization of patent ductus arteriosus in dogs

Background: Long‐term follow‐up studies after interventional therapy of patent ductus arteriosus (PDA) in dogs are rare. Hypothesis: Transvenous PDA embolization with a single detachable coil is a highly effective method in patients with an angiographically determined PDA ≤ 4.0 mm. Animals: Twenty‐eight dogs with an angiographic PDA ≤ 4.0 mm were included. Methods: Prospective follow‐up study after PDA coil embolization. Results: The median follow‐up time was 792 days (range, 2–3, 248 days). The rate of complete closure demonstrated by Doppler color flow was 54% at day 3 after intervention and the final cumulative rate was 71%. The rate of complete closure was significantly different between small and moderately sized PDA over the study period (P < .0001) and finally was 100 and 50%, respectively. In 16 dogs with complete closure, no recanalization was found. Disappearance of the continuous heart murmur was found in 89% after 3 days, and this increased to a final cumulative rate of 96%. Indexed left ventricular internal diameter in diastole (LVDd‐I) decreased significantly (P < .0001). In the group with moderately sized PDA, a significant difference (P= .0256) was seen in LVDd‐I between patients with and without residual shunt after exclusion of patients with persistent severe mitral valve regurgitation. Conclusion and Clinical Importance: Long‐term follow‐up after single coil embolization showed complete closure in all small PDA but a residual shunt with mild hemodynamic consequences was present in half of the moderately sized PDA.     

Transcatheter Atrial Septal Defect Closure with the AMPLATZER® Atrial Septal Occluder in 13 Dogs: Short- and Mid-Term Outcome

Background: Transcatheter atrial septal defect (ASD) closure in the dog was first reported in 2005.
Objectives: Describe the technique and both short- and mid-term outcome of transcatheter ASD closure with the Amplatzer^® atrial septal occluder (ASO).
Animals: Thirteen client-owned dogs with ASD.
Methods: Records of the initial 13 dogs in which transcatheter ASD closure was attempted at Texas A&M University were reviewed.
Results: All dogs had hemodynamically relevant septum secundum ASD. Two dogs had concurrent congenital abnormalities. ASOs were deployed in 13 dogs and released in 12. Eleven were released by a right jugular approach and 1 by a transatrial approach through a right lateral thoracotomy. Transthoracic echocardiographic estimates of ASD size were 14.0 ± 5.4 mm (mean ± 1 standard deviation) with a range of 7–22 mm. Accidental right atrial release occurred in 1 dog and embolization after release occurred in 2 dogs. Transcatheter ASD closure was successful in 10 dogs. Transthoracic color Doppler echocardiography the day after ASD closure indicated complete occlusion in 5 dogs, trivial to mild residual shunting in 4 dogs, and moderate residual shunting in 1 dog. Follow-up echocardiograms (mean of 12.4 ± 7.4 months postprocedure) were available for 9 dogs. There was no residual ASD shunting in 6 dogs. In 3 of the 5 dogs with postoperative residual shunting it was judged to be decreased and hemodynamically unimportant relative to the dogs' postoperative evaluations. The mean length of event-free survival in the 10 dogs that underwent successful transcatheter ASD closure was 22.2 ± 10.2 months.     

Closure of a persistent ductus arteriosus of Botallo in two dogs using transarterial coil embolization

Non-surgical occlusion of persistent ductus arteriosus (PDA) by catheter guided coil embolisation was performed in two dogs. In both dogs the procedure was performed through the femoral artery. The exact location and the narrowest diameter of the PDA were evaluated angiographically after contrast medium injection into the ascending aorta. Based on shunt diameter measurements of 4 mm in dog no. 1 and 2.4 mm in dog no. 2, a coil of 8 mm diameter was chosen for dog no. 1, and of 5 mm diameter for dog no. 2. The coils were placed within the shunt vessel under fluoroscopic guidance using the Cook delivery-system for detachable PDA coil. The success of the intervention was documented angiographically 10 minutes after coil release. The shunt vessel was completely occluded in dog no. 1, while minimal blood flow was detected in dog no. 2 at that time. The technique of transvascular PDA closure compares favorably with the traditional surgical technique due to minimal invasiveness and hence excellent postinterventional comfort to the patient.     

Hybrid technique for ventricular septal defect closure in a dog using an Amplatzer® Duct Occluder II

A left-to-right shunting muscular ventricular septal defect (VSD) was diagnosed in a 4-month-old, female, 1.8 kg Bichon Frise – poodle mix dog. Echocardiographic evidence of cardiac remodeling, calculated pulmonary blood flow (Qp) to systemic blood flow (Qs) ratio of 2.8, and radiographic evidence of pulmonary edema supported the diagnosis of a hemodynamically important VSD. Using a combination of surgery and interventional catheter-based techniques to approach the VSD through the right ventricle, the VSD was occluded with an Amplatzer^® Duct Occluder (ADO) II device. The ADO II is a low profile, flexible device originally developed for patent ductus arteriosus closure in humans that has been used to close muscular and perimembranous VSD in children. This report describes the hybrid procedure and imaging that was essential for successful occlusion of the VSD in this dog.     

Transcatheter closure of patent ductus arteriosus using occluding spring coils

The purpose of this study is to report our initial experience with the use of spring coils to close the patent ductus arteriosus in the dog. There are few large-patient series reported in the veterinary literature. Coil closure was attempted in 15 dogs (median weight, 6.5 kg; range, 1.2 to 38.7 kg) presenting with a patent ductus arteriosus between May 1997 and May 1999. Arterial catheterization followed by angiography was used to decide if coil placement was adequate. A 5- or 8-mm embolization coil, depending on the angiographic diameter of the ductus, was delivered, with 1 loop in the pulmonary arterial side and the remainder of the coil in the aortic side of the duct. Additional coils were used if a residual shunt was present, and closure was confirmed by aortography. Patients were discharged the day after the procedure. Successful coil closure, without residual shunt on angiography, was achieved in 11 of 13 dogs in which coils were released. In 6 dogs, a coil embolized to the pulmonary artery. Four of these dogs had successful closure with multiple coils, and 2 others had surgery. None of these dogs experienced adverse effects. In 2 dogs with conical patent ductus arteriosus >5 mm in minimal diameter, coil closure was not done. We conclude that the patent ductus arteriosus size and anatomical shape are crucial in deciding whether coil closure is the method of choice. In selected cases, coil closure represents an elegant alternative to surgical ligation. Although pulmonary embolism occurred commonly, it did not cause any obvious clinical problem.     

Comparison of right atrium incision and right ventricular outflow incision for surgical repair of membranous ventricular septal defect using cardiopulmonary bypass in dogs

OBJECTIVE: To compare right atrium incision (RAI) and right ventricular outflow incisions (RVI) for surgical repair of membranous ventricular septal defect (VSD) facilitated by cardiopulmonary bypass (CPB). STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=10) with VSD. METHODS: Medical records of dogs that had VSD repair were reviewed. Membranous VSD without any malformation and abnormality was confirmed on several clinical examinations and by angiocardiography. RAI (5 dogs) and RVI (5 dogs) was used for VSD access and repair facilitated by CPB. Procedure comparison was by surgical duration, postoperative recovery period, and occurrence of postoperative arrhythmia. RESULTS: Duration of surgery was similar for RAI and RVI; however, postoperative recovery time was significantly reduced with RAI. Significant moderate operative damage occurred with right atrium incision. CONCLUSIONS: Right atrium incision was more effective than RVI for repair of membranous VSD using CPB. CLINICAL RELEVANCE: RAI should be considered in preference to RVI for repair of membranous VSD using CPB.     

Transcatheter closure of patent ductus arteriosus in 11 dogs and one cat after incomplete or aborted surgical ligation

ObjectiveTo describe the characteristics and outcomes of transcatheter patent ductus arteriosus (PDA) occlusion after incomplete or aborted surgical ligation in dogs and cats.AnimalsTwelve client-owned animals (11 dogs and one cat).Materials and methodsThis retrospective study describes data from animals with aborted or incomplete surgical PDA ligation that subsequently underwent transcatheter closure using endovascular methods. Patient demographics, reason for incomplete or aborted surgery, complications, and method of transcatheter occlusion were recorded. Data are presented as mean ± standard deviation or median (interquartile range), where appropriate.ResultsFor all cases, median age at surgery was 12.2 months (4.9–15.1 months) and at catheterization was 15.4 months (8.9–21.9 months), with 79 days (29–209 days) between surgical and interventional procedures. Median weight at catheterization was 4.5 kg (2.5–12.6 kg). Reasons for failed surgical ligation included hemorrhage during ductal dissection in seven dogs, residual flow in four dogs, and inability to identify the ductus in one cat. Transcatheter closure was successfully performed using a canine duct occluder in eight dogs, transarterial coil embolization in two dogs, and transvenous coil embolization in one dog and one cat. Metallic hemoclips partially obscured angiographic findings in three cases with prior surgical hemorrhage but did not prevent transcatheter closure. In all cases, ductal flow was successfully attenuated, with no or trace residual shunting on angiography and complete occlusion the following day on echocardiography.ConclusionsWhen surgery is unsuccessful, either owing to hemorrhage or residual flow, transcatheter closure of PDA is feasible, even in small patients.     

Transvenous detachable coiling of patent ductus arteriosus in small dogs

ObjectiveTo report on transvenous detachable coiling in small dogs deemed ineligible for traditional transarterial patent ductus arteriosus occlusion and compare transthoracic echocardiographic and angiographic measurements to determine their equivalence.Materials and methodsA retrospective study of 35 dogs that underwent transvenous coiling of a patent ductus arteriosus. Demographic information, echocardiographic and angiographic studies, surgery reports, and follow-up evaluation of residual flow were obtained. A Bland-Altman analysis was used to compare echocardiographic and angiographic measurements of the minimal ductal diameter (Echo-MDD, Ang-MDD) and ampulla diameter (Echo-A, Ang-A).ResultsThirty-four of 35 dogs had successful deployment of a coil, with one dog undergoing occlusion with a different device after the exteriorized coil pulled through the ductus. Complete occlusion was achieved in 18 dogs within 24 h; four dogs were lost to follow-up, and the remaining 12 dogs had no residual flow or a significant reduction in shunting with normalization in cardiac chamber dimensions by a median of 99 days. Thirty percent of dogs (11/35) experienced perioperative complications of which 10 were minor complications. The analysis of 26 dogs with both echocardiographic and angiographic ductal measurements showed a −0.14 mm mean difference (95% limits of agreement −1.08 to 0.8 mm) in minimal ductal diameter and −0.68 mm mean difference (95% limits of agreement −2.73 to 1.37 mm) in ampulla diameter.ConclusionsDogs less than 3 kg deemed too small for transarterial occlusion can successfully undergo transvenous coil embolization of patent ductus arteriosus.     

Utility of Transesophageal Echocardiography for Transcatheter Occlusion of Patent Ductus Arteriosus in Dogs: Influence on the Decision‐Making Process

Background: Appropriate device selection for transcatheter occlusion of patent ductus arteriosus (PDA) is essential to procedural success. Objectives: To determine if transesophageal echocardiography (TEE) influences device selection for PDA occlusion and to report benefits, limitations, and complications associated with TEE. Animals: Twenty‐two client‐owned dogs with left‐to‐right shunting PDA. Methods: PDA dimensions were obtained via transthoracic echocardiography (TTE) and then TEE followed by angiography. Based solely on information from TTE and angiography, an initial device type and size were selected. After initial device selection, TEE measurements were disclosed and changes in device selection were recorded. After device release, angiography, TEE, or both were performed to assess occlusion. Results: An Amplatz canine duct occluder (ACDO) was securely positioned and released in 21 dogs and an embolization coil was deployed in 1 dog. Based on TEE evaluation, initial selected device type was unchanged but ACDO size was changed in 3 dogs. TEE was utilized throughout the procedure allowing real time visualization of device deployment, release and assessment of closure in 17 dogs. No complications occurred related to TEE. Complete PDA closure was achieved in all dogs. Conclusions and Clinical Importance: TEE provided anatomic information regarding PDA morphology that closely approximated angiographic ductal dimensions while aiding in device deployment, release and confirmation of closure. We conclude that TEE provides complementary anatomical and intraprocedural information and is well tolerated in dogs.     

Echocardiographic diagnosis of congenital membranous ventricular septal aneurysm in the dog and cat

Membranous ventricular septal aneurysm was diagnosed by echocardiography in 17 dogs and three cats. The aneurysm appeared as a thin membrane protruding into the right ventricle from the margins of a congenital ventricular septal defect (VSD). The aneurysm was intact in nine dogs and two cats and perforated by a small VSD in eight dogs and one cat. Other congenital heart defects were present in seven dogs. In all animals, the aneurysm was an incidental finding observed during echocardiographic examination, and it did not appear to directly cause any cardiac dysfunction.     

Closure of large patent ductus arteriosus with a self-expanding duct occluder in two dogs

Of the different catheterisation methods described for closure of patent ductus arteriosus (PDA), coil embolisation is most commonly used in dogs. However, for a PDA larger than 4 to 5 mm in diameter, coil implantation is difficult. For these cases, the Amplatzer duct occluder (ADO) offers an alternative method. This report describes the successful implantation of an ADO in two dogs with large PDAs of approximately 6 mm diameter. The self-expandible device attached to an implantation wire was advanced through a long sheath antegrade to the femoral vein through the right heart and pulmonary artery to the duct and delivered into the PDA. Thereafter the device was released by unscrewing it from the delivery cable. The large PDA in both dogs was totally occluded by these means without any residual shunt. Thus, the ADO is a controlled release implant that also allows occlusion of a large PDA. Its high costs limit its general use in veterinary medicine at the present time.     

Effectiveness of a bipolar vessel sealant device for sealing uterine horns and bodies from dogs

OBJECTIVE: To compare the bursting strength of a vessel sealant device (VSD) with that of an encircling suture on uterine horns and bodies from dogs. SAMPLE: Uteri from 24 shelter dogs with unknown reproductive histories. PROCEDURES-Uterine horns and bodies were allocated to groups to be sealed with suture or a VSD. Uteri were then infused with saline (0.9% NaCl) solution until the seals burst or the uteri reached a maximal pressure of 300 mm Hg. Variables recorded included dog age, uterine body and horn diameter, and maximal pressure. RESULTS-The median (range) bursting pressure reached in sealed uterine horns was 300 (0 to 300) mm Hg for the VSD group and 300 (200 to 300) mm Hg for the suture group. Within the VSD group, seals of 2 of 3 uterine horns with a diameter ≥ 9 mm burst before intraluminal pressure reached 100 mm Hg, compared with 1 of 21 uterine horns with a diameter < 9 mm. The median bursting pressure for uterine bodies was 237 (0 to 300) mm Hg for the VSD group versus 300 (175 to 300) mm Hg for the suture group. Within the VSD group, seals in uterine bodies with a diameter ≥ 9 mm failed at a significantly lower pressure (125 [0 to 125]) mm Hg than those with a diameter < 9 mm (275 [125 to 300]) mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE-The failure pressure for both sealing techniques was high, which indicated that the VSD may be a safe instrument for sealing the uterine horn in dogs. Given the low mean bursting pressure for seals in uterine bodies with large diameters, the VSD cannot be recommended for sealing uterine bodies ≥ 9 mm in diameter.     

Interventional Closure of a Patent Ductus Arteriosus Using an Amplatz Canine Duct Occluder in an Alpaca Cria

A 6‐month old female alpaca cria presented to The Ohio State University for evaluation of a cardiac murmur. Echocardiography revealed a left‐to‐right shunting patent ductus arteriosus, a restrictive left‐to‐right shunting perimembranous ventricular septal defect, and secondary moderate left atrial and ventricular dilation. Aortic root angiography demonstrated a type IIA patent ductus arteriosus (PDA). Interventional closure of the PDA was successfully performed, without complication, using an Amplatz canine duct occluder. This case report describes the materials and methods used for interventional closure of a PDA in an alpaca cria.