Right atrioventricular atresia and ventricular septal defect in a foal

Right atrioventricular atresia with a ventricular septal defect, a rare congenital cardiac anomaly of either animals or man, was diagnosed in a one week old Arabian foal. The foal had been weak and cyanotic since birth, sometimes becoming dyspneic when stressed. Necropsy revealed a dilated and hypertrophied left ventricle with the right ventricle being small. The right atrioventricular valve was absent. The right and left ventricles communicated via a septal defect which was located immediately adjacent to the aortic valve.     

Surgical correction of ventricular septal defect with aortic regurgitation in a dog

An 8-month-old entire Miniature Dachshund, weighing 4.2 kg, was presented for examination following delvelopment of a cough. Ventricular septal defect had been diagnosed tentatively in its infancy on the basis of a cardiac murmur detected by auscultation and echocardiography. Echocardiography using a B mode right parasternal long-axis view showed a defect at the atrioventricular junction and a thickened cusp of the aortic valve prolapsing into the defect. Colour-flow Doppler showed shunt blood flow across the defect at the level of the atrioventricular junction, from left to right. The sinus of Valsalva was dilated, with turbulent blood flow. Aortic regurgitation was also observed. Cardiac catheterisation studies confirmed the diagnosis of a supracristal ventricular septal defect with aortic regurgitation. Despite medication with digoxin, enalapril and aminophylin, started from the first admission, left ventricular internal dimensions gradually increased, and fractional shortening of the left ventricle gradually decreased. Surgery, with the aid of extracorporeal circulation, to close the ventricular septal defect, was performed 1 year after the initial examination. The aortic valve was left untreated. Postoperatively, the systolic murmur disappeared. Shunt flow from the left to the right ventricle was no longer observed on echocardiography, however there was still a small amount of aortic regurgitation during diastole visualised with colour-flow Doppler echocardiography. The prolapse of the cusp of the aortic valve on B-mode echocardiography was no longer observed and thickening of the cusp had not progressed. Left ventricular function measurement using M mode echocardiography showed a reduced left ventricular volume overload with reduced left ventricular internal dimensions and increased fractional shortening. The cough was relieved and no follow-up medication was scheduled. Early surgical closure of the ventricular septal defect improved the patient's condition and controlled prolapse and thickening of the aortic valve.     

Trifoliate left atrioventricular valve with and without intact septal structures in four dogs: echocardiographic findings and surgical repair

Trifoliate left atrioventricular (AV) valve with common atrioventricular junction is considered part of the spectrum of atrioventricular septal defect. This valve morphology is typically associated with defects in the AV septum resulting in communication at the atrial or ventricular level, but has also been described as an isolated defect in the setting of a common AV junction without AV septal defect. Trifoliate left AV valve exhibits a line of apposition between the bridging leaflets that is directed toward the inlet interventricular septum, distinguishing it from isolated mitral valve cleft in which the orientation of the bridging leaflets are toward the left ventricular outflow tract. The echocardiographic findings of four dogs with trifoliate left AV valve are described; two with intact septal structures and two with large ostium primum defects. Three dogs underwent open surgical repair using different approaches depending on the presence or absence of a septal defect. One of these underwent concurrent surgical repair for right AV valve dysplasia. One dog with intact septal structures underwent interventional closure of a concurrent patent ductus arteriosus. Current terminology associated with trileaflet left AV valve malformations is reviewed.     

Ventricular septal defect with aortic valve insufficiency in a New Zealand White rabbit

A heart murmur was detected in a 10 mo old, female New Zealand White rabbit. Auscultation revealed cardiac murmurs both at the left and right hemithorax. Phonocardiography confirmed the systolic-diastolic nature of the left-sided and the systolic character of the right-sided murmur. Electrocardiography showed normal sinus rhythm; tall R waves and large T waves in lead II; and deep S waves in leads II, III, and aVF. Thoracic radiography demonstrated generalized cardiomegaly with prominent pulmonary vasculature. Echocardiography revealed a perimembraneous ventricular septal defect with aortic insufficiency. Signs of biventricular volume overload, relative pulmonic stenosis, and pulmonary valve insufficiency were also seen as consequences of the defect. Necropsy demonstrated a ventricular septal defect just below the aortic valve, a dilated pulmonary trunk, dilated and hypertrophied ventricles, dilated atria, and rightward displacement of the aortic root. Cardiac histopathology showed ventricular cardiomyocyte degeneration (swelling and hypereosinophilia of the cytoplasm with a loss of cross striation, and nuclear hyperchromasia), cartilaginous metaplasia of the aorta, and subendocardial fibrosis of the right ventricular flow tract.     

Ventricular septal defect in a blue duiker (Cephalophus monticola).

A 9-mo-old female blue duiker (Cephalophus monticola) weighing 3.9 kg was diagnosed with a cardiac murmur during quarantine examination. Evaluation of the heart by auscultation, electrocardiography, two-dimensional echocardiography, and Doppler color-flow echocardiography revealed a restrictive outlet ventricular septal defect with left atrial and left ventricular dilation. Trivial mitral, tricuspid, and aortic regurgitation was also noted. Though the duiker was clinically asymptomatic at the time of cardiac evaluation, it was found dead 1 wk later. The cause of death was not determined.     

Ventricular septal defect repair in a small dog using cross-circulation

SUMMARY A haemodynamically significant ventricular septal defect was diagnosed in a 3-month-old male Cavalier King Charles Spaniel. A median sternotomy was performed and the 6.5 kg dog placed on cardiopulmonary bypass using pump-assisted cross-circulation. A 10 mm diameter peri-membranous ventricular septal defect was closed using a continuous suture of 4–0 polypropylene, via a 2.5 cm incision in the right ventricular outflow tract. The duration of cardiopulmonary bypass was 90 minutes. Complications in the immediate postoperative period were mild and easily managed.     

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.     

Ventricular septal defect in a houbara bustard (Chlamydotis undulata macqueenii)

A ventricular septal defect was found in a juvenile captive-bred houbara bustard (Chlamydotis undulata) that died suddenly. The case history indicated that the bird had a retarded growth and maturation rate. Gross pathology demonstrated massive internal hemorrhage, an enlarged heart with an interventricular septal defect, one shrunken liver lobe, and hypoplastic kidneys. Histologically, the liver was characterized by fatty degeneration, and there was hydropic degeneration of the cardiac muscle fibers. We suggest that the occurrence of this defect led to cardiac insufficiency, which resulted in sudden death caused by hemorrhage from the liver.     

Surgical repair of a complete endocardial cushion defect in a dog

Objective: To describe surgical repair of a complete endocardial cushion defect (ECD) in a dog. Study Design: Clinical report. Animal: A 5‐month‐old, 9.2 kg male Shetland sheepdog. Methods: Echocardiographic examination revealed an ostium primum atrial septal defect (ASD), an inlet ventricular septal defect (VSD), mitral regurgitation (MR) and tricuspid regurgitation (TR), and a complete ECD was diagnosed. Surgical correction was performed using cardiopulmonary bypass (CPB) via right atriotomy. A polytetrafluoroethylene (PTFE) patch was secured along the margin of the inlet VSD using simple continuous suture, then the cleft in the septal mitral leaflet was sutured. Similarly, the cleft in the septal tricuspid leaflets was sutured. To complete inlet VSD closure, the VSD patch was secured to these sutured leaflets by simple continuous suture. Another PTFE patch was used to close the ostium primum ASD. Result: After surgery, MR, TR, and interventricular shunting were decreased. The dog was alive 6 years and 5 months after the surgery with no evidence of an interventricular shunt, TR, or other clinical signs. Conclusions: Complete ECD in a dog was corrected using a 2‐patch technique under CPB.     

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.     

Pulmonary atresia and ventricular septal defect with aortopulmonary collaterals in an adult dog

Pulmonary atresia and ventricular septal defect (PA-VSD) was diagnosed in a 2-year-old castrated male Terrier mix. Transthoracic echocardiography identified a large ventricular septal defect, overriding aorta and severe right ventricular hypertrophy. A main pulmonary artery could not be identified, consistent with pulmonary atresia or persistent truncus arteriosus. Transesophageal echocardiography and angiography confirmed PA-VSD with aortopulmonary collateral circulation arising from the descending thoracic aorta. This case report describes the antemortem diagnosis of the rare congenital defect PA-VSD in an adult dog.     

Partial atrioventricular canal defect in a dog

A case of a partial atrial canal defect is described in a nine-month-old female English setter. The patient had a large ostium primum atrial septal defect and a concurrent malformation of the mitral valve. Electrocardiographic and radiographic findings were suggestive of marked enlargement of the right heart and pulmonary overcirculation. Definitive diagnosis and assessment of the haemodynamic consequences were made using echocardiography. The magnitude of the left-to-right intracardiac shunt was estimated by measuring the pulmonary to systemic flow ratio (Qp/Qs) from Doppler-derived pulmonary and aortic blood flow. The results of this report suggest that dogs with a partial atrioventricular canal defect and concurrent mild mitral regurgitation may exhibit no clinical signs during the first years of life, even in cases with a Qp/Qs ratio of greater than 2.     

Hypoplastic left ventricular syndrome in a foal

A necropsy diagnosis of hypoplastic left ventricular syndrome was made in a day-old foal. The cardiac abnormalities included mitral and aortic valve atresia, patent ductus arteriosus, and a secundum atrial septal defect. The left ventricle was hypoplastic and nonfunctional. The brief survival of the foal was a consequence of left-to-right shunting through the atrial septal defect and right-to-left shunting through the patent ductus. The information is presented to demonstrate the existence of the syndrome as a congenital defect in the horse and to clarify the necropsy findings for the practitioner to diagnose if seen.     

Coexisting tricuspid valve dysplasia and ventricular septal defect in a young patas monkey (Erythrocebus patas).

A 1.5-kg, 6-mo-old male patas monkey (Erythrocebus patas) was cyanotic and panting. Evaluation of the heart by electrocardiography, thoracic radiography, two-dimensional echocardiography, and Doppler color-flow echocardiography revealed a ventricular septal defect (VSD) with right-to-left shunting as well as tricuspid valve dysplasia with dilated annulus of the tricuspid ring, dilated right atrium, dilated right ventricle, and deformity of the tricuspid valve. Because of the severity of the cardiac disease, the patas monkey had complications recovering from anesthesia and died 3 days later. Gross postmortem findings included VSD, tricuspid dysplasia, and cerebral hemorrhage.     

Atrial septal defect in five dogs

The clinical, electrocardiographic, radiographic, and two-dimensional, M-mode and Doppler echocardiographic findings of five cases of canine ostium secundum type atrial septal defect (ASD) are described. The atrial septal anomaly was associated with other congenital cardiac abnormalities in two dogs: ventricular septal defect in one case and tricuspid dysplasia in the other. ASD was found in addition to dilated cardiomyopathy and suspected atrial thrombosis in one geriatric dog, but was the only cardiac abnormality detected in the remaining two dogs. Colour Doppler imaging facilitated the diagnosis of ASD in all subjects. The long-term prognosis for dogs with isolated and small-sized ASD is usually good, but can be compromised by the presence of concurrent congenital or acquired cardiac diseases.     

Ventricular septal defect in a ferret (Mustela putorius furo)

A four-year-old, castrated male ferret (Mustela putorius furo) was evaluated because of a one-year history of sporadic cough. On physical examination a grade 5 of 6 holosystolic murmur was audible over the right apex of the heart. Radiographic findings included the presence of air bronchograms in apical lobes accompanied by pulmonary venous congestion. Colour Doppler echocardiography revealed a left-to-right shunting compatible with a ventricular septal defect. Medical therapy was initiated at the time of the diagnosis. The ferret was presented again 2 months after the initial examination for coughing and respiratory distress. Echocardiographic findings included tricuspid regurgitation, relative enlargement of left-atrial diameter and decreased systolic function, with presence of pleural effusion. Thoracocentesis was performed and the therapeutic plan was revised. In the following months the symptoms did not recur. In the authors' opinion this is the first report to describe the clinical findings of isolated ventricular septal defect in the ferret. Congenital heart defects are rare in this species, the present ferret being only the second case described.     

First Description of Partial Atrioventricular Septal Defect in a Rabbit

Congenital heart diseases have rarely been described in rabbits. The purpose of the present case report is to describe the clinical, radiographic, echocardiographic, and pathological features of a partial atrioventricular septal defect in a pet rabbit. A 3-month-old, 380-g male vaccinated pet rabbit was presented for decreased activity, increased respiratory rate and effort, anorexia, and decreased fecal output of 2 days duration. Total body radiographic images revealed severe cardiomegaly associated with enlarged caudal pulmonary vessels and increased interstitial to alveolar lung pattern. Echocardiographic imaging showed evidence of distended heart chambers, abnormal flow through the atria, and mitral valve regurgitation. The rabbit was treated with furosemide and an angiotensin-converting enzyme inhibitor but rapidly deteriorated and died. Necropsy confirmed the dilation of both ventricles and the presence of a partial atrioventricular septal defect associated with an ostium primum atrial septal defect just over the tricuspid valve and the mitral valve.     

Right ventricular aneurysm and atrial septal defect in a cat

This case report shows the development of a right ventricular aneurysm in a cat with a large atrial septal defect. Despite this complex cardiac pathology, the cat lived normally for more than 4 years and developed fatal congestive heart failure.     

Pulmonary artery banding for ventricular septal defect in dogs and cats

Five dogs and 1 cat had pulmonary artery banding for ventricular septal defect and congestive heart failure. An umbilical tape band constricted the pulmonary artery to one-third its original diameter, increased the right ventricular pressure, and decreased the left ot right shunt. Five animals had remission of clinical signs; 1 dog died of right ventricular failure due to a band that had been applied too tightly. The results indicated pulmonary artery banding is helpful in reduction of clinical signs, due to increased flow to the lungs from ventricular septal defect.     

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.