Coil Occlusion of Patent Ductus Arteriosus in a 12 week old Miniature Dachshund
This case presents a 10 week old male intact Dachshund canine presented to Cornell University’s Cardiology service on 07/17/18 after being referred for a grade V/VI heart murmur and suspected patent ductus arteriosus. This was an incidental finding at a routine veterinary visit; at home the patient had been acting like a normal puppy with no episodes of cyanosis or syncope. On presentation to the Cardiology service the patient was bright, alert and responsive. Cardiac auscultation revealed a grade V/VI continuous heart murmur with palpable thrill, loudest at the left heart base. The rest of the physical exam was within normal limits. An echocardiogram was performed, which showed severe left ventricular enlargement and moderate left atrial enlargement. Color Doppler showed continuous flow through an anatomical structure connecting the aorta and pulmonary artery. These findings were consistent with a patent ductus arteriosus (PDA) which was measured to be approximately 4.0-4.5 mm in diameter. The patient was scheduled for an endovascular procedure. The challenge was in deciding if a catheter of the appropriate size to occlude the PDA would be able to pass transarterially in such a small patient. It was decided that the transarterial approach would be attempted and if unsuccessful a thoracotomy and ligation would be performed. A catheter was placed from the right femoral artery and seated to the PDA, and two Flipper Detachable Embolization coils were placed in the ductus. Placement was confirmed with fluoroscopy and transesophageal echocardiography, and blood pressure normalized intra-operatively after the coil was placed. A post-operative echocardiogram showed occlusion of the PDA, but with mild residual blood flow. A one month recheck echocardiogram was scheduled, however the patient was lost to follow up.