Jamie was a 6 and a half week-old puppy when she was first brought to Dr. Chuck Noonan at Animal Doctors of Weston. She was acting normally and seemed to have had no issues in her first weeks of life. Dr. Noonan examined her and listened to her heart only to discover a significant heart murmur that was continuous throughout her heartbeat cycle. Dr. Noonan astutely recognized that this was likely a very significant heart defect that she was likely born with and recommended that Jamie’s mother take her to a veterinary cardiologist.
A week later, Jamie was seen by Dr. Mandi Kleman, a board-certified veterinary cardiologist at Cornell University Veterinary Specialists. Dr. Kleman performed an echocardiogram (ultrasound of the heart), which revealed a structural abnormality called a patent ductus arteriosus (PDA). A PDA is a congenital cardiac abnormality in which a connection exists between the aorta (the major systemic artery) and the pulmonary artery (the major vessel to the lungs). This abnormal connection results in the heart becoming overloaded by recirculating blood and typically results in heart failure within the first year of life. It was imperative, therefore, that we correct Jamie’s PDA.
There are 2 ways to correct PDAs. The first is via open chest surgery, to locate and ligate (tie off) the abnormal PDA vessel. This is the traditional method. The second option is to occlude (close off) the PDA vessel via an Interventional Radiology technique. Interventional Radiology is a method of surgery that uses video xrays (fluoroscopy) to allow the surgeon to see into the body and manipulate structures. This is a new technique in veterinary medicine, available at few academic and specialty institutions, including Cornell University Veterinary Specialists. The advantages of these techniques are that they are less invasive; there is no open surgery and thus, less pain and a faster recovery. For PDA correction via Interventional Radiology, an Amplatz ductal occluder or embolic coil can be inserted via a blood vessel until it is placed across the abnormal PDA vessel. The device then causes obstruction of blood flow across the PDA.
Here, at CUVS, both techniques are possible. In Jamie’s case, however, it was decided that surgery was her best option given her very small size. Dr Oli Morgan, staff surgeon at Cornell University Veterinary Specialists, performed the surgery - a left lateral thoracotomy via the 4th intercostal space. The PDA was carefully dissected and ligated, restoring normal blood flow. Jamie recovered smoothly in the Intensive Care Unit. Her heart murmur resolved. That evening she was already standing and eating! The next day, she was giving kisses and behaving like a puppy again. She was discharged to her owners care for at home recovery. After two weeks of exercise restriction she was healed. Her prognosis is excellent with a normal life expectancy.
