Clinical findings, surgical treatment and long‐term outcome of dogs and cats with double aortic arch: four cases (2005–2022)

Abstract

Objective To describe the clinical presentation, diagnostic findings, treatment and long‐term outcome following surgery of dogs and cats undergoing surgical treatment for a double aortic arch. Materials and Methods Medical records of dogs and cats diagnosed with a double aortic arch between 2005 and 2022 at three small animal referral hospitals were retrospectively reviewed. Long‐term outcome was assessed by a clinical examination and/or by contacting the owners or referring veterinarians. Results Two dogs and two cats were included. Regurgitation after eating, stunted growth and poor weight gain were the predominant clinical features. All animals had thoracic radiography and oesophagography; a dilation of the cranial thoracic oesophagus cranial to the heart base, was described in all animals. CT angiography confirmed double aortic arch in three of these and the right aortic arch was larger and appeared more well developed compared with the left aortic arch in all based on CT or surgical findings. Surgery was performed via a left fourth intercostal thoracotomy; ligation and transection of the lesser left aortic arch was performed. Follow‐up time ranged from 360 to 1563 days. All animals showed a marked improvement during the postoperative period, and all gained weight gradually. Owners' perception of the surgical procedure outcome and quality of life was described as excellent for all animals. Clinical Significance Surgical ligation of the lesser aortic arch in dogs and cats with double aortic arch is associated with a favourable prognosis for recovery, resolution of clinical signs, and quality of life with only minor feeding modifications.

Computed tomographic features of double aortic arch in six dogs

“…However, the most common features associated with a DAA in this cohort included the following: a dominant have often been documented at the time of corrective surgery. 9,10,16 In this cohort of dogs, half had persistent esophageal constriction due to residual extraluminal fibrous bands that required further surgical dissection and balloon dilation. Additionally, a partial esophagectomy was performed concurrently in one dog (Case 2) in order to excise redundant esophageal tissue that occurred secondarily.…”

“…The development of such sequelae may contribute to persistent cranial esophageal dilation and sacculation following surgical ligation and transection of the minor aortic arch, often resulting in impaired esophageal motility that may have variable degrees of clinical resolution, including a lifelong risk of aspiration pneumonia. 4,9,10,16 Respiratory signs, such as coughing, stridor, wheezing, and dyspnea have also been reported in patients with DAA, supposedly secondary to either entrapment of the trachea by the vascular ring or concurrent aspiration pneumonia. 4,[9][10][11] However, despite the common prevalence and variable degrees of tracheal narrowing noted on CTA images in this study, only three dogs presented with the initial clinical sign of coughing, of which, all were diagnosed with aspiration pneumonia by their referring veterinarians based on radiographic findings.…”

“…4,9,10,16 Respiratory signs, such as coughing, stridor, wheezing, and dyspnea have also been reported in patients with DAA, supposedly secondary to either entrapment of the trachea by the vascular ring or concurrent aspiration pneumonia. 4,[9][10][11] However, despite the common prevalence and variable degrees of tracheal narrowing noted on CTA images in this study, only three dogs presented with the initial clinical sign of coughing, of which, all were diagnosed with aspiration pneumonia by their referring veterinarians based on radiographic findings. Additionally, the patient with the greatest degree of tracheal luminal diameter reduction (Case 6, −64.0%) did not have reported clinical signs of coughing.…”

“…In dogs, double aortic arch (DAA) is a rare, congenital vascular ring anomaly (VRA) infrequently published in the veterinary literature. [1][2][3][4][5][6][7][8][9][10][11][12] During normal embryological development, six symmetrical pairs of aortic arches develop from the aortic sac and fuse the right and left dorsal aortae. These vessels undergo selective regression and trans-Abbreviations: ACVR, American College of Veterinary Radiology; CTA, computed tomography angiography; DAA, double aortic arch; ECVDI, European College of Veterinary Diagnostic Imaging; PRAA, persistent right aortic arch; VRA, vascular ring anomaly.…”

“…Thus, CT imaging features are currently lacking in the literature. 4,9,10,12 Concurrently, the surgical treatment and outcome for these conditions are also lacking, with only a handful of cases reported in dogs. [2][3][4][5]9,10 The aims of this study were to report the clinical and CTA imaging features of DAA in a series of six dogs and to describe their response to surgical treatment.…”