Comparison of major complication and survival rates between surgical ligation and use of a canine ductal occluder device for treatment of dogs with left-to-right shunting patent ductus arteriosus

Abstract

OBJECTIVE To compare rates of major intraoperative complications and survival to hospital discharge between surgical ligation (SL) and canine ductal occluder (CDO) implantation for treatment of dogs with left-to-right shunting patent ductus arteriosus (PDA). DESIGN Retrospective cohort study. ANIMALS 120 client-owned dogs with left-to-right shunting PDA (62 treated by SL and 58 treated by CDO implantation). PROCEDURES Data were retrieved from medical records of included dogs regarding signalment, medical history, vertebral heart scale, preoperative echocardiographic findings, complications encountered during surgery, and durations of anesthesia and surgery (SL or CDO implantation). Data were compared between dogs treated by SL and those treated by CDO implantation. RESULTS Dogs treated by CDO implantation were significantly older and heavier than dogs treated by SL and had more pathological cardiac remodeling (as indicated by mitral regurgitation scores, left atrial-to-aortic root diameter ratios, and fractional shortening values). Durations of anesthesia and surgery were also significantly longer for CDO implantation versus SL. The major complication rate for dogs treated by SL (6/62 [10%]) was significantly greater than that for dogs treated by CDO implantation (0/58 [0%]). One dog in the SL group died during surgery. Overall rate of survival to hospital discharge was 99% (119/120). CONCLUSIONS AND CLINICAL RELEVANCE Both SL and CDO implantation were viable methods for PDA attenuation in the evaluated dogs. Although a greater proportion of dogs had major complications during the SL procedure, the 2 procedures had comparable rates of survival to hospital discharge.

Life-Threatening Hemorrhage During Patent Ductus Arteriosus Ligation in a Cat: Xenotransfusion With Canine Blood

“…Definitive therapy consists in closing the PDA, either by surgical ligation or by transcatheter embolization (15,16). Although surgical ligation is associated with a higher rate of major intraoperative complication, both procedures have comparable rate of survival to hospital discharge in dogs (17). Perioperative or intraoperative complication rate of surgical ligation ranges from 15.1 to 26.7% in cats (18,19).…”

“…Intraoperative hemorrhage is the most common complication and occurs in 6.1 to 13.3% of feline patients (18,19). Hemorrhage usually results from a tear of the PDA (17,20). Complications related to chest tube placement are uncommon and include leakage of fluid, subcutaneous emphysema and inadvertent lung laceration (17,21).…”

“…Hemorrhage usually results from a tear of the PDA (17,20). Complications related to chest tube placement are uncommon and include leakage of fluid, subcutaneous emphysema and inadvertent lung laceration (17,21).…”

Persistierender Ductus arteriosus beim Hund – Klinik, Diagnostik und Therapie

“…Insgesamt treten jedoch bei dem interventionellen Verschluss mit einem ACDO nur in 0-2 % der Fälle schwerwiegende Komplikationen auf [1,11,12]. Bei den anderen Methoden liegt die Komplikationsrate teilweise bei 26-33 % [13].…”

Alternative anaesthetic management in a reintervention for correction of a left‐to‐right shunting patent ductus arteriosus (PDA) in a dog

“…Surgical ligation of the PDA by intercostal thoracotomy had been considered the primary treatment in dogs since the first surgical procedures were performed in 1950s and 1960s 10–11 . Later introduction of minimally invasive methods, such as transvascular occlusion, brought new insights to PDA management, showing comparable success rate with lower risk of major complications and lower fatality rates 12,13 . Recently, thoracoscopic PDA occlusion in five dogs has been described as a safe and reliable technique 14 .…”