Constrictive pericarditis following surgical repair of a peritoneopericardial diaphragmatic hernia in a cat

Abstract

A 4-year-old female spayed domestic longhair cat was referred for dyspnea. Further diagnostics revealed severe pleural effusion and a peritoneopericardial diaphragmatic hernia (PPDH). Following surgical correction of the PPDH the pleural effusion persisted. Re-check echocardiogram 4 weeks after initial evaluation revealed leftward deviation of the interventricular septum and interatrial septum occurring with inspiration. There were also exaggerated phasic changes in trans-tricuspid flow velocities suggestive of constrictive pericardial disease. Cardiac catheterization was performed and revealed elevated pressures in the right atrium and right ventricle. Constrictive pericarditis (CP) and epicarditis was confirmed at surgery, where subtotal pericardiectomy was performed with epicardial decortication. The cat continued to develop recurrent pleural effusion after surgery, although the volume and frequency of recurrence slowed over time. This is the first reported case of CP following PPDH repair in a cat.

Congenital peritoneopericardial diaphragmatic hernia in a family of Persian cats

“…1,2 Overall prevalence of PPDH in domestic cat populations has been reported to be 0.062-0.59%. 2,14 It is reported to be over-represented in long-haired breeds, 15 especially Maine Coons and Persians. 10,16 In addition to unknown or genetic causes of midline defects, environmental, chemical and toxin effects must be considered.…”

“…Clinical signs reported included none, muffled heart sounds, respiratory distress and/or gastrointestinal signs, such as anorexia, regurgitation or vomiting. 14,15,18 One case report describes a 4-year-old queen that had given birth to numerous litters without incident or clinical signs of PPDH prior to its diagnosis and repair. These findings, combined with the report of PPDH in the 4-year-old multiparous queen, 12 and the lack of clinical signs in many of the affected animals, suggest that there may be a higher incidence of PPDH in the breeding population than previously described.…”

Pneumopericardium with concomitant pericardial effusion following peritoneopericardial diaphragmatic hernia repair in a dog

“…Tissue damage results in accumulation of debris and blood in the pericardium; this results in immune responses, which would have maintained a potential pericardial inflammation and could bear the risk of development of constrictive pericarditis triggered by ischaemic myocardial necrosis or postpericardiotomy syndrome after the surgical trauma. 20 Both pneumopericardium and haemopericardium were selflimiting. Most described cases of pneumopericardium did not need specific treatment; however, none of them reported pericardial effusion as an additional complication.…”

Surgical treatment of a circumferential oesophagogastric mass associated with a peritoneopericardial diaphragmatic hernia in a Maine Coon cat

“… 1 The prevalence of PPDH has been reported to be 0.06–0.6% in cats. 1 – 4 It is one of the most common congenital cardiac defects diagnosed in cats over 1 year of age; 1 – 3 , 5 – 7 however, its aetiology is still not fully understood. In humans, PPDH may occur as a result of trauma or be a congenital anomaly, whereas, in cats, traumatic PPDH does not occur as the pericardium and diaphragm are not connected.…”