Cutting balloon and high-pressure balloon dilation for palliative treatment of congenital double-chambered right ventricle and primary infundibular stenosis in a Golden retriever dog

Anaesthetic management and complications during cutting balloon and high‐pressure balloon dilation in a dog with a double‐chambered right ventricle

“…Arrhythmias could develop due to the structural changes of the myocardium, such as areas of fibrosis and ischaemia, or during RV catheterization and ballooning. Frequent RV ectopic beats and short runs of RV tachycardia, which were easily controlled by infusing lidocaine, were previously reported in a dog undergoing CB‐HPB dilation 6 . To decrease the myocardial excitability and minimise the occurrence of arrhythmias, lidocaine continuous infusion was administered from the beginning of anaesthesia in our dog.…”

“…In patients with DCRV, the anaesthetic technique should have minimal cardiovascular effects. In the previous report describing CB‐HPB dilation in a dog with DCRV, acepromazine‐hydromorphone were administered as pre‐anaesthetic medications, propofol and isoflurane were used for induction and maintenance of anaesthesia, respectively 6 . In our case, acepromazine was not used due to its vasodilatory effect and methadone was administered to provide sedation and analgesia, with minimal cardiovascular effects 28,29 .…”

“…A recent interventional technique combining cutting balloon and high‐pressure balloon (CB‐HPB) dilation has been performed in a dog with DCRV, aiming to provide temporary relief of the RV obstruction. Unfortunately, little information regarding anaesthetic management was available 6 . We would like to report the anaesthetic management and related complications in a dog with DCRV undergoing CB‐HPB dilation.…”

Progressive Right Ventricular Obstruction Caused by a Double-Chambered Right Ventricle Resulting in Shunt-Reversal via a Concomitant Congenital Ventricular Septal Defect and Subsequent Erythrocytosis in a Dog

“…Double-chambered right ventricle is a rare anomaly in dogs and humans [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ].…”

“…Interestingly, the simultaneous presence of a DCRV and a VSD in the same heart is relatively common, where the high-velocity jet resulting from the left-to-right shunting VSD-flow is thought to lead to the tissue proliferation in the right ventricle, contributing to the development of a DCRV (also known as Gasul phenomenon) and a progressive right ventricular outflow tract obstruction [ 7 , 8 , 9 ]. Depending on the severity of the obstruction and the anatomical localization of the VSD, the obstruction caused by DCRV can increase the right ventricular pressure to such a degree that a supra-systemic systolic pressure develops, and flow reversal via the VSD takes place, resulting in an intracardiac right-to-left shunting [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. A right-to-left shunting VSD can cause hypoxemia and on long-term also erythrocytosis because of increased renal erythropoietin production [ 13 ].…”