Right Atriotomy Using Total Venous Inflow Occlusion for Removal of Heartworms in a Cat

Abstract

ABSTRACT. Heartworm infection with caval syndrome was detected in a thirteen-year-old male cat. However, removal of the heartworms via a jugular venotomy was infeasible because the size of the jugular vein limited our ability to use flexible alligator forceps. Therefore, a right atriotomy using total venous inflow occlusion was performed to remove the heartworms. The procedure was accomplished successfully, and the cat recovered from its symptoms. The present case suggests that right atriotomy using venous inflow occlusion is practical for removal and prevention of rupture of heartworms. KEY WORDS: atriotomy, feline, heartworm, total venous inflow occlusion.

First Autochthonous Infection of a Cat with Dirofilaria immitis in Austria

“…It is associated with poor tissue perfusion and hyporexia of these organs. In necropsy of dogs with caval syndrome tubular necrosis and haemosiderosis was found [ 14 , 35 , 38 ].…”

“…Caval syndrome is quite rare in cats, but it usually arises when one or two worms are located in the right heart causing tricuspid regurgitation. Most cats show moderate to mild symptoms, but owners also report chronic vomiting, anorexia and/or cachexia and respiratory signs [ 14 ].…”

Interventional cardiology for the criticalist

“…Caval syndrome in the cat is much less common than the dog and occurs with a much lesser worm burden 66–69 . However, similar interventional techniques to that described above in the dog have been reported in cats with caval syndrome and heartworm disease including alligator forceps, 67 endoscopic basket‐type forceps, 68 a horsehair brush, 67 and a nitinol snare 70 .…”

Dirofilarioses in cats: European guidelines from the ABCD on prevention and management

“…33,46 Surgical procedures to mechanically remove adult parasites visualised in the right heart and main pulmonary arteries have been proposed in symptomatic cats, but worms have to be retrieved intact to avoid anaphylaxis. 46,57 Successful surgical removal of an adult heartworm that had migrated to the femoral artery, achieved via direct access to the worm from the arteriotomy site, has been reported. 38 Slow kill protocols combining monthly administration of heartworm-preventive drugs with a 1-month course of doxycycline therapy are used in dogs when melarsomine is contraindicated, 58 and have been reported in cats, 21 but their efficacy and safety are unknown and therefore these protocols are not recommended.…”

“…33,46 Surgical procedures to mechanically remove adult parasites visualised in the right heart and main pulmonary arteries have been proposed in symptomatic cats, but worms have to be retrieved intact to avoid anaphylaxis. 46,57 Successful surgical removal of an adult heartworm that had migrated to the femoral artery, achieved via direct access to the worm from the arterioto-my site, has been reported. 38…”