Patent Ductus Arteriosus (PDA)

Question 1

Wesselowski, JVIM, 2019:
PDA in German Shepherds

1. What % of dogs showed clinical signs?
2. What % of dogs had concurrent congenital heart disease?
3. What % of dogs had arrhythmias?
4. What was the most common type of PDA?

Answer 1

Wesselowski, JVIM, 2019:

1. 50% showed clinical signs
2. 36% had concurrent congenital heart disease
3. 29% had arrhythmias
4. Type II PDA was the most common (88%)

Question 2

Lee, VRU, 2019:
Cardiac MRI for PDA

Using electrocardiogram gating and breath-hold techniques, what MRI images clearly depicted the course of the PDA?

Answer 2

Lee, VRU, 2019:

Using electrocardiogram gating and breath-hold techniques, black blood images clearly depicted the course of the PDA

Question 3

Silva, JVIM, 2013:
Transesophageal echocardiography guided PDA occlusion with a ductal occluder

1. What % achieved complete ductal occlusion?
2. Which was consistently superior for PDA visualization - transesophageal echocardiography or transthoracic echocardiography?
3. Which method of echocardiography showed higher values for ductal dimensions?
4. What was required when transesophageal echocardiography monitoring was not feasible or incomplete?

Answer 3

Silva, JVIM, 2013:

1. 99% achieved complete ductal occlusion
2. Transesophageal echocardiography was consistently superior to transthoracic echocardiography for PDA visualization
3. Transthoracic echocardiography showed higher values for ductal dimensions
4. Fluoroscopy was required when transesophageal echocardiography monitoring was not feasible or incomplete

Question 4

Wesselowski, JVIM, 2017:
Amplatz Canine Ductal Occluder (ACDO)

Correlation between minimal ductal diameter and body weight?

Answer 4

Wesselowski, JVIM, 2017:

There was poor correlation between minimal ductal diameter and body weight, and weight-based assumptions about expected ACDO device size for a given patient are not recommended

Question 5

Ranganathan, JAVMA, 2018:
Surgical ligation vs ductal occluder device

1. Which technique was associated with longer anesthesia and surgery durations?
2. Which technique was associated with hypotension and administration of vasopressors?
3. Which technique was associated with the need to administer antiarrhythmic and parasympatholytic medications?
4. Major complication rates for surgical ligation vs ductal occluder device?
5. Intra-op mortality rates for surgical ligation vs ductal occluder device?

Answer 5

Ranganathan, JAVMA, 2018:

1. Use of the ductal occluder device was associated with longer anesthesia and surgery durations
2. Use of the ductal occluder device was associated with hypotension and administration of vasopressors
3. Surgical ligation was associated with the need to administer antiarrhythmic and parasympatholytic medications, possibly due to arrhythmias caused by manual handling of the heart
4. Major complication rates: 10% for surgical ligation vs 0% for ductal occluder device
5. Intra-op mortality rates: 2% for surgical ligation vs 0% for ductal occluder device

Question 6

Hutton, JAVMA, 2015:
Surgical vs non-surgical management of PDA in cats

1. Peri-op complication rate for the surgical group?
2. Effect of surgical ductal occlusion on survival time?

Answer 6

Hutton, JAVMA, 2015:

1. Peri-op complication rate: 27%
2. Ductal occlusion did not significantly extend survival time

Question 7

Stauthammer, JAVMA, 2013:

1. Effect(s) of complete ductal occlusion?
2. Systolic function improved in all dogs, however what % of dogs had some evidence of systolic function at the 12-month evaluation?
3. Median CHF-free survival time after ductal occlusion?

Answer 7

Stauthammer, JAVMA, 2013:

1. Complete ductal occlusion resulted in immediate removal of the left-sided volume overload with subsequent return of left heart chamber dimension and wall thickness to reference ranges
2. Systolic function improved in all dogs, however 58% of dogs had some evidence of systolic function at the 12-month evaluation
3. Median CHF-free survival time after ductal occlusion was >11.5 years