Aortic cross-clamping, resection, and end-to-end anastomosis in a dog presenting with rib osteosarcoma.

Abstract

A 3-year-old castrated male French bulldog was presented with a mass on the left thorax that had appeared 3 wk before the consultation. Blood analyses were unremarkable. Computed tomography revealed a large heterogeneous mass arising from the 10th rib, invading the left chest, contiguous to but not infiltrating the aorta. Based on biopsies, the diagnosis was an osteoblastic osteosarcoma. Surgical treatment occurred 10 d after the computed tomographic scan and biopsies. Due to a rapid increase in the tumor's extent, the aorta was partially surrounded by the mass. Poor visibility led to an accidental aortic section with a vessel-sealing device (LigaSure; Covidien). Aortic cross-clamping allowed a 25-millimeter-long resection of the descending aorta from T7 to T11, followed by an end-to-end anastomosis. Postoperatively, the dog had temporary hind-limb ataxia for < 2 wk. At 4 mo postoperatively, the dog was euthanized due to the reappearance and degradation of new neurological symptoms associated with a left paravertebral recurrence of the tumor with slight penetration of the vertebral canal. Necropsy revealed no long-term ischemic lesions in any abdominal organ or the spine, but there was spinal cord axonal degeneration (attributed to chronic mild compression). However, the site of recurrence of the tumor-induced neurological symptoms was unrelated to the aortic resection and cross-clamping. Key clinical message: Aortic cross-clamping, resection of the descending aorta, and their neurological sequelae induced by ischemia are rarely described in nonexperimental studies in veterinary medicine. This is the first report of an 18-minute cross-clamping and a 25-millimeter-long resection of the descending aorta in which aortic cross-clamping and resection were done as an unplanned salvage procedure, and of its outcome 4 mo later, with no long-term ischemic lesions.