Severe pulmonary trunk stenosis associated with R2A-type coronary artery anomaly in a dog: echocardiographic findings and post-mortem contrast-enhanced CT confirmation.

Abstract

A 1.5-year-old female French Bulldog was diagnosed with severe valvular pulmonic stenosis, coronary artery anomaly, and clinical signs of right-sided heart failure. Despite medical management, the patient’s condition deteriorated, and euthanasia was elected after 6 months of treatment. Post-mortem contrast-enhanced computed tomography additionally revealed a single right coronary ostium and confirmed a prepulmonary course of the left coronary artery, consistent with an R2A-type coronary anomaly. This anomaly could have significantly complicated potential surgical or catheter-based interventions on the right ventricular outflow tract in patients with pulmonic stenosis. Contrast-enhanced post-mortem computed tomography enabled non-destructive, reproducible 3D visualization of the coronary course and its spatial relationship to the RVOT before dissection. This approach can complement conventional necropsy by enhancing anatomical documentation, communication, and targeted sampling in cases of complex congenital cardiovascular anomalies.