Closing patent ductus arteriosus in dogs and cats after failed surgery

Abstract

OBJECTIVE: To describe the characteristics and outcomes of transcatheter patent ductus arteriosus (PDA) occlusion after incomplete or aborted surgical ligation in dogs and cats. ANIMALS: Twelve client-owned animals (11 dogs and one cat). MATERIALS AND METHODS: This retrospective study describes data from animals with aborted or incomplete surgical PDA ligation that subsequently underwent transcatheter closure using endovascular methods. Patient demographics, reason for incomplete or aborted surgery, complications, and method of transcatheter occlusion were recorded. Data are presented as mean ± standard deviation or median (interquartile range), where appropriate. RESULTS: For all cases, median age at surgery was 12.2 months (4.9-15.1 months) and at catheterization was 15.4 months (8.9-21.9 months), with 79 days (29-209 days) between surgical and interventional procedures. Median weight at catheterization was 4.5 kg (2.5-12.6 kg). Reasons for failed surgical ligation included hemorrhage during ductal dissection in seven dogs, residual flow in four dogs, and inability to identify the ductus in one cat. Transcatheter closure was successfully performed using a canine duct occluder in eight dogs, transarterial coil embolization in two dogs, and transvenous coil embolization in one dog and one cat. Metallic hemoclips partially obscured angiographic findings in three cases with prior surgical hemorrhage but did not prevent transcatheter closure. In all cases, ductal flow was successfully attenuated, with no or trace residual shunting on angiography and complete occlusion the following day on echocardiography. CONCLUSIONS: When surgery is unsuccessful, either owing to hemorrhage or residual flow, transcatheter closure of PDA is feasible, even in small patients.