RVC surgeons save dog with rare heart condition

RVC surgeons save dog with rare heart condition

Last updated 16 July 2015

Surgeons at the RVC's Queen Mother Hospital for Animals (QMHA) have successfully treated a puppy with rare congenital heart condition that would have killed her within months if left untreated.

Kayla was diagnosed with a heart murmur at four months and QMHA specialists identified that it was caused by double-chambered right ventricle, which is so unusual in dogs that there are few references to it in veterinary literature.

The RVC is the only centre in Europe offering surgery for the condition and Kayla is the third dog the QMHA has treated.

Outlining the case, Daniel Brockman, leader of the cardiac surgery team within the Soft Tissue Surgery Service said: "Kayla was diagnosed with a heart murmur in April. Investigations at the QMHA confirmed that the cause of the murmur was double-chambered right ventricle. This is a developmental abnormality in which a fibromuscular obstruction forms mid-way between the valves that allow inflow (tricuspid) and outflow (pulmonic) of blood through the right ventricle.

"The assessment was that Kayla had very severe disease that would be predicted to lead to heart failure within 12 months. This condition does not respond to non-surgical intervention and so she underwent surgical treatment under cardiopulmonary bypass, to allow the open-heart manipulations required to treat this disease. During the operation, the right ventricle is opened and the obstruction to blood flow relieved by suturing a patch of polytetrofluroethylene across the narrow part of the ventricle."

Professor Brockman also said: "The operation was done without a hitch and she recovered uneventfully. Follow-up echocardiography has confirmed that the velocity of the blood going through the narrow area is massively reduced and, therefore, the pressure gradient – the measure of the severity of the narrowing - is correspondingly reduced. Kayla is now able to lead a normal quality of life and it is anticipated that her lifespan will also be normal now."

The surgical team included Professor Brockman, Vicky Lipscomb and Alison Young. The anaesthesia was supervised by specialists Hatim Alibhai and Christopher Seymour and a perfusionist from Great Ormond Street Hospital was present to run the heart-lung machine.

Emphasising the importance of multidisciplinary working in such cases, Professor Brockman added: "The post-operative care is overseen by our critical care team headed by Dan Chan, Sophie Adamantos, Karen Humm and Lindsay Kellett-Gregory. In addition, our transfusion medicine team do a fantastic job of finding the blood transfusions necessary to get these dogs through the whole procedure. These are genuinely team efforts from the cardiology diagnosis to the diagnostic imaging confirmation, the surgical anaesthesia and perfusion teamwork and finally the critical care management and cardiology follow-up."