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Interventional Cardiology is an advanced field of cardiology that uses minimally invasive techniques to diagnose and treat a variety of congenital and acquired heart diseases. Often, pets with congenital cardiac anomalies have a reduced life span. CARE’s new interventional cardiology program will allow us treat pets with congenital heart disease and help them lead normal lives. These procedures require highly trained veterinary specialists, staff and advanced technology necessary to diagnose congenital cardiac anomalies and perform minimally invasive, catheter-based interventions. In fact, we are the only veterinary hospital in the Charlotte area that has a catheterization lab.
Congenital Cardiac Anomalies
Congenital cardiac anomalies are present at birth and may be hereditary. Though only about one percent of cats and dogs are born with heart defects, they pose serious health threats to our beloved pets. Veterinarians perform physical exams on kittens and puppies which may detect signs that are consistent with an anomaly.
The presence of a loud systolic heart murmur or any diastolic or continuous heart murmur is supportive of a congenital cardiac anomaly. This condition warrants further investigation by a veterinarian or veterinary cardiologist. The presence of a heart murmur in a pediatric animal is not always due a congenital heart defect. Subsequently, many young animals can have a low-grade heart murmur (also known as innocent) that is not associated with a congenital heart defect.
Signs Of Heart Defects
Congenital cardiac anomaly signs include lethargy, weakness, fainting, decreased appetite, sustained increased respiratory rate/effort and an inability to gain weight. If you notice the aforementioned clinical signs, please contact or see a veterinarian at your earliest convenience. Not all pets with congenital cardiac anomalies show overt clinical signs..
Testing For Cardiac Anomalies
The evaluation of patients with a suspected congenital defect usually consists of a physical examination and chest x-rays (thoracic radiographs). Electrocardiography and echocardiography are performed by a veterinary cardiologist). Echocardiography is crucial to assess the defect, the severity of the defect and determine the best therapeutic options for the pet.
Common Defects Treated With Interventional Cardiology
The most common defects in dogs are patent ductus arteriosus (PDA), pulmonic stenosis, and (sub)aortic stenosis. The most common defects in cats are atrioventricular septal defects (including ventricular septal defects, atrial septal defects, and endocardial cushion defects), patent ductus arteriosus and atrioventricular valve dysplasia.
Patent Ductus Arteriosus (PDA)
There are two major options to correct this defect, including surgical ligation of the abnormal vessel and catheter-based transvenous occlusion. Fortunately, both procedures are very successful with minimal complications. Surgical ligation is an open-chest procedure that involves placement of a suture around the abnormal vessel to close off blood flow. Catheter-based transvenous occlusion, the less invasive interventional cardiology option, involves the placement of an occlusive device through a peripheral vessel, inside of the abnormal vessel.
The major limitations of the transvenous occlusion are the size of both the ductus and patient. Surgical ligation is considered most often for cats and dogs weighing less than one and a half pounds. Both procedures should be performed by veterinary specialists and are offered at CARE. However, medical management for congestive heart failure may be necessary prior to surgery or in cases where surgery is not an option.
Pulmonic Stenosis
Patients with overt clinical signs and/or severe defects may benefit from a minimally invasive, catheter-based procedure called balloon valvuloplasty. Additionally, some patients with coexisting coronary vessel abnormalities may prevent the ability to perform a balloon valvuloplasty. Medical management may be warranted in moderate to severely affected patients. Balloon valvuloplasty procedures can be performed at CARE.
(Sub)aortic Stenosis
Balloon valvuloplasty or open-heart surgery may be attempted. However, neither procedure has been shown to prolong the reduced life span of severely affected patients. Medical management may be warranted in moderate to severely affected patients. Balloon valvuloplasty procedures can be performed at CARE.
CARE’s Catheterization Lab
At CARE, we are able to diagnose congenital cardiac anomalies and perform minimally invasive, catheter-based procedures using interventional cardiology. We will work with your family veterinarian to determine the best course of treatment for your beloved pet. If your dog or cat has been diagnosed with a loud heart murmur, congenital heart disease or clinical sign supportive of a congenital heart disease, ask for a referral to our Cardiology department.
