C03 - Multicentre Per-catheter Ductal Occlusion in Small Dogs; Device Selection, Patient Characteristics, Outcomes, and Complication Rates

Abstract:

Background: Per-catheter occlusion of patent ductus arteriosus (PDA) in dogs ≤3.5kg is challenging, often requiring ligation via thoracotomy with higher complication rates. A number of occlusive devices have been individually described in small dogs for ductal occlusion.

Objective: Present the results and complications of ductal occlusion in small dogs with AVPII, AVPIV, Flipper Coils, Vet-PDA occluder and ACDO devices. Animals: 213 dogs (0.7-3.5kg) underwent interventional occlusion of a PDA.

Methods: Multi-institutional retrospective analysis of outcomes and complications in < 3.5kg dogs receiving ACDO, AVPII, AVPIV, Vet-PDA occluder and Flipper coils. Ductal morphology and dimensions, procedural outcomes, complication rates, and residual flow were evaluated at 24hr and between 2-4 weeks post-implantation. Procedural success was defined as successful device placement within the ductus.

Results: Successful occlusion was achieved in 206 (96.71%). Four (2.52%) perioperative deaths occurred and one post operative mortality occurred (1.26%). Three (1.41%) additional cases were unsuccessful in device placement. At 2-4 week recheck, 81.69% showed no residual flow, 2.35% trivial, 4.69% mild, 1.41% moderate, 0.94% severe 6.10% lost to follow up and 2.82% other. Major complications occurred in 23 (10.8%) patients, including death, severe pulmonary hypertension, hemorrhage, right atrial perforation, asystole when wire passed into the right ventricle, caval perforation, hemorrhagic pleural effusion of unknown etiology, and device embolization. Conclusions and clinical importance: Per-catheter ductal occlusion in small dogs < 3.5kg may be safely achieved. Our study reveals comparable outcomes regardless of device or patient weight, refining intervention recommendations for PDA occlusion in small dogs.