Rumple, a 2-year-old Havanese, undergoes a stenting procedure usually used in young human cardiac patients.
Rumple (photo courtesy of the University of Florida)
Veterinarians at the University of Florida (UF) Small Animal Hospital recently treated a 2-year-old Havanese named Rumple for a life-threatening heart condition by performing a procedure often performed in human medicine, according to a university release. The small dog was brought to the UF veterinary cardiology service with severe pulmonic stenosis, which involves a narrowing of the pulmonary artery and obstructs blood flow from the right ventricle of the heart. A team of veterinary cardiologists and human pediatric doctors worked together to save the dog's life.
Veterinary cardiologists at the university typically treat 10 to 15 dogs per year with pulmonic stenosis by passing a catheter from a vein through the right ventricle into the narrowed part of the artery, and then inflate a balloon to relieve the obstruction and allow normal blood flow to the lungs, says Simon Swift, VetMB, CSAC, DECVIM (cardiology) assistant professor of cardiology at the UF College of Veterinary Medicine, in the release. This standard approach didn't work with Rumple.
Rumple's care team considered using a valve stenting technique or a surgical approach that would have opened up the dog's artery, but ruled both procedures out. Swift then came up with another idea.
"We discussed Rumple's problem with our pediatric interventional cardiology colleagues at UF Health and agreed that the best option for Rumple would be to use a hybrid technique, where we'd place a bare metal stent mounted on a balloon but use a direct approach that involves entering the heart directly within the chest," Swift says in the release. "This would give us a more direct route to place the stent. As we inflate the balloon, it opens the stent, relieving the obstruction."
This technique is commonly used to treat the same condition in young human patients. Swift assembled a team of veterinarians and human pediatric cardiologists from the UF Health Congenital Heart Center. After Rumple's chest had been opened surgically, the team used ultrasound to determine where to place the needles and wires needed to allow the best access for the stent. They positioned the stent, inflated and deflated the balloon, and used contrast dye to test that the obstruction had been cleared, the release states.
"We were able to observe fantastic blood flow with no obstruction," Swift says. "We knew straightaway that we had been successful."
The dog recovered well from the surgery, and the following day Swift was able to measure a large reduction in blood pressure using echocardiography, giving further evidence that the obstruction had been removed.
Rumple's owner, Ligia Sandi, says the dog is doing well and the family is happy to have him home. "He's feeling like his old, happy self for the most part now," she says. "We are doing everything that we can to ensure that he has a long, happy life with us and he will be very well-loved and immensely spoiled."