Interventional Cardiology at Upstate Veterinary Specialties
How is IC different from classic heart surgery?
Generally surgery of the heart and major vessels had required surgically opening the chest. IC only requires a very small incision over one of the peripheral vessels most commonly the femoral artery or jugular vein. For this reason, these patients experience minimal pain or discomfort and have a much shorter recovery time. There is also a lower risk for complications.
What are the most common procedures performed using this minimally invasive technique?
This technique is most commonly used for congenital heart diseases:
- Patent ductus arteriosus (PDA)
- Pulmonic stenosis
In older patients, the placement of a pacemaker can be implanted utilizing IC as well.
What is a patent ductus arteriosus (PDA) and how can IC help?
Before birth animals (as well as people) have a vessel called the ductus arteriosus that connects the aorta to the pulmonary artery. This allows oxygenated blood that the fetus receives from its mother to bypass the lungs (since the baby is not breathing air) and flow into the aorta, the big blood vessel that supplies blood to the body. After birth, when the baby starts to breathe air, this vessel should close.
In some animals this vessel remains open and is called a patent ductus arteriosus (PDA) and places them at risk for congestive heart failure and death. The newer IC technique allows placement of a device into the PDA to close off the blood flow. After closure of the PDA these patients generally have a very good prognosis and go on to lead normal lives.
What is pulmonic stenosis and what does balloon valvuloplasty mean?
Pulmonic stenosis means that the valve controlling blood flow from the right side of the heart into the pulmonary artery does not form normally. Instead of opening freely to allow easy flow of blood into the pulmonary artery the valve is fused together and potentially thickened and abnormal. As a result of the obstructed blood flow across this valve the right side of the heart is under high pressure and the muscle of the heart becomes very thick. These patients can have severe complications including exercise intolerance, collapsing or fainting spells or sudden death.
The IC procedure used to treat this disease is balloon valvuloplasty of the pulmonic valve. A small incision is generally made in the jugular vein and a catheter with an inflatable balloon is placed across the pulmonic valve. The balloon is then rapidly inflated to break the valve apart and allow easier flow of blood into the pulmonary artery.
Pacemakers are placed in animals too?
Pacemakers are used in animals and people to help regulate the heart rate and rhythm. Typically pacemakers are used in patients that have an inappropriately low heart rate or abnormal pauses in heart rhythm that cannot be treated with medication. Without this intervention these patients can have significant intolerance to exercise, be very lethargic, faint several times a day and can die from their disease.
A pacemaker is a small device that transmits electrical impulses through electrodes into the right side of the heart. This stimulates the heart to contract at an appropriate heart rate and prevent pauses in heart rhythm. As long as patients are otherwise healthy the prognosis after placement of a pacemaker is generally very good and they go on to live a normal life. They only have to come to see the cardiologist intermittently to check the settings on the pacemaker.
How would I know if my pet has a congenital heart disease that could benefit from IC?
Most young pets are referred to the UVS cardiology service because a heart murmur was found on one of their initial veterinary visits. When they come to see the cardiologist an ultrasound of the heart, called an echocardiogram, is performed. This permits the visualization of the heart, shows how the heart functions and how the blood flows through the heart and great vessels. Echocardiography allows the cardiologist to identify the cause of the heart murmur and determine what treatment would most benefit the patient.
If your pet has a heart murmur or arrhythmia, or symptoms that suggest heart disease such as exercise intolerance, collapse or fainting, coughing, labored breathing and difficulty resting comfortably please speak with your family veterinarian to see if a referral to one of our cardiologists is appropriate.
For general practice veterinarians: UVS specialists welcome your questions about whether a cardiology referral or Interventional Cardiology could help your patients who have challenging medical conditions.