Felis ISSN 2398-2950

Patent ductus arteriosus

Synonym(s): PDA, Ductus

Contributor(s): Serena Brownlie, Mark Oyama, Mark Rishniw

Introduction

  • Uncommon congenital heart disease of cats. As compared to dogs, PDA is is significantly less common.
  • Fetal communication between aorta and pulmonary artery fails to close at birth.
  • Signs: spectrum from asymptomatic murmur to left congestive heart failure, continuous, waxing and waning - 'machinery murmur' (pathognomonic).
  • Diagnosis: signs, ultrasonography.
  • Treatment: surgical correction before symptomatic.
  • Prognosis: good if corrected, guarded without surgery.

Pathogenesis

Etiology

  • Failure of normal ductal muscle development which prevents physiologic or functional closure at birth.

Pathophysiology

  • The ductus arteriosus, a normal fetal vessel, fails to close in the first hours or days after birth    →    conduit between the descending aorta and the pulmonary trunk.

Typical

  • Pulmonary vascular resistance much lower than systemic vascular resistance so:
    • Left to right shunt (aorta to pulmonary artery)    →     increased flow through pulmonary vasculature    →     increased return to left heart    →     volume overload of left heart    →     chronic left-sided CHF.
    • Dilation and eccentric hypertrophy of left atrium/ventricle can result in mitral regurgitation (MR) due to stretching of the mitral annulus.

Rare

  • Right-to-left shunt.
  • Pulmonary hypertension    →   due to retention of fetal type pulmonary vasculature and/or massive pulmonary overcirculation with a left-right shunt resulting in reactive hypertension (a left-to-right shunt typical of PDA)    →   pulmonary overcirculation    →   pulmonary hypertension (as Eisenmenger's physiology)    →    right-left shunt.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Summerfield N J & Holt D E (2005) Patent ductus arteriosus ligation and pulmonary artery banding in a kitten. J Am Anim Hosp Assoc 41 (2), 133-136 PubMed.
  • Schneider M & Hildebrant N (2003) Transvenous embolization of the patent ductus arteriosus with detachable coils in 2 cats. J Vet Intern Med 17 (3), 349-353 PubMed.
  • Allen D G (1982) Patent ductus arteriosus in a cat. Can Vet J 23 (1), 22-23 PubMed.
  • Jones C L & Buchanan J W (1981) Patent ductus arteriosus: anatomy and surgery in a cat. JAVMA 179 (4), 364-369 PubMed.


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