Patent ductus arteriosus (PDA) is a congenital heart defect in which a fetal blood vessel, the ductus arteriosus, fails to close after birth. This results in abnormal blood flow between the aorta and pulmonary artery, increasing the heart’s workload and potentially leading to heart failure. If left untreated, dogs with hemodynamically severe PDA usually do not survive beyond one year of age, with a reported mortality rate of 64%.
In Malaysia, breeds such as the Pomeranian, Poodle, and Corgi are overrepresented. Sporadically, cats can be affected too
Until recently, dogs in Malaysia diagnosed with PDA could only be treated through open-chest surgery by a handful of surgeons or managed conservatively with medications.
Minimally Invasive Procedure as an alternative to surgical ligation
Unlike open-chest surgery to ligate the PDA, a small incision is made on the dog’s neck or inguinal region. An occluder is delivered through a long catheter inserted via the jugular vein (in small dogs) or femoral artery (in larger dogs), with guidance from transesophageal echocardiography and fluoroscopy.
The minimally invasive procedure offers several advantages:
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A small incision site without the need for open-chest surgery, hence faster recovery
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A reduced fatal risk of massive bleeding from PDA rupture due to surgical manipulation
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Possibility of early hospital discharge
However, this procedure is more expensive than open-chest surgery due to the complexity and cost of the various catheters and occluders involved, as well as the associated expertise required.
On March 23, 2025, our team successfully implanted an Amplatzer Vascular Plug II in a 3.5 kg Poodle with PDA using a minimally invasive procedure. The biggest challenge was establishing access to the dog’s jugular vein, given the smaller venous diameter compared to the catheter. However, we were able to address the problem by downsizing the catheter and successfully deploy the occluder to seal off the PDA.
The dog recovered uneventfully from general anaesthesia. A post-operative examination revealed disappearance of the shunt through the PDA, indicating a successful procedure.
