Large partial AV canal defect in a 6mo cat

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Large partial AV canal defect in a 6mo cat

This is a very interesting one!

 

6mo female DSH with heart murmur (mainly systolic) more audible on the left heart base.

– I think it is a partial AV canal defect with Eisenmenger syndrome (big MPA, LPA and RPA) with secondary pulmonary hypertension and RV eccentric hypertrophy + narrow LVOT due to malformation

– AVmax 2m/s; PVmax 1,9m/s; AVSDmax 2,0m/s (left to right)

This is a very interesting one!

 

6mo female DSH with heart murmur (mainly systolic) more audible on the left heart base.

– I think it is a partial AV canal defect with Eisenmenger syndrome (big MPA, LPA and RPA) with secondary pulmonary hypertension and RV eccentric hypertrophy + narrow LVOT due to malformation

– AVmax 2m/s; PVmax 1,9m/s; AVSDmax 2,0m/s (left to right)

– If you agree with me how would you calculate the PHT? Would you subtract the defect systolic pressure to the mean arterial pressure of 120mmHg? (120-17 = 103mmHg > severe PHT)

– The cat is currently assintomatic (but I suspect exercise intolerance). Would you treat it? How?!

 

Comments

jobrag

new images

new images

Peter

Hi
very nice case, thanks for

Hi

very nice case, thanks for posting

I agree on the ASD (Type I) and PHT which has to be severe based on PA diameters. 

By definition, there has to be a little step between the mitral and tricuspid anulus. If there is none, you can call it Av-canal defect. Furthermore, AV-canal defects are usually assiciated with MI/TI. 

If you want to calculate PA pressures you might have to use the PI jet (mean pressure) or a TI jet (in the latter case a higher RA pressure has to be added).

Re treatment: From my gut feeling I would likely use Sildenafil here.

Peter

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