At the Heart of the Matter

By Sarah Freeman

The Cardiology service at The UGA Veterinary Teaching Hospital (UGA VTH) is expanding with the addition of several new interventional procedures for congenital heart disease. These procedures have been made possible by the addition of a new fluoroscopic imaging system, introduced to the hospital in the Spring of 2011. The introduction of these procedures, positions UGA’s VTH as Georgia’s most comprehensive small animal cardiology care center.

The new procedures being offered at the UGA VTH include:

  1. Balloon valvuloplasty (BVP) –- This procedure is utilized in the treatment of severe pulmonic stenosis (PS), a congenital heart defect that results in the narrowing of the right ventricular outflow tract. Utilizing jugular venous access, a series of catheters are inserted into the right heart chambers, where they are used to dilate the pulmonic valve to a more physiologic diameter. “Currently, no conventional surgical procedure offers the safety and efficacy of BVP in the treatment of this common congenital defect,” according to Gregg Rapoport, DVM, DACVIM.

  2. Patent ductus arteriosus (PDA) occlusion – Using minimally invasive techniques, elimination of abnormal ductal flow can now be achieved via implantation of a novel device, the Amplatz® Canine Duct Occluder (ACDO). The ACDO is a self-expanding implant that straddles the defect and is introduced through a catheter placed in the femoral artery. Previously, PDA occlusion was only made possible by invasive surgical methods and thoracotomy; however, utilizing this technique it can be accomplished through a small incision in the thigh. PDA is the most common congenital defect in dogs and the ACDO implantation procedure has a very high success rate. “The recovery time is so much faster with this procedure as compared to previous methods since it doesn’t require major surgery,” according to Mandy Erickson, DVM, DACVIM, one of two cardiologists on staff at UGA’s Veterinary Teaching Hospital. “This relatively new procedure reduces the risks in a vast majority of the dogs, too.

  3. Heartworm extraction – In dogs experiencing caval syndrome, a severe and life-threatening complication of chronic heartworm disease, heartworms can be removed via jugular venotomy and a fluoroscopically-guided retrieval instrument. The majority of dogs undergoing this procedure do very well and can later be treated with medical adulticide therapy.

  4. Pacemaker implantation – As in humans, artificial pacemaker therapy is recommended in dogs and cats experiencing symptomatic bradycardia. Indications for artificial pacemaker therapy include third degree atrioventricular block, sick sinus syndrome and vasovagal syncope. Pacemaker devices can be implanted via an incision in the neck in all but the smallest of dogs and in cats.

  5. Electrical cardioversion –During this procedure, a strategically-timed transthoracically-delivered current of electricity is used to convert atrial fibrillation to a normal sinus rhythm. Cardioversion is typically reserved for animals with lone atrial fibrillation (that which occurs in the absence of significant underlying heart disease.)

In addition to this impressive menu of cardiology services, the UGA VTH also boasts two Board-certified cardiologists, Gregg Rapoport, DVM, DACVIM, and Mandy Erickson, and two cardiology residents, Justin Thomason, DVM, DACVIM (Internal Medicine) and Amy Dixon-Jimenez, DVM.

The addition of the new fluoroscopic equipment has greatly enhanced the cardiology service’s diagnostic and therapeutic capabilities. “The C-Arm is important in diagnostic procedures to visualize what’s going on in the heart,” said Dr. Rapoport. “If something isn’t clear through ultrasound, we can use fluoroscopy to view abnormal blood vessels.”

The UGA VTH cardiology team is also available for complimentary phone consults with interested RDVMs. This service is offered by calling one of our Referral Coordinators at 800-861-7456. Response time is typically within 24 hours.

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