Surgical correction of an infundibular pulmonic stenosis and ventricular septal defect in a Shetland Sheepdog

A four-month-old male Shetland Sheepdog presented with exercise intolerance. Physical examination revealed an IV/VI left cranial systolic heart murmur. Echocardiography showed a severe infundibular pulmonic stenosis and a concomitant restrictive ventricular septal defect. As clinical signs of congestive right-sided heart failure worsened and were refractory to medical treatment, sur-gical correction was advised. Via sternotomy, with cardiopulmonary bypass and cardioplegic cardiac arrest, ventricular septal defect closure and resection of the stenotic infundibular band were performed through right ventriculotomy, followed by patch enlargement. Postoperative recovery was uneventful and echocardiogra-phy showed complete resolution of the stenosis and successful closure of the ven-tricular septal defect. Follow-up echocardiography revealed restenosis after seven weeks and recurrence of right-sided heart failure three months postoperatively. Stenting of the restenosis was attempted via a hybrid procedure with sternotomy and direct transventricular approach. The dog developed fatal ventricular fibrilla-tion during stent deployment. This is the first dog in which surgical right ventricular patch enlargement under cardiopulmonary bypass is reported for the treatment of a primary infundibular pulmonic stenosis. 2023 Elsevier B.V. All rights reserved.

Automated summary

A four-month-old male Shetland Sheepdog presented with exercise intolerance and was diagnosed with severe infundibular pulmonic stenosis and a concomitant restrictive ventricular septal defect. Surgical correction was performed but restenosis occurred after seven weeks, leading to fatal complications during stenting.