Congenital Heart Disease
World Small Animal Veterinary Association World Congress Proceedings, 2015
Etienne Côté, DVM, DACVIM (Cardiology, Small Animal Internal Medicine)
Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada



Patent ductus arteriosus (PDA)*

Subaortic stenosis*

Pulmonic stenosis*

Ventricular septal defect*

Atrial septal defect

Tetralogy of Fallot

Tricuspid dysplasia -Vascular ring anomaly*

Mitral dysplasia*

Cor triatriatum

Situs inversus

Budd-Chiari syndrome

Aorticopulmonary window

Ebstein's anomaly

Reversed PDA

Vascular ring anomaly*

Peritoneopericardial diaphragmatic hernia (PPDH)*

Ventricular septal defect*

Mitral dysplasia*

Tricuspid dysplasia

Aortic stenosis


Vascular ring anomaly


* Common

 How is congenital heart disease detected?

 Murmur location.

 Pulse - hyperdynamic, normal, or attenuated?

 Innocent murmurs.

 "What if we don't do any tests?" Follow-up if client declines cardiac evaluation.

 Prognosis - identifying the problem and quantifying severity.

Treatment Options

PDA (common, left-to-right)1–3

 Thoracotomy and ligation1,2 (A)

 Any closure (thoracotomy and ligation, coils, plug, or occluder)3 (A)

Pulmonic stenosis4–7

 Balloon valvuloplasty4–6 (B)*

 Thoracotomy and direct surgical correction4,7 (E)*

Subaortic stenosis8

 Surgical resection of stenotic tissue (open-heart)9 (E)

 Closed-heart surgical repair10 (D)

 Cutting balloon high-pressure dilation11 (C)

 Balloon dilation12 (C)

 Beta-blockers13,14 (D)

Atrial septal defect, ventricular septal defect, AV canal

 Open surgical correction15,16 (D)

 Pulmonary artery banding17 (C)

Cor triatriatum, Budd-Chiari syndrome18

 Thoracotomy and direct surgical correction19–22 (C)

 Balloon dilation23,24 (C)

Tetralogy of Fallot25

 Open surgical correction25,26 (C)

 Beta-blockers27 (C)

Tricuspid or mitral dysplasia or stenosis

 Balloon dilation28 (C)

 Open surgical correction (valve repair/replacement)29 (C)

Vascular ring anomaly30,31

 Surgical correction30,31 (A)

Peritoneopericardial diaphragmatic hernia32 (PPDH)

 Surgical repair32,33 (B)

Reversed (right-to-left) PDA

 Phlebotomy34 (C)

 Anti-erythropoietic drugs35 (C)


A.  Shown to increase longevity versus medical management or no treatment (large or multiple case series). "Clearly helps."

B.  Suspected to help clinical signs +/- longevity but unproven at this time (small case series or several case reports). "Looks like it clearly helps."

C.  Palliation of clinical signs noted after intervention, but small case series, no control subjects. "Helped in a few cases."

D.  No demonstrable effect on longevity; unclear benefit over no treatment (case reports, no controls, or conflicting evidence). "Can't tell if it helps."

E.  To date, shown to be inferior to other treatment or to no treatment. "Does not seem to help."

*  Only if stenosis due to fused valvular leaflets; excludes severe valve dysplasia, aberrant coronary artery.



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Speaker Information
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Etienne Côté, DVM, DACVIM (Cardiology, Small Animal Internal Medicine)
Atlantic Veterinary College
University of Prince Edward Island
Charlottetown, PE, Canada

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