Thoracoscopy with Concurrent Esophagoscopy for Persistent Right Aortic Arch in 9 Dogs

Sarah Townsend, Michelle L. Oblak, Ameet Singh, Michele A Steffey, Jeffrey J. Runge

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. Study Design: Multi-institutional retrospective case series. Animals: Dogs with suspected PRAA (n=9). Methods: Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included. Signalment, clinical signs, diagnostic imaging, anesthesia protocol (including the use of one-lung ventilation), surgical approach, complications, and short-term outcome were recorded. Dogs underwent a left-sided intercostal thoracoscopic approach with concurrent intraoperative esophagoscopy. The ligamentum arteriosum (LA) and constricting fibers were divided using a vessel-sealing device using a 3 or 4 port thoracoscopy technique. Visualization and dissection of the LA was aided by transesophageal illumination by esophagoscopy. Results: Thoracoscopy confirmed PRAA in 9 dogs, with an aberrant left subclavian artery (LS) identified in 5 dogs. Major complications occurred in 2 dogs: postoperative hemorrhage from the LS and esophageal perforation, which resulted in euthanasia. Median follow-up was 250 days (range, 56–1,595). Regurgitation resolved in 4 of 8 surviving dogs. One dog had recurrence of regurgitation 1,450 days postoperatively, esophageal compression by the LS was identified, and regurgitation resolved following LS transection. Conclusion: Esophagoscopy aided identification and dissection of the LA in all cases. Due to the potential for the LS to cause clinical esophageal constriction postoperatively, a recommendation for LS transection may be warranted. Vascular clips can also be considered as an alternative for vessel ligation to avoid complications associated with vessel-sealing device use.

Original languageEnglish (US)
Pages (from-to)O111-O118
JournalVeterinary Surgery
Volume45
DOIs
StatePublished - Nov 1 2016

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esophagoscopy
thoracoscopy
Esophagoscopy
Thoracoscopy
Thoracic Aorta
Dogs
Subclavian Artery
arteries
dogs
Dissection
One-Lung Ventilation
Esophageal Perforation
Postoperative Hemorrhage
Equipment and Supplies
Euthanasia
euthanasia
Diagnostic Imaging
Lighting
Surgical Instruments
blood vessels

ASJC Scopus subject areas

  • veterinary(all)

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Thoracoscopy with Concurrent Esophagoscopy for Persistent Right Aortic Arch in 9 Dogs. / Townsend, Sarah; Oblak, Michelle L.; Singh, Ameet; Steffey, Michele A; Runge, Jeffrey J.

In: Veterinary Surgery, Vol. 45, 01.11.2016, p. O111-O118.

Research output: Contribution to journalArticle

Townsend, Sarah ; Oblak, Michelle L. ; Singh, Ameet ; Steffey, Michele A ; Runge, Jeffrey J. / Thoracoscopy with Concurrent Esophagoscopy for Persistent Right Aortic Arch in 9 Dogs. In: Veterinary Surgery. 2016 ; Vol. 45. pp. O111-O118.
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abstract = "Objective: To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. Study Design: Multi-institutional retrospective case series. Animals: Dogs with suspected PRAA (n=9). Methods: Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included. Signalment, clinical signs, diagnostic imaging, anesthesia protocol (including the use of one-lung ventilation), surgical approach, complications, and short-term outcome were recorded. Dogs underwent a left-sided intercostal thoracoscopic approach with concurrent intraoperative esophagoscopy. The ligamentum arteriosum (LA) and constricting fibers were divided using a vessel-sealing device using a 3 or 4 port thoracoscopy technique. Visualization and dissection of the LA was aided by transesophageal illumination by esophagoscopy. Results: Thoracoscopy confirmed PRAA in 9 dogs, with an aberrant left subclavian artery (LS) identified in 5 dogs. Major complications occurred in 2 dogs: postoperative hemorrhage from the LS and esophageal perforation, which resulted in euthanasia. Median follow-up was 250 days (range, 56–1,595). Regurgitation resolved in 4 of 8 surviving dogs. One dog had recurrence of regurgitation 1,450 days postoperatively, esophageal compression by the LS was identified, and regurgitation resolved following LS transection. Conclusion: Esophagoscopy aided identification and dissection of the LA in all cases. Due to the potential for the LS to cause clinical esophageal constriction postoperatively, a recommendation for LS transection may be warranted. Vascular clips can also be considered as an alternative for vessel ligation to avoid complications associated with vessel-sealing device use.",
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