Operation carried out for the first time in the Netherlands at the Faculty of Veterinary Medicine in Utrecht
Big news: dog gets vascular prosthesis for congenital heart defect
At the University Clinic for Companion Animal Health at Utrecht University, a congenital heart defect in a dog was repaired in a successful operation at the beginning of this year. This defect (Tetralogy of Fallot) is treated in dogs only sporadically in a couple of places worldwide. This is the first time that such an operation has been performed on dogs in the Netherlands. The operation was made possible thanks to the special collaboration between human and veterinary medicine.
Veterinary surgeon Bas van Nimwegen worked with human paediatric cardiac surgeon Dr Evens to fit the Old English bulldog with what is known as a ‘modified Blalock-Taussig shunt’. A plastic vascular prosthesis (the ‘shunt’) was used to make a connection between a branch of the aorta and the pulmonary artery.
In babies with the same heart defect, this procedure is performed on a regular basis to reduce clinical symptoms until the patient has grown sufficiently and is fit enough for definitive treatment via open-heart surgery. In dogs, this latter operation is rarely performed due to the need for a heart-lung machine, a specialist team and the high costs involved.
Van Nimwegen explains why he called upon the help of a human surgeon: 'This kind of vascular surgery, the insertion of a vascular prosthesis so close to the heart, is rarely performed in veterinary medicine. As a result, there is very little expertise and certainly no routine, even though complications can naturally be disastrous. I have experience in vascular surgery myself, but in order to insert this vascular prosthesis into a dog, I wanted to be assisted by a competent surgeon with a great deal of experience.'
Constant shortness of breath
The purpose of the operation is to increase the flow of blood through the lungs, thus providing it with oxygen. In patients with this heart defect, a combination of a large opening between the left and right ventricles and a narrowed outflow opening from the right ventricle to the pulmonary artery directly pumps a large part of the blood flowing into the heart from the body straight back into the body without flowing through the lungs first. As a result, these patients constantly have too little oxygen in their blood and are always tired and short of breath. They have extremely low levels of endurance. For example, this dog could only walk 25 metres slowly before becoming exhausted and turning blue. 'The shunt causes considerably more blood to flow through the lungs, increasing stamina and allowing the dog to lead a more normal life. The dog's condition has already improved greatly in recent weeks: he can now go on 4 km walks without getting out of breath or turning blue,' says Van Nimwegen.
Interdisciplinary collaboration, in this case between human doctors, scientists and veterinarians, generates a great deal of knowledge and creativity. It falls under the heading of One Medicine and focuses on similarities between animal and human diseases and the creation of innovative treatments.