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

Vet Surg. 2016 Nov;45(S1):O111-O118. doi: 10.1111/vsu.12572. Epub 2016 Oct 12.

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.

MeSH terms

  • Animals
  • Aorta, Thoracic / abnormalities
  • Aorta, Thoracic / surgery*
  • Dogs / abnormalities
  • Dogs / surgery*
  • Esophagoscopy / veterinary*
  • Female
  • Male
  • Retrospective Studies
  • Thoracoscopy / veterinary*