Atrioventricular Septal Defect with Severe Subaortic Stenosis

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A 30-month-old female Shetland sheepdog was referred to with a history of cardiac murmur, dyspnea and exercise intolerance. The electrocardiogram showed biatrial and biventricular enlargements. The phonocardiogram revealed holosystolic murmurs at the cardiac apex and crescendo-decrescendo ejectional murmurs at the aortic area. The thoracic radiography indicated an extreme enlargement of the left atrium and mild enlargement of the left and right ventricles. The cross sectional echocardiography showed a subaortic stenosis and a mitral valve prolapse in the long axis view of the right side, and suggested the perimembranous ventricular septal defect(VSD) in the four chamber view. Severe subaortic stenosis was demonstrated with a systolic pressure gradient which was estimated by means of cardiac catheterization to be 100 mmHg at the obstruction. Moreover, mitral regurgitation, aortic regurgitation and VSD were detected.<BR>The dog died 7 months after the first medical examination. At autopsy, there were huge left atrium, severe subaortic stenosis and small perimembronous VSD. Furthermore, atrioventricular valve abnormalities were recognized as mitral cleft and septal insertion of the anterior mitral leaflet. We considered that these mitral valve abnormalities were associated with atrioventricular septal defect.
日本獣医循環器学会の論文