Case Studies In Small Animal

Cardiovascular Medicine

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Case 6

Cardiac Catheterization and Angiography

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At cardiac catheterization, a 4 French balloon wedge catheter was advanced from the jugular vein into the right heart. Initially, the catheter was advanced into one position (left picture). When it was withdrawn and advanced again, it went into a totally different position that was more dorsal than the first. It appeared that the catheter initially advanced into the pulmonary artery and the second time advanced into the aorta.

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The catheter was partially withdrawn and advanced toward the pulmonary artery where it ended up the first time. A nonionic contrast agent was injected. The resultant angiogram above shows an enlarged and very tortuous caudal lobar pulmonary artery branch.

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The catheter was repositioned and another angiogram performed. The catheter is now lying within the same structure (S) identified on the echocardiogram that was between the aorta (Ao) and the main pulmonary artery (MPA). Contrast agent fills this structure, the main pulmonary artery back to the pulmonic valve and the caudal lobar branches, and the aorta from the aortic root to the diaphragm.

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Mark D. Kittleson, D.V.M., Ph.D. All rights reserved.