Quadricuspid aortic valve and a ventricular septal defect in a horse

BMC Veterinary Research

Urszula Pasławska¹  Józef M Nicpoń¹  Marta A Szmigielska²  Radomir Z Henklewski²  Anna K Biazik²  Katarzyna M Michlik¹ 

[1] Department of Internal Medicine and Clinic of Disease of Horses, Dogs and Cats, Veterinary Faculty of Wrocław University of Environmental and Life Sciences, pl. Grunwaldzki 47, 50-366 Wrocław, Poland;Department and Clinic of Surgery, Veterinary Faculty of Wrocław University of Environmental and Life Sciences, pl. Grunwaldzki 51, 50-366 Wrocław, Poland

关键词: Echocardiography;    Congenital heart defect;    Ventricular septal defect;    Quadricuspid aortic valve;    Horse;   

Others  :  1119125
DOI  :  10.1186/1746-6148-10-142

 received in 2013-09-03, accepted in 2014-06-17,  发布年份 2014

【 摘 要 】

Background

Quadricuspid aortic valve (QAV) and ventricular septal defect (VSD) are congenital heart defects and have been described in both human and veterinary medical literature.

Case presentation

A 5-year-old half-bred bay stallion was referred for surgical castration. Cardiac murmurs were heard on the presurgical clinical examination and the cardiac examination revealed subcutaneous oedema, tachycardia with a precodrial thrill and a grade 5/6 pansystolic murmur, which was heard on auscultation of the right and left side of the chest. Examination of the B-mode echocardiograms revealed the presence of a QAV (one small cusp, two equal-sized cusps, and one large cusp) and VSD in the membranous portion of the intraventricular septum. These two congenital cardiac defects were accompanied by mild aortic valve regurgitation and severe tricuspid regurgitation. Despite the presence of these cardiac defects, the horse underwent surgical castration under general anesthesia. Surgery, anaesthesia and recovery from anaesthesia were uneventful. The gelding was euthanasied after 17 months because of a progressive loss of body weight, weakness and recumbency.

Conclusion

A QAV in combination with VSD in a horse is an interesting finding, because to the best of our knowledge, this has not been previously described in equine literature.

【 授权许可】

   
2014 Michlik et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Hurwitz LE, Roberts WC: Quadricuspid semilunar valve. Am J Cardiol 1973, 5:623-626.
• [2]Sisson D, Riepe R: Congenital quadricuspid aortic valve anomaly in two dogs. J Vet Cardiol 2000, 2:23-26.
• [3]Kettner F, Côté E, Kirberger RM: Quadricuspid aortic valve and associated abnormalities in a dog. J Am Anim Hosp Assoc 2005, 41:406-412.
• [4]Serres F, Chetboul V, Sampedrano CC, Gouni V, Pouchelon JL: Quadricuspid aortic valve and associated abnormalities in the dog: report of six cases. J Vet Cardiol 2008, 10:25-31.
• [5]Duran AC: Quadricuspid aortic valve and single coronary artery in a greater white-toothed shrew, Crocidura russula. J Wildl Dis 1996, 32:658-660.
• [6]Fernandez B, Duran AC, Martire A, Lopez D, Sans-Coma V: New embryological evidence for the formation of quadricuspid aortic valves in the syrian hamster (Mesocricetus auratus). J Comp Pathol 1999, 121:89-94.
• [7]Iglesias A, Oliver J, Munoz JE, Nunez L: Quadricuspid aortic valve associated with fibromuscular subaortic stenosis and aortic regurgitation treated by conservative surgery. Chest 1981, 80:327-328.
• [8]Schwarzwald CC: Sequential segmental analysis – A systematic approach to the diagnosis of congenital cardiac defects. Equine Vet Educ 2008, 20(6):305-309.
• [9]Hall TL, Magdesian KG, Kittleson MD: Congenital cardiac defects in neonatal foals: 18 cases (1992-2007). J Vet Intern Med 2010, 24:206-212.
• [10]Critchley KL: An interventricular septal defect, pulmonary stenosis and bicuspid pulmonary valve in a Welsh pony foal. Equine Vet J 1976, 8:176-178.
• [11]Keith JC Jr: Tetralogy of Fallot in a quarter horse foal. Vet Med Small Anim Clin 1981, 76:889-895.
• [12]Vitums A, Bayly WM: Pulmonary atresia with dextroposition of the aorta and ventricular septal defect in three Arabian foals. Vet Pathol 1982, 2:160-168.
• [13]McClure JJ, Gaber CE, Watters JW, Qualls CW: Complete transposition of the great arteries with ventricular septal defect and pulmonary stenosis in a Thoroughbred foal. Equine Vet J 1983, 15:377-380.
• [14]Dirven MJ, Szatmari V, Cornelissen JM, van den Ingh TS: Case report: double-chambered right ventricle (DCRV), ventricular septal defect, and double caudal vena cava in a cat. Tijdschr Diergeneeskd 2010, 135(5):180-188.
• [15]Cargile J, Lombard C, Wilson JH, Buergelt CD: Tetralogy of Fallot and segmental uterine aplasia in a three-year-old Morgan filly. Cornell Vet 1991, 81:411-418.
• [16]Gesell S, Brandes K: Tetralogy of Fallot in a 7-year-old gelding. Pferdeheilkunde 2006, 4:427-430.
• [17]Schmitz RR, Klaus C, Grabner A: Detailed echocardiographic findings in a newborn foal with tetralogy of Fallot. Equine Vet Edu 2008, 6:298-303.
• [18]Buhl R, Ersboll A, Eriksen L, Koch J: Sources and magnitude of variation of echocardiographic measurements in normal Standardbred horses. Vet Radiol Ultrasound 2004, 6:505-512.
• [19]Kaya M, Alkan Z, Kibar M, Sen J, Acar A, Bumin A, Toker M: The evaluation of echocardiographic findings on sports horses. Kafkas Univ Vet Fak Derg 2009, 15:751-757.
• [20]Boon JA: Acquired Valvular Disease. In Veterinary Echocardiography. 2nd edition. Edited by Boon JA. Oxford: Wiley-Blackwell; 2011:407-504.
• [21]Slater JD, Herrtage ME: Echocardiographic measurements of cardiac dimensions in normal ponies and horses. Equine Vet J Suppl 1995, 19:28-32.
• [22]Tang Y, Xu JB, Han L, Lu FL, Lang XL, Song ZG, Xu ZY: Clinical experience. Congenital quadricuspid aortic valve: analysis of 11 surgical cases. CMJ 2011, 124:2779-2781.
• [23]de Abreu Silva EO, Iglesias AG, de Abreu SE: Quadricuspid aortic valve by transthoracic echocardiography. Arq Bras Cardiol 2008, 91:e21-e24.
• [24]Tutarel O: The quadricuspid aortic valve: a comprehensive review. J Heart Valve Dis 2004, 13:534-537.
• [25]Nalbantgil I, Cagatay G: Quadricuspid aortic valve. Chest 1975, 67:623-624.
• [26]Moreno R, Zamorano J, De Marco E, Almeria C, Villate A, Collantes P, Sanchez-Harguindey L: Congenital quadricuspid aortic valve associated with congenital complete heart block. Eur J Echocardiogr 2002, 3:236-237.
• [27]Dencker M, Stagmo M: Quadricuspid aortic valve not discovered by transthoracic echocardiography. Cardiovasc Ultrasound 2006, 4:41.
• [28]D’Aloia A, Vizzardi E, Bugatti S, Chiari E, Repossini A, Muneretto C, Dei Cas L: A quadricuspid aortic valve associated with severe aortic regurgitation and left ventricular systolic dysfunction. Eur J Echocardiogr 2009, 10:724-725.
• [29]Tsukioka K, Nobara H, Takano T, Wada Y, Amano J: Quadricuspid aortic valve with ascending aortic aneurysm: a case report and histopathological investigation. Ann Thorac Cardiovasc Surg 2011, 17:418-421.
• [30]Van Mierop LH, Kutsche LM: Cardiovascular anomalies in DiGeorge syndrome and importance of neural crest as a possible pathogenetic factor. Am J Cardiol 1986, 58:133-137.
• [31]Wilson DI, Cross IE, Goodship JA, Coulthard S, Carey AH, Scambler PJ, Bain HH, Hunter AS, Carter PE, Burn J: DiGeorge syndrome with isolated aortic coarctation and isolated ventricular septal defect in three sibs with 22q11 deletion of maternal origin. Br Heart J 1991, 66:308-312.
• [32]Wilson DI, Goodship JA, Burn J, Cross IE, Scambler PJ: Deletion within chromosome 22q11 in familial congenital heart disease. Lancet 1992, 340:573-575.
• [33]Scambler PJ, Kelly D, Lindsay E, Williamson R, Goldberg R, Shprintzen R, Wilson DI, Goodship JA, Cross IE, Burn J: Velo-cardio-facial syndrome associated with chromosome 22 deletion encompassing the DiGeorge locus. Lancet 1992, 339:1138-1139.
• [34]Godefroid O, Colles P, Vercauteren S, Louagie Y, Marchandise B: Quadricuspid aortic valve: A rare etiology of aortic regurgitation. Eur J Echocardiogr 2006, 7:168-170.
• [35]Holm H, Jacobson S, Reul GJ, Stainback RF: Quadricuspid aortic valve. Tex Heart Inst J 2004, 31:450-451.
• [36]Marr CM: Cardiac murmurs: valvular regurgitation and insufficiency. In Cardiology of the horse. 2nd edition. Edited by Marr CM, Bowen IM. London: Saunders Elsevier; 2010:208-209.
• [37]Marr CM: Cardiac murmurs: congenital heart disease. In Cardiology of the horse. 2nd edition. Edited by Marr CM, Bowen IM. London: Saunders Elsevier; 2010:196-200.
• [38]Kurihara Y, Kurihara H, Oda H, Maemura K, Nagai R, Ishikawa T, Yazaki Y: Aortic arch malformations and ventricular septal defect in mice deficient in endothelin-1. J Clin Invest 1995, 96:293-300.
• [39]Sucov HM, Dyson E, Gumeringer CL, Price J, Chien KR, Evans RM: RXRα mutant mice establish a genetic basis for vitamin A signaling in heart morphogenesis. Genes Dev 1994, 8:1007-1018.
• [40]Reef VB: Evaluation of ventricular septal defects in horses using two-dimensional and Doppler echocardiography. Equine Vet J 1995, 19(Suppl):86-95.
• [41]Magee AG, Fenn L, Vellekoop J, Godman MJ: Left ventricular function in adolescents and adults with restrictive ventricular septal defect and moderate left-to-right shunting. Cardiol Young 2000, 10:126-129.
• [42]Bonagura JD, Pipers FS: Echocardiographic features of aortic valve endocarditis in a dog, a cow, and a horse. J Am Vet Med Assoc 1983, 182:595-599.
• [43]Gehlen H, Stadler P, Deegen E: Colour doppler technique and heart catheterization for haemodynamic evaluation of a ventricular septal defect . Pferdeheilkunde 1999, 15(3):233-238.
• [44]Bonagura JD, Blissitt KJ: Echocardiography. Equine Vet J 1995, 19(Suppl):5-17.
• [45]Yotsumoto G, Iguro Y, Kinjo T, Matsumoto H, Masuda H, Sakata R: Congenital quadricuspid aortic valve: report of nine surgical cases. Ann Thorac Cardiovasc Surg 2003, 9:134-137.
• [46]Flecher E, Corbineau H, Leguerrier A: A quadricuspid aortic valve. Can J Cardiol 2008, 12:e105.
• [47]Menzel B, Kalmar P, Pokar H: Surgical correction of a ventricular septum defect in a mare with the help of extracorporeal circulation. Praktische Tierarzt 1995, 76:1069-1072.
• [48]Short DM, Seco OM, Jesty SA, Reef VB: Spontaneous closure of a ventricular septal defect in a horse. J Vet Int Med 2010, 24:1515-1518.