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Home / Equine Research Bank / J Vet Intern Med / Three-dimensional and catheter-based intracardiac echocardio...
Journal of veterinary internal medicine2022; 36(4); 1535-1542; doi: 10.1111/jvim.16451

Three-dimensional and catheter-based intracardiac echocardiographic characterization of the interatrial septum in 2 horses with suspicion of a patent foramen ovale.

Abstract: This case report describes the 2-dimensional transthoracic (2D-TTE), 3-dimensional transthoracic (3D-TTE) and intracardiac echocardiographic (ICE) characterization of the fossa ovalis region in 2 horses. The first case was presented for poor performance and showed an anechoic zone in the interatrial septum on 2D-TTE. Based on 3D-TTE a deepened fossa ovalis could be identified and using ICE the presence of an interatrial shunt could be excluded. The second case was referred for a cardiac murmur and the presence of turbulent flow in and around the interatrial septum on 2D-TTE color flow Doppler. The complementary use of 2D-TTE, 3D-TTE, and ICE allowed detailed characterization of a patent foramen ovale, with evidence of a left-to-right shunt in a dorsocranial to ventrocaudal direction with limited hemodynamic implications. These 2 cases underline the feasibility of 3D-TTE and ICE in horses and especially show the added value of ICE in a clinical setting.
© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
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Publication Date: 2022-05-30 PubMed ID: 35635303PubMed Central: PMC9308446DOI: 10.1111/jvim.16451Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research report explores how echocardiographic technology can be used to diagnose and study a potential patent foramen ovale (PFO) – a hole in the heart – in two horses. The study uses non-invasive imaging methods which involve 2D and 3D imaging of the heart and an intracardiac procedure for a detailed view of the heart’s structure.

About Patent Foramen Ovale (PFO)

  • A PFO is an issue found in the heart where a hole that usually closes after birth remains open. This situation, while not always problematic, can cause health issues such as poor performance in horses, as well as cardiac murmurs, or unusual heart sounds.
  • The patent foramen ovale is located in the interatrial septum, the wall that divides the two upper chambers of the heart, the atria. In this case, two horses suspected to have PFOs were studied.

TRansthoracic Echocardiography (2D-TTE, 3D-TTE)

  • The researchers used the transthoracic echocardiography (TTE) approach, an ultrasound technology to create two-dimensional and three-dimensional images of the horses’ hearts, for the initial part of the study.
  • The 2D-TTE revealed an area void of echo reflections (‘anechoic zone’) in the interatrial septum in the first horse, hinting at a deepened fossa ovalis, the remnant of the foramen ovale after it has closed post birth.
  • The 3D-TTE provided a detailed image of the deepened fossa ovalis recognized earlier.

Intracardiac Echocardiography (ICE)

  • Here, a catheter is threaded into the heart, via the vascular system to provide detailed, high-resolution images of the heart’s interior, and can evaluate some malformations that could have been missed or not clearly seen on the TTE.
  • In this study, the ICE method ruled out the existence of an interatrial shunt – a malfunction causing blood to flow from the left atrium to the right or vice versa, bypassing the normal circulatory route in the first horse.
  • In contrast, the second horse showed evidence of a patent foramen ovale, with blood shunting from the left atrium to the right revealing a PFO through the use of the 2D-TTE, 3D-TTE, and ICE methods.

Significance of the Study

  • The findings from this research reiterate the powerful role non-invasive imaging technologies like 2D-TTE and 3D-TTE, coupled with ICE, can play in accurately diagnosing potential heart malformations in horses.
  • Using such thorough characterization protocols, veterinarians can uncover details of potential PFOs, and formulate appropriate intervention plans to improve the health outcomes of the subjects.

Cite This Article

APA
Vernemmen I, Paulussen E, Dauvillier J, Decloedt A, van Loon G. (2022). Three-dimensional and catheter-based intracardiac echocardiographic characterization of the interatrial septum in 2 horses with suspicion of a patent foramen ovale. J Vet Intern Med, 36(4), 1535-1542. https://doi.org/10.1111/jvim.16451

Publication

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 36
Issue: 4
Pages: 1535-1542

Researcher Affiliations

Vernemmen, Ingrid
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
Paulussen, Ellen
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
Dauvillier, Julie
  • Vet Inside, Equine Internal and Sports Medicine Referral Practice, Sainte-Terre, France.
Decloedt, Annelies
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
van Loon, Gunther
  • Equine Cardioteam Ghent University, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.

MeSH Terms

  • Animals
  • Catheters
  • Echocardiography / methods
  • Echocardiography / veterinary
  • Foramen Ovale, Patent / diagnostic imaging
  • Foramen Ovale, Patent / veterinary
  • Horse Diseases / diagnostic imaging
  • Horses

Grant Funding

  • 1S56217N / Fonds Wetenschappelijk Onderzoek

Conflict of Interest Statement

Authors declare no conflict of interest.

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Citations

This article has been cited 1 times.
  1. De Lange L, Vernemmen I, van Loon G, Decloedt A. Echocardiographic Features of the Ductus Arteriosus and the Foramen Ovale in a Hospital-Based Population of Neonatal Foals.. Animals (Basel) 2022 Aug 30;12(17).
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