Cranial vena caval syndrome secondary to central venous obstruction associated with a pacemaker lead in a dog.
This report describes the case of an 11-year-old castrated male Shih Tzu who developed chylothorax three years following implantation of a transvenous pacemaker. Imaging demonstrated one definitive obstruction in the cranial vena cava and 3 additional suspected filling abnormalities within both external jugular veins, brachiocephalic veins and cranial vena cava. A thrombus was visualized in the cranial vena cava via transesophageal echocardiography. Thoracic duct ligation and cisterna chyli ablation were performed, with a resultant change in the nature of the fluid from chylous to a modified transudate. Repeat angiography and computed tomography three months later demonstrated a stenosis within the cranial vena cava. Balloon angioplasty was attempted, however it was unsuccessful in decreasing pleural effusion. Palliative thoracocentesis was continued until the patient developed a lung lobe torsion, at which time euthanasia was elected. Necropsy confirmed cranial vena caval syndrome secondary to transvenous pacemaker implantation induced fibrous proliferation within the vessel lumen.
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA.
Jennifer M
JM
Mulz
Marc S
MS
Kraus
Margret
M
Thompson
James A
JA
Flanders
D000818:Animals; D002916:Chylothorax / Q000473:pathology / Q000662:veterinary; D004283:Dog Diseases / Q000175:diagnosis* / Q000473:pathology; D004285:Dogs; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000662:veterinary*; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000662:veterinary*; D020246:Venous Thrombosis / Q000473:pathology / Q000662:veterinary