Thoracoscopy with Concurrent Esophagoscopy for Persistent Right Aortic Arch in 9 Dogs

Area of Science:

• Veterinary Surgery
• Comparative Pathology
• Thoracic Surgery

Background:

• Persistent right aortic arch (PRAA) is a congenital defect causing esophageal obstruction in young dogs.
• Diagnosis often involves advanced imaging, and surgical correction is the primary treatment.
• Thoracoscopy offers a minimally invasive approach for surgical intervention.

Purpose of the Study:

• To evaluate the efficacy and outcomes of thoracoscopy with concurrent esophagoscopy for diagnosing and treating suspected PRAA in dogs.
• To assess short-term outcomes and identify potential complications associated with the procedure.

Main Methods:

• A retrospective case series of 9 dogs with suspected PRAA undergoing thoracoscopy.
• A left-sided intercostal thoracoscopic approach was used with concurrent intraoperative esophagoscopy.
• The ligamentum arteriosum (LA) was divided using a vessel-sealing device, with esophagoscopy aiding visualization.

Main Results:

• Thoracoscopy confirmed PRAA in all 9 dogs, with 5 having an aberrant left subclavian artery (LS).
• Two major complications occurred: hemorrhage from the LS and esophageal perforation, leading to euthanasia in one case.
• Regurgitation resolved in 4 of 8 surviving dogs; one experienced recurrence due to LS compression, successfully treated by LS transection.

Conclusions:

• Concurrent esophagoscopy is valuable for identifying and dissecting the LA during thoracoscopic PRAA repair.
• Aberrant left subclavian artery (LS) ligation or transection should be considered to prevent postoperative esophageal constriction.
• Vascular clips may be a safer alternative to vessel-sealing devices for vessel ligation in this procedure.