Intraoperative hemorrhage during patent ductus arteriosus ligation in dogs

Objective-To determine the prevalence of intraoperative hemorrhage in a con secutive series of dogs undergoing patent ductus arteriosus (PDA) ligation at a veterinary teaching hospital, and to describe strategies to reduce the risk of ductus perforation and deal with hemorrhage when it occurs. Study Design-Retrospective clinical study. Animals-Sixty-four dogs. Methods-The records of all dogs undergoing PDA ligation at the University V eterinary Center, Sydney between May 1989 and February 1998 were reviewed a nd the prevalence and nature of complications identified. Results-Serious hemorrhage occurred in 4 of 64 dogs (6.25 %) that underwent PDA ligation. In all cases, hemorrhage resulted from perforation of the cr aniomedial aspect of the ductus while attempting to expose the tips of the dissecting forceps. Hemorrhage was controlled in 3 dogs by clamping the mai n pulmonary artery, digital compression of the descending aorta, and comple tion of ductus ligation during an approximately 5-minute period of circulat ory arrest. The remaining dog exsanguinated during an unsuccessful attempt to locate, clamp, and ligate the bleeding point. The mortality rate for PDA ligation was 1 of 64 dogs (1.6 %). Conclusions-The technique described in this report permits simple ligation of a range of different ductus morphologies in dogs of varying breeds, weig hts, and ages. In the event of serious hemorrhage, prompt ventricular outfl ow occlusion and ductus ligation followed by rapid whole blood transfusion is life saving in most cases. (C) Copyright 2001 by The American College of Veterinary Surgeons.