Feline heart surgery first is ‘way forward’

A pioneering procedure that saved the life of a kitten with a rare and potentially fatal heart condition could transform the way similar cases are treated in future.
In what is believed to be a world first for feline medicine, surgeons from North Downs Specialist Referrals in Surrey successfully performed keyhole surgery on a kitten with a double-chambered right ventricle – a rare condition – meaning it had a severe obstruction on the right side of the heart. Until now, the condition could only be corrected with open-heart surgery.

Cat keyhole heart surgery
Sylvie recuperating after the successful pioneering cutting balloon angioplasty operation. Image: North Downs Specialist Referrals.

The procedure was performed by cardiologist João Loureiro, who believed the kitten was too frail to withstand open-heart surgery, so opted for a keyhole procedure that has historically only been used in dogs, on account of felines having such small hearts.
To conduct the cutting balloon angioplasty, Mr Loureiro and fellow cardiology specialist Joel Silva inserted two tiny balloons on a wire into the heart via a vein in the kitten’s neck.
The first balloon had four cutting blades that were manipulated to score the obstruction. The second was then inflated to relieve it.
After the equipment had been removed, the incision in the neck required two stitches.
A subsequent scan showed the level of obstruction had reduced from severe to mild and, within 48 hours, the kitten, named Sylvie, was able to go home.
“I think this [technique] is the way forward and could open the door to other applications,” Mr Loureiro said.
The avoidance of open heart surgery is also a big benefit for animal welfare, he said, as it is “massive surgery” for such small animals.
Reflecting on the situation post-surgery, Mr Loureiro said: “There was a certain sense of relief because there was a lot at stake… and the owner was obviously putting a lot of trust in our ability. I am very proud of my colleagues as it was a team effort.”
Implementing such a technique also benefits patient welfare, Mr Loureiro said, not least because recovery time is expedited considerably.
Dan Brockman, professor of small animal surgery and director of the cardiothoracic surgery service at the RVC, described the development as very exciting.
Prof Brockman said: “I think it is a very exciting development – that this team has managed to treat this cat, with what is quite a rare condition, successfully with a non-surgical technique.
“Looking at what has been done, it is really fantastic and if they demonstrate, over the long term, this is a durable resolution of the obstruction to blood flow through this cat‘s heart, I think that‘s very exciting.”