# Perimembranous Ventricular Septal Defect Concurrent with an Aorto-Right Ventricular Fistula Caused by a Ruptured Sinus of Valsalva in Three Dogs

## TL;DR

This paper reports three dogs with a rare heart condition involving a ruptured aortic aneurysm and a ventricular septal defect, showing that surgical repair can resolve the issue in some cases.

## Contribution

The paper presents three novel canine cases of aorto-right ventricular fistula caused by ruptured sinuses of Valsalva aneurysms concurrent with VSDs.

## Key findings

- Surgical closure of the VSD resolved the ARVF in one dog.
- Two dogs remained asymptomatic with mild heart enlargements on follow-up.
- Echocardiography revealed turbulent blood flow through VSDs and ARVFs in all cases.

## Abstract

An aorto-right ventricular fistula (ARVF) is a rare heart condition in dogs, characterized by an abnormal connection between the aorta and the right ventricle. This report describes three dogs diagnosed with an ARVF secondary to a ruptured sinus of Valsalva aneurysm, all of which also had ventricular septal defects (VSDs). Echocardiography revealed turbulent blood flow through the VSD during systole and through the ARVF during diastole. A surgical closure of the VSD successfully resolved the ARVF in one case, while the other two dogs remained asymptomatic with mild heart enlargements on follow-up. These findings highlight the importance of considering ARVF and VSD in dogs with continuous murmurs.

An aorto-right ventricular fistula, a rare condition in humans, is characterized by communication between the ascending aorta and the right ventricle through a defect in the aortic wall. This report describes three cases of dogs with continuous murmurs: a 6-month-old Coton de Tulear, a 5-year-old Maltese, and a 6-month-old Jindo. Notably, all of the dogs presented with no severe clinical signs. Echocardiography revealed a turbulent jet through restrictive perimembranous ventricular septal defects (VSD) during systole and aorto-right ventricular fistulas secondary to ruptured sinuses of Valsalva aneurysm during diastole. In one case, a surgical closure of the VSD simultaneously resolved the aorto-right ventricular fistula. Follow-up echocardiography in the other two cases revealed mild left heart volume overload and a slight increase in the pulmonary-to-systemic blood flow ratio. However, the dogs remained asymptomatic. In conclusion, aorto-right ventricular fistulas with VSDs should be considered in the differential diagnosis of continuous murmurs in dogs.